2020 National Health Interview Survey (NHIS) Questionnaire

Contents
1. Introduction
This National Health Interview Survey (NHIS) questionnaire report provides the questions administered to NHIS respondents in the order they were asked. It is organized hierarchically into these parts: Contents, Index, and NHIS questionnaire, which in turn includes the Roster, Adult and Child modules.
2. Section Index
A section index is provided for each of the three modules: Roster, Adult, and Child. The index can be navigated via the Bookmarks pane to quickly get information about the different sections in the module. The display pane lists information about each section in the module including the three-letter section name, the section description, the type of content in the section (annual core, rotating core, sponsored or emerging content) and the page range in this document for each section for ease of printing.
3. NHIS questionnaire: Roster, Adult and Child modules
The questionnaire is the main part of the report and provides detailed information about each question in the survey. The hierarchy in the Bookmarks pane has three levels: module (Roster, Adult, and Child), sections within each module, and questions within each section represented by the variable name in the instrument. The sections and questions are listed in questionnaire order. Selecting a specific question in the Bookmarks pane will display a detailed report for that question in the display pane while selecting a section abbreviation will display the report for the first question in the section.
In the question text field of the report, text displayed in bold and in blue font is an interviewer instruction which is sometimes followed by optional text in gray, italic font.
Information provided for each question includes:

- Question ID: unique alphanumeric code for each question beginning with the 3-letter section abbreviation
- Variable: instrument variable name for the question
- Interview Module: module where the question is located: Roster, Adult, or Child
- Content Type: indicates whether the question is part of the Annual Core, Rotating Core, Sponsored Content, or Emerging Content
- Question Text: question wording administered to respondent with indicators for fills; may also include interviewer instructions
- Fills: table of contextual text substitutions that are filled into the question text
- Response: table of possible responses to the question
- Universe: group of respondents who received the question
- Skip Instructions: instructions for moving to the next question in the questionnaire

Additional information may include:

- Hard Edit: prompt received when response entered is not allowed; response must be changed in order to proceed
- Soft Edit: prompt received when response entered is questionable; must follow instructions in order to proceed
- Replicate To: indicates family-level information obtained in the Sample Adult interview that is copied to a replicated variable in the Sample Child and vice versa for efficiency when the Sample Child and the Sample Adult are in the same family.

Questions deleted in 2020 Q3, Q4
Adult: LNG (Lung Cancer Screening)

Question ID: LNG.0010.00.3
Section Name: LNG
Variable: CTSCANEV_A
Question Text:

The following questions are about CT scans. During this test, you lie down on your back and are moved through an open, donut-shaped x-ray machine.
Have you EVER HAD a CT scan?

Question ID: LNG. 0020.00.3
Section Name: LNG
Variable: CTSCANCHST _A
Question Text:

Were any of the CT scans of your chest area?

Question ID: LNG. 0030.00.3
Section Name: LNG
Variable: CTLNGCAN _A
Question Text:

The next question is only about CT scans to check or screen for lung cancer, sometimes called low-dose CT scans.
Were any of the CT scans of your chest area done mainly to check or screen for lung cancer?

Question ID: LNG. 0040.00.3
Section Name: LNG
Variable: CTLNGWHEN _A
Question Text:

When did you have your MOST RECENT CT scan of your chest area done mainly to check or screen for lung cancer?

Questions added in 2020 Q3, Q4
Adult: CNV (Cancer COVID-19)

Question ID: CNV.0010.00.4
Section Name: CNV
Variable: CANCOVTREA_A
Question Text:

The next question refers to treatments for cancer such as surgery, radiation therapy, chemotherapy, bone marrow transplants, stem cell transplants, or hormone therapy.
At any time since the start of the coronavirus pandemic, were you in treatment or supposed to receive treatment for your cancer?
* Read if necessary: Hormone therapy includes Tamoxifen, Fulvestrant (full-VESS-trant) or Aromatase (uh-ROH-muh-tayz) inhibitors for breast cancer and androgen therapy, such as Eligard or Zoladex for prostate cancer.

Question ID: CNV.0020.00.4
Section Name: CNV
Variable: CANCOVCHG_A
Question Text:

Were any of your treatments for cancer changed, delayed, or cancelled because of the coronavirus pandemic?

Question ID: CNV.0030.00.4
Section Name: CNV
Variable: CANCOVOTH_A
Question Text:

As a cancer patient or cancer survivor, you may need OTHER medical care related to your cancer such as lab visits, imaging, monitoring visits, rehabilitation, physical therapy, care for side effects, or visits with medical specialists.
At any time since the start of the coronavirus pandemic, did you need any of this OTHER medical care related to your cancer?

Question ID: CNV.0040.00.4
Section Name: CNV
Variable: CANCOVCARE _A
Question Text:

Was any of this OTHER medical care related to your cancer changed, delayed, or cancelled because of the coronavirus pandemic?

Questions added in 2020 Q3, Q4
Adult: CVD (Positive COVID-19 Diagnosis)

Question ID: CVD.0010.00.
Section Name: CVD
Variable: CVDINTRO_A
Question Text:

The next set of questions are about coronavirus or COVID-19.
* Enter '1' to continue.

Question ID: CVD.0020.00.4
Section Name: CVD
Variable: CVDDIAG_A
Question Text:

Has a doctor or other health professional ever told you that you had or likely had coronavirus or COVID-19?

Question ID: CVD.0030.00.4
Section Name: CVD
Variable: COVIDTEST_A
Question Text:

Have you ever been tested for coronavirus or COVID-19?

Question ID: CVD.0040.00.4
Section Name: CVD
Variable: CVDRSLT_A
Question Text:

Did the test find that you had coronavirus or COVID-19?
* If any test has shown they have COVID-19, enter '1' for yes.
* If the respondent indicates they are waiting for their results, enter '3' for Did not receive results.
* If the respondent indicates the test was inconclusive, enter 'CTRL-D' for Don't Know.

Question ID: CVD.0050.00.4
Section Name: CVD
Variable: CVDSEV_A
Question Text:

How would you describe your coronavirus symptoms when they were at their worst? Would you say no symptoms, mild symptoms, moderate symptoms, or severe symptoms?

Questions added in 2020 Q3, Q4
Adult: SDW (Social distancing at work)

Question ID: SDW.0010.00.4
Section Name: SDW
Variable: CURJOBSD_A
Question Text:

Thinking about your MAIN job or business, are there currently social distancing measures in effect to help keep people apart?
* If this person is working from home full-time because of COVID-19, answer '1' for yes.

Question ID: SDW. 0020.00.4
Section Name: SDW
Variable: WRKCLSSD _A
Question Text:

Currently, at your MAIN job or business, how often do you still need to work closer than 6 feet to other people? Would you say all of the time, most of the time, some of the time, or none of the time?
* If person works from home full-time and does not know how to answer, ask, "Does your job require you to be face-to-face with any people you don't live with?"
* If no, answer '4' for "none of the time."
* If yes, ask, "How much of your time at work is spent with people who are closer than 6 feet?"

Question ID: SDW.0030.00.4
Section Name: SDW
Variable: WRKCLSNOSD_A
Question Text:

When social distancing measures were NOT in effect, how often did you need to work closer than 6 feet to other people? Would you say all of the time, most of the time, some of the time, or none of the time?
* Enter '5' if respondent only worked at main job when social distancing measures were in effect.
If person worked from home full-time and does not know how to answer, ask, "Did your job require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Question ID: SDW.0040.00.4
Section Name: SDW
Variable: WRKCLSOFT_A
Question Text:

Currently, at your MAIN job or business, how often do you need to work closer than 6 feet to other people? Would you say all of the time, most of the time, some of the time, or none of the time?
If person works from home full-time and does not know how to answer, ask, "Does your job require you to be face-to-face with any people you don't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work is spent with people who are closer than 6 feet?"

Question ID: SDW.0050.00.4
Section Name: SDW
Variable: SDMSRS_A
Question Text:

At any time since the start of the coronavirus pandemic, did your MAIN job or business put social distancing measures into effect?
* If this person was working from home full-time because of COVID-19, answer '1' for yes.
* If person started job while social distancing measures were in effect, answer '1' for yes.

Question ID: SDW.0060.00.4
Section Name: SDW
Variable: SDMSRSOFT_A
Question Text:

When social distancing measures were in effect, how often did you need to work closer than 6 feet to other people? Would you say all of the time, most of the time, some of the time, or none of the time?
* Enter '5' if respondent did not work at main job when social distancing measures were in effect.
If person worked from home full-time and does not know how to answer, ask, "Did your job require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Question ID: SDW.0070.00.4
Section Name: SDW
Variable: RECJOBSD_A
Question Text:

Thinking about the MAIN job you held in the past 12 months, were there ever any social distancing measures in effect while you worked there? That is, were there ever practices in place to help keep people apart?
* If this person was working from home full-time because of COVID-19, answer '1' for yes.

Question ID: SDW.0080.00.4
Section Name: SDW
Variable: RJWRKCLSSD_A
Question Text:

When social distancing measures were in effect, how often did you still need to work closer than 6 feet to other people? Would you say all of the time, most of the time, some of the time, or none of the time?
If person worked from home full-time and does not know how to answer, ask, "Did your job require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Question ID: SDW.0090.00.4
Section Name: SDW
Variable: RJWCLSNOSD_A
Question Text:

Question ID: SDW.0100.00.4
Section Name: SDW
Variable: RJWKCLSOFT_A
Question Text:

How often did you need to work closer than 6 feet to other people? Would you say all of the time, most of the time, some of the time, or none of the time?
If person worked from home full-time and does not know how to answer, ask, "Did your job require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Questions added in 2020 Q3, Q4
Adult: ACC (Access to Care)

Question ID: ACC.0010.00.4
Section Name: ACC
Variable: DLYCARE_A
Question Text:

Was there any time when you DELAYED getting medical care because of the coronavirus pandemic?

Question ID: ACC.0020.00.4
Section Name: ACC
Variable: DNGCARE_A
Question Text:

Was there any time when you needed medical care for something other than coronavirus, but DID NOT GET IT because of the coronavirus pandemic?

Question ID: ACC.0030.00.4
Section Name: ACC
Variable: VIRAPP12M_A
Question Text:

In the past 12 months, have you had an appointment with a doctor, nurse, or other health professional by video or by phone?

Question ID: ACC.0040.00.4
Section Name: ACC
Variable: VIRAPPCVD_A
Question Text:

Were any of your appointments done by video or by phone because of reasons related to the coronavirus pandemic?

Questions added in 2020 Q3, Q4
Adult: CGR (Caregiving Received)

Question ID: CGR.0010.00.4
Section Name: CGR
Variable: HOMECAREDG _A
Question Text:

Was there any time when you needed care at home from a nurse or other health professional but DID NOT GET IT because of the coronavirus pandemic?

Question ID: CGR.0020.00.4
Section Name: CGR
Variable: FAMCARE12M _A
Question Text:

During the past 12 months, did you receive care at home from a friend or family member?
* If the respondent asks what is meant by the term "care," say: "A wide range of activities that a person may need help with can be considered care. For example, care at home can include personal tasks such as giving medications or helping with eating, dressing, or bathing or household tasks such as cleaning, managing money, or preparing meals."

Question ID: CGR.0030.00.4
Section Name: CGR
Variable: FAMCAREDNG _A
Question Text:

Was there any time when you needed care at home from a friend or family member but DID NOT GET IT because of the coronavirus pandemic?

Question ID: CGR.0040.00.4
Section Name: CGR
Variable: FAMCARECVD _A
Question Text:

Did a friend or family member provide some or all of the care that a nurse or other health professional did not provide due to the coronavirus pandemic?

Questions added in 2020 Q3, Q4
Adult: RCN (Rotating Conditions)

Question ID: RCN.0010.00.4
Section Name: RCN
Variable: KIDWEAKEV _A
Question Text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Weak or failing kidneys?

* Read if necessary: Do not include kidney stones, bladder infections, or incontinence.

Question ID: RCN.0020.00.4
Section Name: RCN
Variable: HEPEV _A
Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Hepatitis?

Question ID: RCN.0030.00.4
Section Name: RCN
Variable: LIVEREV _A
Question Text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had

...Cirrhosis (suh-ROE-siss) or any other kind of long-term liver condition?

Questions added in 2020 Q3, Q4
Adult: PAI (Chronic Pain)

Question ID: PAI.0040.00.2
Section Name: PAI
Variable: PAIWKLM3M _A
Question Text:

Over the past three months, how often did your pain limit your life or work activities? Would you say never, some days, most days, or every day?

Question ID: PAI.0050.00.2
Section Name: PAI
Variable: PAIAFFM3M _A
Question Text:

Over the past three months, how often did YOUR pain affect your family and significant others? Would you say never, some days, most days, or every day?

Questions added in 2020 Q3, Q4
Adult: SOS (Social Support)

Question ID: SOS.0010.00.4
Section Name: SOS
Variable: SUPPORT _A
Question Text:

How often do you get the social and emotional support you need? Would you say always, usually, sometimes, rarely, or never?

Question ID: SOS.0020.00.4
Section Name: SOS
Variable: CMPSUPPORT _A
Question Text:

Compared with 12 months ago, would you say that you now receive more social and emotional support, less social and emotional support, or about the same?

Questions added in 2020 Q3, Q4
Adult: ISN (Immunosuppression)

Question ID: ISN.0010.00.4
Section Name: ISN
Variable: MEDRXTRT _A
Question Text:

In the past 12 months, have you taken prescription medication or had any medical treatments that a doctor or other health professional told you would weaken your immune system?
* Read if necessary: Examples include steroid or corticosteroid (Core-tih-coe-STAIR-oid) pills, such as prednisone (PRED-nuh-sown), or other oral or injected medications for treating many types of autoimmune conditions or certain cancers.

Question ID: ISN.0020.00.4
Section Name: ISN
Variable: HLTHCOND _A
Question Text:

Do you currently have a health condition that a doctor or other health professional told you weakens the immune system ^MEDTRT?
* Read if necessary: Examples include certain kinds of leukemia, lymphoma, or HIV infection.

Questions added in 2020 Q3, Q4
Child: CVD (Positive COVID-19 Diagnosis)

Question ID: CVD.0010.00.4
Section Name: CVD
Variable: CVDINTRO_C
Question Text:

The next set of questions are about coronavirus or COVID-19.
* Enter '1' to continue.

Question ID: CVD.0020.00.4
Section Name: CVD
Variable: CVDDIAG_C
Question Text:

Has a doctor or other health professional ever told you that ^SCNAME had or likely had coronavirus or COVID-19?

Question ID: CVD.0030.00.4
Section Name: CVD
Variable: COVIDTEST_C
Question Text:

Has ^SCNAME ever been tested for coronavirus or COVID-19?

Question ID: CVD.0040.00.4
Section Name: CVD
Variable: CVDRSLT_C
Question Text:

Did the test find that ^SCNAME had coronavirus or COVID-19?
* If any test has shown that ^SCNAME had COVID-19, enter '1' for yes.
* If the respondent indicates they are waiting for ^SCNAME's results, enter '3' for Did not receive results.
* If the respondent indicates the test was inconclusive, enter 'CTRL-D' for Don't Know.

Question ID: CVD.0050.00.4
Section Name: CVD
Variable: CVDSEV_C
Question Text:

How would you describe ^SCNAME's coronavirus symptoms when they were at their worst? Would you say no symptoms, mild symptoms, moderate symptoms, or severe symptoms?

Questions added in 2020 Q3, Q4
Child: ACC (Access to Care)

Question ID: ACC.0010.00.4
Section Name: ACC
Variable: DLYCARE _C
Question Text:

Was there any time when ^SCNAME DELAYED getting medical care because of the coronavirus pandemic?

Question ID: ACC.0020.00.4
Section Name: ACC
Variable: DNGCARE _C
Question Text:

Was there any time when ^SCNAME needed medical care for something other than coronavirus, but DID NOT GET IT because of the coronavirus pandemic?

Question ID: ACC.0030.00.4
Section Name: ACC
Variable: VIRAPP12M _C
Question Text:

In the past 12 months, has ^SCNAME had an appointment with a doctor, nurse, or other health professional by video or by phone?

Question ID: ACC.0040.00.4
Section Name: ACC
Variable: VIRAPPCVD _C
Question Text:

Were any of ^SCNAME's appointments done by video or by phone because of reasons related to the coronavirus pandemic?

2020 National Health Interview Survey (NHIS) Questionnaire

Navigate to the module of interest in the Bookmarks pane to see information about all the sections in the module in questionnaire order. The display pane will show a table with the following information for each section:
- Section abbreviation: a short, 3 letter abbreviation for the section, e.g., INS
- Section description: a description of the topic area for questions in the section
- Content type: a list of values indicating if the questions in the section come from annual core, rotating core, sponsored content or emerging content
- Page Range: range of pages in this document containing the content for each section

2020 National Health Interview Survey (NHIS) Questionnaire
Interview Module: Roster

Section Name: ROS
Section Description: Roster
Content Type: Annual Core
Page Range: 22-23
Section Name: HHC
Section Description: Household Composition
Content Type: Annual Core
Page Range: 24-56
Section Name: REL
Section Description: Relationship of children to parents
Content Type: Annual Core
Page Range: 57-60
Section Name: FAM
Section Description: Family Composition
Content Type: Annual Core
Page Range: 61-77

2020 National Health Interview Survey (NHIS) Questionnaire
Interview Module: Adult

Section Name: VFY
Section Description: Sample Adult Verification
Content Type: Annual Core
Page Range: 78-113
Section Name: HIS
Section Description: Health Status
Content Type: Annual Core
Page Range: 114-114
Section Name: HYP
Section Description: Hypertension
Content Type: Annual Core
Page Range: 115-119
Section Name: CHL
Section Description: Cholesterol
Content Type: Annual Core
Page Range: 120-122
Section Name: CVC
Section Description: Cardiovascular Conditions
Content Type:Annual Core
Page Range: 123-126
Section Name: AST
Section Description: Asthma
Content Type: Annual Core, Sponsored Content
Page Range: 127-135
Section Name: CAN
Section Description: Cancer
Content Type: Annual Core
Page Range: 136-149
Section Name: DIB
Section Description: Diabetes
Content Type: Annual Core, Sponsored Content
Page Range: 150-161
Section Name: CON
Section Description: Other Chronic Conditions
Content Type: Annual Core
Page Range: 162-166
Section Name: RCN
Section Description: Rotating Conditions
Content Type: Emerging Content
Page Range: 167-169
Section Name: ISN
Section Description: Immunosuppression
Content Type: Emerging Content
Page Range: 170-171
Section Name: BMI
Section Description: Current pregnant, height, weight
Content Type: Annual Core
Page Range: 172-179
Section Name: VIS
Section Description: Vision
Content Type: Annual Core
Page Range: 180-182
Section Name: HEA
Section Description: Hearing
Content Type: Annual Core
Page Range: 183-185
Section Name: MOB
Section Description: Mobility
Content Type: Annual Core
Page Range: 186-199
Section Name: COM
Section Description: Communication
Content Type: Annual Core
Page Range: 200-200
Section Name: COG
Section Description: Cognition
Content Type: Annual Core
Page Range: 201-204
Section Name: UPP
Section Description: Self-care and Upper Body
Content Type: Annual Core
Page Range: 205-207
Section Name: SOC
Section Description: Social Functioning
Content Type: Annual Core
Page Range: 208-210
Section Name: ADO
Section Description: Age of Disability Onset
Content Type: Sponsored Content
Page Range: 211-211
Section Name: INS
Section Description: Health Insurance
Content Type: Annual Core
Page Range: 212-291
Section Name: PAY
Section Description: Difficulty Paying for Health Care
Content Type: Annual Core
Page Range: 292-295
Section Name: CVD
Section Description: Positive COVID-19 Diagnosis
Content Type: Emerging Content
Page Range: 296-300
Section Name: DNC
Section Description: Dental Care
Content Type: Rotating Core
Page Range: 301-304
Section Name: UTZ
Section Description: Utilization
Content Type: Annual Core
Page Range: 305-315
Section Name: ACC
Section Description: Access to Care
Content Type: Emerging Content
Page Range: 316-319
Section Name: CNV
Section Description: Cancer COVID-19
Content Type: Emerging Content
Page Range: 320-323
Section Name: PMD
Section Description: Prescription Medication
Content Type: Annual Core
Page Range: 324-328
Section Name: OPD
Section Description: Opioid Use - ALL
Content Type: Sponsored Content
Page Range: 329-333
Section Name: IMS
Section Description: Immunization with 2020 supplements
Content Type: Annual Core, Sponsored Content
Page Range: 334-353
Section Name: PTC
Section Description: Physical and other therapeutic care
Content Type: Rotating Core
Page Range: 354-356
Section Name: CGR
Section Description: Caregiving Received
Content Type: Emerging Content
Page Range: 357-360
Section Name: ANX
Section Description: Anxiety
Content Type: Annual Core
Page Range: 361-363
Section Name: DEP
Section Description: Depression
Content Type: Annual Core
Page Range: 364-366
Section Name: MHC
Section Description: Mental Health Care
Content Type: Annual Core
Page Range: 367-371
Section Name: PAI
Section Description: Chronic Pain
Content Type: Sponsored Content
Page Range: 372-384
Section Name: REP
Section Description: Repetitive Strain Injury
Content Type: Rotating Core
Page Range: 385-392
Section Name: INJ
Section Description: Injury
Content Type: Rotating Core
Page Range: 393-414
Section Name: FGE
Section Description: Fatigue
Content Type: Rotating Core
Page Range: 415-417
Section Name: CIG
Section Description: Cigarettes and E-cigarettes w/ Cigarette History
Content Type: Annual Core, Rotating Core, Sponsored Content
Page Range: 418-432
Section Name: OTB
Section Description: Other Tobacco
Content Type: Sponsored Content
Page Range: 433-439
Section Name: ALC
Section Description: Alcohol Use
Content Type: Rotating Core
Page Range: 440-448
Section Name: PHY
Section Description: Physical Activity
Content Type: Rotating Core
Page Range: 449-458
Section Name: WLK
Section Description: Walking
Content Type: Rotating Core
Page Range: 459-468
Section Name: ENV
Section Description: Perceptions of the Walking Environment
Content Type: Sponsored Content
Page Range: 469-480
Section Name: SUN
Section Description: Sun Care and Protection
Content Type: Sponsored Content
Page Range: 481-490
Section Name: DPV
Section Description: Diabetes Prevention
Content Type: Rotating Core, Sponsored Content
Page Range: 491-496
Section Name: SLP
Section Description: Sleep
Content Type: Rotating Core
Page Range: 497-501
Section Name: SOS
Section Description: Social Support
Content Type: Emerging Content
Page Range: 502-503
Section Name: ORN
Section Description: Sexual Orientation
Content Type: Annual Core
Page Range: 504-505
Section Name: MAR
Section Description: Marital Status
Content Type: Annual Core
Page Range: 506-520
Section Name: VET
Section Description: Veterans Status
Content Type: Annual Core
Page Range: 521-526
Section Name: NAT
Section Description: Nativity
Content Type: Annual Core
Page Range: 527-531
Section Name: SCH
Section Description: Schooling
Content Type: Annual Core
Page Range: 532-533
Section Name: EMP
Section Description: Employment
Content Type: Rotating Core
Page Range: 534-548
Section Name: SDW
Section Description: Social distancing at work
Content Type: Emerging Content
Page Range: 549-558
Section Name: FEM
Section Description: Employment of family members
Content Type: Annual Core
Page Range: 559-561
Section Name: INC
Section Description: Family Income
Content Type: Annual Core
Page Range: 562-584
Section Name: FOO
Section Description: Food Related Programs
Content Type: Annual Core, Sponsored Content
Page Range: 585-593
Section Name: FDS
Section Description: Food Security
Content Type: Sponsored Content
Page Range: 594-604
Section Name: HOU
Section Description: Housing
Content Type: Annual Core
Page Range: 605-607
Section Name: REC
Section Description: Person's name
Content Type: Annual Core
Page Range: 608-610
Section Name: TEL
Section Description: Telephone Use
Content Type: Annual Core
Page Range: 611-614
Section Name: LNK
Section Description: Linkage
Content Type: Annual Core
Page Range: 615-619
Section Name: THX
Section Description: Thanks
Content Type: Annual Core
Page Range: 620-620

2020 National Health Interview Survey (NHIS) Questionnaire
Interview Module: Child

Section Name: VFY
Section Description: Verification and demographic details
Content Type: Annual Core
Page Range: 621-659
Section Name: HIS
Section Description: Health Status
Content Type: Annual Core
Page Range: 660-660
Section Name: AST
Section Description: Asthma
Content Type: Annual Core, Sponsored Content
Page Range: 661-669
Section Name: DIB
Section Description: Diabetes
Content Type: Annual Core
Page Range: 670-671
Section Name: DLD
Section Description: Developmental and Learning Disabilities
Content Type: Annual Core
Page Range: 672-681
Section Name: BMI
Section Description: Height and Weight - Rotate
Content Type: Annual Core
Page Range: 682-691
Section Name: VIS
Section Description: Vision
Content Type: Annual Core
Page Range: 692-694
Section Name: HEA
Section Description: Hearing
Content Type: Annual Core
Page Range: 695-696
Section Name: MOB
Section Description: Mobility
Content Type: Annual Core
Page Range: 697-706
Section Name: UPP
Section Description: Upper Body, Motor skills and self-care
Content Type: Annual Core
Page Range: 707-708
Section Name: COM
Section Description: Communication
Content Type: Annual Core
Page Range: 709-712
Section Name: COG
Section Description: Cognition
Content Type: Annual Core
Page Range: 713-714
Section Name: ANX
Section Description: Anxiety
Content Type: Annual Core
Page Range: 715-715
Section Name: DEP
Section Description: Depression
Content Type: Annual Core
Page Range: 716-716
Section Name: BEH
Section Description: Behavior
Content Type: Annual Core
Page Range: 717-722
Section Name: BSC
Section Description: Baby Pediatric Symptom Checklist
Content Type: Annual Core
Page Range: 723-735
Section Name: SCH
Section Description: Schooling
Content Type: Annual Core
Page Range: 736-739
Section Name: INS
Section Description: Health Insurance
Content Type: Annual Core
Page Range: 740-815
Section Name: PAY
Section Description: Difficulty Paying for Health Care
Content Type: Annual Core
Page Range: 816-819
Section Name: CVD
Section Description: Positive COVID-19 Diagnosis
Content Type: Emerging Content
Page Range: 820-824
Section Name: DNC
Section Description: Dental Care - Rotate
Content Type: Rotating Core
Page Range: 825-828
Section Name: UTZ
Section Description: Utilization
Content Type: Annual Core
Page Range: 829-839
Section Name: ACC
Section Description: Access to Care
Content Type: Emerging Content
Page Range: 840-843
Section Name: PMD
Section Description: Prescription medications
Content Type: Annual Core
Page Range: 844-846
Section Name: IMM
Section Description: Immunization
Content Type: Annual Core
Page Range: 847-852
Section Name: PTC
Section Description: Physical and other therapeutic care - Rotate
Content Type: Rotating Core
Page Range: 853-855
Section Name: MHC
Section Description: Mental health care - Rotate
Content Type: Rotating Core
Page Range: 856-859
Section Name: INJ
Section Description: Injury
Content Type: Rotating Core
Page Range: 860-878
Section Name: TBI
Section Description: Concussions - lifetime
Content Type: Emerging Content
Page Range: 879-884
Section Name: PHY
Section Description: Physical Activity
Content Type: Rotating Core
Page Range: 885-890
Section Name: NHC
Section Description: Neighborhood Characteristics
Content Type: Rotating Core
Page Range: 891-894
Section Name: SLP
Section Description: Sleep - Rotate
Content Type: Rotating Core
Page Range: 895-900
Section Name: SCR
Section Description: Screen time
Content Type: Rotating Core
Page Range: 901-901
Section Name: PAR
Section Description: Parent Demographics
Content Type: Annual Core
Page Range: 902-923
Section Name: NAT
Section Description: Nativity
Content Type: Annual Core
Page Range: 924-928
Section Name: FEM
Section Description: Employment of family members
Content Type: Annual Core
Page Range: 929-931
Section Name: INC
Section Description: Family Income
Content Type: Annual Core
Page Range: 932-952
Section Name: FOO
Section Description: Food Related Programs
Content Type: Annual Core, Sponsored Content
Page Range: 953-961
Section Name: FDS
Section Description: Food Security
Content Type: Sponsored Content
Page Range: 962-972
Section Name: HOU
Section Description: Housing
Content Type: Annual Core
Page Range: 973-975
Section Name: REC
Section Description: Child's full name
Content Type: Annual Core
Page Range: 976-978
Section Name: TEL
Section Description: Telephone ownership
Content Type: Annual Core
Page Range: 979-980
Section Name: LNK
Section Description: Linkage
Content Type: Annual Core
Page Range: 981-984
Section Name: THX
Section Description: Thanks
Content Type: Annual Core
Page Range: 985-987

2020 National Health Interview Survey (NHIS) Questionnaire

Navigate the hierarchy in the Bookmarks pane to the module and section of interest. Selecting the module or section name will display the detail for the first variable for that module or section, respectively. Expanding the hierarchy further and selecting a question will display the detail for that specific question. The detailed report will show the following information for a question: Question ID, Variable, Content Type, Question Text, Fills, Response, Universe, Skip Instructions, and optionally, Hard Edit, Soft Edit, and Replication.

2020 National Health Interview Survey (NHIS) Questionnaire
ROS: Roster
Question ID: ROS.0020.00.1
Variable: HHCLock
Interview Module: Roster
Content Type: Annual Core
Question text:

* The demographic information is now locked and cannot be changed.
* Enter '1' to continue with the interview.
* If reentering the case, press the END key to go to the next unanswered question.

Response:

1 - Enter 1 to Continue

Universe:

HHC section has been locked.

Skip Instructions:

1 If GEN.PCNTUNDER18 GT 0, [goto REL.WHOPAR]
else [goto SASCSELECT]

Question ID: ROS.0030.00.1
Variable: ROSTERCHECK
Interview Module: Roster
Content Type: Annual Core
Question text:

* The roster will now be locked. If you are confident that it has been recorded accurately,
enter 1 to continue. Otherwise go back and correct now.

Response:

1 - Enter 1 to Continue

Universe:

At least one person in the household is greater than 18 and there is at least one child in the household and at least one person's age is not guessed and not all household members in the armed forces and the HHC section has not been locked.

Skip Instructions:

1 If GEN.PCNTUNDER18 GT 0, [goto tblREL.WHOPAR]
if SURVTYPE=T and eligible adults [goto SELECT_SA]
elseif SURVTYPE=T and eligible children [goto SELECT_SC]
else [goto SASCSELECT]

2020 National Health Interview Survey (NHIS) Questionnaire
HHC: Household Composition
Question ID: HHC.0020.00.1
Variable: NAME_FNAME
Interview Module: Roster
Content Type: Annual Core
Question text:

^FNAME
* Enter 999 if no more persons.

Fills:

^FNAME

Description: NAME_FNAME Introduction
Instruction:
If first person in roster, fill: "Starting with you, what are the names of all the persons living or staying here?"
Else for next person fill: "What is the name of the next
person living or staying here?"

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

All persons

Skip Instructions:

allow 20 if name on fake/false name list [goto ERR2_NAME_FNAME];
elseif NAME_FNAME is identical to any other NAME_FNAME or ALIAS [goto ERR3_NAME_FNAME]
else [goto NAME_LNAME]
999 if LNO=1 [goto ERR1_NAME_FNAME]
else [goto USUALRES]
RF,DK [goto ALIAS]

Hard Edit:

Check Text: ERR1_NAME_FNAME
Check Description: 999 for first person hard edit
Check Text: {check ERR1_NAME_FNAME}
999 not allowed for the first person in the household. Please correct.
Check Text: ERR3_NAME_FNAME
Check Description: Identical first name hard edit
Check Text: {check ERR3_NAME_FNAME}
First name cannot be the same as previous ^NameMatch.

Soft Edit:

Check Text: ERR2_NAME_FNAME
Check Description: Fake name soft edit
Check Text: {signal ERR2_NAME_FNAME} You are entering a possible fake/false name. Please correct. If this is a legitimate name, suppress this error message and continue. Otherwise, go back to the name field and enter a legitimate name. To enter an alias, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused' at the name field. Then, enter a matching identifier/alias at the next screen (ALIAS).

Question ID: HHC.0030.00.1
Variable: NAME_LNAME
Interview Module: Roster
Content Type: Annual Core
Question text:

* Enter last name if provided. Last name is optional.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

A valid first name was entered

Skip Instructions:

allow 20,RF,DK,empty [If PX less than 25 goto NAME_FNAME for next person, else goto USUALRES]

Question ID: HHC.0040.00.1
Variable: ALIAS
Interview Module: Roster
Content Type: Annual Core
Question text:

How shall I refer to ^youthisperson for the rest of the interview?

Fills:

^youthisperson

Description: you/this person
Instruction:
If subject=respondent, fill "you", else if subject NE respondent, fill "this person"

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Persons who don't know or refused to give first name.

Skip Instructions:

allow 20 if ALIAS is identical to any other NAME_FNAME or ALIAS [goto ERR1_ALIAS]
elseif ALIAS = 999 [goto ERR2_ALIAS]
else [If PX less than 25 goto NAME_FNAME for next person, else goto USUALRES]

Hard Edit:

Check Text: ERR2_ALIAS
Check Description: 999 for alias hard edit
Check Text: {check ERR2_ALIAS}*999 not allowed as an alias. *Please correct
Check Text: ERR1_ALIAS
Check Description: Identical alias hard edit
Check Text: {check ERR1_ALIAS} Alias cannot be the same as previous ^NameMatch.

Question ID: HHC.0050.00.1
Variable: USUALRES
Interview Module: Roster
Content Type: Annual Core
Question text:

^DoDoes ^youALIAS usually live here?

Fills:

^DoDoes

Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

All persons where NAME_FNAME ne 999

Skip Instructions:

1 if (PX less than 25) [goto USUALRES for next person in household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]
2,RF,DK [goto ASKURE]

Question ID: HHC.0060.00.1
Variable: ASKURE
Interview Module: Roster
Content Type: Annual Core
Question text:

^DoDoes ^youALIAS have some other place where ^youthey usually live?

Fills:

^DoDoes

Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^youthey

Description: you/they
Instruction:
If subject=respondent, fill "you", else if subject NE respondent, fill "they"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

If the usual residence is not here, or respondent refused or didn't know

Skip Instructions:

1 [goto USUALSCHOOL]
2,RF,DK if (PX less than 25) [goto USUALRES for next person in the household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]

Question ID: HHC.0070.00.1
Variable: USUALSCHOOL
Interview Module: Roster
Content Type: Annual Core
Question text:

^AreIs ^youALIAS usually away at school or college?

Fills:

^AreIs

Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Person does not usually live in household and usual residence is elsewhere

Skip Instructions:

1 [goto ONOFFCAMPUS]
2,RF,DK if (PX less than 25) [goto USUALRES for next person in the household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]

Question ID: HHC.0080.00.1
Variable: ONOFFCAMPUS
Interview Module: Roster
Content Type: Annual Core
Question text:

^DoDoes ^youALIAS live in on-campus housing or off-campus housing?
* Read if necessary: On-campus housing includes residence halls and dorms where students live
together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.

Fills:

^DoDoes

Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - On campus
2 - Off campus
7 - Refused
9 - Don't Know

Universe:

Person's usual residence is not in the household and person has a usual residence other than the place of interview and lives away at school or college

Skip Instructions:

1,2,RF,DK if (PX less than 25) [goto USUALRES for next person in the household]
else [goto MISPERS_MCHILD]
elseif PX=25 and PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]
elseif PX=25 and PCNT=1 and HHSTAT_D[1]=empty [goto SEX]
elseif PX=25 and PCNT=0 [goto EXIT]

Question ID: HHC.0090.00.1
Variable: MISPERS_MCHILD
Interview Module: Roster
Content Type: Annual Core
Question text:

^ROSTEREXCEPTION
^HHROSTERINTRO
^HHROSTER
Have I missed any babies or small children?

Fills:

^ROSTEREXCEPTION

Description: Exception to Roster
Instruction:
If PCNT less than TOTPCNT, fill: "Students living in on-campus housing will be included in the interview. Other people
who do not usually live here and have another residence
elsewhere will not be included in this interview."

^HHROSTERINTRO

Description: I have listed the household members as...
Instruction:
If PCNT ne 0, fill: I have listed the household members as...

^HHROSTER

Description: Entire roster of non deleted people
Instruction:
entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Less than 25 persons listed on roster

Skip Instructions:

1[goto NAME_FNAME to add person to roster]
2,RF,DK [goto MISPERS_MSCHOOL]

Question ID: HHC.0140.00.1
Variable: MISPERS_MSCHOOL
Interview Module: Roster
Content Type: Annual Core
Question text:

* Read if necessary.
I have listed the household members as...
^HHROSTER
Have I missed anyone who USUALLY lives here, but is away now at school or college?

Fills:

^HHROSTER

Description: Entire roster of non deleted people
Instruction:
entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Less than 25 persons listed on roster

Skip Instructions:

1 [goto ERR_MISPERS_MSCHOOL]
[goto NAME_FNAME to add person to roster]
2,RF,DK [goto MISPERS_MELSE]

Soft Edit:

Check Text: ERR_MISPERS_MSCHOOL
Check Description:
Check Text: {signal ERR_MISPERS_MSCHOOL}Do not read to the respondent. After adding the name of the household member who is now away at school or college to the roster, press the END key, enter '2' at USUALRES, enter '1' at ASKURE, and answer the USUALSCHOOL question. Suppress message to continue.

Question ID: HHC.0160.00.1
Variable: MISPERS_MELSE
Interview Module: Roster
Content Type: Annual Core
Question text:

* Read if necessary.
I have listed the household members as...
^HHROSTER
Have I missed anyone else who USUALLY lives here, including people who are not related to you or
people who are away traveling?

Fills:

^HHROSTER

Description: Entire roster of non deleted people
Instruction:
entire roster for [^ALIASNAME[PX]] if HHSTAT ne 'D' (non deleted persons)

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Less than 25 persons listed on roster

Skip Instructions:

1 [goto NAME_FNAME to add person to roster]
2,RF,DK if PCNT = 0 [goto EXIT]
elseif PCNT = 1 [goto SEX]
elseif PCNT gt 1 or (PCNT=1 and HHSTAT_D[1]=1) [goto HHRESP]

Question ID: HHC.0180.00.1
Variable: HHRESP
Interview Module: Roster
Content Type: Annual Core
Question text:

Which adults living here would you say know about the members of this household?
* Person(s) selected must be over 18.
* You may select someone who is marked as deleted.
* Enter all that apply, separate with commas.

Response:

01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25

Universe:

All households with more than one non-deleted person OR there is only one non-deleted person in the household and deleted person is first person on roster and first person on the roster was answering for the household but does not usually live there.

Skip Instructions:

1 not IN HHRESP [goto HHRESPAVAIL]
One Person selected at HHRESP and that person has HHSTAT_D=1 [goto HHRESPPROXY]
else [goto tblSex.bPerson.SEX]

Question ID: HHC.0190.00.1
Variable: HHRESPAVAIL
Interview Module: Roster
Content Type: Annual Core
Question text:

^HHRESP_fill
Select the line number of the person who can continue the interview.
* If no one is available press F9 to set up a callback.

Fills:

^HHRESP_fill

Description: Of the people you just mentioned, who can speak with me now?/Can ^ALIASNAME speak with me now?
Instruction:
If multiple people are selected, fill "Of the people you just mentioned, who can speak with me now?"
If one person is selected, fill "Can ^ALIASNAME speak with
me now?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

Universe:

Person to whom you are speaking (LNO=1) is not knowledgeable

Skip Instructions:

1-25 (person selected at HHRESPAVAIL has HHSTAT_D=1) [goto HHRESPPROXY]
else [goto tblSex.bPerson.SEX]

Question ID: HHC.0200.00.1
Variable: HHRESPPROXY
Interview Module: Roster
Content Type: Annual Core
Question text:

*^ALIASNAME does not usually live here.
^DoyouDoesALIAS take care of someone who lives here?

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^DoyouDoesALIAS

Description: Do you/Does ^ALIASNAME
Instruction:
For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Person selected at HHRESP or HHRESPAVAIL has been deleted from the roster.

Skip Instructions:

1 [goto tblSex.bPerson.SEX]
2,RF,DK [goto ERR_HHRESPPROXY]

Soft Edit:

Check Text: ERR_HHRESPPROXY
Check Description:
Check Text: {signal ERR_HHRESPPROXY} Person was deleted from this household.

Question ID: HHC.0210.00.1
Variable: SEX
Interview Module: Roster
Content Type: Annual Core
Question text:

^AreIs ^youALIAS male or female?

Fills:

^AreIs

Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Male
2 - Female
7 - Refused
9 - Don't Know

Universe:

All nondeleted persons

Skip Instructions:

If last non-deleted person on roster [goto AGENO]
else [goto SEX for next non-deleted person on roster]

Question ID: HHC.0220.01.1
Variable: AGENO
Interview Module: Roster
Content Type: Annual Core
Question text:

* 1 of 2
What is ^yourALIAS age?
* Enter number for age.

Fills:

^yourALIAS

Description: your/^ALIASNAME's
Instruction:
If PX=LNO_RESP fill "your"; else fill "^ALIASNAME's"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

001-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

All nondeleted persons

Skip Instructions:

001-120 [goto AGETP]
RF,DK [goto AGE18]

Question ID: HHC.0220.02.1
Variable: AGETP
Interview Module: Roster
Content Type: Annual Core
Question text:

* 2 of 2
* Enter number for age time period.

Response:

1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)

Universe:

Valid number entered at AGENO[PX]

Skip Instructions:

If last non-deleted person on roster AND ((AGENO = RF, DK and AGE18 =1) or AGE LT 018 for
everyone) then [goto Exit]
elseif last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]

Question ID: HHC.0230.00.1
Variable: AGE18
Interview Module: Roster
Content Type: Annual Core
Question text:

Certain sections of this interview depend on knowing if a person is 18 years or older. Could you
please tell me if ^youALIAS ^areis less than 18 years old or 18 years or older?

Fills:

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^areis

Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

Response:

1 - Less than 18
2 - 18 or older
7 - Refused
9 - Don't Know

Universe:

Refused or did not know age

Skip Instructions:

RF,DK [goto AGEGUESS]
2 [goto AGE65]
1 If last non-deleted person on roster AND ((AGENO=RF,DK and AGE18=1) or AGE LT 018 for
everyone then [goto Exit]
Else if last non-deleted person on roster [goto NATORG]
Else [goto AGENO for next non-deleted person on roster]

Question ID: HHC.0240.00.1
Variable: AGE65
Interview Module: Roster
Content Type: Annual Core
Question text:

^AreIs ^youALIAS less than 65 years old or 65 years or older?

Fills:

^AreIs

Description: Are/Is
Instruction:
If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Less than 65
2 - 65 or older
7 - Refused
9 - Don't Know

Universe:

No numerical age provided and person is 18 or over

Skip Instructions:

1,2,RF,DK if last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]

Question ID: HHC.0250.00.1
Variable: AGEGUESS
Interview Module: Roster
Content Type: Annual Core
Question text:

* Use your judgement to guess if ^ALIASNAME is less than 18 or 18 or older.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Less than 18
2 - 18 or older

Skip Instructions:

If last non-deleted person on roster AND AGEGUESS = 1,2 for everyone then [goto Exit]
elseif last non-deleted person on roster [goto NATORG]
else [goto AGENO for next non-deleted person on roster]

Question ID: HHC.0290.00.1
Variable: NATORG
Interview Module: Roster
Content Type: Annual Core
Question text:

^NATORGAGE

Fills:

^NATORGAGE

Description: Is ^ALIASNAME Hispanic or Latino?/^DoyouDoesALIAS consider ^yourhimherself to be Hispanic or Latino?
Instruction:
If person is 17 or younger: "Is ^ALIASNAME Hispanic or Latino?"
If person is 18 or older: "^DoyouDoesALIAS consider
^yourhimherself to be Hispanic or Latino?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^DoyouDoesALIAS

Description: Do you/Does ^ALIASNAME
Instruction:
For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else fill "himself" if SEX=1 or "herself" if SEX=2 or
"themself" if SEX=DK or RF

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

All nondeleted persons

Skip Instructions:

If last non-deleted person on roster [goto RACE]
else [goto NATORG for next non-deleted person on roster]

Question ID: HHC.0300.00.1
Variable: RACE
Interview Module: Roster
Content Type: Annual Core
Question text:

^RACEAGE
^RACEFILL
* Enter all that apply, separate with commas.

Fills:

^RACEAGE

Description: What race or races is ^ALIASNAME/What race or races ^dodoes ^youALIAS} consider ^yourhimherself to be?
Instruction:
If person is 17 or younger: "What race or races is ^ALIASNAME?"
If person is 18 or older: "What race or races ^dodoes
^youALIAS consider ^yourhimherself to be?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^dodoes

Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else fill "himself" if SEX=1 or "herself" if SEX=2 or
"themself" if SEX=DK or RF

^RACEFILL

Description: Race list fill
Instruction:
For first or only non-deleted person: Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska
Native, Native Hawaiian, Pacific Islander, Asian, or some
other race?
Else fill:
*Read if necessary: Please select 1 or more of these
categories:
White, Black, African American, American Indian, Alaska
Native, Native Hawaiian, Pacific Islander, Asian, or some
other race?

Response:

01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
97 - Refused
- 99 - Don't Know

Universe:

All nondeleted persons

Skip Instructions:

8 IN RACE [goto RACE_SP]
1-7,RF,DK If last non-deleted person on roster AND at least one person with AGE18=2 or
AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC]
else [goto RACE for next non-deleted person on roster]

Question ID: HHC.0310.00.1
Variable: RACE_SP
Interview Module: Roster
Content Type: Annual Core
Question text:

^RACESPAGE
Start typing and then select from list. If race is not on the list, type "ZZ" and enter
verbatim.
* If any of the following are mentioned, back up to previous screen and correct the entry.
White
Black
African American
American Indian
Alaska Native
Native Hawaiian
Pacific Islander
Asian
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the
next question, enter ALL the other races in the verbatim field.

Fills:

^RACESPAGE

Description: What other race or races is ^ALIASNAME?/What other race or races ^dodoes ^youALIAS consider ^yourhimherself to be?
Instruction:
If person is 17 or younger: "What other race or races is ^ALIASNAME?"
If person is 18 or older: "What other race or races
^dodoes ^youALIAS consider ^yourhimherself to be?"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^dodoes

Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else fill "himself" if SEX=1 or "herself" if SEX=2 or
"themself" if SEX=DK or RF

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Person identifies as some other race

Skip Instructions:

selection from picklist,RF,DK If last non-deleted person on roster AND at least one person
with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC]
else [goto RACE for next non-deleted person on roster]
ZZ [goto RACE_VRBAT]

Question ID: HHC.0320.00.1
Variable: RACE_VRBAT
Interview Module: Roster
Content Type: Annual Core
Question text:

* Read if necessary.
^RACESPAGE

Fills:

^RACESPAGE

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^dodoes

Description: Do/Does
Instruction:
If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^yourhimherself

Description: yourself/himself/herself/themself
Instruction:
if subject=respondent fill "yourself"; else fill "himself" if SEX=1 or "herself" if SEX=2 or
"themself" if SEX=DK or RF

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Person identifies as some other race and Interviewer does not use pick-list to select this race

Skip Instructions:

allow 80 If last non-deleted person on roster AND at least one person with AGE18=2 or
AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC]
else [goto RACE for next non-deleted person on roster]

Question ID: HHC.0330.00.1
Variable: AFNOW
Interview Module: Roster
Content Type: Annual Core
Question text:

^AreyouIsALIASIsanyone now on full-time active duty with the Armed Forces?
*Read if necessary: Active duty does not include training for the Reserves or National Guard,
but DOES include activation, for example, for service in the U.S. or in a foreign country, in
support of military or humanitarian operations.

Fills:

^AreyouIsALIASIsanyone

Description Are you/Is ^ALIASNAME/Is anyone in the household
Instruction If PCNTAGEAF=1 and that person=respondent, fill "Are you",
elseif PCNTAGEAF=1 and that person NE respondent, fill "Is
^ALIASNAME"
elseif PCNTAGEAF GT 1 fill "Is anyone in the household"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

At least one person in the household is greater than 18 and at least one person's age is not guessed and at least one non-deleted person age 17-64 years old or who is greater than or equal to 18 or whose age was guessed to be greater than or equal to 18

Skip Instructions:

1 if GEN.PCNTAGEAF GT 1 [goto AFNOWWHO]
elseif GEN.PCNTAGEAF=1 and GEN.PCNT=1[goto EXIT]
elseif GEN.PCNTAGEAF=1 and GEN.PCNT GT 1[goto EDUC]
2,RF,DK [goto EDUC]

Question ID: HHC.0340.00.1
Variable: AFNOWWHO
Interview Module: Roster
Content Type: Annual Core
Question text:

Who is this? (Anyone else?)
* Enter all that apply, separate with commas.

Response:

Universe:

At least 1 person in the Armed Forces and more than 1 person eligible to be in the Armed Forces

Skip Instructions:

1-25 if all PX have GEN.HHSTAT_D=1 or GEN.HHSTAT_M = 1 [goto EXIT]
else [goto EDUC]

Question ID: HHC.0350.00.1
Variable: EDUC
Interview Module: Roster
Content Type: Annual Core
Question text:

What is the HIGHEST level of school ^youALIAS ^havehas completed or the highest degree ^youALIAS
^havehas received?
* Enter highest level of school completed.

Fills:

^youALIAS

Description: you/^ALIASNAME
Instruction:
If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^havehas

Description: have/has
Instruction:
If subject=respondent, fill "have", else if subject NE respondent fill "has"

Response:

00 - Never attended/kindergarten only
01 - Grade 1-11
02 - 12th grade, no diploma
03 - GED or equivalent
04 - High School Graduate
05 - Some college, no degree
06 - Associate degree: occupational, technical, or vocational program
07 - Associate degree: academic program
08 - Bachelor's degree (Example: BA, AB, BS, BBA)
09 - Master's degree (Example: MA, MS, MEng, MEd, MBA)
10 - Professional School degree (Example: MD, DDS, DVM, JD)
11 - Doctoral degree (Example: PhD, EdD)
97 - Refused
99 - Don't Know

Universe:

All non-deleted persons flagged as aged 18+

Skip Instructions:

0-11,RF,DK If last non-deleted adult on roster [goto next section]
else [goto EDUC for next non-deleted adult on roster]

Question ID: HHC.0360.00.1
Variable: EXIT
Interview Module: Roster
Content Type: Annual Core
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 continue.

Response:

1 - Enter 1 to Continue

Universe:

All armed forces, all usual residence elsewhere, all under age 18, all where aged is guessed

Skip Instructions:

1 [goto BCK.WHOREADLTR]

2020 National Health Interview Survey (NHIS) Questionnaire
REL: Relationship of children to parents
Question ID: REL.0010.00.1
Variable: WHOPAR
Interview Module: Roster
Content Type: Annual Core
Question text:

Which people living in this household are ^ALIASNAME's parents? Please include biological, step,
or adoptive parents, but not foster parents or other relatives who may act as parents.
* If respondent is a foster parent or relative who acts as a parent, probe "Does ^ALIASNAME have
any biological, step, or adoptive parents living in this household?"
* Enter '0' if no biological, step, or adoptive parents live in the household.
* Legal guardians who are not biological, step, or adoptive parents should not be selected at
this question.
* Enter all that apply, separate with commas.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

00 - No biological, step, or adoptive parents
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
- 25 - Name of Person 25
97 - Refused
99 - Don't Know

Universe:

All persons with age less than 18 years old or age was guessed or reported to be less than 18

Skip Instructions:

If 0 selected with any other value [goto ERR4_WHOPAR]
If AGEDIFF LT 15 [goto ERR1_WHOPAR]
elseif AGEDIFF GE 50 [goto ERR2_WHOPAR]
elseif AGEDIFF LE 0 [goto ERR3_WHOPAR]
0, RF, DK [goto FOSTPAR]
1-25 If last non-deleted child on roster [goto next section]
else [goto WHOPAR for next non-deleted child on roster]

Hard Edit:

Check Text: ERR4_WHOPAR
Check Description: 0 and another entry
Check Text: {check ERR4_WHOPAR} Invalid entry. Cannot mark 0 and a valid line number. Please correct.

Soft Edit:

Check Text: ERR1_WHOPAR
Check Description: Age difference between parent selected and child less than 15 years
Check Text: {signal ERR1_WHOPAR}
Age difference between parent and child is ^AGEDIFF years. I have recorded the parent ^PARENTNAME is ^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.
Check Text: ERR3_WHOPAR
Check Description: Parent is younger than child
Check Text: {signal ERR3_WHOPAR} Please verify. Parent is younger than child. I have recorded the parent ^PARENTNAME is ^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.
Check Text: ERR2_WHOPAR
Check Description: Age difference GE 50 years
Check Text: {signal ERR2_WHOPAR} Age difference between parent and child is greater than or equal to 50 years. I have recorded the parent ^PARENTNAME is ^PARENTAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

Question ID: REL.0040.00.1
Variable: WHOFOST
Interview Module: Roster
Content Type: Annual Core
Question text:

Which people living in this household are ^ALIASNAME's foster parents?
Read if necessary: Please include grandparents or other family members if they are acting as
foster parents under the supervision of a state or county child welfare agency.
* Enter all that apply, separate with commas.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

Universe:

Child is in foster care

Skip Instructions:

If AGEDIFF LT 15 [goto ERR1_WHOFOST]
elseif AGEDIFF GE 50 [goto ERR2_WHOFOST]
elseif AGEDIFF LE 0 [goto ERR3_WHOFOST]
If last non-deleted child on roster [goto next section]
else [goto WHOPAR for next non-deleted child on roster]

Soft Edit:

Check Text: ERR1_WHOFOST
Check Description: Age difference between foster parent selected and child less than 15 years
Check Text: {signal ERR1_WHOFOST}
Age difference between parent and child is ^AGEDIFF years. I have recorded the foster parent ^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.
Check Text: ERR3_WHOFOST
Check Description: Foster parent is younger than child
Check Text: {signal ERR3_WHOFOST}
Please verify. Parent is younger than child. I have recorded the foster parent ^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.
Check Text: ERR2_WHOFOST
Check Description: Age difference GE 50 years
Check Text: {signal ERR2_WHOFOST} Age difference between parent and child is greater than or equal to 50 years. I have recorded the foster parent ^FOSTPARNAME is ^FOSTPARAGE years old and the child ^CHILDNAME is ^CHILDAGE years old. Are these ages and relationships correct? Please correct relationship code or age.

2020 National Health Interview Survey (NHIS) Questionnaire
FAM: Family Composition
Question ID: FAM.0050.00.1
Variable: ALLFAM
Interview Module: Roster
Content Type: Annual Core
Question text:

? [F1]
Is everyone in this household a member of the same family?
*Read if necessary: For this survey, a family is two or more people living together who are
related by birth, marriage, or adoption, as well as any unrelated children who are cared for by
the family, such as foster children, and any people living together as a couple and their
children.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

The number of unique families as identified in REL section is greater than 1

Skip Instructions:

IF (Roster.PCNTEligibleSA > 1 OR Roster.PCNTEligibleSC > 1) [goto SASCID]
ELSE [goto procSetFAMILY_FLGs]

Question ID: FAM.0060.00.1
Variable: SASCID
Interview Module: Roster
Content Type: Annual Core
Question text:

One ^SASCID_fill randomly selected from every household in the survey to be asked a series of
health related questions. In this household, ^SASCID_fill2 chosen.

Fills:

^SASCID_fill

Description: adult and child are/adult is/child is
Instruction:
If PX_A gt 0 and PX_C gt 0, fill "adult and child are" elseif PX_A gt 0, fill "adult is"
else fill "child is"

^SASCID_fill2

Description: you and ^SCNAME were/^SANAME and ^SCNAME were/you were/^SANAME was/^SCNAME was
Instruction:
If PX_A gt 0 and PX_C gt 0 and HHRESPAVAIL = PX_A, fill "you and ^SCNAME were"
elseif PX_A gt 0 and PX_C gt 0 and HHRESPAVAIL ne PX_A,
fill "^SANAME and ^SCNAME were"
elseif PX_A gt 0 and HHRESPAVAIL = PX_A, fill "you were"
elseif PX_A gt 0 and HHRESPAVAIL ne PX_A, fill "^SANAME
was"
else fill "^SCNAME was"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

1 - Enter 1 to Continue

Universe:

Count of all persons eligible to be SA is greater than 1 or count of all persons eligible to be SC is greater than 1 or there are multiple adults or children in the family but only 1 adult or child is eligible to be the SA or SC because the others are in the Armed Forces.

Skip Instructions:

IF ALLFAM IN (2,RF,DK) AND PX_A 0 AND PCNTFX_SA_AfterREL PCNT {Not everyone in same family,
there's a SA, and not everyone's in SA's famly} [goto FAMINTRO_SA]
ELSEIF ALLFAM IN (2,RF,DK) {Not everyone in same family (and there's a SC)} [goto
procSetFX_RELATE_SA]
ELSE [goto procSetFAMILY_FLGs]

Question ID: FAM.0070.00.1
Variable: FAMINTRO_SA
Interview Module: Roster
Content Type: Annual Core
Question text:

^FAMINTRO_fill
I will now ask you some questions about how other people in this household are related to
^you_SA.

Fills:

^FAMINTRO_fill

Description: FAMINTRO_SA Introduction
Instruction:
If PCNTFAMAREL ge 2, fill "Based on questions I asked you earlier, we have that ^SAFAM are in the same family."
else leave fill empty.

^SAFAM

Description: List of people in SA's family
Instruction:
For all people with FAMA_REL_FLG =1 and are not Household Respondent, fill with their names.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.

^you_SA

Description: you/^ALIASNAME
Instruction:
If HHRESPAVAIL eq PX_A, fill "you" else fill "^ALIASNAME" of Sample Adult

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Enter 1 to Continue

Universe:

Not everyone in same family, there's a SA, and not everyone's in SA's family

Skip Instructions:

1 [goto tblRelate_SA.bPerson.RELATE for 1st non-deleted person on roster with FX_REL[PX] ne
FX_REL[PX_A]]

Question ID: FAM.0140.00.1
Variable: FAMINTRO_SC
Interview Module: Roster
Content Type: Annual Core
Question text:

I will now ask you some questions about who in this household is related to ^SCNAME.
Based on questions I asked you earlier, we have that ^SCNames_fill related to ^SCNAME.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^SCNames_fill

Description: List of people in Sample Child's family
Instruction:
For all people with FAMC_REL_FLG =1 OR (SAME_REL_FLG=1 for SC and tblRelate_SA.bPerson.RELATE in (1-13,DK,RF)) OR
(FAMA_REL_FLG=1 and 1st person in SC's family has
tblRelate_SA.bPerson.RELATE in (1-13,DK,RF), fill with
their names.
Description: Person was identified as being in the SC's
family at WHOPAR/WHOFOST OR (Sample Child is related to
the Sample Adult and person on roster was placed in Sample
Adult's family based on answer provided at RELATE),
include their name as part of the list of SC's family.
Do not include Sample Child on list.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
If only one person on the list of names and person ne
Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on
list and person is Household Respondent
(Roster.HHC.HHRESPAVAIL), follow list with "are".

Response:

1 - Enter 1 to Continue

Universe:

Not everyone in same family and there is a SC, and there is no SA and not everyone in SC's family or SA/SC in separate families and not everyone in SA or SC's families or SA/SC in same family and not everyone in that family

Skip Instructions:

1 [goto tblRelate_SC.bPerson.RELATE for 1st non-deleted person on roster with FX_RELATESA[PX]
ne FX_RELATESA[PX_A] and FX_RELATESA[PX] ne FX_RELATESA[PX_C]]

Question ID: FAM.0240.00.1
Variable: KNOWSC
Interview Module: Roster
Content Type: Annual Core
Question text:

Who lives here and is knowledgeable about and responsible for ^SCNAME's health care?
^ANYONEELSE
Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Universe:

There's a SC and either multiple eligible adults or only one eligible adult but that person is not a parent of the SC

Skip Instructions:

RF,DK [goto NOFAMSC]
1-25 IF Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and (PX_A ne
Roster.HHC.HHRESPAVAIL) [goto ONCAMPINTRO_A]
ELSE [goto CASESTATUS]

Question ID: FAM.0250.00.1
Variable: NOFAMSC
Interview Module: Roster
Content Type: Annual Core
Question text:

* Because there are no adults who are related to ^SCNAME living in this household, or respondent
refused or did not know who was knowledgeable about and responsible for ^SCNAME's health care,
the Sample Child Interview cannot be completed.
Not everyone in our survey is asked all questions. I have all the information that I need from
you about ^SCNAME.
* Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

No one is knowledgeable about and responsible for the sample child's health or don't know or refused to identify knowledgeable person

Skip Instructions:

1 if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and (PX_A ne
Roster.HHC.HHRESPAVAIL) [goto ONCAMPINTRO_A]
elseif PX_A > 0 {there is a Sample Adult} [goto CASESTATUS]
else [goto BCK.THANKS_SUF]

Question ID: FAM.0260.00.1
Variable: ONCAMPINTRO_A
Interview Module: Roster
Content Type: Annual Core
Question text:

As I previously mentioned ^SANAME was randomly selected to be asked a series of health related
questions. We would like to contact ^himherthem to complete ^hishertheir portion of this
interview.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

^himherthem

Description: him/her/them
Instruction:
If GEN.SEX_FINAL=1 fill "him"; else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "them"

^hishertheir

Description: his/her/their
Instruction:
If GEN.SEX_FINAL=1 fill "his"; else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their"

Response:

1 - Enter 1 to Continue

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not the Household Respondent

Skip Instructions:

1[goto TLNO_FAM_DRM]

Question ID: FAM.0280.00.1
Variable: ONCAMPLNAME
Interview Module: Roster
Content Type: Annual Core
Question text:

* Ask or verify: What is ^SANAME's last name?

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 20,RF,DK [goto ONCAMPADD1_A]

Question ID: FAM.0290.01.1
Variable: ONCAMPADD1_A
Interview Module: Roster
Content Type: Annual Core
Question text:

What is ^SANAME's exact mailing address on campus?
* Enter the house or building number, house or building number suffix and street name.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 54, empty [goto ONCAMPADD2_A]

Question ID: FAM.0290.02.1
Variable: ONCAMPADD2_A
Interview Module: Roster
Content Type: Annual Core
Question text:

* Enter the unit description.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 54, empty [goto ONCAMPPO_A]

Question ID: FAM.0290.03.1
Variable: ONCPUNTDES_A
Interview Module: Roster
Content Type: Annual Core
Question text:

Enter the correct unit designation or press "ENTER" if there is none.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 20, empty [goto ONCAMPPO_A]

Question ID: FAM.0290.04.1
Variable: ONCAMPPO_A
Interview Module: Roster
Content Type: Annual Core
Question text:

* Enter the city.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 28, empty [goto ONCAMPST_A]

Question ID: FAM.0290.05.1
Variable: ONCAMPST_A
Interview Module: Roster
Content Type: Annual Core
Question text:

* Enter the state.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

allow 2 [goto ONCAMPZIP5_A]

Question ID: FAM.0290.07.1
Variable: ONCAMPZIP5_A
Interview Module: Roster
Content Type: Annual Core
Question text:

* Enter the zip code.

Response:

01001-99995 - Range of values
99997 - Refused
99999 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

01001-99996, RF, DK, empty
if ONCAMPZIP5_A lt 5 characters [goto ERR1_ONCAMPZIP5_A]
elseif ONCAMPZIP5_A lt 01001 [goto ERR2_ONCAMPZIP5_A]
elseif (ONCAMPZIP5_A gt 99996 and SURVTYPE ne T) or (ONCAMPZIP5_A gt
99997 and SURVTYPE=T) [goto ERR3_ONCAMPZIP5_A]
else [goto ONCAMPZIP4_A]

Hard Edit:

Check Text: ERR1_ONCAMPZIP5_A
Check Description: ONCAMPZIP5_A must have a length of 5
Check Text: {check ERR1_ONCAMPZIP5_A}
The entire zip code must be entered. Please correct.
Check Text: ERR2_ONCAMPZIP5_A
Check Description: ONCAMPZIP5_A must be greater than or equal to 01001
Check Text: {check ERR2_ONCAMPZIP5_A}
A valid zip code must be entered. Please correct.
Check Text: ERR3_ONCAMPZIP5_A
Check Description: ONCAMPZIP5_A gt 99996/99997
Check Text: {check ERR3_ONCAMPZIP5_A} A valid zip code must be entered. Please correct.

Question ID: FAM.0290.08.1
Variable: ONCAMPZIP4_A
Interview Module: Roster
Content Type: Annual Core
Question text:

* Enter the zip 4.

Response:

0000-9996 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

0000-9997, RF, DK, empty
if ONCAMPZIP4_A lt 4 characters [goto ERR1_ONCAMPZIP4_A]
elseif (ONCAMPZIP4_A gt 9996 and SURVTYPE ne T) or (ONCAMPZIP4_A gt 9997 and SURVTYPE=T) [goto
ERR2_ONCAMPZIP4_A]
else [goto ONCAMPADDR_A]

Hard Edit:

Check Text: ERR2_ONCAMPZIP4_A
Check Description: ONCAMPZIP4_A gt 9996/9997
Check Text: {check ERR2_ONCAMPZIP4_A} A valid zip code must be entered. Please correct.
Check Text: ERR1_ONCAMPZIP4_A
Check Description: ONCAMPZIP4_A must have a length of 4
Check Text: {check ERR1_ONCAMPZIP4_A}
The entire zip code must be entered. Please correct.

Question ID: FAM.0300.00.1
Variable: ONCAMPADDR_A
Interview Module: Roster
Content Type: Annual Core
Question text:

Please confirm the following information about the Sample Adult living on campus:
Name: ^SANAME
Phone Number: ^ONCAMPPHONE_fill
Address:
^ONCAMPADD1_A_fill
^ONCAMPADD2_A_fill
^ONCAMPPO_A_fill, ^ONCAMPST_A_fill ^ONCAMPZIP5_A_fill - ^ONCAMPZIP4_A_fill

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

^ONCAMPPHONE_fill

Description: {Value of DISPLAYSTRING}
Instruction:
Fill the phone number associated with the on-campus SA from bContact.arrayPhones
[Roster.FAM.TLNO_FAM_DRM].DisplayString

^ONCAMPADD1_A_fill

Description: {Value of ONCAMPADD1_A}
Instruction:
Fill ONCAMPADD1_A_fill with value from ONCAMPADD1_A

^ONCAMPADD2_A_fill

Description: {Value of ONCAMPADD2_A}
Instruction:
Fill ONCAMPADD2_A_fill with value from ONCAMPADD2_A

^ONCAMPPO_A_fill

Description: {Value of ONCAMPPO_A}
Instruction:
Fill ONCAMPPO_A_fill with value from ONCAMPPO_A

^ONCAMPST_A_fill

Description: {Value of ONCAMPST_A}
Instruction:
Fill ONCAMPST_A_fill with value collected at ONCAMPST_A

^ONCAMPZIP5_A_fill

Description: {Value of ONCAMPZIP5_A}
Instruction:
Fill ONCAMPZIP5_A_fill with value collected at ONCAMPZIP5_A

^ONCAMPZIP4_A_fill

Description: {Value of ONCAMPZIP4_A}
Instruction:
Fill ONCAMPZIP4_A_fill will value collected at ONCAMPZIP4_A

Response:

1 - Enter 1 to Continue

Universe:

Sample Adult lives on campus or don't know or refuse and Sample Adult is not Household Respondent

Skip Instructions:

1 [goto CASESTATUS]

2020 National Health Interview Survey (NHIS) Questionnaire
VFY: Sample Adult Verification
Question ID: VFY.0010.00.1
Variable: CURRES_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Enter the line number of the person to whom you are speaking.

Response:

00 - Not on roster
01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused
99 - Don't Know

Universe:

The Sample Adult section has not been started or completed or has a Sample Adult callback setup

Skip Instructions:

1-25 [goto AVAIL_A]

Question ID: VFY.0050.00.1
Variable: PROXYLNO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Select the person in this household who is the proxy for ^SANAME.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

01 - ^ALIASNAME[1]
02 - ^ALIASNAME[2]
03 - ^ALIASNAME[3]
04 - ^ALIASNAME[4]
05 - ^ALIASNAME[5]
06 - ^ALIASNAME[6]
07 - ^ALIASNAME[7]
08 - ^ALIASNAME[8]
09 - ^ALIASNAME[9]
10 - ^ALIASNAME[10]
11 - ^ALIASNAME[11]
12 - ^ALIASNAME[12]
13 - ^ALIASNAME[13]
14 - ^ALIASNAME[14]
15 - ^ALIASNAME[15]
16 - ^ALIASNAME[16]
17 - ^ALIASNAME[17]
18 - ^ALIASNAME[18]
19 - ^ALIASNAME[19]
20 - ^ALIASNAME[20]
21 - ^ALIASNAME[21]
22 - ^ALIASNAME[22]
23 - ^ALIASNAME[23]
24 - ^ALIASNAME[24]
25 - ^ALIASNAME[25]
97 - Refused
99 - Don't Know

Universe:

Sample adult proxy is a relative or non relative who lives in the household

Skip Instructions:

1-25 if PROXYLNO_A ne CURRES_A [goto INTMODE_A]
elseif PROXYLNO_A=CURRES_A and Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and
HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]

Question ID: VFY.0060.00.1
Variable: PROXYCALL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Can a callback with someone knowledgeable about ^SANAME's health be arranged?

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Knowledgeable proxy is not available.

Skip Instructions:

1 [goto bCallback.CB_POSSIBLE], then
if there is a Sample child and they have not been interviewed [goto Child.VFY.CURRES_C]
else [goto BCK.THANKS_CB]
2 if there is a Sample child and they have not been interviewed [goto Child.VFY.CURRES_C]
elseif GEN.OUTCOME=203 [goto BCK.THANKS_SUF]
else [goto BCK.THANKS_INSUF]

Question ID: VFY.0070.00.1
Variable: INTMODE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* How are you contacting ^SARESP?

Fills:

^SARESP

Description: Sample Adult respondent's name
Instruction:
fill Sample Adult respondent's name

Response:

1 - Personal visit
2 - Telephone

Universe:

Sample Adults 18+ and Not initially speaking to the Sample Adult but now speaking to the Sample Adult OR Now speaking to a proxy respondent who is not on the roster or refused or don't know if on the roster OR Now speaking to a proxy respondent who is on the roster and who wasn't who you were initially speaking to

Skip Instructions:

1 if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and GEN.HHRESPSA_FLG ne 1 [goto
VFYONCAMP_A]
else[goto VFYALL_A]
2 [goto TINTRO_A]

Question ID: VFY.0080.00.1
Variable: TINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Hello, my name is (* say your name). I'm calling from the U.S. Census Bureau. We are conducting
the National Health Interview Survey on behalf of the National Center for Health Statistics,
part of the Centers for Disease Control and Prevention (CDC). This is a nationwide survey about
the health of both adults and children. I have some information from ^HHRESP. Now, I would like
to ask you some questions.
* Read if necessary: I believe I am calling you on a cell phone.
Before we continue, I have to ask: Are you currently driving a vehicle?
* Even if the respondent is using a hands-free device while driving, you must enter '1'.

Fills:

^HHRESP

Description: {Value of HHRESPAVAIL}
Instruction:
Display the name of the person selected at Roster.HHC.HHRESPAVAIL

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent

Skip Instructions:

1,RF,DK [goto ATTN_A]
2 [goto LETTER_A]

Question ID: VFY.0090.00.1
Variable: ATTN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

For your safety, we will call you back at another time.
* Enter 1 to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is driving

Skip Instructions:

1 [goto bCallback.CB_POSSIBLE]

Question ID: VFY.0100.00.1
Variable: LETTER_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* If sample adult is a new respondent read question below, otherwise enter 1
* Read if necessary: A letter describing the National Health Interview Survey was sent to your
home recently. Do you remember seeing the letter?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1,2,RF,DK [goto S_INTRO_A]

Question ID: VFY.0110.00.1
Variable: S_INTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
* If sample adult is a new respondent read question below, otherwise enter 1
* Read if necessary: There are a few things I need to cover before we continue. I'd like you to
know that taking part in this survey is voluntary. You may choose not to answer any questions
you don't wish to answer, or end the interview at any time without penalty. We are required by
Federal law to develop and follow strict procedures to protect the confidentiality of your
information and use your answers only for statistical research. I can describe these laws if you
wish. Except for the National Center for Health Statistics and Census Bureau employees and
specially designated agents, no one can see your answers until all information that could
identify you and/or your family has been removed. Only after that will your data be made
available to researchers. For most adults, the survey will take less than ^SATIME minutes. I'd
like to continue now unless you have any questions.
* If respondent asks for more information about the privacy laws, press F1.

Fills:

^SATIME

Description: 35/45
Instruction:
If GEN.CSTAT=1 and GEN.SAMEFAM_FLG=1, fill: 35 else, fill: 45

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1 if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and GEN.HHRESPSA_FLG ne 1 [goto
VFYONCAMP_A]
else [goto VFYALL_A]

Question ID: VFY.0120.00.1
Variable: VFYONCAMP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

I want to confirm some information.
Do you live in on-campus housing or off-campus housing?
Read if necessary: On-campus housing includes residence halls and dorms where students live
together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.

Response:

1 - On campus
2 - Off campus
7 - Refused
9 - Don't Know

Universe:

Sample Adults living in on-campus housing and the Sample Adult is not the household respondent

Skip Instructions:

1,RF,DK [goto VFYALL_A]
2 [goto NOMORE_A]

Question ID: VFY.0130.00.1
Variable: VFYALL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^Verifyintro
I have recorded ^yoursexis, you are ^AGE_A, ^NATORG_A, and ^RACE_A. Would you like to make any
changes to this ^additionalinfo_A?
^RACEVRBATvalue_A
* If respondent "refuses" or says "don't know", enter "2" for "no."

Fills:

^Verifyintro

Description: I want to confirm some information.
Instruction:
If VFYONCAMP_A=empty "I want to confirm some information." else fill nothing

^yoursexis

Description: your sex is male/your sex is female/you do not know you sex/you do not wish to provide your sex/your sex was not
Instruction:
Instruction If GEN.SEX_FINAL=1 fill "your sex is male"
If GEN.SEX_FINAL=2 fill "your sex is female"
If GEN.SEX_FINAL=DK and GEN.HHRESPSA_FLG=1 fill "you do
not know your sex"
If GEN.SEX_FINAL=RF and GEN.HHRESPSA_FLG=1 fill "you do
not wish to provide your sex"
If GEN.SEX_FINAL IN (DK,RF) and GEN.HHRESPSA_FLG ne 1 fill
"your sex was not provided"

^AGE_A

Description: {Value of AGE}/65 or older/between 18 and 64/18 and older
Instruction:
if GEN.AGE_FINAL ne RF, DK fill with age elseif GEN.AGE_FINAL IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2 fill "65 or
older"
elseif GEN.AGE_FINAL in (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=1 fill "between 18
and 64"
elseif GEN.AGE_FINAL IN (RF, DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (RF,DK,empty)
fill "18 and older"

^NATORG_A

Description: Verify Hispanic or Latino origin
Instruction:
If GEN.NATO_FINAL=1 fill: "you are of Hispanic or Latino origin"
If GEN.NATO_FINAL=2 fill: "you are not of Hispanic or
Latino origin"
If GEN.NATO_FINAL=DK and GEN.HHRESPSA_FLG=1 fill: "you do
not know if you are of Hispanic or Latino origin"
If GEN.NATO_FINAL=RF and GEN.HHRESPSA_FLG=1 fill: "you do
not wish to provide information about your Hispanic or
Latino origin"
If GEN.NATO_FINAL IN (DK,RF) and GEN.HHRESPSA_FLG ne 1
fill "information about your Hispanic or Latino origin was
not provided"

^RACE_A

Description: you are ^RACEFILLAND_A/you do not know your race/you d not wish to provide your race/your race was not provided
Instruction:
Instruction If race or races IN GEN.RACE_FINAL[PX_A].RACE_FINAL fill:
"you are ^RACEFILLAND_A."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=DK and
GEN.HHRESPSA_FLG=1 fill "you do not know your race."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=RF and
GEN.HHRESPSA_FLG=1 fill: "you do not wish to provide your
race."
If GEN.RACE_FINAL[PX_A].RACE_FINAL IN (DK,RF) and
GEN.HHRESPSA_FLG ne 1 fill "your race was not provided."

^RACEFILLAND_A

Description: Categories selected at the RACE screen
Instruction:
Fill categories stored in GEN.RACE_FINAL[PX_A].RACE_FINAL. If more than two categories separate the categories with
commas. Add the word "and" before the last category.
When GEN.RACE_FINAL[PX_A].RACE_FINAL=8,
if GEN.RACE_FINAL[PX_A].RACE_SP_FINAL not in (ZZ,RF,DK)
display picklist selection from
GEN.RACE_FINAL[PX_A].RACE_SP_FINAL
elseif GEN.HHRESPSA_FLG=1 and GEN.RACE_FINAL
[PX_A].RACE_VERBAT_FINAL not in (empty,DK,RF) display
GEN.RACE_FINAL[PX_A].RACE_VERBAT_FINAL
else display "some other race"

^additionalinfo_A

Description: if any information is missing "or provide additional information about"
Instruction:
See attachment for fill instructions

^RACEVRBATvalue_A

Description: Information collected at RACEVRBAT for Sample adult
Instruction:
IF GEN.HHRESPSA_FLG ne 1 and GEN.RACE_FINAL [PX_A].RACE_VRBAT_FINAL ne (empty,RF,DK), fill " If
respondent wants information on which other race they are
listed as, say ^RACE_VRBAT."

^RACE_VRBAT

Description: {Value of RACE_VRBAT_FINAL}
Instruction:
fill with value from GEN.RACE_FINAL[PX].RACE_VRBAT_FINAL

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+ and the Sample Adult or a proxy is available to continue the interview and the Sample Adult is not identified as away at college and living in off-campus housing

Skip Instructions:

1 [goto VFYDEM_A]
2 if GEN.SEX_FINAL IN (RF,DK) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0140.00.1
Variable: VFYDEM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: What should I change?
* Enter all that apply, separate with commas.

Response:

1 - Sex
2 - Age
3 - Hispanic or Latino Origin
4 - Race
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ would like to change demographic information

Skip Instructions:

if 1 IN VFYDEM_A [goto NEWSEX_A]
elseif (2,3,4) IN VFYDEM_A and GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto SEXGUESS_A]
elseif 2 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK)[goto NEWAGE_A]
elseif 3 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK) [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK) [goto NEWRACE_A]
RF,DK If GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0150.00.1
Variable: NEWSEX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you male or female?

Response:

1 - Male
2 - Female
7 - Refused
9 - Don't Know

Universe:

Respondent said his/her sex is not correct

Skip Instructions:

if GEN.SEX_FINAL[PX_A]=RF,DK and NEWSEX_A=RF,DK [goto SEXGUESS_A]
elseif 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0160.00.1
Variable: SEXGUESS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Enter your best guess of ^SANAME's sex.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

1 - Male
2 - Female

Universe:

Sample adults for whom there is no sex provided by the household respondent and did not give a sex when asked to verify information

Skip Instructions:

1,2
if 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0170.00.1
Variable: NEWAGE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How old are you?
* Enter age.

Response:

000-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adult 18+ said his/her age is not correct

Skip Instructions:

0-120, RF, DK if 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0190.00.1
Variable: NEWNATORG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you consider yourself to be Hispanic or Latino?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adult 18+ said his/her Hispanic Origin is not correct

Skip Instructions:

1,2,RF,DK if 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bpersonRACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0200.00.1
Variable: NEWRACE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What race or races do you consider yourself to be? Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific
Islander, Asian, or some other race?
Enter all that apply, separate with commas.

Response:

01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+ said his/her race is not correct

Skip Instructions:

1-8,RF,DK if GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0210.00.1
Variable: HISPTYPE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What is your Hispanic or Latino ancestry or origin, such as Mexican, Mexican American,
^CHICANOA, Central or South American, Puerto Rican, Cuban, Dominican (Republic), or Other
Hispanic, ^LATINOA, or Spanish -- and if you have more than one, tell me all of them.
* Enter all that apply, separate with commas.

Fills:

^CHICANOA

Description: Chicano/Chicano or Chicana
Instruction:
If SEX_FINAL = 1 fill: "Chicano" if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"

^LATINOA

Description: Latino/Latino or Latina
Instruction:
If SEX_FINAL= 1 fill: "Latino" if SEX_FINAL = 2,DK,RF fill "Latino or Latina"

Response:

01 - Mexican, Mexcian American, or Chicano(a)
02 - Central American
03 - South American
04 - Puerto Rican
05 - Cuban
06 - Dominican (Republic)
07 - Other Hispanic, Latino(a), or Spanish (specifiy)
97 - Refused
99 - Don't Know

Universe:

Respondent is of Hispanic Origin

Skip Instructions:

7 [goto HISPOTHER_A]
1-6,RF,DK
if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0220.00.1
Variable: HISPOTHER_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
What is your Hispanic or Latino ancestry or origin? If you have more than one, tell me all of
them.
* Start typing and then select from list. If Hispanic or Latino ancestry is not on the list,
type "ZZ" and enter verbatim.
* If any of the following are mentioned, backup to previous screen and correct the entry.
Mexican
Mexican American
Chicano/Chicana
Central American (REFER TO HELP SCREEN)
South American (REFER TO HELP SCREEN)
Puerto Rican (Boricua)
Cuban/Cuban American
Dominican (Republic)
* If respondent provides more than one other Hispanic or Latino ancestry or origin, select 'ZZ'
from the lookup table. At the next question, enter ALL the other Hispanic or Latino ancestries
or origins in the verbatim field.

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Respondent is of Other Hispanic Origin

Skip Instructions:

ZZ [goto HISPVRBAT_A]
lookup table selection,RF,DK if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0230.00.1
Variable: HISPVRBAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: What is your Hispanic or Latino ancestry or origin? If you have more than
one, tell me all of them.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+ who report some other Hispanic Ancestry and this is not choosen from the picklist

Skip Instructions:

allow 80,RF,DK if GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A].RACE_FINAL in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0240.00.1
Variable: PITYPE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

I have recorded that you are Pacific Islander. What specific ethnic group or groups are you--
such as Guamanian or Chamorro, Samoan, or other Pacific Islander? If you are more than one, tell
me all of them.
* Enter all that apply, separate with commas.

Response:

1 - Guamanian or Chamorro
2 - Samoan
3 - Other Pacific Islander
7 - Refused
9 - Don't Know

Universe:

Respondent identifies race as Pacific Islander

Skip Instructions:

3 [goto PIOTHER_A]
1,2,RF,DK if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0250.00.1
Variable: PIOTHER_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic group
or groups are you? If you are more than one, tell me all of them.
* Start typing and then select from list. If Pacific Islander ethnic group is not on the list,
type "ZZ" and enter verbatim.
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+ who identifies as Other Pacific Islander

Skip Instructions:

ZZ [goto PIVRBAT_A]
picklist selection, RF, DK
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0260.00.1
Variable: PIVRBAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic group or
groups are you? If you are more than one, tell me all of them.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+ who report some other group of Pacific Islander not on the picklist

Skip Instructions:

allow 80,RF,DK
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0270.00.1
Variable: ASIANTYPE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

I have recorded that you are Asian. What specific ethnic group or groups are you-- such as Asian
Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian? If you are more than
one, tell me all of them.
* Enter all that apply, separate with commas.

Response:

01 - Asian Indian
02 - Chinese
03 - Filipino
04 - Japanese
05 - Korean
06 - Vietnamese
07 - Other Asian
97 - Refused
99 - Don't Know

Universe:

Sample Adult identifies race as Asian

Skip Instructions:

7 [goto ASIANOTHER_A]
1-6,RF,DK
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK)))[goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0280.00.1
Variable: ASIANOTHER_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What is your specific Asian ethnic group or groups? If you have more than one, tell me all of
them.
Start typing and then select from list. If Asian ethnic group is not on the list, type "ZZ" and
enter verbatim.
* If any of the following are mentioned, backup to previous screen and correct the entry.
(Asian) Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Respondent identifies as other Asian

Skip Instructions:

allow 80,RF,DK (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0290.00.1
Variable: ASIANVRBAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Read if necessary: What is your specific Asian ethnic group or groups? If you have more than
one, tell me all of them.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+ who report some other ethnic group of Asian that is not on the picklist

Skip Instructions:

allow 80,RF,DK
if (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne 1 and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]

Question ID: VFY.0300.00.1
Variable: RACEOTHER_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What other race or races do you consider yourself to be?
Start typing and then select from list. If race is not on the list, type "ZZ" and enter
verbatim.
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the
next question, enter ALL the other races in the verbatim field.

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ and race was changed to "some other race" in verification section or where the Sample Adult respondent is not the Household respondent and did not report a new race and were identified by the household respondent as being "some other race" not on the roster other race picklist

Skip Instructions:

ZZ [goto RACEVRBAT]
picklist selection,RF,DK [goto BMONTH_A]

Question ID: VFY.0310.00.1
Variable: RACEVRBAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Read if necessary: What other race or races do you consider yourself to be?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample adults 18+ who are some other race and this is not selected from Sample adult picklist

Skip Instructions:

verbatim,RF,DK [goto BMONTH_A]

Question ID: VFY.0340.01.1
Variable: BMONTH_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* 1 of 3
What is your date of birth?
Please give month, day, and year for the date of birth.
* Enter month of birth.

Response:

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

Universe:

Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times

Skip Instructions:

1-12,RF,DK [goto BDAY_A]

Question ID: VFY.0340.02.1
Variable: BDAY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* 2 of 3
* Enter day of birth.

Response:

01-31 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times

Skip Instructions:

1-31,RF,DK Only allow valid days for month entered. if days not valid [goto ERR_BDAY_A]
else [goto BYEAR_A]

Hard Edit:

Check Text: ERR_BDAY_A
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAY_A}
^BDAY_A is not a valid day for ^BMONTH_A.

Question ID: VFY.0340.03.1
Variable: BYEAR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* 3 of 3
* Enter year of birth.
* If year of birth is before 1900, enter 1900.

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample adults 18+ and someone is available to continue the interview and date of birth was verified as incorrect fewer than 2 times

Skip Instructions:

1900-current year,RF,DK
if (BYEAR_A gt current year) or (BYEAR_A=current year and BMONTH_A gt current month) or
(BYEAR_A=current year and BMONTH_A=current month and BDAY_A gt current day) [goto ERR_BYEAR_A]
elseif BDAY_A=29 and BMONTH_A=2 and (BYEAR=2000 or BYEAR_A/4 remainder ne 0) [goto
ERR_BDAYLEAP_A]
elseif GEN.AGE_FINAL IN (RF,DK) [goto AGEGUESS_A]
elseif ((BYEAR_A not IN (RF,DK) and AGETEMP_A not IN (RF,DK) and AGETEMP_A ne AGE_CALC_A) AND
(AGETEMP_A not IN (RF,DK) and AGETEMP_A ne AGE_CALCMINUS1_A)) and DOB_COUNT_A ne 1 [goto
VFYDOB_A]
elseif (AGETEMP_A eq (AGE_CALC_A or AGE_CALCMINUS1_A)) or DOB_COUNT_A=1
if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]

Hard Edit:

Check Text: ERR_BDAYLEAP_A
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAYLEAP_A}
^BDAY_A is not a valid day for ^BMONTH_A.
Check Text: ERR_BYEAR_A
Check Description: Future date hard edit
Check Text: {check ERR_BYEAR_A}Future date invalid

Question ID: VFY.0370.00.1
Variable: AGEGUESS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* An age has not been collected and we are unable to determine an age based upon the date of
birth.
What is your best guess at ^ALIASNAME's age?

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

018-120 - Range of values

Universe:

Sample Adult's age is don't know or refused

Skip Instructions:

18-120 [goto next section]

Question ID: VFY.0380.00.1
Variable: VFYDOB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

There is a difference between the age the computer calculated from your date of birth of
^AGEDOB_A_fill and the age I had previously recorded of ^TEMPAGE_A.
I recorded your ^dateofbirth

Fills:

^AGEDOB_A_fill

Description: Age(s) calculated from Date of Birth for SA
Instruction:
Fill one age calculated from AGE_CALC_A as "(age)" Fill two ages calculated from AGE_CALC_A and
AGE_CALCMINUS1_A as "(age) or (age)"

^TEMPAGE_A

Description: {Value of AGETEMP_A}
Instruction:
fill value of AGETEMP_A

^dateofbirth

Description: date of birth when any of BDAY_A, BMONTH_A or BYEAR_A are not valid
Instruction:
If BDAY_A, BMONTH,A and BYEAR_A are all valid, fill: "date of birth as ^BMONTH_A ^BDAY_A, ^BYEAR_A, is that correct?"
If only BMONTH_A and BYEAR_A are valid, fill: "date of
birth as ^BMONTH_A ^BYEAR_A, is that correct?"
If only BDAY_A and BYEAR_A are valid, fill: "year of birth
as ^BYEAR_A, is that correct?"
If only BYEAR_A is valid, fill: "year of birth as
^BYEAR_A, is that correct?"

^BMONTH_A

Description: {Value of BMONTH_A}
Instruction:
Fill value from BMONTH_A

^BDAY_A

Description: {Value of BDAY_A}
Instruction:
Fill value from BDAY_A

^BYEAR_A

Description: {Value of BYEAR_A}
Instruction:
Fill with value in BYEAR_A

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults whose age provided in either HHC or NEWAGE_A does not match either age calculated from date of birth information.

Skip Instructions:

1,RF,DK if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
2 if DOB_COUNT_A le 1 [goto BMONTH_A]
else if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]

Question ID: VFY.0390.00.1
Variable: NOMORE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* ^SANAME is no longer the sample adult for this family. End this interview and begin the Sample
Child Interview. If there is no Sample Child or the Sample Child interview has been completed,
EXIT
Not everyone in our survey is asked all questions. I have all the information that I need about
you at this time.
* Enter '1' to Continue.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

1 - Enter 1 to Continue

Universe:

Sample adult whose age is now less than 18 or lives off campus

Skip Instructions:

1 if there is a Sample Child that has not been interviewed [goto Child.VFY.CURRES_C]
else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

2020 National Health Interview Survey (NHIS) Questionnaire
HIS: Health Status
Question ID: HIS.0010.00.1
Variable: PHSTAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Would you say your health in general is excellent, very good, good, fair, or poor?

Response:

1 - Excellent
2 - Very Good
3 - Good
4 - Fair
5 - Poor
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
HYP: Hypertension
Question ID: HYP.0010.00.1
Variable: HYPINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Now I am going to ask you about certain medical conditions.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto HYPEV_A]

Question ID: HYP.0020.00.1
Variable: HYPEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER been told by a doctor or other health professional that you had
...Hypertension, also called high blood pressure?
* Enter '1' if respondent is taking medication to control his/her high blood pressure.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto HYPDIF_A]
2,RF,DK [goto next section]

Question ID: HYP.0030.00.1
Variable: HYPDIF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Were you told on two or more DIFFERENT visits that you had hypertension or high blood pressure?
* Enter '1' if respondent is taking medication to control his/her high blood pressure.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had hypertension

Skip Instructions:

1 [goto HYP12M_A]
2,RF,DK [goto HYPMED_A]

Question ID: HYP.0040.00.1
Variable: HYP12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you had hypertension or high blood pressure?
* Enter '1' if respondent is taking medication to control his/her high blood pressure.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had hypertension (2+ visits)

Skip Instructions:

1,2,RF,DK [goto HYPMED_A]

Question ID: HYP.0050.00.1
Variable: HYPMED_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you NOW taking any medication prescribed by a doctor for your high blood pressure?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they have hypertension

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CHL: Cholesterol
Question ID: CHL.0010.00.1
Variable: CHLEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER been told by a doctor or other health professional that you had high cholesterol?
* Enter '1' if respondent is taking medication to control his/her high cholesterol.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto CHL12M_A]
2,RF,DK [goto next section]

Question ID: CHL.0020.00.1
Variable: CHL12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you had high cholesterol?
* Enter '1' if respondent is taking medication to control his/her high cholesterol.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had high cholesterol

Skip Instructions:

1,2,RF,DK [goto CHLMED_A]

Question ID: CHL.0030.00.1
Variable: CHLMED_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you NOW taking any medication prescribed by a doctor to help lower your cholesterol?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had high cholesterol

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CVC: Cardiovascular Conditions
Question ID: CVC.0010.00.1
Variable: CHDEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER been told by a doctor or other health professional that you had
...Coronary heart disease?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto ANGEV_A]

Question ID: CVC.0020.00.1
Variable: ANGEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Angina, also called angina pectoris?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto MIEV_A]

Question ID: CVC.0030.00.1
Variable: MIEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...A heart attack, also called myocardial infarction?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto STREV_A]

Question ID: CVC.0040.00.1
Variable: STREV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...A stroke?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
AST: Asthma
Question ID: AST.0010.00.1
Variable: ASEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER been told by a doctor or other health professional that you had asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto ASTILL_A]
2,RF,DK [goto next section]

Question ID: AST.0020.00.1
Variable: ASTILL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you still have asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they have asthma

Skip Instructions:

1,2,RF,DK [goto ASAT12M_A]

Question ID: AST.0030.00.1
Variable: ASAT12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you had an episode of asthma or an asthma attack?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had asthma

Skip Instructions:

1,2,RF,DK [goto ASER12M_A]

Question ID: AST.0040.00.1
Variable: ASER12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you had to visit an emergency room or urgent care center because
of asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had asthma

Skip Instructions:

1,2,RF,DK if ASTILL_A=1 or ASAT12M_A=1 [goto ASHOSP12M_A]
else [goto next section]

Question ID: AST.0050.00.3
Variable: ASHOSP12M_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, have you stayed overnight in a hospital because of your asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1,2,RF,DK [goto ASDAYS12M_A]

Question ID: AST.0060.00.3
Variable: ASDAYS12M_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, how many days were you UNABLE to work or get work done around the
house because of your asthma?

Response:

000-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

0-99,RF,DK [goto ASINHALE3M_A]
100-365 [goto ERR_ASDAYS12M_A], then [goto ASINHALE3M]

Soft Edit:

Check Text: ERR_ASDAYS12M_A
Check Description: Days of work missed in the past 12 months unusually high
Check Text: {signal ERR_ASDAYS12M_A}
^ASDAYS12M_A days is unusually high. Please verify. Make corrections if necessary.

Question ID: AST.0070.00.3
Variable: ASINHALE3M_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 3 months, have you used the kind of PRESCRIPTION asthma inhaler that gives QUICK
relief from asthma symptoms during an attack?
* Read if necessary: Include only medication prescribed by a doctor or health professional.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1,2,RF,DK [goto ASPREVR_A]

Question ID: AST.0080.00.3
Variable: ASPREVR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Are you NOW taking a preventive asthma medication every day, most days, some days, or never?

Response:

1 - Every day
2 - Most days
3 - Some days
4 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1-4,RF,DK [goto ASJOB_A]

Question ID: AST.0090.00.3
Variable: ASJOB_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Have you ever been TOLD BY a doctor or other health professional that your asthma was caused by,
or your symptoms were made worse by, any job you ever had?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CAN: Cancer
Question ID: CAN.0010.00.1
Variable: CANEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER been told by a doctor or other health professional that you had
...Cancer or a malignancy of any kind?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto CANKIND1_A]
2,RF,DK [goto next section]

Question ID: CAN.0020.00.1
Variable: CANKIND1_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What kind of cancer was it?
* Enter code for the first kind of cancer.

Response:

01 - Bladder
02 - Blood
03 - Bone
04 - Brain
05 - Breast
06 - Cervix/Cervical
07 - Colon
08 - Esophagus/Esophageal
09 - Gallbladder
10 - Kidney
11 - Larynx-trachea
12 - Leukemia
13 - Liver
14 - Lung
15 - Lymphoma
16 - Melanoma
17 - Mouth/tongue/lip
18 - Ovary/Ovarian
19 - Pancreas/Pancreatic
20 - Prostate
21 - Rectum/Rectal
22 - Skin (melanoma)
23 - Skin (non-melanoma)
24 - Skin (don't know kind)
25 - Stomach
26 - Testis/Testicular
27 - Throat - pharynx
28 - Thyroid
29 - Uterus/Uterine
30 - Other
97 - Refused
99 - Don't Know
-

Universe:

Sample Adults 18+ who were ever told they had cancer

Skip Instructions:

If GEN.SEX_FINAL[PX_A]=1 and CANKIND1_A IN (6,18,29) [goto ERR1_CANKIND_A]
elseif GEN.SEX_FINAL[PX_A]=2 and CANKIND1_A IN (20,26) [goto ERR2_CANKIND_A]
1-30,RF,DK [goto CANAGE1_A]

Soft Edit:

Check Text: ERR2_CANKIND_A
Check Description: CANKIND_A female soft edit
Check Text: {signal ERR2_CANKIND_A} Verify. Code 20 or 26 is unavailable for females.
Check Text: ERR1_CANKIND_A
Check Description: CANKIND_A male soft edit
Check Text: {signal ERR1_CANKIND_A} Verify. Code 6 or 18 or 29 is unavailable for males.

Question ID: CAN.0030.00.1
Variable: CANAGE1_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND1?
* Enter 1 if reported age is 1 or younger.

Fills:

^CANKIND1

Description: {Value of CANKIND1_A}
Instruction:
If CANKIND1_A = RF,DK fill "this cancer"; else fill "bladder cancer" if CANKIND1_A = 1;
else fill "blood cancer" if CANKIND1_A = 2;
else fill "bone cancer" if CANKIND1_A = 3;
else fill "brain cancer" if CANKIND1_A = 4;
else fill "breast cancer" if CANKIND1_A = 5;
else fill "cervical cancer" if CANKIND1_A = 6;
else fill "colon cancer" if CANKIND1_A = 7;
else fill "esophageal cancer" if CANKIND1_A = 8;
else fill "gallbladder cancer" if CANKIND1_A = 9;
else fill "kidney cancer" if CANKIND1_A = 10;
else fill "larynx-trachea cancer" if CANKIND1_A = 11;
else fill "leukemia" if CANKIND1_A = 12;
else fill "liver cancer" if CANKIND1_A = 13;
else fill "lung cancer" if CANKIND1_A = 14;
else fill "lymphoma" if CANKIND1_A = 15;
else fill "melanoma" if CANKIND1_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND1_A = 17;
else fill "ovarian cancer" if CANKIND1_A = 18;
else fill "pancreatic cancer" if CANKIND1_A = 19;
else fill "prostate cancer" if CANKIND1_A = 20;
else fill "rectal cancer" if CANKIND1_A = 21;
else fill "skin (melanoma) cancer" if CANKIND1_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND1_A = 23;
else fill "skin (don't know kind) cancer" if CANKIND1_A =
24;
else fill "stomach cancer" if CANKIND1_A = 25;
else fill "testicular cancer" if CANKIND1_A = 26;
else fill "throat/pharynx cancer" if CANKIND1_A = 27;
else fill "thyroid cancer" if CANKIND1_A = 28;
else fill "uterine cancer" if CANKIND1_A = 29;
else fill "other cancer" if CANKIND1_A = 30

Response:

001-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who were ever told they had cancer

Skip Instructions:

1-120,DK [goto CANKIND2_A]
RF if CANKIND1_A=RF [goto next section] else [goto CANKIND2_A]
If number in CANAGE1_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE1_A]

Hard Edit:

Check Text: ERR_CANAGE1_A
Check Description: CANAGE1_A years with cancer greater than age hard edit
Check Text: {check ERR_CANAGE1_A}
^CANAGE1_A years old is older than age ^SA_AGE. Please correct.

Question ID: CAN.0040.00.1
Variable: CANKIND2_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER had any other kinds of cancer?
* If yes, ask respondent for second kind of cancer, enter code.
* If no, enter '96' for no more.

Response:

Universe:

Sample Adults 18+ who were ever told they had cancer and mentioned or didn't know a first type of cancer OR gave a valid age or did not know age for first cancer

Skip Instructions:

If GEN.SEX_FINAL[PX_A]=1 and CANKIND2_A IN (6,18,29) [goto ERR1_CANKIND_A]
elseif GEN.SEX_FINAL[PX_A]=2 and CANKIND2_A IN (20,26) [goto ERR2_CANKIND_A]
1-30,RF,DK [goto CANAGE2_A]
96 [goto next section]

Question ID: CAN.0050.00.1
Variable: CANAGE2_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND2?
* Enter 1 if reported age is 1 or younger.

Fills:

^CANKIND2

Description: {Value of CANKIND2_A}
Instruction:
If CANKIND2_A = R,D fill "this cancer"; else fill "bladder cancer" if CANKIND2_A = 1;
else fill "blood cancer" if CANKIND2_A = 2;
else fill "bone cancer" if CANKIND2_A = 3;
else fill "brain cancer" if CANKIND2_A = 4;
else fill "breast cancer" if CANKIND2_A = 5;
else fill "cervical cancer" if CANKIND2_A = 6;
else fill "colon cancer" if CANKIND2_A = 7;
else fill "esophageal cancer" if CANKIND2_A = 8;
else fill "gallbladder cancer" if CANKIND2_A = 9;
else fill "kidney cancer" if CANKIND2_A = 10;
else fill "larynx-trachea cancer" if CANKIND2_A = 11;
else fill "leukemia" if CANKIND2_A = 12;
else fill "liver cancer" if CANKIND2_A = 13;
else fill "lung cancer" if CANKIND2_A = 14;
else fill "lymphoma" if CANKIND2_A = 15;
else fill "melanoma" if CANKIND2_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND2_A = 17;
else fill "ovarian cancer" if CANKIND2_A = 18;
else fill "pancreatic cancer" if CANKIND2_A = 19;
else fill "prostate cancer" if CANKIND2_A = 20;
else fill "rectal cancer" if CANKIND2_A = 21;
else fill "skin (melanoma) cancer" if CANKIND2_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND2_A = 23;
else fill "skin (don't know kind) cancer" if CANKIND2_A =
24;
else fill "stomach cancer" if CANKIND2_A = 25;
else fill "testicular cancer" if CANKIND2_A = 26;
else fill "throat/pharynx cancer" if CANKIND2_A = 27;
else fill "thyroid cancer" if CANKIND2_A = 28;
else fill "uterine cancer" if CANKIND2_A = 29;
else fill "other cancer" if CANKIND2_A = 30

Response:

001-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who selected a second kind of cancer or don't know the second kind of cancer or refused the second kind of cancer

Skip Instructions:

1-120,DK [goto CANKIND3_A]
RF if CANKIND2_A=RF [goto next section] else [goto CANKIND3_A]
If CANAGE2_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE2_A]

Hard Edit:

Check Text: ERR_CANAGE2_A
Check Description: CANAGE2_A age greater than years with cancer hard edit
Check Text: {check ERR_CANAGE2_A}
^CANAGE2_A years old is older than age ^SA_AGE. Please correct.

Question ID: CAN.0060.00.1
Variable: CANKIND3_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER had any other kinds of cancer?
* If yes, ask respondent for third kind of cancer, enter code.
* If no, enter '96' for no more.

Response:

Universe:

Sample Adults 18+ who selected a second kind of cancer or don't know the second kind of cancer or gave a valid age for second cancer or did not know age for second cancer

Skip Instructions:

If GEN.SEX_FINAL=1 and CANKIND3_A IN (6,18,29) [goto ERR1_CANKIND_A]
elseif GEN.SEX_FINAL=2 and CANKIND3_A IN (20,26) [goto ERR2_CANKIND_A]
1-30,RF,DK[goto CANAGE3_A]
96 [goto next section]

Question ID: CAN.0070.00.1
Variable: CANAGE3_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How old were you when a doctor or other health professional first told you that you had
^CANKIND3?
* Enter 1 if reported age is 1 or younger.

Fills:

^CANKIND3

Description: {Value of CANKIND3_A}
Instruction:
If CANKIND3_A = R,D fill "this cancer"; else fill "bladder cancer" if CANKIND3_A = 1;
else fill "blood cancer" if CANKIND3_A = 2;
else fill "bone cancer" if CANKIND3_A = 3;
else fill "brain cancer" if CANKIND3_A = 4;
else fill "breast cancer" if CANKIND3_A = 5;
else fill "cervical cancer" if CANKIND3_A = 6;
else fill "colon cancer" if CANKIND3_A = 7;
else fill "esophageal cancer" if CANKIND3_A = 8;
else fill "gallbladder cancer" if CANKIND3_A = 9;
else fill "kidney cancer" if CANKIND3_A = 10;
else fill "larynx-trachea cancer" if CANKIND3_A = 11;
else fill "leukemia" if CANKIND3_A = 12;
else fill "liver cancer" if CANKIND3_A = 13;
else fill "lung cancer" if CANKIND3_A = 14;
else fill "lymphoma" if CANKIND3_A = 15;
else fill "melanoma" if CANKIND3_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND3_A = 17;
else fill "ovarian cancer" if CANKIND3_A = 18;
else fill "pancreatic cancer" if CANKIND3_A = 19;
else fill "prostate cancer" if CANKIND3_A = 20;
else fill "rectal cancer" if CANKIND3_A = 21;
else fill "skin (melanoma) cancer" if CANKIND3_A = 22;
else fill "skin (non-melanoma) cancer" if CANKIND3_A = 23;
else fill "skin (don't know kind) cancer" if CANKIND3_A =
24;
else fill "stomach cancer" if CANKIND3_A = 25;
else fill "testicular cancer" if CANKIND3_A = 26;
else fill "throat/pharynx cancer" if CANKIND3_A = 27;
else fill "thyroid cancer" if CANKIND3_A = 28;
else fill "uterine cancer" if CANKIND3_A = 29;
else fill "other cancer" if CANKIND3_A = 30

Response:

001-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who selected a third kind of cancer or don't know or refused the third kind of cancer

Skip Instructions:

1-120,DK [goto CANMORE_A]
RF if CANKIND3_A=RF [goto next section] else [goto CANMORE_A]
if CANAGE3_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE3_A]

Hard Edit:

Check Text: ERR_CANAGE3_A
Check Description: CANAGE3_A age with cancer greater than age
Check Text: {check ERR_CANAGE3_A}
^CANAGE3_A years old is older than age ^SA_AGE. Please correct.

Question ID: CAN.0080.00.1
Variable: CANMORE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Did you have any other kinds of cancer?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who selected a third kind of cancer or don't know the third kind of cancer or selected a valid age for third type of cancer or did not know age for third type of cancer

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DIB: Diabetes
Question ID: DIB.0010.00.1
Variable: PREDIB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Has a doctor or other health professional EVER told you that you had prediabetes or borderline
diabetes?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK If GEN.SEX_FINAL[PX_A]=2 [goto GESDIB_A]
elseif GEN.SEX_FINAL[PX_A]=1,RF,DK [goto DIBEV_A]

Question ID: DIB.0020.00.1
Variable: GESDIB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Has a doctor or other health professional EVER told you that you had gestational diabetes, a
type of diabetes that occurs ONLY during pregnancy?
* Read if necessary: Gestational diabetes is diabetes that you did not have prior to being
pregnant and goes away after you are pregnant. Pregnant women are usually screened for
gestational diabetes during the 24th to 28th week of pregnancy.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Female Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto DIBEV_A]

Question ID: DIB.0030.00.1
Variable: DIBEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^NOTPREGDM a doctor or other health professional EVER told you that you had
diabetes?

Fills:

^NOTPREGDM

Description: Has/Not including (gestational diabetes, prediabetes)
Instruction:
If GESDIB_A ne 1 AND PREDIB_A ne 1: "Has" If GESDIB_A=1 AND PREDIB_A ne 1: "Not including
gestational diabetes, has"
If PREDIB_A=1 AND GESDIB_A ne 1: "Not including
prediabetes, has"
If GESDIB_A=1 AND PREDIB_A=1: "Not including prediabetes
or gestational diabetes, has"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto DIBAGE_A]
2,RF,DK if PREDIB_A=1 [goto DIBPILL_A]
else if PREDIB_A=2,RF,DK [goto DIBREL_A]

Question ID: DIB.0040.00.1
Variable: DIBAGE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How old were you when a doctor or other health professional FIRST told you that you had
diabetes^NOTPREGDM2?
* Enter '1' if reported age is 1 or younger.

Fills:

^NOTPREGDM2

Description: not including (gestational diabetes, prediabetes)
Instruction:
If GESDIB_A ne 1 AND PREDIB_A ne 1: NO FILL If GESDIB_A=1 AND PREDIB_A ne 1: ", not including
gestational diabetes"
If PREDIB_A=1 AND GESDIB_A ne 1: ", not including
prediabetes"
If GESDIB_A=1 AND PREDIB_A=1: ", not including prediabetes
or gestational diabetes"

Response:

001-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who were told they had diabetes

Skip Instructions:

1-120 if DIBAGE_A gt GEN.AGE_FINAL [goto ERR_DIBAGE_A]
else [goto DIBPILL_A]

Hard Edit:

Check Text: ERR_DIBAGE_A
Check Description: DIBAGE_A age greater than SA age hard edit
Check Text: {check ERR_DIBAGE_A}
^DIBAGE_A years old is older than your age ^SA_AGE. Please correct.

Question ID: DIB.0050.00.1
Variable: DIBPILL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you NOW taking diabetic pills to lower your blood sugar? These are sometimes called oral
agents or oral hypoglycemic agents.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were told they had prediabetes and/or diabetes

Skip Instructions:

1-2,RF,DK [goto DIBINS_A]

Question ID: DIB.0060.00.1
Variable: DIBINS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Insulin can be taken by shot or pump. Are you NOW taking insulin?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were told they had prediabetes and/or diabetes

Skip Instructions:

1 if DIBEV_A=1 [goto DIBINSTIME_A]
else [goto DIBREL_A]
2,RF,DK if DIBEV_A=1 [goto DIBTYPE_A]
else [goto DIBREL_A]

Question ID: DIB.0070.00.3
Variable: DIBINSTIME_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Thinking back to when you were first diagnosed with diabetes, how long was it before you started
taking insulin?

Response:

1 - Less than 1 month
2 - 1 month to less than 6 months
3 - 6 months to less than 1 year
4 - 1 year or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have diabetes and currently take insulin

Skip Instructions:

1-4,RF,DK [goto DIBINSSTOP_A]

Question ID: DIB.0080.00.3
Variable: DIBINSSTOP_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Since you started taking insulin, have you ever stopped taking it for more than 6 months?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have diabetes and are taking insulin

Skip Instructions:

1 if DIBINSTIME_A IN (1,2,3) [goto DIBINSSTYR_A]
else [goto DIBTYPE_A]
2,RF,DK [goto DIBTYPE_A]

Question ID: DIB.0090.00.3
Variable: DIBINSSTYR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Was this only during the first year after you were diagnosed with diabetes?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have diabetes, who started taking insulin less than 1 year from when they were diagnosed with diabetes, and who stopped taking insulin for more than 6 months

Skip Instructions:

1,2,RF,DK [goto DIBTYPE_A]

Question ID: DIB.0100.00.1
Variable: DIBTYPE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

According to your doctor or other health professional, what type of diabetes do you have? Is it
type 1, type 2, or some other type? If you don't remember or weren't told, that's OK.

Response:

1 - Type 1
2 - Type 2
3 - Other type of diabetes
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were told they had diabetes

Skip Instructions:

1-3,RF,DK [goto DIBREL_A]

Question ID: DIB.0110.00.3
Variable: DIBREL_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Has your mother, father, brother, or sister EVER been told by a doctor or other health
professional that they have diabetes?
* Read if necessary: Include only blood relatives. Do not include step-relatives or those
unrelated by blood.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto DIABLAST_A]

Question ID: DIB.0120.00.3
Variable: DIABLAST_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

When was the last time you had a blood test for high blood sugar or diabetes by a doctor, nurse,
or other health professional?

Response:

0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know

Universe:

Sample Adult 18+

Skip Instructions:

0-6,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CON: Other Chronic Conditions
Question ID: CON.0010.00.1
Variable: COPDEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you EVER been told by a doctor or other health professional that you had
...Chronic Obstructive Pulmonary Disease, C.O.P.D., emphysema, or chronic bronchitis?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto ARTHEV_A]

Question ID: CON.0020.00.1
Variable: ARTHEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia (fy-bro-my-AL-jeeuh)?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto DEMENEV_A]

Question ID: CON.0030.00.1
Variable: DEMENEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Dementia, including Alzheimer's disease?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto ANXEV_A]

Question ID: CON.0040.00.1
Variable: ANXEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Any type of anxiety disorder?
* Read if necessary: Some common types of anxiety disorders include generalized anxiety
disorder, social anxiety disorder, panic disorder, post-traumatic stress disorder, obsessivecompulsive disorder, and phobias.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto DEPEV_A]

Question ID: CON.0050.00.1
Variable: DEPEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Any type of depression?
* Read if necessary: Some common types of depression include major depression (or major
depressive disorder), bipolar depression, dysthymia, post-partum depression, and seasonal
affective disorder.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
RCN: Rotating Conditions
Question ID: RCN.0010.00.4
Variable: KIDWEAKEV_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

* Read if necessary: Have you EVER been told by a doctor or other health professional that you
had
...Weak or failing kidneys?
* Read if necessary: Do not include kidney stones, bladder infections, or incontinence.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto HEPEV_A]

Question ID: RCN.0020.00.4
Variable: HEPEV_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had
...Hepatitis?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto LIVEREV_A]

Question ID: RCN.0030.00.4
Variable: LIVEREV_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Read if necessary: Have you EVER been told by a doctor or other health professional that you had
...Cirrhosis (suh-ROE-siss) or any other kind of long-term liver condition?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ISN: Immunosuppression
Question ID: ISN.0010.00.4
Variable: MEDRXTRT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

In the past 12 months, have you taken prescription medication or had any medical treatments that
a doctor or other health professional told you would weaken your immune system?
* Read if necessary: Examples include steroid or corticosteroid (Core-tih-coe-STAIR-oid) pills,
such as prednisone (PRED-nuh-sown), or other oral or injected medications for treating many
types of autoimmune conditions or certain cancers.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto HLTHCOND_A]

Question ID: ISN.0020.00.4
Variable: HLTHCOND_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Do you currently have a health condition that a doctor or other health professional told you
weakens the immune system^MEDTRT?
* Read if necessary: Examples include certain kinds of leukemia, lymphoma, or HIV infection.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
BMI: Current pregnant, height, weight
Question ID: BMI.0010.00.1
Variable: PREGNOW_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you currently pregnant?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Female Sample Adults 18-49 or age is don't know or refused

Skip Instructions:

1,2,RF,DK [goto HEIGHTFT_A]

Question ID: BMI.0020.01.1
Variable: HEIGHTFT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How tall are you without shoes?
* Enter M to record metric measurements.
* If ^SANAME's height is less than 2 feet, enter 2. If ^SANAME's height is greater than 7 feet,
enter 7.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

02 - 2 feet
03 - 3 feet
04 - 4 feet
05 - 5 feet
06 - 6 feet
07 - 7 feet
M - Answered in Metric
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+

Skip Instructions:

If HEIGHTFT_A NE 2-7,RF,DK,M [goto ERR1_HEIGHTFT_A]
If HEIGHTFT_A = 2,3 [goto ERR2_HEIGHTFT_A]
2-7 [goto HEIGHTIN_A]
RF,DK [goto WEIGHTLB_A]
M [goto HEIGHTM_A]

Hard Edit:

Check Text: ERR1_HEIGHTFT_A
Check Description: Hard edit for height in feet
Check Text: {check ERR1_HEIGHTFT_A}
Only 2-7, Don't Know/Refused or M allowed in this field. Please correct.

Soft Edit:

Check Text: ERR2_HEIGHTFT_A
Check Description: Soft edit to verify height in feet
Check Text: {signal ERR2_HEIGHTFT_A}
Respondent's height in feet is ^HEIGHTFT? Please verify.

Question ID: BMI.0020.02.1
Variable: HEIGHTIN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Enter inches.
* Enter '0' if exactly ^HEIGHTFT feet tall.

Fills:

^HEIGHTFT

Description: {Value of HEIGHTFT_A}
Instruction:
Fill value from HEIGHTFT_A

Response:

00 - 0 inches
01 - 1 inch
02 - 2 inches
03 - 3 inches
04 - 4 inches
05 - 5 inches
06 - 6 inches
07 - 7 inches
08 - 8 inches
09 - 9 inches
10 - 10 inches
11 - 11 inches
97 - Refused
99 - Don't Know

Universe:

Sample Adult 18+ and height is 2-7ft

Skip Instructions:

0-11,RF,DK [goto WEIGHTLB_A]

Question ID: BMI.0020.04.1
Variable: HEIGHTM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How tall are you without shoes?
* Enter height in metric.
* If the height is given in centimeters, press '0' at meters and enter the measure in
centimeters (241 centimeters maximum).

Response:

0 - 0 meters
1 - 1 meter
2 - 2 meters
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who choose to give their height in metric measurements

Skip Instructions:

0-2 [goto HEIGHTCM_A]
RF,DK [goto WEIGHTLB_A]

Hard Edit:

Check Text: ERR_HEIGHTM_A
Check Description: Height in meters hard edit
Check Text: {check ERR_HEIGHTM_A} If height is being given in centimeters only, enter "0"; otherwise enter number of meters.

Question ID: BMI.0020.05.1
Variable: HEIGHTCM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Enter centimeters.
* Enter height in metric.
* If ^SANAME's height is greater than 241 centimeters, enter 241.

Fills:

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

000-241 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who entered 0 to 2 meters for height

Skip Instructions:

0-241,RF,DK [goto WEIGHTLB_A]

Question ID: BMI.0030.01.1
Variable: WEIGHTLB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^PREGWEIGH
* Enter M to record metric measurements.
* If ^SANAME's weight is less than 50 pounds, enter 50. If ^SANAME's weight is greater than 500
pounds, enter 500.

Fills:

^PREGWEIGH

Description: How much did you weigh before your pregnancy?/How much do you weigh?
Instruction:
If GEN.SEX_FINAL=2 AND PREGNOW_A=1: "How much did you weigh before your pregnancy?"
else: "How much do you weigh?"

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

050-500 - Range of values
M - Answered in Metric
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

If WEIGHTLB_A lt 50 or WEIGHTLB_A gt 500 [goto ERR1_WEIGHTLB_A]
elseif ((GEN.SEX_FINAL[PX_A]=1 and (WEIGHTLB_A lt 113 or WEIGHTLB_A gt 316)) or (GEN.SEX_FINAL
[PX_A]=2 and (WEIGHTLB_A lt 96 or WEIGHTLB_A gt 293)) or (GEN.SEX_FINAL[PX_A] IN (RF,DK) and
(WEIGHTLB_A lt 96 or WEIGHTLB_A gt 316))) [goto ERR2_WEIGHTLB_A]
50-500,RF,DK [goto next section]
M [goto WEIGHTKG_A]

Hard Edit:

Check Text: ERR1_WEIGHTLB_A
Check Description: SA weight pounds hard edit
Check Text: {check ERR1_WEIGHTLB_A} Weight is out of range. Only "50-500" or "M" or "Don't know/Refused" allowed in this field.

Soft Edit:

Check Text: ERR2_WEIGHTLB_A
Check Description: SA weight pounds soft edit
Check Text: {signal ERR2_WEIGHTLB_A} Please verify that the weight was entered correctly. Probe only if necessary.

Question ID: BMI.0030.02.1
Variable: WEIGHTKG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^PREGWEIGH
* Enter weight in kilograms.
* If ^SANAME's weight is less than 23 kilograms, enter 23. If ^SANAME's weight is greater than
226 kilograms, enter 226.

Fills:

^PREGWEIGH

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

Response:

023-226 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who chose to give their weight in metric measurements

Skip Instructions:

If WEIGHTKG_A lt 23 or WEIGHTKG_A gt 226 [goto ERR1_WEIGHTKG_A]
elseif ((GEN.SEX_FINAL[PX]=1 and (WEIGHTKG_A lt 51 or WEIGHTKG_A gt 143)) or (GEN.SEX_FINAL
[PX]=2 and (WEIGHTKG_A lt 43 or WEIGHTKG_A gt 133)) or (GEN.SEX_FINAL[PX] IN (RF,DK) and
(WEIGHTKG_A lt 43 or WEIGHTKG_A gt 143)))[goto ERR2_WEIGHTKG_A]
23-226,RF,DK [goto next section]

Hard Edit:

Check Text: ERR1_WEIGHTKG_A
Check Description: SA weight KG hard edit
Check Text: {check ERR1_WEIGHTKG_A} Weight is out of range (23-226). Please correct.

Soft Edit:

Check Text: ERR2_WEIGHTKG_A
Check Description: SA weight KG soft edit
Check Text: {signal ERR2_WEIGHTKG_A} Please verify that the weight was entered correctly. Probe only if necessary.

2020 National Health Interview Survey (NHIS) Questionnaire
VIS: Vision
Question ID: VIS.0010.00.1
Variable: VISINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

The next questions ask about difficulties you may have doing certain activities because of a
health problem.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto WEARGLSS_A]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you wear glasses or contact lenses?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto VISIONDF_A]

Question ID: VIS.0030.00.1
Variable: VISIONDF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty ^AGLASSCNTS? Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?

Fills:

^AGLASSCNTS

Description: seeing, even when wearing glasses or contact lenses/seeing
Instruction:
If WEARGLSS_A=1 fill "seeing, even when wearing glasses or contact lenses"; else fill "seeing"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
HEA: Hearing
Question ID: HEA.0010.00.1
Variable: HEARAID_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you use a hearing aid?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [HEARAIDFR_A]
2,RF,DK [HEARINGDF_A]

Question ID: HEA.0020.00.1
Variable: HEARAIDFR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How often do you use your hearing aid(s)? Would you say all of the time, some of the time,
rarely, or never?

Response:

1 - All of the time
2 - Some of the time
3 - Rarely
4 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use a hearing aid

Skip Instructions:

1-4,RF,DK [HEARINGDF_A]

Question ID: HEA.0030.00.1
Variable: HEARINGDF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty hearing^HEARAID? Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?

Fills:

^HEARAID

Description: , even when using your hearing aid(s)
Instruction:
If HEARAID_A=1, fill: ", even when using your hearing aid (s)"
else NO FILL

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
MOB: Mobility
Question ID: MOB.0010.00.1
Variable: DIFF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty walking or climbing steps? Would you say no difficulty, some difficulty,
a lot of difficulty, or you cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto EQUIP_A]

Question ID: MOB.0020.00.1
Variable: EQUIP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you use any equipment or receive help for getting around?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto CANEWLKR_A]
2,RF,DK [goto WLK100_A]

Question ID: MOB.0030.00.1
Variable: WLK100_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty walking 100 yards on level ground, that would be about the length of one
football field or one city block? Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who do not use equipment or receive help for getting around or refused or don't know

Skip Instructions:

1-3,RF,DK [goto WLK13M_A]
4 [goto STEPS_A]

Question ID: MOB.0040.00.1
Variable: WLK13M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty walking a third of a mile on level ground, that would be the length of
five football fields or five city blocks?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or refused or don't know

Skip Instructions:

1-4,RF,DK [goto STEPS_A]

Question ID: MOB.0050.00.1
Variable: STEPS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty walking up or down 12 steps?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who do not use equipment or receive help for getting around or refused or don't know

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: MOB.0060.00.1
Variable: CANEWLKR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you use any of the following...
...Cane or walker?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1,2,RF,DK [goto WCHAIR_A]

Question ID: MOB.0070.00.1
Variable: WCHAIR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Do you use any of the following?
...Wheelchair or scooter?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1,2,RF,DK [goto PERASST_A]

Question ID: MOB.0080.00.1
Variable: PERASST_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Do you use any of the following?
...Someone's assistance?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1,2,RF,DK [goto NOEQWLK100_A]

Question ID: MOB.0090.00.1
Variable: NOEQWLK100_A
Interview Module: Adult
Content Type: Annual Core
Question text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking 100 yards on level ground, that
would be about the length of one football field or one city block? Would you say no difficulty,
some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around

Skip Instructions:

1-3,RF,DK [goto NOEQWLK13M_A]
4 [goto NOEQSTEPS_A]

Question ID: MOB.0100.00.1
Variable: NOEQWLK13M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking a third of a mile on level ground,
that would be the length of five football fields or five city blocks?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards without the use of their aid or refused or don't know

Skip Instructions:

1-4,RF,DK [goto NOEQSTEPS_A]

Question ID: MOB.0110.00.1
Variable: NOEQSTEPS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

WITHOUT THE USE OF YOUR AID, do you have difficulty walking up or down 12 steps?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment

Skip Instructions:

1-4,RF,DK if WCHAIR_A ne 1 [goto EQWLK100_A]
else [goto next section]

Question ID: MOB.0120.00.1
Variable: EQWLK100_A
Interview Module: Adult
Content Type: Annual Core
Question text:

WHEN USING YOUR AID, do you have difficulty walking 100 yards on level ground, that would be
about the length of one football field or one city block?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around but do not use a wheelchair or scooter or refused or don't know

Skip Instructions:

1-3,RF,DK [goto EQWLK13M_A]
4 [goto EQSTEPS_A]

Question ID: MOB.0130.00.1
Variable: EQWLK13M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

WHEN USING YOUR AID, do you have difficulty walking a third of a mile on level ground, that
would be the length of five football fields or five city blocks?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty walking 100 yards, when using their aid or refused or don't know

Skip Instructions:

1-4,RF,DK [goto EQSTEPS_A]

Question ID: MOB.0140.00.1
Variable: EQSTEPS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

WHEN USING YOUR AID, do you have difficulty walking up or down 12 steps?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who use equipment or receive help for getting around but do not use a wheelchair or scooter

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
COM: Communication
Question ID: COM.0010.00.1
Variable: COMDIFF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Using your usual language, do you have difficulty communicating, for example, understanding or
being understood?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
COG: Cognition
Question ID: COG.0010.00.1
Variable: COGMEMDFF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty remembering or concentrating?
*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK [goto next section]
2-4 [goto COGTYPEDFF_A]

Question ID: COG.0020.00.1
Variable: COGTYPEDFF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Is that a difficulty with remembering, concentrating, or both?

Response:

1 - Difficulty remembering only
2 - Difficulty concentrating only
3 - Difficulty with both remembering and concentrating
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have some difficulty, a lot of difficulty, or are unable to remember or concentrate

Skip Instructions:

1,3 [goto COGFRQDFF_A]
2,RF,DK [goto next section]

Question ID: COG.0030.00.1
Variable: COGFRQDFF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How often do you have difficulty remembering? Would you say sometimes, often or all of the time?

Response:

1 - Sometimes
2 - Often
3 - All of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have difficulty remembering or remembering and concentrating

Skip Instructions:

1-3,RF,DK [goto COGAMTDFF_A]

Question ID: COG.0040.00.1
Variable: COGAMTDFF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty remembering a few things, a lot of things, or almost everything?

Response:

1 - A few things
2 - A lot of things
3 - Almost everything
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have difficulty remembering or remembering and concentrating

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
UPP: Self-care and Upper Body
Question ID: UPP.0010.00.1
Variable: UPPSLFCR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty with self care, such as washing all over or dressing? Would you say no
difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto UPPRAISE_A]

Question ID: UPP.0020.00.1
Variable: UPPRAISE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty raising a 2 liter bottle of water or soda from waist to eye level?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto UPPOBJCT_A]

Question ID: UPP.0030.00.1
Variable: UPPOBJCT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have difficulty using your hands and fingers, such as picking up small objects, for
example, a button or pencil, or opening or closing containers or bottles?
*Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SOC: Social Functioning
Question ID: SOC.0010.00.1
Variable: SOCERRNDS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Because of a physical, mental, or emotional condition, do you have difficulty doing errands
alone such as visiting a doctor's office or shopping?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto SOCSCLPAR_A]

Question ID: SOC.0020.00.1
Variable: SOCSCLPAR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Because of a physical, mental, or emotional condition, do you have difficulty participating in
social activities such as visiting friends, attending clubs and meetings, or going to parties?
* Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto SOCWRKLIM_A]

Question ID: SOC.0030.00.1
Variable: SOCWRKLIM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you limited in the kind OR amount of work you can do because of a physical, mental or
emotional problem?
* Read if necessary: Work includes paid work, volunteer work, school work, and homework.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ADO: Age of Disability Onset
Question ID: ADO.0010.00.3
Variable: DEVDONSET_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

You said that you have difficulty with ^DIFF. Did ^THISDIFF begin before age 22?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults age 22+ who said they had a lot of difficulty or could not do the following activities at all: Walking or climbing stairs, communicating, remembering or concentrating, self-care, or doing errands alone

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
INS: Health Insurance
Question ID: INS.0010.00.1
Variable: HICOV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
The next questions are about health insurance. Include health insurance obtained through
employment or purchased directly as well as government programs like Medicare, Medicaid, and the
Children's Health Insurance Program that provide medical care or help pay medical bills. Are you
covered by any kind of health insurance or some other kind of health care plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK [goto HIKIND_A]
2 if (GEN.AGE_FINAL[PX_A] ge 65 or Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2) [goto
MCAREPRB_A]
else [goto MCAIDPRB_A]

Question ID: INS.0020.00.1
Variable: HIKIND_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
What kinds of health insurance or health care coverage do you have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, a state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.

Response:

01 - Private health insurance
02 - Medicare
03 - Medigap
04 - Medicaid
05 - Children's Health Insurance Program (CHIP)
06 - Military related health care: TRICARE (CHAMPUS) / VA health care / CHAMPVA
07 - Indian Health Service
08 - State-sponsored health plan
09 - Other government program
10 - No coverage of any type
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

Skip Instructions:

if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A]
elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto MCAREPRB_A]
elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and HIKIND_A IN (10,RF,DK) [goto
MCAIDPRB_A]
else [goto SINCOVDE_A]

Hard Edit:

Check Text: ERR1_HIKIND_A
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_A}
Cannot mark "no coverage of any kind" and another type. Please correct.

Question ID: INS.0030.00.1
Variable: MCAREPRB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you covered by Medicare?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 65+ who have not indicated they had Medicare in HIKIND_A

Skip Instructions:

1,2,RF,DK [goto SINCOVDE_A]

Question ID: INS.0040.00.1
Variable: MCAIDPRB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
There is a program called Medicaid that pays for health care for persons in need. ^STATEMA Are
you covered by Medicaid?

Fills:

^STATEMA

Description: In ^STATENAME it is also called ^STMEDICAID.
Instruction:
if STMEDICAID ne empty, fill: "In ^STATENAME it is also called ^STMEDICAID."
else fill: blank

^STATENAME

Description: State name
Instruction:
If ST=AL, fill: Alabama else if ST=AK, fill: Alaska
else if ST=AR, fill: Arkansas
else if ST=AZ, fill: Arizona
else if ST=CA, fill: California
else if ST=CO, fill: Colorado
else if ST=CT, fill: Connecticut
else if ST=DE, fill: Delaware
else if ST=DC, fill: District of Columbia
else if ST=FL, fill: Florida
else if ST=GA, fill: Georgia
else if ST=HI, fill: Hawaii
else if ST=ID, fill: Idaho
else if ST=IL, fill: Illinois
else if ST=IN, fill: Indiana
else if ST=IA, fill: Iowa
else if ST=KS, fill: Kansas
else if ST=KY, fill: Kentucky
else if ST=LA, fill: Louisiana
else if ST=ME, fill: Maine
else if ST=MD, fill: Maryland
else if ST=MA, fill: Massachusetts
else if ST=MI, fill: Michigan
else if ST=MN, fill: Minnesota
else if ST=MS, fill: Mississippi
else if ST=MO, fill: Missouri
else if ST=MT, fill: Montana
else if ST=NE, fill: Nebraska
else if ST=NV, fill: Nevada
else if ST=NH, fill: New Hampshire
else if ST=NJ, fill: New Jersey
else if ST=NM, fill: New Mexico
else if ST=NY, fill: New York
else if ST=NC, fill: North Carolina
else if ST=ND, fill: North Dakota
else if ST=OH, fill: Ohio
else if ST=OK, fill: Oklahoma
else if ST=OR, fill: Oregon
else if ST=PA, fill: Pennsylvania
else if ST=RI, fill: Rhode Island
else if ST=SC, fill: South Carolina
else if ST=SD, fill: South Dakota
else if ST=TN, fill: Tennessee
else if ST=TX, fill: Texas
else if ST=UT, fill: Utah
else if ST=VT, fill: Vermont
else if ST=VA, fill: Virginia
else if ST=WA, fill: Washington
else if ST=WV, fill: West Virginia
else if ST=WI, fill: Wisconsin
else if ST=WY, fill: Wyoming

^STMEDICAID

Description: State Medicaid name
Instruction:
If AL then fill "Patient 1st, Alabama Coordinated Health Network"
If AK then fill "Alaska Medicaid; DenaliCare"
If AZ then fill "Arizona Health Care Cost Containment
System (AHCCCS)"
If AR then fill "ARKids First A; Arkansas Works"
If CA then fill "Medi-Cal"
If CO then fill "Health First Colorado"
If CT then fill "HUSKY A, HUSKY C, HUSKY D; Med-Connect"
If DE then fill "Diamond State Health Plan; Children's
Community Alternative Disabilities Program"
If DC then fill "DC Medicaid"
If FL then fill "Florida Medicaid; Medically Needy
Program"
If GA then fill "Georgia Families; Health Insurance
Premium Payment Program (HIPP)"
If HI then fill "Med QUEST"
If ID then fill "Idaho Medicaid Program"
If IL then fill "Medical Assistance"
If IN then fill "Traditional Medicaid; Healthy Indiana
Plan (HIP); Hoosier Healthwise"
If IA then fill "IA Health Link; Iowa Health and Wellness
Plan"
If KS then fill "KanCare; Kansas Medical Assistance
Program (KMAP)"
If KY then fill "Kentucky Medicaid; Kentucky HEALTH"
If LA then fill "Healthy Louisiana; LaCHIP; LaMOMS"
If ME then fill "MaineCare"
If MD then fill "HealthChoice; Maryland Children's Health
Program (MCHP)"
If MA then fill "MassHealth"
If MI then fill "Medicaid; Healthy Michigan Plan (HMP)"
If MN then fill "Medical Assistance (MA)"
If MS then fill "MississippiCAN"
If MO then fill "MO Healthnet"
If MT then fill "Passport to Health; Healthy Montana Kids
Plus (HMK Plus); HELP Plan"
If NE then fill "Heritage Health"
If NV then fill "Nevada Medicaid"
If NH then fill "NH Medicaid; Granite Advantage Health
Care Program"
If NJ then fill "NJ Medicaid; NJ Family Care"
If NM then fill "Centennial Care"
If NY then fill "Medicaid; Children's Medicaid"
If NC then fill "NC Medicaid; Medical Assistance"
If ND then fill "North Dakota Medicaid"
If OH then fill "Ohio Medicaid State Plan; Healthy
Families; Healthy Start; Alternative Benefit Plan"
If OK then fill "SoonerCare"
If OR then fill "Oregon Health Plan (OHP)"
If PA then fill "Medical Assistance"
If RI then fill "RIte Care; Affordable Care Coverage
(ACC)"
If SC then fill "Healthy Connections"
If SD then fill "South Dakota Medicaid"
If TN then fill "TennCare"
If TX then fill "Texas Medicaid; State of Texas Access
Reform (STAR); STAR+PLUS; Children's Medicaid; STAR Kids"
If UT then fill "Utah Medicaid"
If VT then fill "Green Mountain Care"
If VA then fill "Medicaid; FAMIS Plus"
If WA then fill "Apple Health"
If WV then fill "Mountain Health Trust (MHT)"
If WI then fill "Wisconsin Medicaid; ForwardHealth"
If WY then fill "WYhealth"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know
-

Universe:

Sample Adults 18-64 who have indicated they are uninsured, refused, or don't know their type of health insurance

Skip Instructions:

1,2,RF,DK [goto SINCOVDE_A]

Question ID: INS.0050.00.1
Variable: SINCOVDE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
^INADDITIONARE you covered by a SEPARATE plan that only pays for dental services?

Fills:

^INADDITIONARE

Description: In addition to ^HITYPEANOSS, are/Are
Instruction:
If (HIKIND_A=1-9 or MCAREPRB_A=1 or MCAIDPRB_A=1), fill "In addition to ^HITYPEANOSS, are"
else fill "Are"

^HITYPEANOSS

Description: Type of health care plans without single service plans
Instruction:
fill coverage types from HIKIND_A, except HIKIND_A=10, HIKIND_A=1 fill: "private health insurance"
HIKIND_A=2 fill: "Medicare"
HIKIND_A=3 fill: "Medicare Supplement or Medigap"
HIKIND_A=4 fill: "Medicaid"
HIKIND_A=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_A=6 fill: "military related health care"
HIKIND_A=7 fill: "Indian Health Service"
HIKIND_A=8 fill: "a state-sponsored health plan"
HIKIND_A=9 fill: "an other government program"
if MCAREPRB_A=1, fill "Medicare"
if MCAIDPRB_A=1, fill "Medicaid"
separate choices with a comma and seperate the last two
choices with "and"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto SINCOVVS_A]

Question ID: INS.0060.00.1
Variable: SINCOVVS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you covered by a SEPARATE plan that only pays for vision services?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto SINCOVRX_A]

Question ID: INS.0070.00.1
Variable: SINCOVRX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you covered by a SEPARATE plan that only pays for prescriptions?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto HICHANGE_A]

Question ID: INS.0080.00.1
Variable: HICHANGE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
I have recorded you are ^COVEREDA. Is this correct?

Fills:

^COVEREDA

Description: not covered by health insurance/covered by ^HITYPEA
Instruction:
if HIKIND_A=10,R,D and (MCAIDPRB_A=2,R,D or MCAREPRB_A= 2,R,D) and SINCOVDE_A=2,R,D and SINCOVVS_A=2,R,D and
SINCOVRX_A=2,R,D fill: "not covered by health insurance"
else fill: "covered by ^HITYPEA"

^HITYPEA

Description: Type of health care plans with single service plans
Instruction:
fill coverage types from HIKIND_A, except HIKIND_A=10, HIKIND_A=1 fill: "private health insurance"
HIKIND_A=2 fill: "Medicare"
HIKIND_A=3 fill: "Medicare Supplement or Medigap"
HIKIND_A=4 fill: "Medicaid"
HIKIND_A=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_A=6 fill: "military related health care"
HIKIND_A=7 fill: "Indian Health Service"
HIKIND_A=8 fill: "a state-sponsored health plan"
HIKIND_A=9 fill: "an other government program"
if MCAREPRB_A=1, fill "Medicare";
if MCAIDPRB_A=1, fill "Medicaid"
If SINCOVDE_A=1 and SINCOVRX_A=2,RF,DK and
SINCOVVS_A=2,RF,DK, fill: "a single service dental plan"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=1 and
SINCOVVS_A=2,RF,DK, fill: "a single service prescription
plan"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=2,RF,DK and
SINCOVVS_A=1, fill: "a single service vision plan"
If SINCOVDE_A=1 and SINCOVRX_A=1 and SINCOVVS_A=2,RF,DK,
fill: "single service dental and prescription plans"
If SINCOVDE_A=1 and SINCOVRX_A=2,RF,DK and SINCOVVS_A=1,
fill: "single service dental and vision plans"
If SINCOVDE_A=2,RF,DK and SINCOVRX_A=1 and SINCOVVS_A=1,
fill: "single service vision and prescription plans"
If SINCOVDE_A=1 and SINCOVRX_A=1 and SINCOVVS_A=1, fill:
"single service dental, vision and prescription plans"
separate choices with a comma and seperate the last two
choices with "and"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK
if 02 in HIKIND_A or MCAREPRB_A=1[goto MCPART_A]
else if 04 in HIKIND_A or MCAIDPRB_A=1[goto MACHMN_A]
else if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A]
else if 09 in HIKIND_A [goto OGNAME_A]
else if 06 in HIKIND_A [goto MILSPC_A]
else if 07 in HIKIND_A [goto HINOTYR_A]
else if 10 in HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN (2,RF,DK))[goto HILAST_A]
else [goto FINISH_A]
2 [goto ERR1_HICHANGE_A]

Soft Edit:

Check Text: ERR1_HICHANGE_A
Check Description: Answered health insurance coverage is incorrect
Check Text: {signal ERR1_HICHANGE_A}
Suppress this error to go back to HIKIND_A and update coverage. Close this error to change your answer to HICHANGE_A.

Question ID: INS.0090.00.1
Variable: MCPART_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
What type of Medicare coverage do you have? Is it Part A - hospital insurance, Part B - medical
insurance, or both?

Response:

1 - Part A- hospital only
2 - Part B- medical only
3 - Both Part A and Part B
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicare

Skip Instructions:

1 [goto MCPARTD_A]
2-3,RF,DK [goto MCCHOICE_A]

Question ID: INS.0100.00.1
Variable: MCCHOICE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you enrolled in a Medicare Advantage plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicare that have part B Medicare or don't know or refused if they have part B Medicare

Skip Instructions:

1,2,RF,DK [goto MCHMO_A]

Question ID: INS.0110.00.1
Variable: MCHMO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you under a Medicare managed care arrangement, such as an HMO, that is, a Health Maintenance
Organization?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicare that have part B Medicare or don't know or refused if they have part B Medicare

Skip Instructions:

1 [goto MCANAME_A]
2,RF,DK if MCCHOICE_A=1 [goto MCANAME_A]
elseif MCCHOICE_A IN (2,RF,DK) [goto MCPARTD_A]

Question ID: INS.0120.00.1
Variable: MCANAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
What is the name of your Medicare Advantage or Medicare HMO plan?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed care arrangement

Skip Instructions:

allow 80,RF,DK [goto MCPARTD_A]

Question ID: INS.0130.00.1
Variable: MCPARTD_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicare

Skip Instructions:

1,2,RF,DK
if 04 in HIKIND_A or MCAIDPRB_A=1 [goto MACHMN_A]
elseif 01 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0140.00.1
Variable: MACHMN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
The next questions are about Medicaid coverage. What is the name of your Medicaid health plan?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

allow 80,RF,DK [goto MAXCHNG_A]

Question ID: INS.0150.00.1
Variable: MAXCHNG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Was your Medicaid obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^MARKETPLACE

Description: Health insurance marketplace names
Instruction:
If no state specified below, fill "Health Insurance Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such as
Covered California"
If CO then fill "Health Insurance Marketplace, such as
Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such as
Access Health CT"
If DC then fill "Health Insurance Marketplace, such as DC
Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such as
Health Connector"
If MD then fill "Health Insurance Marketplace, such as
Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such as
MNsure"
If NY then fill "Health Insurance Marketplace, such as New
York State of Health"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such as
Washington Healthplanfinder"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1,2,RF,DK [goto MAPREM_A]

Question ID: INS.0160.00.1
Variable: MAPREM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount you or a family member pay each month for health care
coverage. Do you or a family member pay a premium for this Medicaid plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1,2,RF,DK [goto MADEDUC_A]

Question ID: INS.0170.00.1
Variable: MADEDUC_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your Medicaid plan have an
annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicaid coverage

Skip Instructions:

1 [goto MAHDHP_A]
2,RF,DK
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A]
else if 09 in HIKIND_A [goto OGNAME_A]
else if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0180.00.1
Variable: MAHDHP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Is the annual deductible for medical care for this plan less than ^HDHPDED or ^HDHPDED or more?
If there is a separate deductible for prescription drugs, hospitalization, or out-of-network
care, do not include those deductible amounts here.

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with Medicaid coverage who have a deductible

Skip Instructions:

1,2,RF,DK
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0270.00.1
Variable: PLANNAME1_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Earlier I recorded that ^SCNAME was covered by ^HIPNAM1_C. Are you covered by this same plan as
^SCNAME?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage, where the Sample Child interview has already been conducted, the Sample Child is in the same family, and the Sample Child also had private health insurance, and the first private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.

Skip Instructions:

1 if Child.INS.bPlan[1].POLHLD_C ne 1 [goto POLHLDA1_A]
elseif Child.INS.bPlan[1].POLHLD_C=1 [goto PRPOLHP1_A]
2,RF,DK if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 and
INSPRI_FLG=1 and SAMEFAM_FLG=1 and CHILD.INS.PLANNAME2_C=empty [goto PLANNAME2_A] else [goto
HIPNAM1_A]

Question ID: INS.0280.00.1
Variable: POLHLDA1_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Health insurance plans are usually obtained in one person's name even if other family members
are covered by that plan. That person is called the policyholder. Are you the policyholder for
^HIPNAM1_C?

Fills:

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the child is not the policyholder for their first private plan or refused or don't know.

Skip Instructions:

1 if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 [goto
PLANNAME2_A]
else [goto MORPLAN_A]
2,RF,DK [goto PRPOLHP1_A]

Question ID: INS.0290.00.1
Variable: PRPOLHP1_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
How are you related to the policyholder for ^HIPNAM1_C? Are you the policyholder's child,
spouse, former spouse, or are you related in some other way?

Fills:

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

Response:

1 - Child
2 - Spouse
3 - Former spouse
4 - Some other relationship
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the Child is the policy holder or where the Sample Adult is not the policyholder for the first plan or refused or don't know.

Skip Instructions:

1-4,RF,DK if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1
[goto PLANNAME2_A]
else [goto MORPLAN_A]

Question ID: INS.0300.00.1
Variable: PLANNAME2_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Earlier I recorded that ^SCNAME was covered by a second plan: ^HIPNAM2_C. Are you covered by
this same plan as ^SCNAME?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage, where the Sample Child interview has already been conducted, the Sample Child is in the same family, and the Sample Child also had private health insurance, and listed two plans. The second private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.

Skip Instructions:

1 if Child.INS.bPlan[2].POLHLD_C ne 1 [goto POLHLDA2_A],
if Child.INS.bPlan[2].POLHLD_C=1 [goto PRPOLHP2_A]
2,RF,DK if PLANNAME1_A IN(2,RF,DK,empty) [goto HIPNAM1_A]
else [goto MORPLAN_A]

Question ID: INS.0310.00.1
Variable: POLHLDA2_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
* Read if necessary: Health insurance plans are usually obtained in one person's name even if
other family members are covered by that plan. That person is called the policyholder.
Are you the policyholder for ^HIPNAM2_C?

Fills:

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the child is not the policyholder for their second private plan or refused or don't know.

Skip Instructions:

1 if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
2,RF,DK[goto PRPOLHP2_A]

Question ID: INS.0320.00.1
Variable: PRPOLHP2_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
How are you related to the policyholder for ^HIPNAM2_C? Are you the policyholder's child,
spouse, former spouse, or are you related in some other way?

Fills:

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Child
2 - Spouse
3 - Former spouse
4 - Some other relationship
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a shared private health plan with the Sample Child, where the Sample Child is the policy holder for the second plan or the Sample Adult is not the policyholder for the second plan or refused or don't know.

Skip Instructions:

1-4,RF,DK if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0330.00.1
Variable: HIPNAM1_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
It is important that we record the complete and accurate name of each private health insurance
plan. What is the COMPLETE name of your plan? Do NOT include plans that only provide extra cash
while in the hospital or plans that pay for only one type of service such as long term care,
accidents, or dental care.
* Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ enrolled in a Medigap plan or private health insurance and the sample adult did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample child

Skip Instructions:

allow 80,RF,DK [goto MORPLAN_A]

Question ID: INS.0340.00.1
Variable: MORPLAN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Are you covered by any other private health insurance plans?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ enrolled in a private health plan where the name of the plan was given or don't know or refused or the sample adult only shared one private plan with the Sample Child.

Skip Instructions:

1 [goto HIPNAM2_A]
2,RF,DK
if (PLANNAME1_A=1 or PLANNAME2_A=1) then
if 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
else [goto bPlan[1].POLHLD_A]

Question ID: INS.0350.00.1
Variable: HIPNAM2_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
What is the name of that private health insurance plan?
* Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with a second private health insurance plan

Skip Instructions:

allow 80,RF,DK [goto bPlan[1].POLHLD_A]

Question ID: INS.0370.00.1
Variable: POLHLD_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
I am going to ask you some questions about ^FIRSTPLANA. Health insurance plans are usually
obtained in one person's name even if other family members are covered by that plan. That person
is called the policyholder. Are you the policyholder for ^THISPLANA?

Fills:

^FIRSTPLANA

Description: this plan/this first plan/this ^HIPNAM1_A plan/this second plan/this ^HIPNAM2_A plan
Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) and HIPNAM2_A= empty fill:
"this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

^THISPLANA

Description: this plan/^HIPNAM1_A/^HIPNAM2_A
Instruction:
if PlanNum=1 then if HIPNAM1_A IN (RF,DK) fill: "this plan"
else fill: "^HIPNAM1_A"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this plan"
Else fill: "^HIPNAM2_A"

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know.

Skip Instructions:

1,RF,DK [goto PRPLCOV_A]
2 [goto PRPOLH_A]

Question ID: INS.0380.00.1
Variable: PRPLCOV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does this plan cover someone other than yourself?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know and where the Sample Adult is the policyholder or refused or don't know

Skip Instructions:

1,2,RF,DK [goto PLNWRK_A]

Question ID: INS.0390.00.1
Variable: PRPOLH_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
How are you related to the policyholder? Are you the policyholder's child, spouse, former
spouse, or are you related in some other way?

Response:

1 - Child
2 - Spouse
3 - Former spouse
4 - Some other relationship
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance who are not the policyholder

Skip Instructions:

1-4,RF,DK [goto PLNWRK_A]

Question ID: INS.0400.00.1
Variable: PLNWRK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Which one of these categories best describes how this plan was obtained? Was it obtained through
an employer or union, purchased directly, obtained through Healthcare.gov or the Affordable Care
Act, also known as Obamacare, obtained through a state or local government or community program
or obtained in some other way?

Response:

1 - Through an employer, union, or professional association
2 - Purchased directly
3 - Through Healthcare.gov or the Affordable Care Act, also known as Obamacare
4 - Through a state or local government or community program
5 - Other
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know

Skip Instructions:

1,3 [goto PLNPAY_A]
2,4,RF,DK [goto PLNEXCHG_A]
5 [goto PLNWKSP_A]

Question ID: INS.0410.00.1
Variable: PLNWKSP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: How was this plan obtained?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know and private health insurance coverage was obtained from an other source

Skip Instructions:

allow 80,RF,DK [goto PLNEXCHG_A]

Question ID: INS.0420.00.1
Variable: PLNEXCHG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know that is directly purchased, or obtained through a state, local, government or community program, or obtained another way, or refused/don't know how obtained

Skip Instructions:

1,2,RF,DK [goto PLNPAY_A]

Question ID: INS.0430.00.1
Variable: PLNPAY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Who pays for this health insurance plan?
* Enter all that apply, separate with commas.

Response:

1 - ^SCNAME or family (living in the household)
2 - Employer or union
3 - Someone outside the household
4 - Medicare
5 - Medicaid
6 - Other government program

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know.

Skip Instructions:

if 1 IN PLNPAY_A [goto HICOSTN_A]
else if 2-6 IN PLNPAY_A or PLNPAY_A IN (RF,DK)[goto PRDEDUC_A]

Question ID: INS.0440.01.1
Variable: HICOSTN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
How much ^DOYOUFAM currently spend for health insurance premiums for ^FIRSTPLANA? Please include
payroll deductions for premiums.

Fills:

^DOYOUFAM

Description: do you/does your family
Instruction:
if PCNT_A=1 fill 'do you', else fill 'does your family'

^FIRSTPLANA

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

Response:

00001-99995 - Range of values
99997 - Refused
99999 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know who paid for by self or family

Skip Instructions:

20000-99995 [goto ERR1_HICOSTN_A]
1-19999 [goto HICOSTT_A]
RF,DK [goto PRDEDUC_A]

Soft Edit:

Check Text: ERR1_HICOSTN_A
Check Description:
Check Text: {signal ERR1_HICOSTN_A}[^HICOSTN_A] is unusually high. Please verify. Make corrections if necessary.

Question ID: INS.0440.02.1
Variable: HICOSTT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
* Enter time period for premium payments.

Response:

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know who gave a premium amount.

Skip Instructions:

1-8,RF,DK [goto PRDEDUC_A]

Question ID: INS.0450.00.1
Variable: PRDEDUC_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does this health plan have an annual
deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance plans where a plan name was given or refused or don't know.

Skip Instructions:

1 [goto PRHDHP_A]
2,RF,DK [goto INTROCOV_A]

Question ID: INS.0460.00.1
Variable: PRHDHP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Is the ^FAM_A annual deductible for medical care for this plan less than ^HDHPAMT_A, or
^HDHPAMT_A or more? If there is a separate deductible for prescription drugs, hospitalization,
or out-of-network care, do not include those deductible amounts here.

Fills:

^FAM_A

Description: family
Instruction:
if POLHLD_A=2 or PRPLCOV_A=1, fill 'family'. Else no fill.

^HDHPAMT_A

Description: ^HDHPDED_family/^HDHPDED
Instruction:
if POLHLD_A=2 or PRPLCOV_A=1, fill '^HDHPDED_family' Else fill ^HDHPDED.

^HDHPDED_family

Description: Family deductible threshold (may change in future year)
Instruction:
fill: $2,700

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPAMT_A
2 - ^HDHPAMT_A or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know with a deductible

Skip Instructions:

1 [goto INTROCOV_A]
2,RF,DK [goto HSAHRA_A]

Question ID: INS.0470.00.1
Variable: HSAHRA_A
Interview Module: Adult
Content Type: Annual Core
Question text:

There are special accounts or funds that can be used to pay for medical expenses, sometimes
referred to as Health Savings Accounts or HSAs, Health Reimbursement Accounts or HRAs, Personal
Care accounts, Personal Medical funds, or Choice funds. These are DIFFERENT from Flexible
Spending Accounts or FSAs. Is there one of these accounts or funds with this plan?

Response:

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know with a high deductible

Skip Instructions:

1,2,RF,DK [goto INTROCOV_A]

Question ID: INS.0475.00.1
Variable: INTROCOV_A
Interview Module: Adult
Content Type:
Question text:

The next three questions are about services ^FIRSTPLANA may cover.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know

Skip Instructions:

1 [goto PRRXCOV_A]

Question ID: INS.0480.00.1
Variable: PRRXCOV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does ^FIRSTPLANA pay for any of the costs for medications prescribed by a doctor?
* Read if necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you were prescribed medications.

Fills:

^FIRSTPLANA

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where the name of the plan was given or refused or don't know

Skip Instructions:

1,2,RF,DK [goto PRDNCOV_A]

Question ID: INS.0490.00.1
Variable: PRDNCOV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does ^FIRSTPLANA pay for any of the costs for dental care?
* Read if necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you did have dental care.

Fills:

^FIRSTPLANA

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where the plan name was given or refused or don't know.

Skip Instructions:

1,2,RF,DK [goto PRVSCOV_A]

Question ID: INS.0500.00.1
Variable: PRVSCOV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does ^FIRSTPLANA pay for any of the costs for routine vision care, such as glasses and contact
lenses?
* Read if necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you did have vision care.

Fills:

^FIRSTPLANA

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with private health insurance coverage where a plan name was given or refused or don't know.

Skip Instructions:

1,2,RF,DK If there is another plan [goto bPlan for next plan]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0510.00.1
Variable: CHNAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that you are covered by the Children's Health Insurance Program or CHIP. What
is the name of the plan?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

allow 80,RF,DK [goto CHXCHNG_A]

Question ID: INS.0520.00.1
Variable: CHXCHNG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Was your CHIP plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

1,2,RF,DK [goto CHPREM_A]

Question ID: INS.0530.00.1
Variable: CHPREM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount you or a family member pays each month for health care
coverage. Do you or a family member pay a premium for this CHIP plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

1,2,RF,DK [goto CHDEDUC_A]

Question ID: INS.0540.00.1
Variable: CHDEDUC_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your CHIP plan have an annual
deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a CHIP plan

Skip Instructions:

1 [goto CHHDHP_A]
2,RF,DK if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0550.00.1
Variable: CHHDHP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have a CHIP plan deductible

Skip Instructions:

1,2,RF,DK if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0560.00.1
Variable: OPNAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that you are covered by a state-sponsored plan. What is the name of the plan?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

allow 80,RF,DK [goto OPXCHNG_A]

Question ID: INS.0570.00.1
Variable: OPXCHNG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Was your state-sponsored plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

1,2,RF,DK [goto OPPREM_A]

Question ID: INS.0580.00.1
Variable: OPPREM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount you or a family member pays each month for health care
coverage. Do you or a family member pay a premium for this state-sponsored plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

1,2,RF,DK [goto OPDEDUC_A]

Question ID: INS.0590.00.1
Variable: OPDEDUC_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your state-sponsored plan have
an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a state-sponsored plan

Skip Instructions:

1[goto OPHDHP_A]
2,RF,DK if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0600.00.1
Variable: OPHDHP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a state-sponsored plan with a deductible

Skip Instructions:

1,2,RF,DK if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0610.00.1
Variable: OGNAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that you are covered by an other government program. What is the name of the
plan?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have an other government plan

Skip Instructions:

allow 80,RF,DK [goto OGXCHNG_A]

Question ID: INS.0620.00.1
Variable: OGXCHNG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Was your other government plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have an other government plan

Skip Instructions:

1,2,RF,DK [goto OGPREM_A]

Question ID: INS.0630.00.1
Variable: OGPREM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount you or a family member pays each month for health care
coverage. Do you or a family member pay a premium for your other government plan?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have an other government plan

Skip Instructions:

1,2,RF,DK [goto OGDEDUC_A]

Question ID: INS.0640.00.1
Variable: OGDEDUC_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does your other government plan have
an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with an other government plan

Skip Instructions:

1 [goto OGHDHP_A]
2,RF,DK if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0650.00.1
Variable: OGHDHP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with an other government plan with a deductible

Skip Instructions:

1,2,RF,DK if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]

Question ID: INS.0660.00.1
Variable: MILSPC_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that you are covered by military related health care. What types of military
related health care are you covered by?
* Enter all that apply, separate with commas.

Response:

1 - VA health care
2 - TRICARE (CHAMPUS)
3 - CHAMP-VA (do not include CHAMPUS)
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with military related health care

Skip Instructions:

1-3,RF,DK [goto HINOTYR_A]

Question ID: INS.0670.00.1
Variable: HILAST_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How long has it been since you last had health care coverage that paid for doctor's visits or
hospital stays?

Response:

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe.

Skip Instructions:

1 [goto HILASTMY_A]
2,3 [goto HISTOPJOB_A]
4,5,6,0,RF,DK [goto RSNHICOST_A]

Question ID: INS.0680.00.1
Variable: HILASTMY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In the past 12 months, how many months were you without coverage?
* If less than 1 month, enter '1'.

Response:

01-12 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ without known health insurance who last had insurance at some time within the last 12 months

Skip Instructions:

1-12,RF,DK [goto HISTOPJOB_A]

Question ID: INS.0690.00.1
Variable: HISTOPJOB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Think about the last time that you did have health care coverage that paid for doctor's visits
or hospital stays. I am going to read a list of reasons why someone might no longer be enrolled
in coverage. Please tell me, yes or no, if this is a reason why you are no longer enrolled in
your last health care plan.
You or the policyholder retired, lost a job, or changed employers?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPMISS_A]

Question ID: INS.0700.00.1
Variable: HISTOPMISS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Are you no longer enrolled in your last health care plan because...
You missed a deadline for signing up or paying for the coverage?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPAGE_A]

Question ID: INS.0710.00.1
Variable: HISTOPAGE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Are you no longer enrolled in your last health care plan because...
You became ineligible because of your age or because you left school?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPCOST_A]

Question ID: INS.0720.00.1
Variable: HISTOPCOST_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: Are you no longer enrolled in your last health care plan because...
The cost for your coverage increased?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPELIG_A]

Question ID: INS.0730.00.1
Variable: HISTOPELIG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
* Read if necessary: Are you no longer enrolled in your last health care plan because...
You had Medicaid or other public coverage, but were no longer eligible?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto RSNHICOST_A]

Question ID: INS.0740.00.1
Variable: RSNHICOST_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^INSREASONS Are you currently uninsured because coverage is not afforable?

Fills:

^INSREASONS

Description: RSNHICOST_A Introduction
Instruction:
If HILAST_A IN (0,4,5,6,RF,DK) fill: "There are many reasons why people do not have health insurance coverage."
If HILAST_A IN (1,2,3) fill: "We just discussed reasons
you lost coverage. Now I am going to ask you some
questions about why you haven't obtained coverage."

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe.

Skip Instructions:

1,2,RF,DK [goto RSNHIWANT_A]

Question ID: INS.0750.00.1
Variable: RSNHIWANT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

There are other reasons that people do not have health insurance coverage. ^PLUSCOSTA you
currently uninsured because...
...you do not need or want coverage?

Fills:

^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe.

Skip Instructions:

1,2,RF,DK [goto RSNHIELIG_A]

Question ID: INS.0760.00.1
Variable: RSNHIELIG_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...you are not eligible for coverage?

Fills:

^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe

Skip Instructions:

1,2,RF,DK [goto RSNHICONF_A]

Question ID: INS.0770.00.1
Variable: RSNHICONF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...the process of signing up for coverage is too difficult or confusing?

Fills:

^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe

Skip Instructions:

1,2,RF,DK [goto RSNHIMEET_A]

Question ID: INS.0780.00.1
Variable: RSNHIMEET_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...you cannot find a plan that meets your needs?

Fills:

^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe

Skip Instructions:

1,2,RF,DK [goto RSNHIWAIT_A]

Question ID: INS.0790.00.1
Variable: RSNHIWAIT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because...
...you applied for coverage but it has not started yet?

Fills:

^PLUSCOSTA

Description: In addition to cost, are/Are
Instruction:
if RSNHICOST_A = 1 then fill 'In addition to cost, are'. Else fill 'Are'

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe

Skip Instructions:

1,2,RF,DK [goto RSNHIOTH_A]

Question ID: INS.0800.00.1
Variable: RSNHIOTH_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Is there another reason that you currently do not have health insurance coverage?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicare probe or the Medicaid probe

Skip Instructions:

1 [goto RSNHIOTHSP_A]
2,RF,DK [goto next section]

Question ID: INS.0810.00.1
Variable: RSNHIOTHSP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What is your other reason for not having coverage?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have another reason for not having coverage

Skip Instructions:

allow 80,RF,DK [goto next section]

Question ID: INS.0820.00.1
Variable: HINOTYR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In the past 12 months, was there any time when you did NOT have ANY health insurance or
coverage?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with known health insurance coverage or responded yes to the medicare probe or medicaid probe

Skip Instructions:

1 [goto HINOTMYR_A]
2,RF,DK [goto FINISH_A]

Question ID: INS.0830.00.1
Variable: HINOTMYR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In the past 12 months, about how many months were you without coverage?
* If less than 1 month, enter '1'.

Response:

01-12 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ with known health insurance coverage and did not have health insurance for some period of time in the past 12 months

Skip Instructions:

1-12,RF,DK [goto FINISH_A]

Question ID: INS.0840.00.1
Variable: FINISH_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* The Sample Adult health insurance section is now complete.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PAY: Difficulty Paying for Health Care
Question ID: PAY.0010.00.1
Variable: PAYINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
Now I am going to ask you about your medical bills. Include bills for doctors, dentists,
hospitals, therapists, medication, equipment, and nursing home or home care.
^Dormfill
* Enter '1' to continue.

Fills:

^Dormfill

Description: think about family living in family home
Instruction:
If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "When I ask about your family, please think about your
family living at ^HNO ^HNOSUF ^STRNAME."
else leave blank

^HNO

Description: {Value of HNO}
Instruction:
Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ living in same family as the Sample Child when the Sample Child PAY section has not been completed or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered don't or refused to PAYBLL12M_C and PAYNOBLLNW_C or Sample adults living in different families than the Sample Child

Skip Instructions:

1 [goto PAYBLL12M_A]
Replicate To: PAYINTRO_C

Question ID: PAY.0020.00.1
Variable: PAYBLL12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
In the past 12 months did ^youanyone have problems paying or were unable to pay any medical
bills?
* Read if necessary: Include bills for doctors, dentists, hospitals, therapists, medication,
equipment, nursing home or home care.

Fills:

^youanyone

Description: you/anyone in the family
Instruction:
If GEN.PCNT_A=1 fill "you"; else fill "anyone in the family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ living in same family as the Sample Child when the Sample Child PAY section has not been completed or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered don't or refused to PAYBILL12M_C and PAYNOBLLNW_C or Sample adults living in different families than the Sample Child

Skip Instructions:

1,RF,DK [goto PAYNOBLLNW_A]
2 [goto PAYWORRY_A]
Replicate To: PAYBLL12M_C

Question ID: PAY.0030.00.1
Variable: PAYNOBLLNW_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^DoyouDoesanyoneinfam currently have any medical bills that you are unable to pay at all?

Fills:

^DoyouDoesanyoneinfam

Description: Do you/Does anyone in your family
Instruction:
If GEN.PCNT_A=1 fill "Do you"; else fill "Does anyone in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ where anyone in the family has difficulty playing medical bills or don't know or refused and Sample Adult is living in same family as the Sample Child when the Sample Child PAY section has not been completed or Sample Adults living in same family as Sample Child when the Sample Child respondent is not the Sample Adult and the Sample Child respondent answered don't or refused to PAYBILL12M_C and PAYNOBLLNW_C or Sample adults living in different families than the Sample Child AND who said they/anyone in their family has problems paying their medical bills or don't know or refuse to answer if they/anyone in their family has problems paying bills

Skip Instructions:

1,2,RF,DK [goto PAYWORRY_A]
Replicate To: PAYNOBLLNW_C

Question ID: PAY.0040.00.1
Variable: PAYWORRY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

If you get sick or have an accident, how worried are you that you will be able to pay your
medical bills? Are you very worried, somewhat worried, or not at all worried?

Response:

1 - Very worried
2 - Somewhat worried
3 - Not at all worried
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CVD: Positive COVID-19 Diagnosis
Question ID: CVD.0010.00.4
Variable: CVDINTRO_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

The next set of questions are about coronavirus or COVID-19.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto CVDDIAG_A]

Question ID: CVD.0020.00.4
Variable: CVDDIAG_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Has a doctor or other health professional ever told you that you had or likely had coronavirus
or COVID-19?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto COVIDTEST_A]

Question ID: CVD.0030.00.4
Variable: COVIDTEST_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Have you ever been tested for coronavirus or COVID-19?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto CVDRSLT_A]
2,RF,DK if CVDDIAG_A=1 [goto CVDSEV_A]
else [goto next section]

Question ID: CVD.0040.00.4
Variable: CVDRSLT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Did the test find that you had coronavirus or COVID-19?
* If any test has shown they have COVID-19, enter '1' for yes.
* If the respondent indicates they are waiting for their results, enter '3' for Did not receive
results.
* If the respondent indicates the test was inconclusive, enter 'CTRL-D' for Don't Know.

Response:

1 - Yes
2 - No
3 - Did not receive results
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been tested for COVID-19

Skip Instructions:

1 [goto CVDSEV_A]
2-3,RF,DK if CVDDIAG_A=1 [goto CVDSEV_A]
else [goto next section]

Question ID: CVD.0050.00.4
Variable: CVDSEV_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

How would you describe your coronavirus symptoms when they were at their worst? Would you say no
symptoms, mild symptoms, moderate symptoms, or severe symptoms?

Response:

1 - No symptoms
2 - Mild symptoms
3 - Moderate symptoms
4 - Severe symptoms
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have been told by a doctor or other health professional that they had or likely had coronavirus or COVID-19 or tested positive for COVID-19

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DNC: Dental Care
Question ID: DNC.0010.00.2
Variable: DNCINTRO_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

These next questions ask about your dental care.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto DENPREV_A]

Question ID: DNC.0020.00.2
Variable: DENPREV_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

About how long has it been since you last had a dental examination or cleaning?
* Read if necessary: Include cleanings from all types of dental care providers such as dentists,
orthodontists, oral surgeons, dental hygienists, and all other dental specialists.

Response:

Universe:

Sample Adults 18+

Skip Instructions:

0-6,RF,DK [goto DENDL12M_A]

Question ID: DNC.0030.00.2
Variable: DENDL12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, have you DELAYED getting dental care because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto DENNG12M_A]

Question ID: DNC.0040.00.2
Variable: DENNG12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, was there any time when you needed dental care, but DID NOT GET IT
because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
UTZ: Utilization
Question ID: UTZ.0010.00.1
Variable: UTZINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Now that we finished talking about dental care, I would like to ask you about other health care.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto LASTDR_A]

Question ID: UTZ.0020.00.1
Variable: LASTDR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

About how long has it been since you last saw a doctor or other health professional about your
health?
* Read if necessary: Include doctors seen while a patient in a hospital.
* Read if necessary: Do not include dental care.

Response:

Universe:

Sample Adults 18+

Skip Instructions:

1-6 [goto WELLNESS_A]
0,RF,DK [goto USUALPL_A]

Question ID: UTZ.0030.00.1
Variable: WELLNESS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was this a wellness visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and
blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health
professional may also discuss topics related to your health such as smoking, alcohol use, diet
and exercise. These visits are usually scheduled in advance and occur when you are not sick or
injured.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have seen a doctor

Skip Instructions:

1 [goto USUALPL_A]
2,RF,DK [goto WELLVIS_A]

Question ID: UTZ.0040.00.1
Variable: WELLVIS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

About how long has it been since you last saw a doctor or other health professional for a
wellness visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: blood pressure, cholesterol, and
blood sugar checks, height and weight measurements, and vaccinations. The doctor or other health
professional may also discuss topics related to your health such as smoking, alcohol use, diet
and exercise. These visits are usually scheduled in advance and occur when you are not sick or
injured.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.

Response:

Universe:

Sample Adults 18+ who have seen a doctor, but the last visit was not a wellness visit or they didn't know or refused whether it was a wellness visit

Skip Instructions:

0-6,RF,DK [goto USUALPL_A]

Question ID: UTZ.0050.00.1
Variable: USUALPL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Is there a place that you USUALLY go to if you are sick and need health care?

Response:

1 - Yes
2 - There is NO place
3 - There is MORE THAN ONE place
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,3,RF,DK [goto USPLKIND_A]
2 [goto URGENT12M_A]

Question ID: UTZ.0060.00.1
Variable: USPLKIND_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What kind of place ^ISITGOMSTOFT - a doctor's office or health center; an urgent care center, a
clinic in a drug store or grocery store; a hospital emergency room; a VA Medical Center or VA
outpatient clinic; or some other place?
* Read if necessary: A doctor's office or health center is a place where you see the same doctor
or the same group of doctors every visit, where you usually need to make an appointment ahead of
time, and where your medical records are on file.
* Read if necessary: Urgent care centers and clinics in a drug store or grocery store are places
where you do not need to make an appointment ahead of time, and do not usually see the same
health care provider at each visit.

Fills:

^ISITGOMSTOFT

Description: is it/do you go to most often
Instruction:
If USUALPL_A=1 fill "is it"; else fill "do you go to most often"

Response:

1 - A doctor's office or health center
2 - Urgent care center or clinic in a drug store or grocery store
3 - Hospital emergency room
4 - A VA Medical Center or VA outpatient clinic
5 - Some other place
6 - Does not go to one place most often
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with 1+ usual place of care or who don't know or refused to answer if they have a usual place of care

Skip Instructions:

1-6,RF,DK [goto URGENT12M_A]

Question ID: UTZ.0070.00.1
Variable: URGENT12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, how many times have you gone to an urgent care center or a clinic in
a drug store or grocery store about your health?
* Enter 96 if number is 96 or greater.
* Read if necessary: Urgent care centers and clinics in drug stores or grocery stores are places
where you do not need to make an appointment ahead of time, and do not usually see the same
health care provider at each visit.
* Read if necessary: This is different from a hospital emergency room.

Response:

00-96 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

0-39,RF,DK [goto EMERGE12M_A]
40-96 [goto ERR1_URGENT12M_A]

Soft Edit:

Check Text: ERR1_URGENT12M_A
Check Description: Urgent care 40-96 times
Check Text: {signal ERR1_URGENT12M_A}^URGENT12M_A is an unusually large number. Did you visit an urgent care center or clinic in a drug store or grocery store about your health ^URGENT12M_A times in the past 12 months? Please verify.

Question ID: UTZ.0080.00.1
Variable: EMERGE12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, how many times have you gone to a hospital emergency room about your
health?
* Read if necessary: This includes emergency room visits that resulted in a hospital admission.
* Enter 96 if number of times is 96 or more.

Response:

00-96 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

0-39,RF,DK [goto HOSPONGT_A]
40-96 [goto ERR1_EMERGE12M_A]

Soft Edit:

Check Text: ERR1_EMERGE12M_A
Check Description: ER 40-96 times
Check Text: {signal ERR1_EMERGE12M_A}^EMERGE12M_A is an unusually large number. Did you visit a hospital emergency room about your health ^EMERGE12M_A times in the past 12 months? Please verify.

Question ID: UTZ.0090.00.1
Variable: HOSPONGT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you been hospitalized overnight? ^PAST12MER_A

Fills:

^PAST12MER_A

Description: Do not include an overnight stay in the emergency room.
Instruction:
If ((EMERGE12M_A ge 01 and EMERGE12M_A le 96) or EMERGE12M_A IN (RF,DK): Fill: "Do not include an overnight
stay in the emergency room."

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto MEDDL12M_A]

Question ID: UTZ.0100.00.1
Variable: MEDDL12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you DELAYED getting medical care because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto MEDNG12M_A]

Question ID: UTZ.0110.00.1
Variable: MEDNG12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, was there any time when you needed medical care, but DID NOT GET IT
because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ACC: Access to Care
Question ID: ACC.0010.00.4
Variable: DLYCARE_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Was there any time when you DELAYED getting medical care because of the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto DNGCARE_A]

Question ID: ACC.0020.00.4
Variable: DNGCARE_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Was there any time when you needed medical care for something other than coronavirus, but DID
NOT GET IT because of the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto VIRAPP12M_A]

Question ID: ACC.0030.00.4
Variable: VIRAPP12M_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

In the past 12 months, have you had an appointment with a doctor, nurse, or other health
professional by video or by phone?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto VIRAPPCVD_A]
2,RF,DK [goto next section]

Question ID: ACC.0040.00.4
Variable: VIRAPPCVD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Were any of your appointments done by video or by phone because of reasons related to the
coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have had a virtual medical appointment

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CNV: Cancer COVID-19
Question ID: CNV.0010.00.4
Variable: CANCOVTREA_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

The next question refers to treatments for cancer such as surgery, radiation therapy,
chemotherapy, bone marrow transplants, stem cell transplants, or hormone therapy.
At any time since the start of the coronavirus pandemic, were you in treatment or supposed to
receive treatment for your cancer?
* Read if necessary: Hormone therapy includes Tamoxifen, Fulvestrant (full-VESS-trant) or
Aromatase (uh-ROH-muh-tayz) inhibitors for breast cancer and androgen therapy, such as Eligard
or Zoladex for prostate cancer.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever had cancer

Skip Instructions:

1 [goto CANCOVCHG_A]
2,RF,DK [goto CANCOVOTH_A]

Question ID: CNV.0020.00.4
Variable: CANCOVCHG_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Were any of your treatments for cancer changed, delayed, or cancelled because of the coronavirus
pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had treatment or were supposed to receive treatment for cancer during the coronavirus pandemic

Skip Instructions:

1,2,RF,DK [goto CANCOVOTH_A]

Question ID: CNV.0030.00.4
Variable: CANCOVOTH_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

As a cancer patient or cancer survivor, you may need OTHER medical care related to your cancer
such as lab visits, imaging, monitoring visits, rehabilitation, physical therapy, care for sideeffects, or visits with medical specialists.
At any time since the start of the coronavirus pandemic, did you need any of this OTHER medical
care related to your cancer?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever had cancer

Skip Instructions:

1 [goto CANCOVCARE_A]
2,RF,DK [goto next section]

Question ID: CNV.0040.00.4
Variable: CANCOVCARE_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Was any of this OTHER medical care related to your cancer changed, delayed, or cancelled because
of the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who needed other medical care related to cancer during coronavirus pandemic

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PMD: Prescription Medication
Question ID: PMD.0010.00.1
Variable: RX12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

At any time in the past 12 months, did you take prescription medication?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto RXSK12M_A]
2,RF,DK [goto RXDG12M_A]

Question ID: PMD.0020.00.1
Variable: RXSK12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, were any of the following true for you?
...You skipped medication doses to save money.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK [goto RXLS12M_A]

Question ID: PMD.0030.00.1
Variable: RXLS12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: During the past 12 months, were any of the following true for you?
...You took less medication to save money.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK [goto RXDL12M_A]

Question ID: PMD.0040.00.1
Variable: RXDL12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: During the past 12 months, were any of the following true for you?
...You DELAYED filling a prescription to save money.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK [goto RXDG12M_A]

Question ID: PMD.0050.00.1
Variable: RXDG12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, was there any time when you needed prescription medication, but DID
NOT GET IT because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
OPD: Opioid Use - ALL
Question ID: OPD.0010.00.3
Variable: OPD12M_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

?[F1]
These next questions are about the use of prescription pain relievers called opioids. When
answering these questions, please do not include over-the-counter pain relievers such as
aspirin, Tylenol, Advil, or Aleve.
During the past 12 months, have you taken any opioid pain relievers prescribed by a doctor,
dentist, or other health professional? Examples include hydrocodone, Vicodin, Norco, Lortab,
oxycodone, OxyContin, Percocet, and Percodan. If you are not sure, please tell me the name of
the drug and I can look it up.
* Press F1 to pull up list of prescription opioids.
* Enter '1' for yes, if any medications provided are on the list.
* Enter '2' for no, if no medications provided are on the list.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and OPIODALL_FLG=1

Skip Instructions:

1 [goto OPD3M_A]
2,RF,DK [goto next section]

Question ID: OPD.0020.00.3
Variable: OPD3M_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 3 months, have you taken any opioid pain relievers prescribed by a doctor,
dentist, or other health professional?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and also have taken any opioids prescribed by a doctor in the past 12 months

Skip Instructions:

1 [goto OPDACUTE_A]
2,RF,DK [goto next section]

Question ID: OPD.0030.00.3
Variable: OPDACUTE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 3 months, did you take a prescription opioid to treat short-term or acute pain,
such as pain due to a broken bone or muscle sprain, pain from dental work, or pain following
surgery?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and have also taken any opioids prescribed by a doctor in the past 3 months

Skip Instructions:

1,2,RF,DK [goto OPDCHRONIC_A]

Question ID: OPD.0040.00.3
Variable: OPDCHRONIC_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 3 months, did you take a prescription opioid to treat long-term or chronic pain,
such as low back pain or neck pain, frequent headaches or migraines, or joint pain or arthritis?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and have also taken any opioids prescribed by a doctor in the past 3 months

Skip Instructions:

1 [goto OPDFREQ_A]
2,RF,DK [goto next section]

Question ID: OPD.0050.00.3
Variable: OPDFREQ_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 3 months, how often did you take a prescription opioid? Would you say some days,
most days, or every day?

Response:

1 - Some days
2 - Most days
3 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have taken prescribed medication in the past 12 months and have also taken any opioids prescribed by a doctor in the past 3 months for chronic pain

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
IMS: Immunization with 2020 supplements
Question ID: IMS.0010.00.3
Variable: PREGFLUYR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Were you pregnant any time ^AUGUSTYEAR?

Fills:

^AUGUSTYEAR

Description: period of pregnancy
Instruction:
If INTERVIEW_MONTH=1-3 "since August 1st, ^LASTYEAR" If INTERVIEW_MONTH=4-7 "from August ^LASTYEAR through
March ^YEAR"
If INTERVIEW_MONTH=8-12 "since August 1st, ^YEAR"

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YEAR

Description: Year of Interview
Instruction:
Current Year

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Female sample adults 18-49 years or age is don't know or refused and who are not currently pregnant or don't know if they are currently pregnant or who are currently pregnant and the interview occurred between April-July

Skip Instructions:

1,2,DK [goto LIVEBIRTH_A]
RF [goto SHTFLU12M_A]

Question ID: IMS.0020.00.3
Variable: LIVEBIRTH_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, did you have a pregnancy that ended in a live birth?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Female sample adults aged 18-49 of age or age is don't know or refused who did not refuse to answer if they are currently pregnant or if they were pregnant in between August and March

Skip Instructions:

1,2,RF,DK [goto SHTFLU12M_A]

Question ID: IMS.0030.00.1
Variable: SHTFLU12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

There are two types of flu vaccinations. One is a shot and the other is a spray, mist, or drop
in the nose. During the past 12 months, have you had a flu vaccination?
* Read if necessary: A flu vaccination is usually given in the fall and protects against
influenza for the flu season.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SHTFLUM_A]
2,RF,DK [goto SHTPNUEV_A]

Question ID: IMS.0040.01.1
Variable: SHTFLUM_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* 1 of 2
During what month and year did you receive your most recent flu vaccine?

Response:

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

Universe:

Sample Adults 18+ who had a flu shot in the past 12 months

Skip Instructions:

1-12,DK [goto SHTFLUY_A]
RF if Adult.BMI.PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A]
else [goto SHTPNUEV_A]

Question ID: IMS.0040.02.1
Variable: SHTFLUY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* 2 of 2
* Enter year of most recent flu vaccine.

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Adults 18+ who gave a month for their last flu shot or who didn't know the month

Skip Instructions:

valid year,RF,DK
if SHTFLUM_A and SHTFLUY_A = a future date [goto ERR1_SHTFLUY_A]
elseif SHTFLUM_A and SHTFLUY_A = a date before 12 months ago [goto ERR2_SHTFLUY_A]
elseif PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A]
else [goto SHTPNUEV_A]

Hard Edit:

Check Text: ERR1_SHTFLUY_A
Check Description: Future date hard edit
Check Text: {check ERR1_SHTFLUY_A} Future date invalid. Please correct.
Check Text: ERR2_SHTFLUY_A
Check Description: Date > 12 months ago hard edit
Check Text: {check ERR2_SHTFLUY_A}
Date more than 12 months ago. Please correct.

Question ID: IMS.0050.00.3
Variable: FLUPREG_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Did you get a flu vaccination before or during your current pregnancy?

Response:

1 - Before pregnancy
2 - During pregnancy
7 - Refused
9 - Don't Know

Universe:

Female Sample Adults 18-49 (or don't know or refuse their age) who are currently pregnant and received a flu vaccination in the past 12 months and the interview takes place in Jan-March or Aug-Dec

Skip Instructions:

1,2,RF,DK [goto SHTPNUEV_A]

Question ID: IMS.0060.00.3
Variable: FLUPREG2_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Earlier you said you were pregnant sometime ^AUGUSTYEAR. Did you get a flu vaccination before,
during, or after your pregnancy?

Fills:

^AUGUSTYEAR

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YEAR

Description: Year of Interview
Instruction:
Current Year

Response:

1 - Before pregnancy
2 - During pregnancy
3 - After pregnancy
7 - Refused
9 - Don't Know

Universe:

Female sample adults 18-49 years of age who reported a pregnancy during August-March and received a flu vaccination in the past 12 months

Skip Instructions:

1-3,RF,DK [goto SHTPNUEV_A]

Question ID: IMS.0070.00.1
Variable: SHTPNUEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

A pneumonia shot is also known as a pneumococcal vaccine. Have you ever had a pneumonia shot?
* Read if necessary: There are two types of pneumonia shots: polysaccharide, also known as
Pneumovax®, and conjugate, also known as Prevnar®.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SHTPNEUNB_A]
2,RF,DK if GEN.AGE_FINAL[PX_A] ge 50 [goto SHTSHINGLE_A]
else if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN (RF,DK)) and LIVEBIRTH_A=1 [goto
TDAPPREG_A]
else [goto WORKHEALTH_A]

Question ID: IMS.0080.00.1
Variable: SHTPNEUNB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How many pneumonia shots have you ever had?

Response:

1 - One pneumonia shot
2 - Two pneumonia shots
3 - More than two pneumonia shots
7 - Refused
9 - Don't Know

Universe:

Sample Adults who ever had a pneumonia shot

Skip Instructions:

1-3,RF,DK if GEN.AGE_FINAL[PX_A] ge 50 [goto SHTSHINGLE_A]
elseif LIVEBIRTH_A=1 [goto TDAPPREG_A]
else [goto WORKHEALTH_A]

Question ID: IMS.0090.00.3
Variable: SHTSHINGLE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Have you had a vaccine for shingles?
* Read if necessary: Shingles is an illness that results in a rash or blisters on the skin, and
is usually painful. There are two vaccines now available for shingles. The first is Zostavax®,
which requires 1 shot and has been available since 2006. The other is Shingrix®, a new vaccine
which requires 2 shots and has been available since 2017.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 50+

Skip Instructions:

1 [goto ZOSTAVAX_A]
2,RF,DK [goto WORKHEALTH_A]

Question ID: IMS.0100.00.3
Variable: ZOSTAVAX_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

There are two vaccines now available for shingles. The first is Zostavax®, which requires one
shot and has been available since 2006. The other is Shingrix®, a new vaccine which requires 2
shots and has been available since 2017.
Have you ever had Zostavax®, the shingles vaccine that requires one shot?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults age 50 or older who ever had a vaccine for shingles

Skip Instructions:

1 [goto ZOSTAVAXYR_A]
2,RF,DK [goto SHINGRIX_A]

Question ID: IMS.0110.00.3
Variable: ZOSTAVAXYR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

What year did you get your most recent Zostavax® shot?
* Read if necessary: The Zostavax® vaccine has been available since 2006.

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Adults age 50 or older who had Zostavax vaccine

Skip Instructions:

1900-2030 if future date [goto ERR1_ZOSTAVAXYR_A]
elseif date before birth [goto ERR2_ZOSTAVAXYR_A]
else [goto SHINGRIX_A]
RF,DK [goto ZOSTAWHEN_A]

Hard Edit:

Check Text: ERR1_ZOSTAVAXYR_A
Check Description: Future date hard edit
Check Text: {check ERR1_ZOSTAVAXYR_A} Future date invalid. Please correct.
Check Text: ERR2_ZOSTAVAXYR_A
Check Description: Date of most recent Zostavax shot is prior to Sample Adult's birth - hard edit
Check Text: {check ERR2_ZOSTAVAXYR_A}
Date of most recent Zostavax® shot is prior to Sample Adult's birth. Please correct.

Question ID: IMS.0120.00.3
Variable: ZOSTAWHEN_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Was it before 2018?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults aged 50 and older who don't know or refused the year they had a Zostavax vaccination

Skip Instructions:

1,2,RF,DK [goto SHINGRIX_A]

Question ID: IMS.0130.00.3
Variable: SHINGRIX_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Have you ever had Shingrix®, the new shingles vaccine which requires 2 shots and has been
available since 2017?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 50+ who had a shingles vaccine

Skip Instructions:

1 [goto SHINGRIXNB_A]
2,RF,DK else [goto WORKHEALTH_A]

Question ID: IMS.0140.00.3
Variable: SHINGRIXNB_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

How many Shingrix® shots have you ever had?

Response:

1 - One Shingrix shot
2 - Two Shingrix shots
7 - Refused
9 - Don't Know

Universe:

Sample Adults aged 50 or older who had a Shingrix vaccine

Skip Instructions:

1,2,RF,DK [goto SHINGRIXYR_A]

Question ID: IMS.0150.00.3
Variable: SHINGRIXYR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

What year did you get your most recent Shingrix® shot?
* Read if necessary: The Shingrix® vaccine has been available since 2017.

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Adults aged 50 or older who had a Shingrix vaccine

Skip Instructions:

1900-2030 if future date [goto ERR1_SHINGRIXYR_A]
elseif date prior to birth [goto ERR2_SHINGRIXYR_A]
else [goto WORKHEALTH_A]
RF,DK [goto SHINGWHEN_A]

Hard Edit:

Check Text: ERR2_SHINGRIXYR_A
Check Description: Date of most recent Shingrix shot is prior to Sample Adult's birth - hard edit
Check Text: {check ERR2_SHINGRIXYR_A}
Date of most recent Shingrix® shot is prior to Sample Adult's birth. Please correct.
Check Text: ERR1_SHINGRIXYR_A
Check Description: Future date hard edit
Check Text: {check ERR1_SHINGRIXYR_A} Future date invalid. Please correct.

Question ID: IMS.0160.00.3
Variable: SHINGWHEN_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Was it before 2018?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults aged 50 and older who had a Shingrix vaccination and don't know or refused the year they had it.

Skip Instructions:

1,2,RF,DK [goto WORKHEALTH_A]

Question ID: IMS.0170.00.03
Variable: TDAPPREG_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

A Tdap vaccination is a tetanus booster shot that also includes pertussis (per-TUH-sis) or
whooping cough vaccine. Earlier you said that you had a pregnancy that ended in a live birth
during the past 12 months. Did you receive a Tdap vaccine during this pregnancy?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Female Sample Adults less than 49 years old or who don't know or refused their age who had a live birth in the past 12 months

Skip Instructions:

1,2,RF,DK [goto WORKHEALTH_A]

Question ID: IMS.0180.00.3
Variable: WORKHEALTH_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In your work or volunteer activities, do you provide direct medical care to patients, such as
being a doctor, nurse, dentist, therapist, home health care worker, or emergency responder?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto next section]
2,RF,DK [goto WRKHLTHFC_A]

Question ID: IMS.0190.00.3
Variable: WRKHLTHFC_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Even if you do not provide direct medical care to patients, do you do any kind of work or
volunteer activities in a health care facility, such as in a hospital, doctor's office,
dentist's office, clinic, nursing home, or residential care home?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who do not provide medical care to patients or don't know or refused if they do

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PTC: Physical and other therapeutic care
Question ID: PTC.0010.00.2
Variable: EYEEX12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, have you had an eye exam from an eye specialist such as an
optometrist, ophthalmologist, or eye doctor?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto THERA12M_A]

Question ID: PTC.0020.00.1
Variable: THERA12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, did you receive physical therapy, speech therapy, rehabilitative
therapy, or occupational therapy?
* Read if necessary: Do not include mental health therapy.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto HOMEHC12M_A]

Question ID: PTC.0030.00.1
Variable: HOMEHC12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, did you receive care at home from a nurse or other health
professional?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CGR: Caregiving Received
Question ID: CGR.0010.00.4
Variable: HOMECAREDG_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Was there any time when you needed care at home from a nurse or other health professional but
DID NOT GET IT because of the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto FAMCARE12M_A]

Question ID: CGR.0020.00.4
Variable: FAMCARE12M_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

During the past 12 months, did you receive care at home from a friend or family member?
* If the respondent asks what is meant by the term "care," say: "A wide range of activities that
a person may need help with can be considered care. For example, care at home can include
personal tasks such as giving medications or helping with eating, dressing, or bathing or
household tasks such as cleaning, managing money, or preparing meals."

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto FAMCAREDNG_A]

Question ID: CGR.0030.00.4
Variable: FAMCAREDNG_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Was there any time when you needed care at home from a friend or family member but DID NOT GET
IT because of the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK if HOMECAREDG_A=1 and FAMCARE12M_A=1[goto FAMCARECVD_A]
else [goto next section]

Question ID: CGR.0040.00.4
Variable: FAMCARECVD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Did a friend or family member provide some or all of the care that a nurse or other health
professional did not provide due to the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who did not get home care from nurse/health professional due to COVID-19 and received home care from friend/family

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ANX: Anxiety
Question ID: ANX.0010.00.1
Variable: ANXFREQ_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How often do you feel worried, nervous or anxious? Would you say daily, weekly, monthly, a few
times a year, or never?
* If respondent asks whether they are to answer about their emotional states after taking moodregulating medications, say: "Please answer based on your usual use of medication."

Response:

1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK [goto ANXMED_A]

Question ID: ANX.0020.00.1
Variable: ANXMED_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you take prescription medication for these feelings?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK [goto ANXLEVEL_A]
2 if ANXFREQ_A=5 [goto next section]
else [goto ANXLEVEL_A]

Question ID: ANX.0030.00.1
Variable: ANXLEVEL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Thinking about the last time you felt worried, nervous or anxious, how would you describe the
level of these feelings? Would you say a little, a lot, or somewhere in between?

Response:

1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who feel worried, anxious, or nervous daily, weekly, monthly, a few times a year or don't know or refused how often OR who do take medication for these feelings or don't know or refused if they take medication for these feelings

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DEP: Depression
Question ID: DEP.0010.00.1
Variable: DEPFREQ_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How often do you feel depressed? Would you say daily, weekly, monthly, a few times a year, or
never?
* If respondent asks whether they are to answer about their emotional states after taking moodregulating medications, say: "Please answer based on your usual use of medication."

Response:

1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK [goto DEPMED_A]

Question ID: DEP.0020.00.1
Variable: DEPMED_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you take prescription medication for depression?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK [goto DEPLEVEL_A]
2 if DEPFREQ_A=5 [goto next section]
else [goto DEPLEVEL_A]

Question ID: DEP.0030.00.1
Variable: DEPLEVEL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Thinking about the last time you felt depressed, how depressed did you feel? Would you say a
little, a lot, or somewhere in between?

Response:

1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who feel depressed daily, weekly, monthly, a few times a year or refused or don't know how often they feel depressed OR who do take medication or refused or don't know if they take medication for depression.

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
MHC: Mental Health Care
Question ID: MHC.0010.00.2
Variable: MHRX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, did you take prescription medication to help you with any other
emotions or with your concentration, behavior or mental health?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have not taken medication for worry or don't know or refused if they have and have not taken medication for depression or don't know or refused if they have

Skip Instructions:

1,2,RF,DK [goto MHTHRPY_A]

Question ID: MHC.0020.00.2
Variable: MHTHRPY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, did you receive counseling or therapy from a mental health
professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK [goto MHTPYNOW_A]
2 [goto MHTHDLY_A]

Question ID: MHC.0030.00.2
Variable: MHTPYNOW_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you currently receiving counseling or therapy from a mental health professional?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have received, or refused to answer or don't know if they have received counseling or therapy from a mental health professional in the past 12 months

Skip Instructions:

1,2,RF,DK [goto MHTHDLY_A]

Question ID: MHC.0040.00.2
Variable: MHTHDLY_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, have you DELAYED getting counseling or therapy from a mental health
professional because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto MHTHND_A]

Question ID: MHC.0050.00.2
Variable: MHTHND_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, was there any time when you needed counseling or therapy from a
mental health professional, but DID NOT GET IT because of the cost?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PAI: Chronic Pain
Question ID: PAI.0010.00.2
Variable: PAIINTRO_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

The next question is about pain you may have had in the past three months.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto PAIFRQ3M_A]

Question ID: PAI.0020.00.2
Variable: PAIFRQ3M_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the past three months, how often did you have pain? Would you say never, some days, most
days, or every day?
* If respondent asks whether they are to answer about their pain when taking their medications,
say: "Please answer based on your usual use of medication."

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,RF,DK [goto next section]
2,3,4 [goto PAIAMNT_A]

Question ID: PAI.0030.00.2
Variable: PAIAMNT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Thinking about the last time you had pain, how much pain did you have? Would you say a little, a
lot, or somewhere in between?

Response:

1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had pain some days, most days, or every day in the past 3 months

Skip Instructions:

1-3,RF,DK [goto PAIOTCMEDS_A]

Question ID: PAI.0060.00.3
Variable: PAIOTCMEDS_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Over the past three months, did you use any of the following to manage your pain?
...Over-the-counter medications such as aspirin, Tylenol, Advil, or Aleve?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had pain at least some days in the past 3 months and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIPRSMEDS_A]

Question ID: PAI.0070.00.3
Variable: PAIPRSMEDS_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...A pain reliever ^opioid prescribed by a doctor, dentist, or other health professional?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had pain at least some days in the past 3 months and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIPHYSTPY_A]

Question ID: PAI.0080.00.3
Variable: PAIPHYSTPY_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Physical therapy, rehabilitative therapy, or occupational therapy?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had pain at least some days in the past 3 months and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAICHIRO_A]

Question ID: PAI.0090.00.3
Variable: PAICHIRO_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Spinal manipulation or other forms of chiropractic care?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAITALKTPY_A]

Question ID: PAI.0100.00.3
Variable: PAITALKTPY_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Talk therapies such as cognitive-behavioral therapy (CBT)?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIYOGA_A]

Question ID: PAI.0110.00.3
Variable: PAIYOGA_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Yoga, Tai Chi, or Qi Gong (chee-GONG)?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIEXRCISE_A]

Question ID: PAI.0120.00.3
Variable: PAIEXRCISE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Other forms of exercise, such as walking, swimming, bike riding, stretching, or strength
training?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIMASSAGE_A]

Question ID: PAI.0130.00.3
Variable: PAIMASSAGE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Massage?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIMEDITAT_A]

Question ID: PAI.0140.00.3
Variable: PAIMEDITAT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Over the past three months, did you use any of the following to manage your
pain?
...Meditation, guided imagery, or other relaxation techniques?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto PAIMOTHER_A]

Question ID: PAI.0150.00.3
Variable: PAIMOTHER_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Over the past three months, did you use any other approaches to manage your pain?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have pain at least some days and PAINMNG_FLG=1

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
REP: Repetitive Strain Injury
Question ID: REP.0010.00.2
Variable: REPSTRAIN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

The next set of questions asks about injuries.
The first question is about repetitive strain injuries. By this, we mean injuries caused by
repeating the same movement over an extended period. Examples include carpal tunnel syndrome,
tennis elbow, or tendonitis.
During the past 3 months, did you have any injuries due to repetitive strain?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto REPLIMIT_A]
2,RF,DK [goto next section]

Question ID: REP.0020.00.2
Variable: REPLIMIT_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Were any repetitive strain injuries serious enough to limit your usual activities for at least
24 hours?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a repetitive strain injury in the past 3 months

Skip Instructions:

1 [goto REPSAWDOC_A]
2,RF,DK [goto next section]

Question ID: REP.0030.00.2
Variable: REPSAWDOC_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

For the next questions, please think only about the repetitive strain injuries that limited your
usual activities for at least 24 hours after the injury occurred.
During the past 3 months, did you talk to or see a doctor or other health professional about
your repetitive strain injuries?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were limited in usual activities for at least 24 hours because of repetitive strain injury

Skip Instructions:

1,2,RF,DK [goto REPWRKDAYS_A]

Question ID: REP.0040.00.2
Variable: REPWRKDAYS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, how many days of work did you miss because of your repetitive strain
injuries?
* If respondent says none, no, or 0 days, ask: Did you work at all the past 3 months?
* Enter '90' if respondent says they missed every day of work in the past 3 months.
* Enter '91' if respondent says they did not work in the past 3 months.

Response:

00-90 - Range of values
91 - Did not work
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who were limited in usual activities for at least 24 hours because of repetitive strain injury

Skip Instructions:

1-90,DK [goto REPFUTWORK_A]
0,RF [goto REPSTOPCHG_A]
91 [goto REPWRKCAUS_A]

Question ID: REP.0050.00.2
Variable: REPFUTWRK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Do you expect to miss any more days of work because of your repetitive strain injuries?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who missed at least one day of work due to repetitive strain injury in past 3 months or don't know

Skip Instructions:

1,2,RF,DK [goto REPSTOPCHG_A]

Question ID: REP.0060.00.2
Variable: REPSTOPCHG_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you stop working or change jobs because of your repetitive strain
injuries?
Enter 'no' if respondent says they did not work in the past 3 months.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who missed 0 or more days of work due to repetitive strain injury in past 3 months or refused or don't know

Skip Instructions:

1,2,RF,DK [goto REPREDUCE_A]

Question ID: REP.0070.00.2
Variable: REPREDUCE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you make a major change in your work activities, such as taking on
fewer hours or lighter duties, because of your repetitive strain injuries?
* Enter 'no' if respondent says they did not work in the past 3 months.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who missed 0 or more days of work due to repetitive strain injury in past 3 months or refused or don't know

Skip Instructions:

1,2,RF,DK [goto REPWRKCAUS_A]

Question ID: REP.0080.00.2
Variable: REPWRKCAUS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Have you ever been told by a doctor or other health professional that any of your repetitive
strain injuries were likely to be work-related?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were limited in usual activities for at least 24 hours because of repetitive strain injury

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
INJ: Injury
Question ID: INJ.0010.00.2
Variable: INJINTRO_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

The next set of questions asks about SUDDEN injuries. People can be injured accidentally or on
purpose. They may hurt themselves or others may cause them to be hurt.
Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto ANYINJURY_A]

Question ID: INJ.0020.00.2
Variable: ANYINJURY_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

^NOTREPS the past 3 months, did you have an accident or an injury where any part of your body
was hurt?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto INJLIMIT_A]
2,RF,DK [goto next section]

Question ID: INJ.0030.00.2
Variable: INJLIMIT_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Did any of these injuries limit your usual activities for at least 24 hours after the injury
occurred?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months

Skip Instructions:

1 [goto NUMINJ_A]
2,RF,DK [goto next section]

Question ID: INJ.0040.00.2
Variable: NUMINJ_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

For the next questions, please think only about the significant injuries that occurred during
the past 3 months. By significant, I mean those injuries that limited your usual activities for
at least 24 hours after the injury occurred.
^NOTREPS the past 3 months, how many times did these accidents or injury events occur?
* Enter '96' if number is 96 or greater.

Response:

01-96 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1-9,RF,DK [goto INJHOME_A]
10-96 [goto ERR1_NUMINJ_A], then [goto INJHOME_A]

Soft Edit:

Check Text: ERR1_NUMINJ_A
Check Description: High number of injuries
Check Text: {signal ERR1_NUMINJ_A} ^NUMINJ_A is an unusually large number. Please verify.

Question ID: INJ.0050.00.2
Variable: INJHOME_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_A occur while you were at your home?
* Read if necessary: Include the yards, garage, basement, and other places on the home property.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 if NUMINJ_A=1 [goto INJSPORTS_A]
elseif NUMINJ_A=2-96,RF,DK [goto INJWORK_A]
2,RF,DK [goto INJWORK_A]

Question ID: INJ.0060.00.2
Variable: INJWORK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_A occur while you were working at a job or business?
Enter 'no' if respondent says they did not work in the past 3 months.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported more than 1 injury in the past 3 months or don't know or who reported 1 injury in the past 3 months but did not report an injury at home

Skip Instructions:

1,2,RF,DK [goto INJSPORTS_A]

Question ID: INJ.0070.00.2
Variable: INJSPORTS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_A occur while you were playing sports or exercising,
including walking, biking, or running, playing baseball, basketball, football or doing any other
physical activity?
* Read if necessary: Include recreational sports such as skating, skiing, tennis, golf, bowling,
or fishing.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1,2,RF,DK [goto INJFALL_A]

Question ID: INJ.0080.00.2
Variable: INJFALL_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_A occur as a result of a fall or falling?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 if NUMINJ_A=1 [goto INJMOTOR_A]
elseif NUMINJ_A IN (2-96,RF,DK) and INJHOME_A=1 [goto INJFALLHOM_A]
elseif NUMINJ_A IN (2-96,RF,DK) and INJWORK_A=1 [goto INJFALLWRK_A]
else [goto INJMOTOR_A]
2,RF,DK [goto INJMOTOR_A]

Question ID: INJ.0090.00.2
Variable: INJFALLHOM_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Did any fall occur while you were at your home?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had more than 1 significant injury or don't know or refused, and were injured as a result of a fall or falling, and who were injured at home

Skip Instructions:

1,2,RF,DK if INJWORK_A=1 [goto INJFALLWRK_A]
else [goto INJMOTOR_A]

Question ID: INJ.0100.00.2
Variable: INJFALLWRK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Did any fall occur while you were working at a job or business?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had more than 1 injury or don't know or refused, and were injured as a result of a fall or falling, and who were injured at work

Skip Instructions:

1,2,RF,DK [goto INJMOTOR_A]

Question ID: INJ.0110.00.2
Variable: INJMOTOR_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_A occur as a result of being in a motor vehicle crash or
being hit by a motor vehicle while walking or biking?
* Read if necessary: Motor vehicles include cars, trucks, vans, buses, motorcycles, motorized
scooters, motorized wheelchairs, motorized carts, tractors, ATVs, snowmobiles, dune buggies, and
other motorized vehicles.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 [goto INJMVTYPE_A]
2,RF,DK [goto INJCHORES_A]

Question ID: INJ.0120.00.2
Variable: INJMVTYPE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Were you a driver, passenger, bicyclist, pedestrian, or doing something else when this occurred?
* Enter all that apply, separate with commas.

Response:

1 - Driver
2 - Passenger
3 - Bicyclist
4 - Pedestrian
5 - Something else
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported a significant injury from a motor vehicle accident

Skip Instructions:

1-5,RF,DK [goto INJCHORES_A]

Question ID: INJ.0130.00.2
Variable: INJCHORES_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_A occur while you were doing household activities, such as
housework, cooking, home maintenance, or yardwork?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1,2,RF,DK [goto INJSAWDOC_A]

Question ID: INJ.0140.00.2
Variable: INJSAWDOC_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you see or talk to a doctor or other health professional about
^siginj_A?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who reported non-repetitive strain injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 if UTZ.EMERGE12M_A IN (1-96,RF,DK) [goto INJER_A]
elseif UTZ.HOSPONGT_A IN (1,RF,DK) [goto INJHOSP_A]
else [goto INJBONES_A]
2,RF,DK [goto INJWRKDAYS_A]

Question ID: INJ.0150.00.2
Variable: INJER_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you go to an emergency room because of ^siginj_A?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who saw doctor about their injuries and went to the ER at least once in the past 12 months or don't know or refused

Skip Instructions:

1,2,RF,DK if UTZ.HOSPONGT_A IN (1,RF,DK) [goto INJHOSP_A]
else [goto INJBONES_A]

Question ID: INJ.0160.00.2
Variable: INJHOSP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, were you hospitalized overnight because of ^siginj_A?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who saw doctor about their injuries and reported being hospitalized at least once in the past 12 months or don't know or refused

Skip Instructions:

1,2,RF,DK [goto INJBONES_A]

Question ID: INJ.0170.00.2
Variable: INJBONES_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you have any broken bones as a result of ^siginj_A?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who saw a doctor about an injury

Skip Instructions:

1,2,RF,DK [goto INJSTITCH_A]

Question ID: INJ.0180.00.2
Variable: INJSTITCH_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you get any stitches or staples because of ^siginj_A?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who saw a doctor about an injury

Skip Instructions:

1,2,RF,DK [goto INJWRKDAYS_A]

Question ID: INJ.0190.00.2
Variable: INJWRKDAYS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, how many days of work did you miss because of ^siginj_A?
* If respondent says none, no, or 0 days, ask: Did you work at all the past 3 months?
* Enter '90' if respondent says they missed every day of work in the past 3 months.
* Enter '91' if respondent says they did not work in the past 3 months.

Response:

00-90 - Range of values
91 - Did not work
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who had a significant non-repetitive strain injury in the past 3 months that limited their usual activities for at least 24 hours

Skip Instructions:

1-90,DK [goto INJFUTWRK_A]
0,RF [goto INJSTOPCHG_A]
91 [goto next section]

Question ID: INJ.0200.00.2
Variable: INJFUTWRK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Do you expect to miss any more days of work because of ^siginj_A that occurred during the past 3
months?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have missed at least one day of work due to injury in past 3 months or don't know

Skip Instructions:

1,2,RF,DK [goto INJSTOPCHG_A]

Question ID: INJ.0210.00.2
Variable: INJSTOPCHG_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you stop working or change jobs because of ^siginj_A?
Enter 'no' if respondent says they did not work in the past 3 months.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have missed 0 or more days of work due to injury in past 3 months or refused or don't know

Skip Instructions:

1,2,RF,DK [goto INJREDUCE_A]

Question ID: INJ.0220.00.2
Variable: INJREDUCE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 3 months, did you make a major change in your work activities, such as taking on
fewer hours or lighter duties, because of ^siginj_A?
Enter 'no' if respondent says they did not work in the past 3 months.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have missed 0 or more days of work due to injury in past 3 months or refused or don't know

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
FGE: Fatigue
Question ID: FGE.0010.00.2
Variable: FGEFRQTRD_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

In the past 3 months, how often did you feel very tired or exhausted? Would you say never, some
days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto next section]
2-4,RF,DK [goto FGELNGTRD_A]

Question ID: FGE.0020.00.2
Variable: FGELNGTRD_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Thinking about the last time you felt very tired or exhausted, how long did it last? Would you
say some of the day, most of the day, or all of the day?

Response:

1 - Some of the day
2 - Most of the day
3 - All of the day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who felt very tired or exhausted some days, most days, every day, or refused or don't know

Skip Instructions:

1-3,RF,DK [goto FGELEVTRD_A]

Question ID: FGE.0030.00.2
Variable: FGELEVTRD_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Thinking about the last time you felt this way, how would you describe the level of tiredness?
Would you say a little, a lot, or somewhere in between?

Response:

1 - A little
2 - A lot
3 - Somewhere in between a little and a lot
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who felt very tired or exhausted some days, most days, every day, or refused or don't know

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CIG: Cigarettes and E-cigarettes w/ Cigarette History
Question ID: CIG.0010.00.1
Variable: CIGINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

These next questions are about cigarette smoking.
*Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SMKEV_A]

Question ID: CIG.0020.00.1
Variable: SMKEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you smoked at least 100 cigarettes in your ENTIRE LIFE?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SMKAGE_A]
2,RF,DK [goto ECIGEV_A]

Question ID: CIG.0030.00.2
Variable: SMKAGE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

How old were you when you FIRST started to smoke fairly regularly?
* Smoking regularly is respondent defined. If asked about what this means, say that "It is
whatever you consider as first starting to smoke fairly regularly."
* Enter '6' if less than 6 years old.
* Enter '95' if 95 years old or older.
* Enter '96' if never smoked regularly.

Response:

06-95 - Range of values
96 - Never smoked regularly
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who ever smoked 100 cigarettes

Skip Instructions:

6-95,96,RF,DK if SMKAGE_A gt GEN.AGE_FINAL and SMKAGE_A ne 96 [goto ERR1_SMKAGE_A]
else [goto SMKNOW_A]

Hard Edit:

Check Text: ERR1_SMKAGE_A
Check Description: Age starting smoking exceeds current age
Check Text: {check ERR1_SMKAGE_A}
Starting age exceeds current age. Please correct

Question ID: CIG.0040.00.1
Variable: SMKNOW_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you NOW smoke cigarettes every day, some days or not at all?

Response:

1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who ever smoked 100 cigarettes

Skip Instructions:

1 [goto CIGNOW_A]
2 [goto SMK30D_A]
3 [goto SMKQTN_A]
RF,DK [goto ECIGEV_A]

Question ID: CIG.0050.00.1
Variable: CIGNOW_A
Interview Module: Adult
Content Type: Annual Core
Question text:

On average, about how many cigarettes do you NOW smoke a day?
* Enter '1' if less than 1 cigarette.
* Enter '95' if 95 or more cigarettes.

Response:

01-95 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who are current every day smokers

Skip Instructions:

1-95,RF,DK [goto SMKQT12M_A]

Question ID: CIG.0060.00.1
Variable: SMK30D_A
Interview Module: Adult
Content Type: Annual Core
Question text:

On how many of the past 30 days did you smoke a cigarette?
* Enter '0' for None.

Response:

00-30 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who are current some day smokers

Skip Instructions:

0 [goto SMKQT12M_A]
1-30,RF,DK [goto CIG30D_A]

Question ID: CIG.0070.00.1
Variable: CIG30D_A
Interview Module: Adult
Content Type: Annual Core
Question text:

On average, when you smoked during the past 30 days, about how many cigarettes did you smoke a
day?
* Enter '1' if less than 1.
* Enter '95' if 95 or more cigarettes.

Response:

01-95 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have smoked any time in the past 30 days or refused or don't know

Skip Instructions:

1-95,RF,DK [goto SMKQT12M_A]

Question ID: CIG.0080.00.2
Variable: SMKQT12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, have you stopped smoking for more than one day BECAUSE YOU WERE
TRYING TO QUIT SMOKING?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are every day or someday smokers

Skip Instructions:

1,2,RF,DK if UTZ.LASTDR_A=1 [goto SMKTLK_A]
else [goto ECIGEV_A]

Question ID: CIG.0090.01.2
Variable: SMKQTN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
How long has it been since you quit smoking cigarettes?
* Enter number for time since quit smoking.

Response:

001-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who quit smoking

Skip Instructions:

1-365 [goto SMKQTTP_A]
RF,DK if SMKAGE_A ne 96 [goto FORNUMCIG_A]
else [goto FORVARCIG_A]

Question ID: CIG.0090.02.2
Variable: SMKQTTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for time since quit smoking.

Response:

1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)

Universe:

Sample Adults 18+ who gave a number for how long ago they quit smoking

Skip Instructions:

1-3,RF,DK if SMKAGE_A ne 96 [goto FORNUMCIG_A]
else [goto FORVARCIG_A]
4 if SMKERR1_CALC_A lt 15 [goto ERR1_SMKQTTP_A]
elseif SMKERR2_CALC_A gt GEN.AGE_FINAL[PX_A] [goto ERR2_SMKQTTP_A]
elseif SMKAGE_A ne 96 [goto FORNUMCIG_A]
else [goto FORVARCIG_A]

Hard Edit:

Check Text: ERR2_SMKQTTP_A
Check Description: Age started smoking plus years since quitting is greater than current age
Check Text: {check ERR2_SMKQTTP_A}
Age started smoking (^SMKAGE_A years) + years since quitting (^SMKQTN_A) exceeds current age. Please correct.

Soft Edit:

Check Text: ERR1_SMKQTTP_A
Check Description: Former smokers who quit before the age of 15
Check Text: {signal ERR1_SMKQTTP_A}
Respondent quit smoking before age 15? Please verify.

Question ID: CIG.0120.00.3
Variable: FORNUMCIG_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

When you last smoked FAIRLY REGULARLY, how many cigarettes did you usually smoke per day?
* Smoking regularly is respondent defined. If asked about what this means, say that "It is
whatever you consider was the last time you were smoking fairly regularly."
Enter '94' if 94 or more cigarettes.
Enter '95' if varied.
Enter '96' if never smoked cigarettes regularly.

Response:

01-94 - Range of values
95 - Varied
96 - Never smoked regularly
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who are former smokers

Skip Instructions:

95,96,DK [goto FORVARCIG_A]
1-94,RF if UTZ.LASTDR_A=1 and ((SMKQTN_A le 365 and SMKQTTP_A=1) or (SMKQTN_A le 52 and
SMKQTTP_A=2) or (SMKQTN_A le 12 and SMKQTTP_A=3) or (SMKQTN_A le 1 and SMKQTTP_A=4)) [goto
SMKTLK_A]
else [goto ECIGEV_A]

Question ID: CIG.0130.00.3
Variable: FORVARCIG_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

What is the average number of cigarettes that you smoked daily during the longest period that
you smoked?
* Read if necessary: 1 pack equals 20 cigarettes.
* Enter '95' if 95 or more.

Response:

01-95 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who answered varied, never, don't know to when they last smoked fairly regularly or said they never smoked regularly and now don't smoke at all

Skip Instructions:

1-95,RF,DK if UTZ.LASTDR_A=1 and ((SMKQTN_A LE 365 and SMKQTTP_A=1) or (SMKQTN_A le 52 and
SMKQTTP_A=2) or (SMKQTN_A le 12 and SMKQTTP_A=3) or (SMKQTN_A le 1 and SMKQTTP_A=4)) [goto
SMKTLK_A]
else [goto ECIGEV_A]

Question ID: CIG.0140.00.2
Variable: SMKTLK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

In the past 12 months, has a doctor, dentist, or other health professional ADVISED you about
ways to stop smoking or prescribed medication to help you quit?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have seen a doctor or other health professional in the past year and are current cigarette smokers or former cigarette smokers who have quit in the past 12 months

Skip Instructions:

1,2,RF,DK [goto ECIGEV_A]

Question ID: CIG.0150.00.1
Variable: ECIGEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you ever used an e-cigarette or other electronic vaping product, even just one time, in
your entire life?
* Read if necessary: Electronic cigarettes (e-cigarettes) and other electronic vaping products
include JUULs, vape pens, e-cigars, and others. These products are battery-powered and usually
contain nicotine and flavors such as fruit, mint, or candy.
* These questions concern electronic vaping products for nicotine use.
* Do not include marijuana use.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto ECIGNOW_A]
2,RF,DK [goto next section]

Question ID: CIG.0160.00.1
Variable: ECIGNOW_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you NOW use e-cigarettes or other electronic vaping products every day, some days, or not at
all?
* These questions concern electronic vaping products for nicotine use.
* Do not include marijuana use.

Response:

1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever used e-cigarettes

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
OTB: Other Tobacco
Question ID: OTB.0010.00.3
Variable: CIGAREV_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Have you ever smoked a regular cigar, cigarillo, or a little filtered cigar EVEN ONE TIME?
* Read if necessary: "Cigarillos" are medium cigars that sometimes are sold with plastic or
wooden tips. Some common brands are Black and Mild, Swisher Sweets, Dutch Masters and Phillies
Blunts. Cigarillos are usually sold individually or in packs of 5 or fewer. Little filtered
cigars look like cigarettes and are usually brown in color. Like cigarettes, little filtered
cigars have a spongy filter and are sold in packs of 20. Some common brands are Prime Time and
Winchester.
* Read if necessary: Do not include electronic cigars or e-cigars.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+

Skip Instructions:

1 [goto CIGARCUR_A]
2,RF,DK [goto PIPEEV_A]

Question ID: OTB.0020.00.3
Variable: CIGARCUR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Do you NOW smoke regular cigars, cigarillos, or little filtered cigars every day, some days, or
not at all?

Response:

1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+ who have ever smoked a regular cigar, cigarillo, or filtered cigar

Skip Instructions:

1,RF,DK [goto PIPEEV_A]
2,3 [goto CIGAR30D_A]

Question ID: OTB.0030.00.3
Variable: CIGAR30D_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

On how many of the past 30 days have you smoked a regular cigar, cigarillo, or little filtered
cigar?

Response:

00-30 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample adults 18+ who now smoke a regular cigar, cigarillo, or little filtered cigar some days or not at all

Skip Instructions:

0-30,RF,DK [goto PIPEEV_A]

Question ID: OTB.0040.00.3
Variable: PIPEEV_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Have you EVER smoked a pipe filled with tobacco - either a regular pipe, water pipe, or hookah
EVEN ONE TIME?
* Read if necessary: A hookah is a type of water pipe. It is sometimes called a "narghile" (NARge-lee) pipe. Do not include electronic hookah or e-hookahs.
* Read if necessary: Do not include electronic pipes or e-pipes.
Read if necessary: Do not include pipes filled with substances other than tobacco.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+

Skip Instructions:

1 [goto PIPECUR_A]
2,RF,DK [goto SMOKELSEV_A]

Question ID: OTB.0050.00.3
Variable: PIPECUR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Do you NOW smoke pipes filled with tobacco - either regular pipes, water pipes, or hookahs,
every day, some days, or not at all?
* Read if necessary: Do not include pipes filled with substances other than tobacco.

Response:

1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+ who have ever smoked a regular pipe, water pipe or hookah filled with tobacco

Skip Instructions:

1-3,RF,DK [goto SMOKELSEV_A]

Question ID: OTB.0060.00.3
Variable: SMOKELSEV_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Smokeless tobacco products are placed in the mouth or nose and can include chewing tobacco,
snuff, dip, snus (SNOOSE), or dissolvable tobacco.
Have you ever used smokeless tobacco products EVEN ONE TIME?
* Read if necessary: Do not include nicotine replacement therapy products such as patch, gum,
lozenge, or spray, which are considered smoking cessation treatments.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+

Skip Instructions:

1 [goto SMOKELSCUR_A]
2,RF,DK [goto next section]

Question ID: OTB.0070.00.3
Variable: SMOKELSCUR_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Do you NOW use smokeless tobacco products every day, some days, or not at all?

Response:

1 - Every day
2 - Some days
3 - Not at all
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+ who have ever used smokeless tobacco products

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ALC: Alcohol Use
Question ID: ALC.0010.00.2
Variable: DRKLIFE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

These next questions are about drinking alcoholic beverages.
Alcohol includes beer, wine, wine coolers, liquors such as vodka, whiskey or rum, mixed drinks
or cocktails with alcohol, and any other type of alcoholic drink.
In your ENTIRE LIFE, have you had at least 1 drink of any kind of alcohol, not counting small
tastes or sips?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto DRK12MN_A]
2,RF,DK [goto next section]

Question ID: ALC.0020.01.2
Variable: DRK12MN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
During the past 12 months, how many days per week, per month or per year did you drink any type
of alcoholic beverage?
* Read if necessary: Alcohol includes beer, wine, wine coolers, liquors such as vodka, whiskey
or rum, mixed drinks or cocktails with alcohol, and any other type of alcoholic drink.
* Enter number for how often alcoholic beverages were consumed in the past 12 months. Then enter
category of response (week, month, year).
* Enter '0' for Never.

Response:

000-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who have had at least 1 drink in their entire life

Skip Instructions:

0 [goto DRK12ANYR_A]
1-365 [goto DRK12MTP_A]
DK [goto DRKAVG12M_A]
RF [goto next section]

Question ID: ALC.0020.02.2
Variable: DRK12MTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for how often alcoholic beverages were consumed in the past year.

Response:

1 - Per week
2 - Per month
3 - Per year

Universe:

Sample Adults 18+ who gave a number for number of days drank per week/month/year

Skip Instructions:

1-3 if ((DRK12MN_A gt 7 and DRK12MTP_A=1) or (DRK12MN_A gt 31 and DRK12MTP_A=2))[goto
ERR1_DRINK12MTP_A] then [goto DRKAVG12M_A]
RF,DK [goto DRKAVG12M_A]

Question ID: ALC.0030.00.2
Variable: DRKAVG12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

When counting number of drinks, one drink is equal to a 12-ounce beer, a 5-ounce glass of wine,
or one shot or 1.5 ounces of liquor. A larger 40-ounce beer would count as 3 drinks, or a
cocktail drink with 2 shots would count as 2 drinks.
During the past 12 months, on those days that you drank alcoholic beverages, on average, how
many DRINKS did you have?
* Enter '0' if never drank in the past 12 months.
* Enter '1' if 1 or fewer drinks.
* Enter '95' if 95 or more drinks.

Response:

00-95 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who drank at least once in the past year or don't know

Skip Instructions:

0 [goto DRK12ANYR_A]
1-3,RF,DK [goto DRKBNG12M_A]
4 if GEN.SEX_FINAL=2 [goto DRKANY30D_A]
elseif GEN.SEX_FINAL IN (1,RF,DK) [goto DRKBNG12M_A]
5-95 [goto DRKANY30D_A]
10-95 [goto ERR1_DRKAVG12M_A]

Soft Edit:

Check Text: ERR1_DRKAVG12M_A
Check Description: 10 or more daily drinks
Check Text: {signal ERR1_DRKAVG12M_A} ^DRKAVG12M_A drinks is an usually high number. Please verify. Do not probe.

Question ID: ALC.0040.00.2
Variable: DRK12ANYR_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

In ANY ONE YEAR, have you had at least 12 drinks of any type of alcoholic beverage?
* Read if necessary: One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a
drink with one shot (1.5 ounces) of liquor. A 40-ounce beer would count as 3 drinks or a
cocktail drink with 2 shots would count as 2 drinks.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have not had a drink in the past 12 months

Skip Instructions:

1,2,RF,DK if DRK12MN_A ne 0 and UTZ.LASTDR_A=1 [goto DRKADVISE_A]
else [goto next section]

Question ID: ALC.0050.00.2
Variable: DRKBNG12M_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, did you ever have ^BINGE drinks in a day?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who drank less than 3(female)/4(male, refused, don't know sex) drinks a day on average

Skip Instructions:

1 [goto DRKANY30D_A]
2,RF,DK if (DRKAVG12M_A IN (RF,DK) and DRK12MN_A GE 1) [goto DRKANY30D_A]
elseif UTZ.LASTDR_A=1 and (DRK12MN_A GE 1 or DRKAVG12M_A GE 1)[goto DRKADVISE_A]
elseif (UTZ.LASTDR_A NE 1 or (DRKAVG12M_A IN (RF,DK) AND DRK12MN_A=DK))[goto next section]

Question ID: ALC.0060.00.2
Variable: DRKANY30D_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

The next question will ask you about ONLY the past 30 days.
During the past 30 days, did you have at least one drink of any type of alcoholic beverage?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who drank 4+(female)/5+(male, refused, don't know sex) drinks in a day in the last year or refused or don't know

Skip Instructions:

1,RF,DK [goto DRKBNG30D_A]
2 if UTZ.LASTDR_A=1[goto DRKADVISE_A]
else [goto next section]

Question ID: ALC.0070.00.2
Variable: DRKBNG30D_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 30 days, how many times did you have ^BINGE drinks on an occasion?
* Read if necessary: A drinking occasion is considered to be approximately two hours.
* Enter '0' if none.
* Enter '60' if 60 or more times.

Response:

00-60 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who drank in the past 30 days or refused or don't know

Skip Instructions:

0-60,RF,DK if UTZ.LASTDR_A=1 and (DRK12MN_A ge 1 or DRKAVG12M_A ge 1) [goto DRKADVISE_A]
else [goto next section]

Question ID: ALC.0080.00.2
Variable: DRKADVISE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

In the past 12 months, has a doctor, dentist, or other health professional ADVISED you to stop
or cut down on your drinking?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have seen a doctor or other health professional in the past year and have had 1 or more drinks in the past 12 months

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PHY: Physical Activity
Question ID: PHY.0010.01.2
Variable: MODN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
The next questions are about physical activities such as exercise, sports, or physically active
hobbies that you may do in your LEISURE time. We are interested in two types of physical
activity --- moderate and vigorous-intensity. Moderate-intensity activities cause moderate
increases in breathing or heart rate whereas vigorous-intensity activities cause large increases
in breathing or heart rate.
How often do you do MODERATE-INTENSITY LEISURE-TIME physical activities?
* If necessary, prompt with: How many times per day, per week, per month, or per year do you do
these activities?
* Enter number for moderate leisure-time physical activities.
* Enter '0' for Never.
* Enter '996' if unable to do this type of activity.

Response:

000-995 - Range of values
996 - Unable to do this type of activity
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-995 [goto MODTP_A]
0,996,RF,DK [goto VIGN_A]

Question ID: PHY.0010.02.2
Variable: MODTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for moderate leisure-time physical activities.

Response:

1 - Per day
2 - Per week
3 - Per month
4 - Per year
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who do moderate physical activities

Skip Instructions:

1-4 if ((MODN_A gt 4 and MODTP_A=1) or (MODN_A gt 28 and MODTP_A=2) or (MODN_A gt 31 and
MODTP_A=3) or (MODN_A gt 365 and MODTP_A=4)) [goto ERR1_MODTP_A]
else [goto MODLN_A]
RF,DK [goto VIGN_A]

Soft Edit:

Check Text: ERR1_MODTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_MODTP_A} ^MODN_A times per ^MODTP_A is unusually high. Please verify.

Question ID: PHY.0020.01.2
Variable: MODLN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
About how long do you do these moderate leisure-time physical activities each time?
Read if necessary: Moderate-intensity activities cause moderate increases in breathing or heart
rate.
* Enter number for length of moderate leisure-time physical activities.

Response:

000-995 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who do moderate physical activities

Skip Instructions:

1-995 [goto MODLTP_A]
RF,DK [goto VIGN_A]

Question ID: PHY.0020.02.2
Variable: MODLTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for length of moderate leisure-time physical activities.

Response:

1 - Minutes
2 - Hours
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who do moderate physical activities

Skip Instructions:

1,2 if ((MODLN_A ge 120 and MODLTP_A=1) or (MODLN_A ge 2 and MODLTP_A=2)) [goto ERR1_MODLTP_A]
else [goto VIGN_A]
RF,DK [goto VIGN_A]

Soft Edit:

Check Text: ERR1_MODLTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_MODLTP_A} ^MODLN_A ^MODLTP_A is unusually high. Please verify.

Question ID: PHY.0030.01.2
Variable: VIGN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
How often do you do VIGOROUS-INTENSITY LEISURE-TIME physical activities?
* Read if necessary: Vigorous-intensity activities cause large increases in breathing or heart
rate.
* Read if necessary: How many times per day, per week, per month, or per year do you do these
activities?
* Enter number for vigorous leisure-time physical activities.
* Enter '0' for Never.
* Enter '996' if unable to do this type of activity.

Response:

000-995 - Range of values
996 - Unable to do this type of activity
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

0,996,RF,DK [goto STRN_A]
1-995 [goto VIGTP_A]

Question ID: PHY.0030.02.2
Variable: VIGTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for vigorous leisure-time physical activities.

Response:

1 - Per day
2 - Per week
3 - Per month
4 - Per year
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who do vigorous physical activities

Skip Instructions:

1-4 if (VIGN_A gt 4 and VIGTP_A=1) or (VIGN_A gt 28 and VIGTP_A=2) or (VIGN_A gt 31 and
VIGTP_A=3) or (VIGN_A gt 365 and VIGTP_A=4) [goto ERR1_VIGTP_A]
else [goto VIGLN_A]

Soft Edit:

Check Text: ERR1_VIGTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_VIGTP_A} ^VIGN_A times per ^VIGTP_A is unusually high. Please verify.

Question ID: PHY.0040.01.2
Variable: VIGLN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
About how long do you do these vigorous leisure-time physical activities each time?
* Read if necessary: Vigorous-intensity activities cause large increases in breathing or heart
rate.
* Enter number for length of vigorous leisure-time physical activities.

Response:

000-995 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who do vigorous physical activities

Skip Instructions:

1-995[goto VIGLTP_A]
RF,DK[goto STRN_A]

Question ID: PHY.0040.02.2
Variable: VIGLTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for length of vigorous leisure-time physical activities.

Response:

1 - Minutes
2 - Hours
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who do vigorous physical activities

Skip Instructions:

1,2 if (VIGLN_A ge 120 and VIGLTP_A=1) or (VIGLN_A ge 2 and VIGLTP_A=2) [goto ERR1_VIGLTP_A]
else [goto STRN_A]
RF,DK [goto STRN_A]

Soft Edit:

Check Text: ERR1_VIGLTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_VIGLTP_A} ^VIGLN_A ^VIGLNTP_A is unusually high. Please verify.

Question ID: PHY.0050.01.2
Variable: STRN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
Including activities that you mentioned earlier, how often do you do LEISURE-TIME physical
activities specifically designed to STRENGTHEN your muscles such as sit-ups, push-ups, or
lifting weights?
* Read if necessary: How many times per day, per week, per month, or per year do you do these
activities?
* Enter number for strengthening activities.
* Enter '0' for Never.
* Enter '996' for Unable to do this type of activity.

Response:

000-995 - Range of values
996 - Unable to do this type of activity
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-995 [goto STRTP_A]
0,996,RF,DK [goto next section]

Question ID: PHY.0050.02.2
Variable: STRTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for strengthening activities.

Response:

1 - Per day
2 - Per week
3 - Per month
4 - Per year
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who do strengthening activities

Skip Instructions:

1-4 if (STRN_A gt 4 and STRTP_A=1) or (STRN_A gt 28 and STRTP_A=2) or (STRN_A gt 31 and
STRTP_A=3) or (STRN_A gt 365 and STRTP_A=4) [goto ERR1_STRTP_A]
else [goto next section]

Soft Edit:

Check Text: ERR1_STRTP_A
Check Description: Unusually high soft edit
Check Text: {signal ERR1_STRTP_A} ^STRN_A times per ^STRTP_A is unusually high. Please verify.

2020 National Health Interview Survey (NHIS) Questionnaire
WLK: Walking
Question ID: WLK.0010.00.2
Variable: WLKTRAN_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

The next questions are about walking for transportation. This is walking you might have done to
travel to and from work, to do errands, or to go from place to place. I will ask you separately
about walking for other reasons like relaxation, exercise, or walking the dog.
In the past 7 days, did you walk for transportation?
* Read if necessary: Include walking to or from a bus, train, or rail stop.
* Read if necessary: Do not include walking for relaxation or exercise.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are able to walk

Skip Instructions:

1 [goto WLKTRANDAY_A]
2,RF,DK [goto WLKLEIS_A]

Question ID: WLK.0020.00.2
Variable: WLKTRANDAY_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

In the past 7 days, how many days did you walk for transportation?

Response:

01-07 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have walked for transportation in the past 7 days

Skip Instructions:

1-7 [goto WLKTRANTPD_A]
RF,DK [goto WLKLEIS_A]

Question ID: WLK.0030.00.2
Variable: WLKTRANTPD_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

^WLKDAYT

Response:

01-94 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have walked for transportation at least one day in the past 7 days

Skip Instructions:

1-94 [goto WLKTRANLGT_A]
RF,DK [goto WLKLEIS_A]

Question ID: WLK.0040.01.2
Variable: WLKTRANLGT_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
^WALKTIMETP
* Enter number for length of walk for transportation.

Response:

000-995 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who have walked for transportation at least one time in the past 7 days

Skip Instructions:

1-995 [goto WLKTRANTP_A]
RF,DK [goto WLKLEIS_A]

Question ID: WLK.0040.02.2
Variable: WLKTRANTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for length of walking for transportation.

Response:

1 - Minutes
2 - Hours
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who entered a number for how long they walked for transportation in the past 7 days

Skip Instructions:

1,2 if ((WLKTRANLGT_A GT 119 and WLKTRANTP_A=1) or (WLKTRANLGT_A GT 1 and WLKTRANTP_A=2))[goto
ERR1_WLKTRANLGT_A]
else [goto WLKLEIS_A]
RF,DK [goto WLKLEIS_A]

Soft Edit:

Check Text: ERR1_WLKTRANLGT_A
Check Description: Amount of time walking is over 2 hours on average
Check Text: {signal ERR1_WLKTRANLGT_A}
Amount of time walking is unusually high. Please verify.

Question ID: WLK.0050.00.2
Variable: WLKLEIS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Sometimes you may walk for fun, relaxation, exercise, or to walk the dog. In the past 7 days,
did you walk for any of these reasons?
* Read if necessary: Do not include walking for transportation.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are able to walk

Skip Instructions:

1 [goto WLKLEISDAY_A]
2,RF,DK [goto next section]

Question ID: WLK.0060.00.2
Variable: WLKLEISDAY_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

In the past 7 days, how many days did you walk for leisure or exercise?
* Read if necessary: Walked for fun, relaxation, exercise, or to walk the dog.
* Read if necessary: Do not include walking for transportation.

Response:

01-07 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have walked for leisure in the past 7 days

Skip Instructions:

1-7 [goto WLKLEISTPD_A]
RF,DK [goto next section]

Question ID: WLK.0070.00.2
Variable: WLKLEISTPD_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

^WLKDAYL

Response:

01-94 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who have walked for leisure at least one day in the past 7 days

Skip Instructions:

1-94 [goto WLKLEISLGT_A]
RF,DK [goto next section]

Question ID: WLK.0080.01.2
Variable: WLKLEISLGT_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 1 of 2
^WALKTIMELE
* Enter number for length of walk for fun, relaxation, or exercise.

Response:

000-995 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who have walked for leisure at least once in the past 7 days

Skip Instructions:

1-995 [goto WLKLEISTP_A]
RF,DK [goto next section]

Question ID: WLK.0080.02.2
Variable: WLKLEISTP_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

* 2 of 2
* Enter time period for length of walking for fun, relaxation, or exercise.

Response:

1 - Minutes
2 - Hours
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who gave a number for amount of time walked for leisure in the past 7 days

Skip Instructions:

1,2 if ((WLKLEISLGT_A GT 119 and WLKLEISTP_A=1) or (WLKLEISLGT_A GT 1 and WLKLEISTP_A=2))
[goto ERR1_WLKLEISLGT_A], then [goto next section]
RF,DK[goto next section]

Soft Edit:

Check Text: ERR1_WLKLEISLGT_A
Check Description: Amount of time walking is over 2 hours on average
Check Text: {signal ERR1_WLKLEISLGT_A}
Amount of time walking is unusually high. Please verify.

2020 National Health Interview Survey (NHIS) Questionnaire
ENV: Perceptions of the Walking Environment
Question ID: ENV.0010.00.3
Variable: HOMEWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

How often does the ^TLwalking you reported earlier take place near ^HOME?
Would you say almost always, most of the time, some of the time, or never?

Response:

1 - Almost always
2 - Most of the time
3 - Some of the time
4 - Never
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+ who report walking for transportation or leisure

Skip Instructions:

1-4,RF,DK [goto ROADSWLK_A]

Question ID: ENV.0020.00.3
Variable: ROADSWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

The next questions are about where you live. By where you live we mean in your neighborhood or
near ^HOME.
Where you live, are there roads, sidewalks, paths or trails where you can walk?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto SHOPSWLK_A]

Question ID: ENV.0030.00.3
Variable: SHOPSWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Are there shops, stores, or markets that you can walk to?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto TRANSITWLK_A]

Question ID: ENV.0040.00.3
Variable: TRANSITWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Are there bus or transit stops that you can walk to?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto FUNWLK_A]

Question ID: ENV.0050.00.3
Variable: FUNWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Are there places like movies, libraries, or places of worship that you can walk to?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto RELAXWLK_A]

Question ID: ENV.0060.00.3
Variable: RELAXWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Are there places that you can walk to that help you relax, clear your mind, and reduce stress?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto SIDEWLK_A]

Question ID: ENV.0070.00.3
Variable: SIDEWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Where you live, do most streets have sidewalks?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto TRAFFICWLK_A]

Question ID: ENV.0080.00.3
Variable: TRAFFICWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Does traffic make it unsafe for you to walk?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto CRIMEWLK_A]

Question ID: ENV.0090.00.3
Variable: CRIMEWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Does crime make it unsafe for you to walk?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto ANIMALWLK_A]

Question ID: ENV.0100.00.3
Variable: ANIMALWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: Where you live...
Do dogs or other animals make it unsafe for you to walk?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto WEATHERWLK_A]

Question ID: ENV.0110.00.3
Variable: WEATHERWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

How often does the weather make you less likely to walk?
Would you say almost always, most of the time, some of the time, or never?
* Read if necessary: We mean any kind of bad weather that makes you less likely to walk, such as
hot, cold, rainy, snowy, and windy weather.

Response:

1 - Almost always
2 - Most of the time
3 - Some of the time
4 - Never
7 - Refused
9 - Don't know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto PEOPLEWLK_A]

Question ID: ENV.0120.00.3
Variable: PEOPLEWLK_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

How often are there people walking within sight of ^HOME?
Would you say every day, every 2 to 3 days, about once a week, or less than once a week?

Response:

1 - Every day
2 - Every 2 to 3 days
3 - About once a week
4 - Less than once a week
7 - Don't know
9 - Refused

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SUN: Sun Care and Protection
Question ID: SUN.0010.00.3
Variable: SUNINTRO_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

The next questions are about sun exposure.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SUNSKIN_A]

Question ID: SUN.0020.00.3
Variable: SUNSKIN_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

After several months of not being in the sun, if you THEN went out into the sun without
sunscreen or protective clothing for one hour, which of these would happen to your skin?
Would you get a severe sunburn with blisters, have a moderate sunburn with peeling, burn mildly
with some or no darkening or tanning, turn darker without sunburn, or would nothing happen to
your skin?
* Read if necessary: Even if you did not go out in the sun, what would happen if you did? Use
the most recent experience. If not, then think about the past.
* Read if necessary: By "sunburn" we mean even a small part of your skin turns red or hurts for
12 hours or more.
* Do not read the choice "do not go out in the sun." Select this choice if respondent
volunteers.

Response:

01 - Get a severe sunburn with blisters
02 - Have a moderate sunburn with peeling
03 - Burn mildly with some or no darkening/tanning
04 - Turn darker without sunburn
05 - Nothing would happen to my skin
06 - Do not go out in the sun
07 - Other
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-7,RF,DK [goto SUNSHADE_A]

Question ID: SUN.0030.00.3
Variable: SUNSHADE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

When you go outside on a sunny day, for more than one hour, how often do you...
...Stay in the shade?
Would you say always, most of the time, sometimes, rarely, or never stay in the shade?
* Do not read the choice "don't go outside on a sunny day for more than one hour." Select this
choice if respondent volunteers.

Response:

1 - Always
2 - Most of the time
3 - Sometimes
4 - Rarely
5 - Never
6 - Don't go outside on a sunny day for more than one hour
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-6,RF,DK [goto SUNHAT_A]

Question ID: SUN.0040.00.3
Variable: SUNHAT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

When you go outside on a sunny day, for more than one hour, how often do you...
...Wear a hat that shades your face, ears AND neck such as a hat with a wide brim all around?
Would you say always, most of the time, sometimes, rarely, or never wear a hat?
* Do not read the choice "don't go outside on a sunny day for more than one hour." Select this
choice if respondent volunteers.

Response:

1 - Always
2 - Most of the time
3 - Sometimes
4 - Rarely
5 - Never
6 - Don't go outside on a sunny day for more than one hour
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-6,RF,DK [goto SUNSHIRT_A]

Question ID: SUN.0050.00.3
Variable: SUNSHIRT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Read if necessary: When you go outside on a sunny day, for more than one hour, how often do
you...
...Wear a long-sleeved shirt?
* Read if necessary: Would you say always, most of the time, sometimes, rarely, or never wear a
long-sleeved shirt?
Do not read the choice "don't go outside on a sunny day for more than one hour." Select this
choice if respondent volunteers.

Response:

1 - Always
2 - Most of the time
3 - Sometimes
4 - Rarely
5 - Never
6 - Don't go outside on a sunny day for more than one hour
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-6,RF,DK [goto SUNSCREEN_A]

Question ID: SUN.0060.00.3
Variable: SUNSCREEN_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Read if necessary: When you go outside on a sunny day, for more than one hour, how often do
you...
...Use sunscreen?
* Read if necessary: Would you say always, most of the time, sometimes, rarely, or never use
sunscreen?
Do not read the choice "don't go outside on a sunny day for more than one hour." Select this
choice if respondent volunteers.

Response:

1 - Always
2 - Most of the time
3 - Sometimes
4 - Rarely
5 - Never
6 - Don't go outside on a sunny day for more than one hour
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-6,RF,DK [goto SUNTAN_A]

Question ID: SUN.0070.00.3
Variable: SUNTAN_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

When spending time outdoors, how often do you try to get some sun for the purpose of developing
a tan?
* Read if necessary: Would you say always, most of the time, sometimes, rarely, or never?
Do not read the choice "don't spend time outdoors." Select this choice if respondent volunteers.

Response:

1 - Always
2 - Most of the time
3 - Sometimes
4 - Rarely
5 - Never
6 - Don't spend time outdoors
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-6,RF,DK [goto ANYSBURN_A]

Question ID: SUN.0080.00.3
Variable: ANYSBURN_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, did you ever have a sunburn?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto NUMSBURNS_A]
2,RF,DK [goto SUNBED_A]

Question ID: SUN.0090.00.3
Variable: NUMSBURNS_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, how many times have you had a sunburn?

Response:

001-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who have had a sunburn in the past 12 months

Skip Instructions:

1-39,RF,DK [goto SUNBED_A]
40-365 [goto ERR1_NUMSBURNS_A], then [goto SUNBED_A]

Soft Edit:

Check Text: ERR1_NUMSBURNS_A
Check Description: Unusually high number of sunburns
Check Text: {signal ERR1_NUMSBURNS_A}
^NUMSBURNS is an unusually high number. Please confirm.

Question ID: SUN.0130.00.3
Variable: SUNBED_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, how many times have you used an indoor tanning device such as a
sunlamp, sunbed, or tanning booth? Do NOT include times you have gotten a spray tan.

Response:

000-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

0-99,RF,DK [goto next section]
100-365 [goto ERR1_SUNBED_A], then [goto next section]

Soft Edit:

Check Text: ERR1_SUNBED_A
Check Description: Unusually high number of tanning bed uses
Check Text: {signal ERR1_SUNBED_A}
^SUNBED is an unusually high number. Please confirm.

2020 National Health Interview Survey (NHIS) Questionnaire
DPV: Diabetes Prevention
Question ID: DPV.0010.00.2
Variable: ADVACTIVE_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 12 months, has a doctor or other health professional ADVISED you to
...Increase the amount of physical activity or exercise you get?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto ADVEAT_A]

Question ID: DPV.0020.00.3
Variable: ADVEAT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

During the past 12 months, has a doctor or other health professional ADVISED you to
...Reduce the amount of fat or calories in your diet?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto ADVWGTPRG_A]

Question ID: DPV.0030.00.3
Variable: ADVWGTPRG_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

* Read if necessary: During the past 12 months, has a doctor or other health professional
ADVISED you to
...Participate in a weight loss program?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto NOWACTIVE_A]

Question ID: DPV.0040.00.3
Variable: NOWACTIVE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Are you NOW
...Increasing your physical activity or exercise?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto NOWEAT_A]

Question ID: DPV.0050.00.3
Variable: NOWEAT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Are you NOW
...Reducing the amount of fat or calories in your diet?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adult 18+

Skip Instructions:

1,2,RF,DK [goto NOWWGTPRG_A]

Question ID: DPV.0060.00.3
Variable: NOWWGTPRG_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Read if necessary: Are you NOW
...Participating in a weight loss program?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SLP: Sleep
Question ID: SLP.0010.01.2
Variable: SLPHOURS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

On average, how many hours of sleep do you get in a 24-hour period?
* Enter hours in whole numbers, rounding 30 minutes (1/2 hour) or more UP to the next whole hour
and dropping 29 or fewer minutes.
* Enter 1 if the respondent reports less than 1 hour of sleep.

Response:

01-24 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5 [goto ERR1_SLPHOURS_A]
6-24,RF,DK [goto SLPREST_A]

Soft Edit:

Check Text: ERR1_SLPHOURS_A
Check Description: Soft error for few sleep hours
Check Text: {signal ERR1_SLPHOURS_A}
Average number of hours of sleep is ^SLPHOURS. Please verify.

Question ID: SLP.0020.00.2
Variable: SLPREST_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 30 days, how often did you wake up feeling well-rested?
Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto SLPFLL_A]

Question ID: SLP.0030.00.2
Variable: SLPFLL_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

During the past 30 days, how often did you have trouble falling asleep?
Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto SLPSTY_A]

Question ID: SLP.0040.00.2
Variable: SLPSTY_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Read if necessary: During the past 30 days...
How often did you have trouble staying asleep?
Read if necessary: Would you say never, some days, most days, or every day?
* Include waking up too early.

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto SLPMED_A]

Question ID: SLP.0050.00.2
Variable: SLPMED_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Read if necessary: During the past 30 days...
How often did you take any medication to help you fall asleep or stay asleep? Include both
prescribed and over-the-counter medications.
Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SOS: Social Support
Question ID: SOS.0010.00.4
Variable: SUPPORT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

How often do you get the social and emotional support you need? Would you say always, usually,
sometimes, rarely, or never?

Response:

1 - Always
2 - Usually
3 - Sometimes
4 - Rarely
5 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK [goto CMPSUPPORT_A]

Question ID: SOS.0020.00.4
Variable: CMPSUPPORT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Compared with 12 months ago, would you say that you now receive more social and emotional
support, less social and emotional support, or about the same?

Response:

1 - More social and emotional support
2 - Less social and emotional support
3 - About the same
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ORN: Sexual Orientation
Question ID: ORN.0010.00.1
Variable: ORNINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Next we have some questions about your demographic characteristics, including sexual
orientation, income, employment, and veteran status. Like all your answers, these will be used
to understand the health of different groups in the population and will be kept confidential.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto ORIENT_A]

Question ID: ORN.0020.00.1
Variable: ORIENT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you think of yourself as ^gaylesbian; straight, that is, not ^gaylesbian; bisexual; something
else; or you don't know the answer?

Fills:

^gaylesbian

Description: Gay/Lesbian or gay
Instruction:
If SEX=1 fill "Gay"; else if SEX='2',RF,DK fill "Lesbian or gay"

Response:

1 - ^GayLesbian
2 - Straight, that is, not ^gaylesbian
3 - Bisexual
4 - Something else
5 - I don't know the answer
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
MAR: Marital Status
Question ID: MAR.0010.00.1
Variable: MARITAL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

The next questions are about marriage and cohabitation. Are you now married, living with a
partner together as an unmarried couple, or neither?
* If respondent answers both married and living with a different partner together as an
unmarried couple, enter living with partner.

Response:

1 - Married
2 - Living with a partner together as an unmarried couple
3 - Neither
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ and the Child PAR section has not been completed for the Sample Adult or the Child PAR section has been completed for the Sample Adult and the Sample Adult is not the Sample Child respondent

Skip Instructions:

1 [goto SPOUSLIV_A]
2 if GEN.PCNT16PLUS=1 [got ERR1_MARITAL_A] else [goto PARTNERWHO_A]
3,RF,DK [goto EVRMARRIED_A]

Soft Edit:

Check Text: ERR1_MARITAL_A
Check Description: One person eligible to be living with a partner in household soft edit
Check Text: {signal ERR1_MARITAL_A}
Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.

Question ID: MAR.0020.00.1
Variable: SPOUSLIV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does your spouse live here?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are married

Skip Instructions:

1 if GEN.PCNT16PLUS=1 [goto ERR1_SPOUSLIV_C] else [goto SPOUSWHO_A]
2 [goto SPOUSEP_A]
RF,DK [goto next section]

Soft Edit:

Check Text: ERR1_SPOUSLIV_C
Check Description: Only one person eligible to be married in household soft edit
Check Text: {signal ERR1_SPOUSLIV_C}
Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.

Question ID: MAR.0030.00.1
Variable: SPOUSWHO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Which person is your spouse?
* Enter line number of spouse.
* Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Response:

Universe:

Sample Adults 18+ with spouse in household

Skip Instructions:

0-25 [goto SPOUSSEX_A]
RF,DK [goto next section]

Question ID: MAR.0040.00.1
Variable: SPOUSSEX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

I previously recorded ^SPOUSENAME's ^spousesex. Is this correct?

Fills:

^SPOUSENAME

Description: Name of spouse
Instruction:
Fill name of spouse selected at SPOUSWHO_A

^spousesex

Description: sex is male/sex is female/sex was not provided
Instruction:
if GEN.SEX_FINAL[person selected at SPOUSWHO_A]=1, fill "sex is male"
if GEN.SEX_FINAL[person selected at SPOUSWHO_A]=2, fill
"sex is female"
if GEN.SEX_FINAL[person selected at SPOUSWHO_A] IN
(DK,RF), fill "sex was not provided"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with spouse in household who entered a line number for their spouse

Skip Instructions:

1,RF,DK [goto next section]
2 [goto SPOUNEWSEX_A]

Question ID: MAR.0050.00.1
Variable: SPOUNEWSEX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Is ^SPOUSENAME male or female?

Fills:

^SPOUSENAME

Description: Name of spouse
Instruction:
Fill name of spouse selected at SPOUSWHO_A

Response:

1 - Male
2 - Female
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with spouse with incorrect sex

Skip Instructions:

1,2,RF,DK [goto next section]

Question ID: MAR.0060.00.1
Variable: SPOUSEP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does your spouse not live here because you and your spouse are legally separated?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ whose spouse does not live in the household

Skip Instructions:

1,2,RF,DK [goto next section]

Question ID: MAR.0070.00.1
Variable: PARTNERWHO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Which person is your partner?
* Enter line number of partner.
* Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Response:

Universe:

Sample Adults 18+ who are living with unmarried partner in household

Skip Instructions:

0-25 [goto PARTNERSEX_A]
RF,DK [goto EVRMARRIED_A]

Question ID: MAR.0080.00.1
Variable: PARTNERSEX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

I previously recorded ^PARTNERNAME's ^partnersex. Is this correct?

Fills:

^PARTNERNAME

Description: Name of partner
Instruction:
Fill name of partner selected at PARTNERWHO_A

^partnersex

Description: sex is male/sex is female/sex was not provided
Instruction:
if GEN.SEX_FINAL[person selected at PARTNERWHO_A]=1, fill "sex is male"
if GEN.SEX_FINAL[person selected at PARTNERWHO_A]=2, fill
"sex is female"
if GEN.SEX_FINAL[person selected at PARTNERWHO_A] IN
(DK,RF), fill "sex was not provided"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with partner in household who entered a line number for their partner

Skip Instructions:

1,RF,DK [goto EVRMARRIED_A]
2 [goto PARTNEWSEX_A]

Question ID: MAR.0090.00.1
Variable: PARTNEWSEX_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Is ^PARTNERNAME male or female?

Fills:

^PARTNERNAME

Description: Name of partner
Instruction:
Fill name of partner selected at PARTNERWHO_A

Response:

1 - Male
2 - Female
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with partner with incorrect sex

Skip Instructions:

1,2,RF,DK [goto EVRMARRIED_A]

Question ID: MAR.0100.00.1
Variable: EVRMARRIED_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you ever been married?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are living with unmarried partner or who are not married or living with an unmarried partner or refused or don't know

Skip Instructions:

1 if MARITAL_A=2 [goto LEGALSTAT_A]
elseif MARITAL_A=3 [goto WIDIVSEP_A]
else [goto next section]
2,RF,DK [goto next section]

Question ID: MAR.0110.00.1
Variable: LEGALSTAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What is your current legal marital status? Are you married, widowed, divorced, or separated?

Response:

1 - Married
2 - Widowed
3 - Divorced
4 - Separated
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are living with a partner but have been married

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: MAR.0120.00.1
Variable: WIDIVSEP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you widowed, divorced, or separated?

Response:

1 - Widowed
2 - Divorced
3 - Separated
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who are neither living with a partner nor married, but have been married

Skip Instructions:

1-3,RF,DK [goto FINISH_MAR_A]

Question ID: MAR.0130.00.1
Variable: FINISH_MAR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* The Sample Adult MAR section is now complete.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Skip Instructions:

1 [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
VET: Veterans Status
Question ID: VET.0010.00.1
Variable: AFVET_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Did you ever serve on active duty in the U.S. Armed Forces, military Reserves, or National
Guard?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto AFVETTRN_A]
2,RF,DK [goto next section]

Question ID: VET.0020.00.1
Variable: AFVETTRN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Were you on active duty ONLY for training in the Reserves or National Guard?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever served in the armed forces

Skip Instructions:

1 [goto VADISB_A]
2,RF,DK [goto COMBAT_A]

Question ID: VET.0030.001
Variable: COMBAT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Did you ever serve in a foreign country during a time of armed conflict or on a humanitarian or
peace-keeping mission?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever served in the armed forces and who were not only activated for training in the Reserves or National Guard

Skip Instructions:

1,2,RF,DK [goto VADISB_A]

Question ID: VET.0040.00.1
Variable: VADISB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have a VA service-connected disability rating?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever served in the armed forces

Skip Instructions:

1,2,RF,DK [goto VAHOSP_A]

Question ID: VET.0050.00.1
Variable: VAHOSP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, did you receive any care at a Veteran's Health Administration
facility or receive any other health care paid for by the VA?
* Read if necessary: Veteran's Health Administration facilities include VA hospitals, VA medical
centers, VA outpatient clinics, and VA nursing homes.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever served in the armed forces

Skip Instructions:

1 [goto next section]
2,RF,DK if 1 IN Adult.INS.MILSPC_A [goto next section]
else [goto VACAREEV]

Question ID: VET.0060.00.1
Variable: VACAREEV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Have you ever enrolled in or used VA health care?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have ever served in the armed forces and did not recieve care at a VHA facility or other health care paid for by the VA in the past 12 months and did not report VA health care when asked about insurance

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
NAT: Nativity
Question ID: NAT.0010.00.1
Variable: NATUSBORN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^Askverify_A Were you born in the United States or a U.S. territory?

Fills:

^Askverify_A

Description: FR Instruction
Instruction:
If GEN.SARESPSC_FLG=1, fill "* Ask or verify:"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto NATSTBORN_A]
2 [goto NATUSYR_A]
RF,DK [goto next section]

Question ID: NAT.0020.00.1
Variable: NATSTBORN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In what state or U.S. territory were you born?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ born in the United States or U.S. territory

Skip Instructions:

American Samoa [goto CITIZEN_A]
else [goto next section]

Question ID: NAT.0040.00.1
Variable: NATUSYR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In what year did you come to the United States to stay?

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Adults 18+ not born in the United States or U.S. territory

Skip Instructions:

1900-Current Year,RF,DK if NATUSYR_A is a future year [goto ERR1_NATUSYR_A]
if NATUSYR_A lt VFY.BYEAR_A [goto ERR2_NATUSYR_A]
else [goto CITIZEN_A]

Hard Edit:

Check Text: ERR2_NATUSYR_A
Check Description: Year prior to birth hard edit
Check Text: {check ERR2_NATUSYR_A}
Year is prior to date of birth. Please correct.
Check Text: ERR1_NATUSYR_A
Check Description: Future year hard edit
Check Text: {check ERR1_NATUSYR_A} Future year invalid. Please correct.

Question ID: NAT.0050.00.1
Variable: CITIZEN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you a citizen of the United States?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ not born in the United States or U.S. territory or born in American Samoa

Skip Instructions:

1 [goto NATCTZN_A]
2,RF,DK [goto next section]

Question ID: NAT.0060.00.1
Variable: NATCTZN_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Were you born abroad to an American parent, born abroad and adopted by an American parent, or
did you become a U.S. citizen by naturalization?

Response:

1 - Born abroad to American parent
2 - Born abroad and adopted by an American parent
3 - Became U.S. citizen by naturalization
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ not born in the United States or a United States territory or born in the U.S. territory of American Samoa but are U.S. citizens

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SCH: Schooling
Question ID: SCH.0010.00.1
Variable: SCHCURENR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Are you currently enrolled in or attending school?
* Read if necessary: School includes high school, college, trade school, and professional
school. Students may be enrolled part-time or full-time.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SCHDYSMSS_A]
2,RF,DK [goto next section]

Question ID: SCH.0020.00.1
Variable: SCHDYSMSS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, about how many days of school did you miss because you had an
illness, injury, or disability?

Response:

000-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who are currently enrolled in school

Skip Instructions:

0-99,RF,DK [goto next section]
100-365 [goto ERR1_SCHDYSMSS_A]

Soft Edit:

Check Text: ERR1_SCHDYSMSS_A
Check Description: Missed 100-365 days
Check Text: {signal ERR1_SCHDYSMSS_A}^SCHDYSMSS_A is an unusually large number. Did you miss ^SCHDYSMSS_A days of school because of illness, injury, or disability? Please verify.

2020 National Health Interview Survey (NHIS) Questionnaire
EMP: Employment
Question ID: EMP.0010.00.1
Variable: EMPLASTWK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

LAST WEEK, did you work for pay at a job or business?
* If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business,
enter '1' for yes.

Fills:

^heshetheywork

Description: he works/she works/they work
Instruction:
elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL=DK,RF fill "they work"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto EMPWRKHRS_A]
2 [goto EMPNOWRK_A]
RF,DK [goto next section]

Question ID: EMP.0020.00.1
Variable: EMPNOWRK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Did you have a job or business LAST WEEK, but were temporarily absent due to illness, vacation,
family or maternity leave, or some other reason?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were not working for pay at a job or business last week

Skip Instructions:

1 [goto EMPWRKHRS_A]
2 [goto EMPRSNOWK_A]
RF,DK [goto next section]

Question ID: EMP.0030.00.1
Variable: EMPWRKHRS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

How many hours ^LASTUSUAL in total at ALL jobs or businesses?

Fills:

^LASTUSUAL

Description: did you work LAST WEEK/do you USUALLY work per week
Instruction:
If EMPLASTWK_A=1 fill "did you work LAST WEEK" else if EMPNOWRK_A=1 fill "do you USUALLY work per week"

Response:

001-168 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week

Skip Instructions:

1-34 if EMPNOWRK_A =1 [goto EMDWHOWRK_A]
elseif EMPLASTWK_A =1 [goto EMPWKFT_A]
35-94 [goto EMDWHOWRK_A]
95-168 [goto ERR_EMPWRKHRS_A], then [goto EMDWHOWRK_A]
RF,DK [goto EMPWKFT_A]

Soft Edit:

Check Text: ERR_EMPWRKHRS_A
Check Description: Hours worked last week/usually work per week unusually high
Check Text: {signal ERR_EMPWRKHRS_A}
^EMPWRKHRS_A hours is unusually high. Please verify. Make corrections if necessary.

Question ID: EMP.0040.00.1
Variable: EMPWKFT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you USUALLY work 35 hours or more per week in total at ALL jobs or businesses?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who refused or didn't know how many hours they worked last week or who were working for pay at a job or business last week and who worked less than 35 hours last week

Skip Instructions:

1,2,RF,DK [goto EMDWHOWRK_A]

Question ID: EMP.0050.00.1
Variable: EMPRSNOWK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

What is the MAIN reason you were not working for pay at a job or business last week?
* Probe if necessary.

Response:

01 - Unemployed, laid off, seasonal/contract work, looking for work
02 - Seasonal/contract work
03 - Retired
04 - Unable to work for health reasons/disabled
05 - Taking care of house or family
06 - Going to school
07 - Working at job business but not for pay
08 - Other
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who were not working for pay and were not on temporary leave from a job or business last week

Skip Instructions:

1,3,4,5,6,8,RF,DK [goto EMPLSTWRK_A]
2,7 [goto EMDWHOWRK_A]

Question ID: EMP.0060.00.1
Variable: EMPLSTWRK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

When was the last time you worked for pay at a job or business, even if only for a few days?

Response:

1 - Within the past 12 months
2 - 1-5 years ago
3 - Over 5 years ago
4 - Never worked
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ whose main reason for not working last week was because they couldn't find work, were retired, unable to work for health reasons, taking care of the house/family, going to school, or some other reason, or refused or didn't know

Skip Instructions:

1 [goto EMDWHOWRK_A]
2-4,RF,DK [goto next section]

Question ID: EMP.0070.00.2
Variable: EMDWHOWRK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

^JOBFOR whom ^dodid you work ^job?
* Enter the name of the company, business or employer.
* Read if necessary for those with more than one MAIN job or business: Where ^dodid you work for
the most amount of time?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week, or who have seasonal/contract work, or who work, but not for pay, or who did not have a job or business last week but had a job or business in the past 12 months

Skip Instructions:

verbatim,RF,DK [goto EMDKINDIND_A]

Question ID: EMP.0080.00.2
Variable: EMDKINDIND_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

What kind of business or industry ^iswas this?
* Read if necessary: For example: hospital, newspaper publishing, mail order house, auto engine
manufacturing, bank.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Skip Instructions:

verbatim,RF,DK [goto EMDKINDWRK_A]

Question ID: EMP.0090.00.2
Variable: EMDKINDWRK_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

What kind of work ^arewere you doing?
* Read if necessary: For example: registered nurse, personnel manager, supervisor of order
department, secretary, accountant.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Skip Instructions:

verbatim,RF,DK [goto EMDIMPACT_A]

Question ID: EMP.0100.00.2
Variable: EMDIMPACT_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

What ^arewere your most important activities or duties on this job or business?
* Read if necessary: For example: patient care, directing hiring policies, supervising order
clerks, typing and filing, reconciling financial records.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Skip Instructions:

verbatim,RF,DK [goto EMDSPRVIS_A]

Question ID: EMP.0110.00.2
Variable: EMDSPRVIS_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

^DoDid you supervise other employees as part of your job?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto EMDWRKCAT_A]

Question ID: EMP.0120.00.2
Variable: EMDWRKCAT_A
Interview Module: Adult
Content Type: Rotating Core
Question text:

Which of these BEST describes your MAIN job or ^WRKCAT?
* Read answer choices.

Response:

1 - Employee of a PRIVATE company for wages
2 - A FEDERAL government employee
3 - A STATE government employee
4 - A LOCAL government employee
5 - Self-employed in OWN business, professional practice or farm
6 - Working WITHOUT PAY in a family-owned business or farm
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-6,RF,DK if (EMPLASTWK_A=1 or EMPNOWRK_A=1 or EMPRSNOWK_A IN (2,7)) [goto EMPPDSKLV_A]
else [goto EMPDYSMSS_A]

Question ID: EMP.0130.00.1
Variable: EMPPDSKLV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Regarding your job or work ^LASTWK, is paid sick leave available if you need it?

Fills:

^LASTWK

Description: last week
Instruction:
if EMPWRKHRS_A IN (1-168,RF,DK) fill: "last week" else fill: blank

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week; or who have seasonal/contract work; or who work, but not for pay

Skip Instructions:

1,2,RF,DK [goto EMPOFFHI_A]

Question ID: EMP.0140.00.1
Variable: EMPOFFHI_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Regarding your job or work ^LASTWK, was health insurance offered to you through your workplace?

Fills:

^LASTWK

Description: last week
Instruction:
if EMPWRKHRS_A IN (1-168,RF,DK) fill: "last week" else fill: blank

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week; or who have seasonal/contract work; or who work, but not for pay

Skip Instructions:

1,2,RF,DK [goto EMPDYSMSS_A]

Question ID: EMP.0150.00.1
Variable: EMPDYSMSS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

During the past 12 months, about how many days of work did you miss because you had an illness,
injury, or disability?
* Read if necessary: Do not include family or ^paternitymaternity leave.

Fills:

^paternitymaternity

Description: paternity/maternity/maternity or paternity
Instruction:
If GEN.SEX_FINAL=1 fill "paternity" else if GEN.SEX_FINAL=2 fill "maternity"
else if GEN.SEX_FINAL=DK,RF fill "maternity or paternity"

Response:

000-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Adults 18+ who were working at or were on temporary leave from a paid job or business last week; or who have seasonal/contract work; or who work, but not for pay or who are not currently working but who had some period of employment in the past 12 months

Skip Instructions:

0-99,RF,DK [goto next section]
100-365 [goto ERR_EMPDYSMSS_A], then [goto next section]

Soft Edit:

Check Text: ERR_EMPDYSMSS_A
Check Description: Days of work missed in the past 12 months unusually high
Check Text: {signal ERR_EMPDYSMSS_A}
^EMPDYSMSS_A days is unusually high. Please verify. Make corrections if necessary.

2020 National Health Interview Survey (NHIS) Questionnaire
SDW: Social distancing at work
Question ID: SDW.0010.00.4
Variable: CURJOBSD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Thinking about your MAIN job or business, are there currently social distancing measures in
effect to help keep people apart?
* If this person is working from home full-time because of COVID-19, answer '1' for yes.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ where the social distancing section is on path and who were working at or were on temporary leave from a paid job or business last week, or who have seasonal/contract work, or who work, but not for pay

Skip Instructions:

1 [goto WRKCLSSD_A]
2,RF,DK [goto WRKCLSOFT_A]

Question ID: SDW.0020.00.4
Variable: WRKCLSSD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Currently, at your MAIN job or business, how often do you still need to work closer than 6 feet
to other people? Would you say all of the time, most of the time, some of the time, or none of
the time?
* If person works from home full-time and does not know how to answer, ask, "Does your job
require you to be face-to-face with any people you don't live with?"
* If no, answer '4' for "none of the time."
* If yes, ask, "How much of your time at work is spent with people who are closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have social distancing measures currently in effect at their main job or business

Skip Instructions:

1-4,RF,DK [goto WRKCLSNOSD_A]

Question ID: SDW.0030.00.4
Variable: WRKCLSNOSD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

When social distancing measures were NOT in effect, how often did you need to work closer than 6
feet to other people? Would you say all of the time, most of the time, some of the time, or
none of the time?
* Enter '5' if respondent only worked at main job when social distancing measures were in
effect.
If person worked from home full-time and does not know how to answer, ask, "Did your job
require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who have social distancing measures currently in effect at their main job or business

Skip Instructions:

1-5,RF,DK [goto next section]

Question ID: SDW.0040.00.4
Variable: WRKCLSOFT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Currently, at your MAIN job or business, how often do you need to work closer than 6 feet to
other people? Would you say all of the time, most of the time, some of the time, or none of the
time?
If person works from home full-time and does not know how to answer, ask, "Does your job
require you to be face-to-face with any people you don't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work is spent with people who are closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who do not have social distancing measures currently in effect at their main job or business or refused or don't know

Skip Instructions:

1-4,RF,DK [goto SDMSRS_A]

Question ID: SDW.0050.00.4
Variable: SDMSRS_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

At any time since the start of the coronavirus pandemic, did your MAIN job or business put
social distancing measures into effect?
* If this person was working from home full-time because of COVID-19, answer '1' for yes.
* If person started job while social distancing measures were in effect, answer '1' for yes.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who do not have social distancing measures currently in effect at their main job or business or refused or don't know

Skip Instructions:

1 [goto SDMSRSOFT_A]
2,RF,DK [goto next section]

Question ID: SDW.0060.00.4
Variable: SDMSRSOFT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

When social distancing measures were in effect, how often did you need to work closer than 6
feet to other people? Would you say all of the time, most of the time, some of the time, or none
of the time?
* Enter '5' if respondent did not work at main job when social distancing measures were in
effect.
If person worked from home full-time and does not know how to answer, ask, "Did your job
require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
5 - Did not work at main job when social distancing measures were in effect
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ whose main job or business put social distancing measures into effect since the start of the coronavirus pandemic

Skip Instructions:

1-5,RF,DK [goto next section]

Question ID: SDW.0070.00.4
Variable: RECJOBSD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

Thinking about the MAIN job you held in the past 12 months, were there ever any social
distancing measures in effect while you worked there? That is, were there ever practices in
place to help keep people apart?
* If this person was working from home full-time because of COVID-19, answer '1' for yes.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who last worked in the past 12 months

Skip Instructions:

1 [goto RJWRKCLSSD_A]
2,RF,DK [goto RJWKCLSOFT_A]

Question ID: SDW.0080.00.4
Variable: RJWRKCLSSD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

When social distancing measures were in effect, how often did you still need to work closer than
6 feet to other people? Would you say all of the time, most of the time, some of the time, or
none of the time?
If person worked from home full-time and does not know how to answer, ask, "Did your job
require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had social distancing measures in effect at their main job or business they held in the past 12 months

Skip Instructions:

1-4,RF,DK [goto RJWCLSNOSD_A]

Question ID: SDW.0090.00.4
Variable: RJWCLSNOSD_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

When social distancing measures were NOT in effect, how often did you need to work closer than 6
feet to other people? Would you say all of the time, most of the time, some of the time, or
none of the time?
* Enter '5' if respondent only worked at main job when social distancing measures were in
effect.
If person worked from home full-time and does not know how to answer, ask, "Did your job
require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who had social distancing measures in effect at their main job or business they held in the past 12 months

Skip Instructions:

1-5,RF,DK [goto next section]

Question ID: SDW.0100.00.4
Variable: RJWKCLSOFT_A
Interview Module: Adult
Content Type: Emerging Content
Question text:

How often did you need to work closer than 6 feet to other people? Would you say all of the
time, most of the time, some of the time, or none of the time?
If person worked from home full-time and does not know how to answer, ask, "Did your job
require you to be face-to-face with any people you didn't live with?"
If no, answer '4' for "none of the time."
If yes, ask, "How much of your time at work was spent with people who were closer than 6 feet?"

Response:

1 - All of the time
2 - Most of the time
3 - Some of the time
4 - None of the time
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who did not have social distancing measures in effect at the job they held in the past 12 months or refused or don't know

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
FEM: Employment of family members
Question ID: FEM.0010.00.1
Variable: FEMINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Now I'm going to ask you about some of the other members of your family.
Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

If Sample Adult lives in a family with at least one other adult AND (Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FEM section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FEM section was answered with RF/DK and the person answering the SC interview and the SA are different people.

Skip Instructions:

1[goto tblFEM_A]
Replicate To: FEMINTRO_C

Question ID: FEM.0030.00.1
Variable: FEMWORK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does ^ALIASNAME work for pay at a job or business?
* If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business,
enter '1' for yes.

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^heshetheywork

Description: he works/she works/they work
Instruction:
elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL=DK,RF fill "they work"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1 [goto FEMWKFT_A]
2,RF,DK if there is another adult in the family [goto FEMWORK_A] for the next adult 18+
else [goto next section]
Replicate To: FEMWORK_C

Question ID: FEM.0040.00.1
Variable: FEMWKFT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Does ^ALIASNAME usually work 35 hours or more per week in total at ^hishertheir job or jobs?

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^hishertheir

Description: his/her/their
Instruction:
If GEN.SEX_FINAL=1 fill "his"; else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK if another adult in the family [goto FEMWORK_A] for the next adult 18+
else [goto next section]
Replicate To: FEMWKFT_C

2020 National Health Interview Survey (NHIS) Questionnaire
INC: Family Income
Question ID: INC.0010.00.1
Variable: INCINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

The next questions are about your total ^FAMILY income in ^LASTYEAR BEFORE TAXES. ^INCSAFAM
* Read if necessary: Income is important in analyzing the health information we collect. For
example, with this information, we can learn whether persons in one income group use certain
types of medical services more or less often than those in another group. Please be assured
that, like all other information you have provided, these answers will remain confidential.
* Enter '1' to continue.

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^INCSAFAM

Description: Based on questions asked earlier, we have that ^SAFAM are in your family.
Instruction:
If more than one person in the Sample Adult's family, fill "Based on questions asked earlier, we have that ^SAFAM are
in your family."
else no fill

^SAFAM

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 [goto INCWRKO_A]
Replicate To: INCINTRO_C

Question ID: INC.0020.00.1
Variable: INCWRKO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ^YOUFAM18YRS receive income from wages, salaries, commissions, bonuses, tips,
or self-employment?
^INCSAFAMoptional

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAM18YRS

Description: you/you or any family members 18 or older
Instruction:
If PCNT18UP_A=1 fill "you" else if PCNT18UP_A GT 1 fill "you or any family members 18 or older"

^INCSAFAMoptional

Description: Read if necessary: For the purpose of this survey, your family includes ^FAMVERSA_fill.
Instruction:
If more than one person in the Sample Adult's family, fill "* Read if necessary: For the purpose of this survey, your
family includes ^FAMVERSA_fill."
else no fill

^FAMVERSA_fill

Description: List of all people in Sample Adult's family
Instruction:
Loop through all persons on roster and add to list of names if:
-people related via REL (FAMA_REL_FLG = 1) or
-people who are related to the SA (RELATE = 1-13) or
-people in SC's family and the 1st person in HH in SC's
family are related to the SA (RELATE = 1-13)
Do not include Sample Adult on list.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
If only one person on the list of names and person ne
Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on
list and person is Household Respondent
(Roster.HHC.HHRESPAVAIL), follow list with "are".

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCINTER_A]
Replicate To: INCWRKO_C

Question ID: INC.0030.00.1
Variable: INCINTER_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ^YOUFAMHERE receive income from interest-bearing accounts or investments,
dividends from stocks or mutual funds, net rental income, royalty income, or income from estates
and trusts?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE

Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,DK [goto INCSSRR_A]
RF if INCWRKO_A IN (1,2,DK) [goto INCSSRR_A]
else [goto next section]
Replicate To: INCINTER_C

Question ID: INC.0040.00.1
Variable: INCSSRR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Income from Social Security or Railroad Retirement?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE

Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent and the Sample Adult did not refuse both the income from wages and income from accounts questions

Skip Instructions:

1,2,RF,DK [goto INCSSISSDI_A]
Replicate To: INCSSRR_C

Question ID: INC.0050.00.1
Variable: INCSSISSDI_A
Interview Module: Adult
Content Type: Annual Core
Question text:

*Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Supplemental Security Income, SSI, or Social Security Disability Income, SSDI, which are
different from Social Security?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE

Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1 [goto SSISSDIBTH_A]
2,RF,DK [goto INCWELF_A]
Replicate To: INCSSISSDI_C

Question ID: INC.0060.00.1
Variable: SSISSDIBTH_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was this Supplemental Security Income, SSI, Social Security Disability Income, SSDI, or both?

Response:

1 - SSI
2 - SSDI
3 - Both SSI and SSDI
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ where someone in the family gets SSI or SSDI and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1-3,RF,DK [goto SSISSDIDSB_A]
Replicate To: SSISSDIBTH_C

Question ID: INC.0070.00.1
Variable: SSISSDIDSB_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was this received as a disability benefit?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+ where someone in the family gets SSI or SSDI and Sample Child and Sample Adult are in the same family and the INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 if GEN.PCNT_A gt 1 [goto SSISSDIP_A]
elseif GEN.PCNT_A=1 [goto INCWELF_A]
2,RF,DK [goto INCWELF_A]
Replicate To: SSISSDIDSB_C

Question ID: INC.0090.00.1
Variable: SSISSDIP_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In ^LASTYEAR, who received this disability benefit?
* Read if necessary: Do NOT include a benefit received on behalf of someone else.
* Enter all that apply, separate with commas.

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

Response:

Universe:

Sample Adults 18+ with more than one person in the family where someone in the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1-25,RF,DK [goto INCWELF_A]
Replicate To: SSISSDIP_C

Question ID: INC.0100.00.1
Variable: INCWELF_A
Interview Module: Adult
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ^YOUFAMHERE receive...
Any public assistance or welfare payments from the state or local welfare office?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE

Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCRETIRE_A]
Replicate To: INCWELF_C

Question ID: INC.0110.00.1
Variable: INCRETIRE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Income from retirement, survivor, or disability pensions?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE

Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCOTHR_A]
Replicate To: INCRETIRE_C

Question ID: INC.0120.00.1
Variable: INCOTHR_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive...
Any other sources of income such as VA payments from the Veterans Benefits Administration,
unemployment compensation, child support, or alimony?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE

Description: you/you or any family members
Instruction:
If PCNT_A=1 fill "you" else if PCNT_A GT 1 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCTOTAL_A]
Replicate To: INCOTHR_C

Question ID: INC.0130.00.1
Variable: INCTOTAL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^INCALLFAM
What is your best estimate of ^TOTALINCOME from all sources, before taxes, in ^LASTYEAR?
* Enter '999995' if the reported income $999,995 or greater.

Fills:

^INCALLFAM

Description: INCTOTAL_A Introduction
Instruction:
IF PCNT_A GT 1 fill "When answering this next question, please remember to include your income PLUS the income of
all family members living in this household."

^TOTALINCOME

Description: your total income/the total income of all family members
Instruction:
If PCNT_A=1 fill "your total income" else if PCNT_A GT 1 fill "the total income of all family members"

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

Response:

000000-999995 - Range of values
999997 - Refused
999998 - Not Ascertained
999999 - Don't Know

Universe:

Skip Instructions:

0-999 [goto ERR1_INCTOTAL_A]
250001-999995 [goto ERR2_INCTOTAL_A]
1000-250000 [goto next section]
RF,DK [goto INC250PCT_A]

Soft Edit:

Check Text: ERR2_INCTOTAL_A
Check Description: Income high soft edit
Check Text: {signal ERR2_INCTOTAL_A} Do not read to the respondent. ^INCTOTAL_A is unusually high. Make corrections if necessary.
Check Text: ERR1_INCTOTAL_A
Check Description: Income low soft edit
Check Text: {signal ERR1_INCTOTAL_A} Do not read to the respondent. ^INCTOTAL_A is unusually low. Make corrections if necessary. Replicate To: INCTOTAL_C

Question ID: INC.0150.00.1
Variable: INC250PCT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than ^250POVERTY_A or ^250POVERTY_A or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

^250POVERTY_A

Description: 250% of poverty threshold
Instruction:
Fill value stored in INC250FILL_A

Response:

1 - Less than ^250POVERTY_A
2 - ^250POVERTY_A or more
7 - Refused
9 - Don't Know

Universe:

Sample Adult 18+ who don't know or refuse the total family income and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 [goto INC138PCT_A]
2 if GEN.PCNT_A IN (1,2) [goto INC75K_A]
else if GEN.PCNT_A=4 or GEN.PCNT_A ge 7 [goto INC400PCT_A]
else if GEN.PCNT_A IN (3,5,6) [goto INC100K_A]
RF,DK [goto next section]
Replicate To: INC250PCT_C

Question ID: INC.0160.01.1
Variable: INC138PCT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than ^138POVERTY_A or ^138POVERTY_A or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

^138POVERTY_A

Description: 138% of poverty threshold
Instruction:
Fill value stored in INC138FILL_A

Response:

1 - Less than ^138POVERTY_A
2 - ^138POVERTY_A or more
7 - Refused
9 - Don't Know

Universe:

Sample Adult 18+ answered less than 250% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 [goto INC100PCT_A]
2 [goto INC200PCT_A]
RF,DK [goto next section]
Replicate To: INC138PCT_C

Question ID: INC.0170.01.1
Variable: INC100PCT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than ^100POVERTY_A or ^100POVERTY_A or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

^100POVERTY_A

Description: 100% of poverty threshold
Instruction:
Fill value stored in INC100FILL_A

Response:

1 - Less than ^100POVERTY_A
2 - ^100POVERTY_A or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who answered less than 138% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: INC100PCT_C

Question ID: INC.0180.01.1
Variable: INC200PCT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than ^200POVERTY_A or ^200POVERTY_A or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

^200POVERTY_A

Description: 200% of poverty threshold
Instruction:
Fill value stored in INC200FILL_A

Response:

1 - Less than ^200POVERTY_A
2 - ^200POVERTY_A or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who answered 138% of poverty or more and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: INC200PCT_C

Question ID: INC.0190.00.1
Variable: INC75K_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than $75,000 or $75,000 or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

Response:

1 - Less than $75,000
2 - $75,000 or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who answered 250% of poverty threshold or more and is from a 1 or 2 person family and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 [goto INC400PCT_A]
2 [goto INC100K_A]
RF,DK [goto next section]
Replicate To: INC75K_C

Question ID: INC.0200.00.1
Variable: INC100K_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than $100,000 or $100,000 or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

Response:

1 - Less than $100,000
2 - $100,000 or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ who answered $75,000 or more OR answered 250% of poverty threshold or more and is from a 3,5, or 6 person family and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 if GEN.PCNT_A IN (1,2,5,6) [goto next section]
elseif GEN.PCNT_A=3 [goto INC400PCT_A]
2 if GEN.PCNT_A IN (1,2,3) [goto INC150K_A]
elseif GEN.PCNT_A IN (5,6) [goto INC400PCT_A]
RF,DK [goto next section]
Replicate To: INC100K_C

Question ID: INC.0210.01.1
Variable: INC400PCT_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than ^400POVERTY_A or ^400POVERTY_A or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

^400POVERTY_A

Description: 400% of poverty threshold
Instruction:
Fill value stored in INC400FILL_A

Response:

1 - Less than ^400POVERTY_A
2 - ^400POVERTY_A or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ and answered less than $75,000 OR answered less than $100,000 and is from a 3 person family OR answered $100,000 or more and is from a 5 or 6 person family or answered 250% of poverty threshold or more and is from a 4 or 7+ person family and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1 if GEN.PCNT_A ge 8 [goto INC150K_A]
else [goto next section]
2 if GEN.PCNT_A IN (1,2,3) or GEN.PCNT_A ge 6 [goto next section]
else if GEN.PCNT IN (4,5) [goto INC150K_A]
RF,DK [goto next section]
Replicate To: INC400PCT_C

Question ID: INC.0220.00.1
Variable: INC150K_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Was your total ^FAMILY income from all sources less than $150,000 or $150,000 or more?

Fills:

^FAMILY

Description: family
Instruction:
If PCNT_A > 1 fill "family"

Response:

1 - Less than $150,000
2 - $150,000 or more
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ answered $100,000 or more and is from 1,2 or 3 person family OR respondent answered 400% of poverty or more and is from 4 or 5 person family OR respondent answered less than 400% of poverty and is from a family of 8 or more persons and Sample Adult and Sample Child are in the same family and the Sample Child INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family, Sample Child respondent answered all questions asked in the INC section with dk/rf and Sample Adult is not the Sample Child respondent

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: INC150K_C

2020 National Health Interview Survey (NHIS) Questionnaire
FOO: Food Related Programs
Question ID: FOO.0010.00.1
Variable: FSNAP12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

At any time in the last 12 months did ^YOUFAMLVHERE_A receive ^FSSNAPNM?
* Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy
food.

Fills:

^YOUFAMLVHERE_A

Description: you/any family members living here/you or any family members living at ^HNO ^HNOSUF ^STRNAME
Instruction:
If GEN.PCNT_A=1, fill: "you"; elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS ne 1, fill: "any family members living
here"
elseif GEN.PCNT_A gt 1 and Roster.HHC.tblNAME.bPerson
[PX_A].ONOFFCAMPUS=1, fill "you or any family members
living at ^HNO ^HNOSUF ^STRNAME"

^FSSNAPNM

Description: food stamp benefits/[state food stamp program name]
Instruction:
If AL then fill "Food Assistance Program or food stamp benefits"
If AK then fill "food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp
benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits"
If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food stamp
benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "Food Assistance Program or food stamp
benefits"
If GA then fill "food stamp benefits"
If HI then fill "SNAP or food stamp benefits"
If ID then fill "food stamp benefits"
If IL then fill "SNAP or food stamp benefits"
If IN then fill "SNAP or food stamp benefits"
If IA then fill "Food Assistance Program or food stamp
benefits"
If KS then fill "Food Assistance Program or food stamp
benefits"
If KY then fill "SNAP or food stamp benefits"
If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food stamp
benefits"
If MD then fill "Food Supplement Program or food stamp
benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program or food stamp
benefits"
If MN then fill "SNAP or food stamp benefits"
If MS then fill "SNAP or food stamp benefits"
If MO then fill "food stamp benefits"
If MT then fill "SNAP or food stamp benefits"
If NE then fill "SNAP or food stamp benefits"
If NV then fill "SNAP or food stamp benefits"
If NH then fill "Food Stamp/SNAP or food stamp benefits"
If NJ then fill "SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits"
If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food stamp
benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "Food Assistance Program or food stamp
benefits"
If OK then fill "SNAP or food stamp benefits"
If OR then fill "SNAP or food stamp benefits"
If PA then fill "SNAP or food stamp benefits"
If RI then fill "SNAP or food stamp benefits"
If SC then fill "SNAP or food stamp benefits"
If SD then fill "SNAP or food stamp benefits"
If TN then fill "SNAP or food stamp benefits"
If TX then fill "SNAP or food stamp benefits"
If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits"
If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food Washington or food stamp
benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp
benefits"
If WY then fill "SNAP or food stamp benefits"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know
-

Universe:

Sample Adults 18+ where the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the Sample Adult is not the Sample Child respondent

Skip Instructions:

1 [goto FSNAP30D_A]
2,RF,DK if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M_A]
else [goto FINISH_FOO_A]
Replicate To: FSNAP12M_C

Question ID: FOO.0020.00.3
Variable: FSNAP30D_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

Did ^YOUFAMLVHERE_A receive ^FSSNAPNM in the LAST 30 days?
* Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy
food.

Fills:

^YOUFAMLVHERE_A

^FSSNAPNM

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know
-

Universe:

Sample Adults 18+ living in families where someone received food stamps in the last 12 months

Skip Instructions:

1,2,RF,DK if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M_A];
else [goto FINISH_FOO_A]
Replicate To: FSNAP30D_C

Question ID: FOO.0030.00.1
Variable: FWIC12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

At any time in the last 12 months did ^YOUFAMLVHERE_A receive benefits from the WIC program,
that is, the Women, Infants, and Children program?

Fills:

^YOUFAMLVHERE_A

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ living in families with females 12-55 years of age or children 0-5 years of age AND the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the Sample Adult is not the sample child respondent OR the Sample Adult and Sample Child are in the same family and at least one question asked in Sample Child FOO section has a valid answer (not dk/rf) and the received WIC benefits question was not asked in the Sample Child FOO section

Skip Instructions:

1,2,RF,DK if PCNTC517_A ge 1 [goto FLUNCH12M_A]
else [goto FINISH_FOO_A]
Replicate To: FWIC12M_C

Question ID: FOO.0040.00.1
Variable: FLUNCH12M_A
Interview Module: Adult
Content Type: Annual Core
Question text:

At any time in the last 12 months, did ^SCCHILDFAM_A receive free or reduced-cost breakfasts or
lunches at school?
* Read if necessary: The National School Lunch Program and the School Breakfast Program provide
cash assistance to states to operate breakfast and lunch programs in schools and residential
childcare institutions. The programs provide low-cost or free breakfasts and lunches to lowincome children in kindergarten through 12th grade.

Fills:

^SCCHILDFAM_A

Description: ^ALIASNAME/any child in your family
Instruction:
if PCNT517_A=1, fill: ^ALIASNAME of child in Sample Adult family,
elseif PCNT517_A gt 1, fill "any child in your family",

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ living in families with children between the ages of 5-17 and the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the sample adult is not the sample child respondent

Skip Instructions:

1,2,RF,DK [goto FINISH_FOO_A]
Replicate To: FLUNCH12M_C

Question ID: FOO.0050.00.1
Variable: FINISH_FOO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* The Sample Adult food related programs section is now complete.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+ where the Sample Adult FOO section has not been completed AND the Sample Adult and Sample Child are in the same family and the Sample Child FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and all questions in the Sample Child FOO section was answered with refused or don't know and the sample adult is not the sample child respondent the OR Sample Adult and Sample Child are in the same family and at least one question asked in Sample Child FOO section has a valid answer (not dk/rf) and the received WIC benefits question was not asked in the Sample Child FOO section and within the family exist at least one female 12-55 years of age or child 0-5 years of age

Skip Instructions:

1 [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
FDS: Food Security
Question ID: FDS.0010.00.3
Variable: FDSINTRO_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

These next questions are about whether ^youyourfamily_A ^waswere always able to afford the food
you needed in the last 30 days. I'm going to read you several statements that people have made
about their food situation. For these statements, please tell me whether the statement was often
true, sometimes true, or never true for ^youyourfamily_A in the last 30 days.
* Enter '1' to continue.

Fills:

^youyourfamily_A

Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"

^waswere

Description: were/was
Instruction:
If PCNT_A=1 "were" else "was"

Response:

1 - Enter 1 to Continue

Universe:

Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people.

Skip Instructions:

1 [goto FDSRUNOUT_A]
Replicate To: FDSINTRO_C

Question ID: FDS.0020.00.3
Variable: FDSRUNOUT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

The first statement is "^IWe_A worried whether ^myour_A food would run out before ^Iwe_A got
money to buy more." Was that often true, sometimes true, or never true for ^youyourfamily_A in
the last 30 days?

Fills:

^IWe_A

Description: I/We
Instruction:
If PCNT_A=1 fill: "I" else fill: "We"

^myour_A

Description: my/our
Instruction:
If PCNT_A=1 fill: "my" else fill: "our"

^youyourfamily_A

Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"

Response:

1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-3,RF,DK [goto FDSLAST_A]
Replicate To: FDSRUNOUT_C

Question ID: FDS.0030.00.3
Variable: FDSLAST_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

"The food that ^Iwe_A bought just didn't last, and ^Iwe_A didn't have money to get more." Was
that often true, sometimes true, or never true for ^youyourfamily_A in the last 30 days?

Fills:

^Iwe_A

Description: I/We
Instruction:
If PCNT_A=1 fill: "I" else fill: "We"

^youyourfamily_A

Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"

Response:

1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-3,RF,DK [goto FDSBALANCE_A]
Replicate To: FDSLAST_C

Question ID: FDS.0040.00.3
Variable: FDSBALANCE_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

^IWe_A couldn't afford to eat balanced meals." Was that often true, sometimes true, or never
true for ^youyourfamily_A in the last 30 days?

Fills:

^IWe_A

Description: I/We
Instruction:
If PCNT_A=1 fill: "I" else fill: "We"

^youyourfamily_A

Description: you/your family
Instruction:
If PCNT_A=1 "you" else "your family"

Response:

1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-2 [goto FDSSKIP_A]
3,RF,DK if FDSRUNOUT_A IN (1,2) OR FDSLAST_A IN (1,2) [goto FDSSKIP_A];
else [goto next section]
Replicate To: FDSBALANCE_C

Question ID: FDS.0050.00.3
Variable: FDSSKIP_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_A ever cut the size of your meals or skip meals because
there wasn't enough money for food?

Fills:

^youorother_A

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals

Skip Instructions:

1 [goto FDSSKIPDYS_A]
2,RF,DK [goto FDSLESS_A]
Replicate To: FDSSKIP_C

Question ID: FDS.0060.00.3
Variable: FDSSKIPDYS_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, how many days did this happen?

Response:

01-30 - Range of values
97 - Refused
99 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent said that they or other adults in their family cut the size of their meals or skipped meals due to cost.

Skip Instructions:

1-30,RF,DK [goto FDSLESS_A]
Replicate To: FDSSKIPDYS_C

Question ID: FDS.0070.00.3
Variable: FDSLESS_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_A ever eat less than you felt you should because there
wasn't enough money for food?

Fills:

^youorother_A

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK [goto FDSHUNGRY_A]
Replicate To: FDSLESS_C

Question ID: FDS.0080.00.3
Variable: FDSHUNGRY_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, were ^youorother_A ever hungry but didn't eat because there wasn't enough
money for food?

Fills:

^youorother_A

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK [goto FDSWEIGHT_A]
Replicate To: FDSHUNGRY_C

Question ID: FDS.0090.00.3
Variable: FDSWEIGHT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_A lose weight because there wasn't enough money for food?

Fills:

^youorother_A

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1 [goto FDSNOTEAT_A]
2,RF,DK if FDSSKIP_A=1 or FDSLESS_A=1 or FDSHUNGRY_A=1 [goto FDSNOTEAT_A]; else [goto next
section]
Replicate To: FDSWEIGHT_C

Question ID: FDS.0100.00.3
Variable: FDSNOTEAT_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_A ever not eat for a whole day because there wasn't enough
money for food?

Fills:

^youorother_A

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_A=1: fill "you" else "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent answered they cut the size of the meals, skipped meals, were hungry but didn't eat, or lost weight in the last 30 days because there wasn't enough money for food.

Skip Instructions:

1 [goto FDSNEDAYS_A]
2,RF,DK [goto next section]
Replicate To: FDSNOTEAT_C

Question ID: FDS.0110.00.3
Variable: FDSNEDAYS_A
Interview Module: Adult
Content Type: Sponsored Content
Question text:

In the last 30 days, how many days did this happen?

Response:

01-30 - Range of values
97 - Refused
99 - Don't Know

Universe:

The Sample Child and Sample Adult are not in the same family OR Sample Child and Sample Adult are in the same family AND Sample Child FDS section has not been completed OR the Sample Adult and Sample Child are in the same family and every question asked in the Sample Child FDS section was answered with RF/DK and the person answering the SC interview and the SA are different people and respondent didn't eat for a whole day in last 30 days because there wasn't enough money for food

Skip Instructions:

1-30,RF,DK [goto next section]
Replicate To: FDSNEDAYS_C

2020 National Health Interview Survey (NHIS) Questionnaire
HOU: Housing
Question ID: HOU.0010.00.1
Variable: HOUYRSLIV_A
Interview Module: Adult
Content Type: Annual Core
Question text:

About how long ^YRSLIV?

Fills:

^YRSLIV

Description: have you lived at ^HNO ^HNOSUF ^STRNAME/have you lived in this house/apartment
Instruction:
If Roster.HHC.tblname.bPerson[PX_A]ONOFFCAMPUS=1 fill "have you lived at ^HNO ^HNOSUF ^STRNAME"
else fill "have you lived in this house/apartment"

^HNO

Description: {Value of HNO}
Instruction:
Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME

Response:

1 - Less than 1 year
2 - 1 to 3 years
3 - 4 to 10 years
4 - 11 to 20 years
5 - More than 20 years
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1-5,RF,DK if ((GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=empty) or (GEN.SAMEFAM_FLG ne 1) or
(GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=2 and GEN.SARESPSC_FLG ne 1))[goto HOUTENURE_A]
else [goto next section]
If GEN.AGE_FINAL[PX_A] lt 21 and HOUYRSLIV_A=5 [goto ERR1_HOUYRSLIV_A]

Hard Edit:

Check Text: ERR1_HOUYRSLIV_A
Check Description: Hard check when years lived in home exceeds age
Check Text: {check ERR1_HOUYRSLIV_A}
Years in house/apartment exceed ^SANAME's age. Please correct.

Question ID: HOU.0020.00.1
Variable: HOUTENURE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^HOUTEN owned or rented by you ^SOMEFAM_A?
* If house has a mortgage, record as owned.

Fills:

^HOUTEN

Description: Is the house/apartment at ^HNO ^HNOSUF ^STRNAME/Is this house/apartment
Instruction:
If Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS=1, fill "Is the house/apartment at ^HNO ^HNOSUF ^STRNAME"
else fill "Is this house/apartment"

^HNO

Description: {Value of HNO}
Instruction:
Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME

^SOMEFAM_A

Description: or someone in your family
Instruction:
If PCNT18UP_A=1 fill: blank If PCNT18UP_A gt 1 fill: "or someone in your family"

Response:

1 - Owned or being bought
2 - Rented
3 - Other arrangement
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ and Sample Adult and Sample Child are in the same family and the HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample child respondent answered refused or don't know to all questions in the sample child HOU section and the sample child respondent is not the sample adult respondent.

Skip Instructions:

1,3,RF,DK [goto next section]
2 [goto HOUGVASST_A]
Replicate To: HOUTENURE_C

Question ID: HOU.0030.00.1
Variable: HOUGVASST_A
Interview Module: Adult
Content Type: Annual Core
Question text:

^HOUGVT paying lower rent because the Federal, State, or local government is paying part of the
cost?
* Read if necessary: Federal, State, or Local government housing programs for persons with low
income may take many forms. Government housing assistance could come from monetary assistance to
help pay rent, a program called "Section 8," direct payments to landlords, vouchers, or other
types of assistance from a local housing authority. Living in public housing is considered
housing assistance from the government.

Fills:

^HOUGVT

Description: Are you/Are you or anyone in your family/Is your family at ^HNO ^HNOSUF ^STRNAME
Instruction:
If Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS ne 1 and GEN.PCNT18UP_A=1, fill "Are you"
elseif Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMPUS ne 1
and PCNT18UP_A gt 1, fill "Are you or anyone in your
family"
elseif Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1,
fill "Is your family at ^HNO ^HNOSUF ^STRNAME"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with a house/apartment that is being rented AND Sample Adult and Sample Child are in the same family and the house/apartment is being owned/rented and the HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family section

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: HOUGVASST_C

2020 National Health Interview Survey (NHIS) Questionnaire
REC: Person's name
Question ID: REC.0010.00.1
Variable: LNKFNAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Ask or verify: What is your full name?
* Enter first name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

allow 20,RF,DK [goto LNKMNAME_A]

Question ID: REC.0020.00.1
Variable: LNKMNAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Enter middle name.
* Press "Enter" to skip to last name if respondent has no middle name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

allow 20,RF,DK [goto LNKLNAME_A]

Question ID: REC.0030.00.1
Variable: LNKLNAME_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Enter last name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

allow 20,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
TEL: Telephone Use
Question ID: TEL.0010.00.1
Variable: TELCURWRK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Is there at least one telephone INSIDE ^HOME that is currently working and is not a cell phone?

Fills:

^HOME

Description: your home at ^HNO ^HNOSUF ^STRNAME/your home
Instruction:
If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "your home at ^HNO ^HNOSUF ^STRNAME"
else fill "your home"

^HNO

Description: {Value of HNO}
Instruction:
Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ where the Sample Adult and Sample Child are in the same family but TELCURWRK_C has not been asked OR Sample Adult and Sample Child are in the same family, TELCURWRK_C was answered don't know or refused and the Sample Adult is not the Sample Child Respondent or where the Sample Adult does not live in same family as Sample Child

Skip Instructions:

1,2,RF,DK [goto TELCEL_A]
Replicate To: TELCURWRK_C

Question ID: TEL.0020.00.1
Variable: TELCEL_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you have a working cell phone?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+

Skip Instructions:

1 if TELCURWRK_A=1 or (TELCURWRK_C=1 and GEN.SAMEFAM_FLG=1)[goto PHONEUSE_A]
else[goto TLNO_TEL_SA]
2,RF,DK if (GEN.SAMEFAM_FLG=1 and PHONELIVE_C=empty) or (GEN.SAMEFAM_FLG=1 and PHONELIVE_C IN
(RF,DK) and GEN.SARESPSC_A ne 1) or (GEN.SAMEFAM_FLG ne 1)) and GEN.PCNT_A gt 1 [goto
PHONELIVE_A]
else [goto TLNO_TEL_SA]

Question ID: TEL.0030.00.1
Variable: PHONELIVE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Do you live with anyone ^ATHOME who has a working cell phone?

Fills:

^ATHOME

Description: at your home at {Value of HNO} {Value of HNOSUF} {Value of STRNAME}
Instruction:
If Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS=1, fill "at your home at ^HNO ^HNOSUF ^STRNAME"
else leave blank

^HNO

Description: {Value of HNO}
Instruction:
Fill GEN.HNO

^HNOSUF

Description: {Value of HNOSUF}
Instruction:
Fill GEN.HNOSUF

^STRNAME

Description: {Value of STRNAME}
Instruction:
Fill GEN.STRNAME

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ in a family with at least one other person without working cell phones where Sample Adult does not live in same family as Sample Child or Sample Adult and Sample Child are in the same family but PHONELIVE_C has not been asked OR Sample Adult and Sample Child are in the same family, PHONELIVE_C was answered dk/rf and the Sample Adult is not the Sample Child Respondent.

Skip Instructions:

1,2,RF,DK [goto TLNO_TEL_SA]
Replicate To: PHONELIVE_C

Question ID: TEL.0040.00.1
Variable: PHONEUSE_A
Interview Module: Adult
Content Type: Annual Core
Question text:

Of all the telephone calls that you answer, are all or almost all on your cell phones, some on
your cell phone and some on your home phone, or very few or none on your cell phones?

Response:

1 - All or almost all calls on cell phone
2 - Some on cell phone and some on home phone
3 - Very few or none on cell phone
7 - Refused
9 - Don't Know

Universe:

Sample Adults 18+ with working personal cell phone and who said they have a working land-line in household or in the same family as sample child respondent who said they have a working landline in the household.

Skip Instructions:

1-3,RF,DK [goto TLNO_TEL_SA]

2020 National Health Interview Survey (NHIS) Questionnaire
LNK: Linkage
Question ID: LNK.0010.00.1
Variable: LNKINTRO_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
We would like the last four digits of your Social Security Number^medicarenum. This information
will help us link your survey data with health-related records of other government agencies, and
allow us to conduct additional research without taking up your time with more questions. The
National Center for Health Statistics (NCHS) uses this information for research purposes only.
Providing this information is voluntary. There will be no effect on your benefits if you do not
provide this information. Federal laws authorize us to ask for this information. Like all other
answers you have provided, this information will remain confidential.
* Read if necessary: The specific federal laws protecting your privacy and the confidentiality
of your data are the Public Health Service Act (Title 42, U.S.C., Section 242m(d)), the
Confidential Information Protection and Statistical Efficiency Act of 2018 (Title III, Public
Law No. 115-435), and the Privacy Act of 1974 (5 U.S.C. § 552a).
* Read if necessary: NCHS collects health-related data from other government agencies, including
records from Medicare and Medicaid Services, Social Security, housing, and death certificates.
If you agree, NCHS will attempt to link records such as these with your survey data to give a
fuller picture of the kinds of things that affect health. NCHS does this linkage. Your name and
your information are not given to these agencies.
* Read if necessary: If asked: Your data will not be linked to records from the IRS (Internal
Revenue Service) or ICE (Immigration and Customs Enforcement).
* Enter '1' to continue.

Fills:

^medicarenum

Description: , and the last four characters of your Medicare number
Instruction:
If INS.HIKIND_A=2 or INS.MCAREPRB_A=1, fill ", and the last four characters of your Medicare number"
else, fill nothing

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto SSN4_A]

Question ID: LNK.0020.00.1
Variable: SSN4_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
What are the last four digits of your Social Security Number?
* Read if necessary: Providing this information is voluntary. There will be no effect on your
benefits if you do not provide this information. Federal laws authorize us to ask for this
information. Like all other information you have provided, these answers will remain
confidential.
* Read if asked about specific laws: The specific federal laws protecting your privacy and the
confidentiality of your data are the Public Health Service Act, which is Title 42, U.S.C.,
Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act of 2018,
which is Title III of Public Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. §
552a.
* Enter 'N' for no Social Security Number.

Response:

0001-9999 - Range of values
N - No Social Security Number
99997 - Refused
99999 - Don't Know

Skip Instructions:

if SSN4_A=000-999 [goto ERR2_SSN4_A]
elseif SSN4_A NOT IN (N,RF,DK,000-999,0001-9999) [goto ERR3_SSN4_A]
0001-9999 if.Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto LAST4C_A]
else [goto next section]
N,RF,DK if Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto LAST4C_A]
else [goto RLINK_A]

Hard Edit:

Check Text: ERR2_SSN4_A
Check Description: Entered less than four digits hard edit
Check Text: {check ERR2_SSN4_A}
You must enter all four of the last four digits of the Social Security Number. Please correct.
Check Text: ERR3_SSN4_A
Check Description: SSN last four digits are 0000 or a letter other than N hard edit
Check Text: {check ERR3_SSN4_A}
The last 4 digits of a SSN should be between 0001-9999. For a respondent who does not want to provide the SSN, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused.' If a respondent does not have a SSN, enter 'N'. Please correct.

Question ID: LNK.0040.00.1
Variable: LAST4C_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
* 1 of 2
What are the last four characters of your Medicare or Health Insurance Claim Number?
* Read if necessary: Providing this information is voluntary. There will be no effect on your
benefits if you do not provide this information. Federal laws authorize us to ask for this
information. Like all other information you have provided, these answers will remain
confidential.
* Read if asked about specific laws: The specific federal laws protecting your privacy and the
confidentiality of your data are the Public Health Service Act, which is Title 42, U.S.C.,
Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act of 2018,
which is Title III of Public Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. §
552a.
* Reports from memory are acceptable if the Medicare card (or some other form of documentation)
is not available.
* Enter the last four characters, which should be letter-letter-number-number.

Response:

Verbatim - Verbatim values
9997 - Refused
9999 - Don't Know

Universe:

Sample adults 18+ who have Medicare

Skip Instructions:

if anything lt 4 alphanumeric characters [goto ERR1_LAST4C_A]
elseif SSN4_A IN (N,RF,DK) or LAST4C_A IN (RF,DK) [goto RLINK_A]
else [goto next section]

Hard Edit:

Check Text: ERR1_LAST4C_A
Check Description: Medicare number less than 4 characters
Check Text: {check ERR1_LAST4C_A}
You must enter all four of the last four alphanumeric characters of the Medicare number. Please correct.

Question ID: LNK.0060.00.1
Variable: RLINK_A
Interview Module: Adult
Content Type: Annual Core
Question text:

?[F1]
May we try to link your survey data without a ^SSNMEDNUM?
* Read if necessary: Any data obtained are protected by strict federal laws, including the
Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential
Information Protection and Statistical Efficiency Act of 2018, which is Title III of Public Law
No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a.

Fills:

^SSNMEDNUM

Description: consent by SSN or Medicare number
Instruction:
if (SSN4_A IN (N,RF,DK) and ((Adult.INS.HIKIND_A ne 2 and Adult.INS.MCAREPRB_A ne 1) or (MCNO4_A ge 001 and MCNO4_A
le 9999) or (LAST4C_A NOT IN (empty,RF, DK)))) fill=
"social security number"
elseif ((SSN4_A ge 0001 and SSN4_A le 9999) and
(Adult.INS.HIKIND_A = 2 or Adult.INS.MCAREPRB_A =1) and
(MCNO4_A IN (RF, DK) or (LAST4C_A IN (RF,DK))) fill =
"Medicare or Health Insurance Claim Number"
else fill = "social security number, Medicare or Health
Insurance Claim Number"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample adults 18+ who answered no SSN or refused or don't know last 4 digits of SSN or who answered refused or don't know at last 4 of Medicare number

Skip Instructions:

1,2,RF,DK[goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
THX: Thanks
Question ID: THX.0080.001
Variable: THANKS_A
Interview Module: Adult
Content Type: Annual Core
Question text:

* Thank respondent for answering these questions. If there is a Sample Child interview to
complete, ask for appropriate person to respond to these questions.
Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Adults 18+

Skip Instructions:

1 [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
VFY: Verification and demographic details
Question ID: VFY.0040.00.1
Variable: CURRES_C
Interview Module: Child
Content Type: Annual Core
Question text:

The next questions are about ^SCNAME.
* Enter the line number of the person to whom you are speaking.
* If Sample Child respondent refuses to participate enter CTRL-R.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample Children 0-17

Skip Instructions:

RF if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
If CURRES_C not in Roster.FAM.KNOWSC [goto KNOAVAIL_C]
Else if CURRES_C ne LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC [goto AVAIL_C]
Else if CURRES_C = LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC AND CURRES_C not in
Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
Else if CURRES_C = LNO_HHRESP AND CURRES_C in Roster.FAM.KNOWSC AND CURRES_C in
Roster.bREL.bPerson[PX_C].PARENTS[goto VFYALL_C]

Question ID: VFY.0060.00.1
Variable: KNOAVAIL_C
Interview Module: Child
Content Type: Annual Core
Question text:

^KNOAVAIL_C_fill
* Enter the line number of available respondent from list or press F9 to set up a callback if no
one is available or refused.
^KNOAVAIL_C_fill_2

Fills:

^KNOAVAIL_C_fill

Description: FR Instruction/I have recorded that ^KNOWSC ^areis_ knowledgeable about and responsible for ^SCNAME's health
Instruction:
IS currently available and willing to answer these questions?
Instruction If (KnowSC_Count = ActiveNotKnow_Count)
fill : "* If there are no other knowledgeable people to
select then press the end key."
ELSE
fill : "I have recorded that ^KNOWSC ^areis_c
knowledgeable about and responsible for ^SCNAME's health
care. ^WHOIS currently available and willing to answer
these questions?"

^KNOWSC

Description: List of household members who are knowledgeable about and responsible for the Sample Child
Instruction:
KNOWSC = list of people identified as being knowledge about and responsible for ^SCNAME's health as selected in
Roster.FAM.KNOWSC. Add "and" before last name if list >
1.

^areis_c

Description: is/are
Instruction:
IF KNOAVAIL_Count = 1 Fill 'is',
ELSE
Fill 'are',

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^WHOIS

Description: Is {Value of ALIAS}/Who is
Instruction:
IF KNOAVAIL_Count = 1 Fill 'Is Alias[I]
ELSE
Fill 'Who is'

^KNOAVAIL_C_fill_2

Description: FR Instruction
Instruction:
If (ActiveNotKnow_Count > 0) fill : "* People listed in gray have said that they are
not knowledgeable about the SC. If you incorrectly set
someone as not knowledgeable then you may select that
person and continue the interview."

Response:

01 - Name of Person 1
02 - Name of Person 2
03 - Name of Person 3
04 - Name of Person 4
05 - Name of Person 5
06 - Name of Person 6
07 - Name of Person 7
- 08 - Name of Person 8
09 - Name of Person 9
10 - Name of Person 10
11 - Name of Person 11
12 - Name of Person 12
13 - Name of Person 13
14 - Name of Person 14
15 - Name of Person 15
16 - Name of Person 16
17 - Name of Person 17
18 - Name of Person 18
19 - Name of Person 19
20 - Name of Person 20
21 - Name of Person 21
22 - Name of Person 22
23 - Name of Person 23
24 - Name of Person 24
25 - Name of Person 25
97 - Refused

Universe:

Sample Children 0-17 and at least one knowledgeable person is still eligible for selection and speaking to the initial respondent and they are not knowledgeable OR speaking to a new respondent

Skip Instructions:

01-25 [goto INTMODE_C]
RF if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
F9 [goto bCallback.ARRANGE_CALLBACK]

Question ID: VFY.0080.00.1
Variable: INTMODE_C
Interview Module: Child
Content Type: Annual Core
Question text:

*How are you contacting ^KNOAVAIL_C?

Fills:

^KNOAVAIL_C

Description: Name of person selected at KNOAVAIL_C
Instruction:
Display name of person whose line number was selected at KNOAVAIL_C

Response:

1 - Personal visit
2 - Telephone

Universe:

Sample Children 0-17 and interviewer is speaking to a new respondent

Skip Instructions:

1 if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else if HHRESPSC_FLG=1 and LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
else [goto VFYALL_C]
2 [goto TINTRO_C]

Question ID: VFY.0090.00.1
Variable: TINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

Hello, my name is (* say your name). I'm calling from the U.S. Census Bureau. We are conducting
the National Health Interview Survey on behalf of the National Center for Health Statistics,
part of the Centers for Disease Control and Prevention (CDC). This is a nationwide survey about
the health of both adults and children. I have some information from ^HHRESP. ^HHSEX told me
that you would be a good person to talk to about the health of ^SCNAME.
* Read if necessary: I believe I am calling you on a cell phone.
Before we continue, I have to ask: Are you currently driving a vehicle?
* Even if the respondent is using a hands-free device while driving, you must enter '1'.

Fills:

^HHRESP

Description: {Value of HHRESPAVAIL}
Instruction:
Display the name of the person selected at Roster.HHC.HHRESPAVAIL

^HHSEX

Description: He/She/They
Instruction:
If GEN.SEX_FINAL[LNO_HHRESP]=1, fill: He elseif GEN.SEX_FINAL[LNO_HHRESP]=2, fill: She
elseif GEN.SEX_FINAL[LNO_HHRESP] in (DK,RF), fill: They

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent

Skip Instructions:

1,RF,DK [goto ATTN_C]
2 [goto LETTER_C]

Question ID: VFY.0100.00.1
Variable: ATTN_C
Interview Module: Child
Content Type: Annual Core
Question text:

For your safety, we will call you back at another time.
* Enter 1 to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is driving

Skip Instructions:

1 [goto bCallback.CB_POSSIBLE]

Question ID: VFY.0110.00.1
Variable: LETTER_C
Interview Module: Child
Content Type: Annual Core
Question text:

* If sample child respondent is a new respondent read question below, otherwise enter 1
* Read if necessary: A letter describing the National Health Interview Survey was sent to your
home recently. Do you remember seeing the letter?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1,2,RF,DK [goto S_INTRO_C]

Question ID: VFY.0120.00.1
Variable: S_INTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
* If sample child respondent is a new respondent read question below, otherwise enter 1
* Read if necessary: There are a few things I need to cover before we continue. I'd like you to
know that taking part in this survey is voluntary. You may choose not to answer any questions
you don't wish to answer, or end the interview at any time without penalty. We are required by
Federal law to develop and follow strict procedures to protect the confidentiality of your
information and use your answers only for statistical research. I can describe these laws if you
wish. Except for the National Center for Health Statistics and Census Bureau employees and
specially designated agents, no one can see your answers until all information that could
identify you and/or your family has been removed. Only after that will your data be made
available to researchers. For most children, the survey will take less than ^SCTIME minutes. I'd
like to continue now unless you have any questions.
* If respondent asks for more information about the privacy laws, press F1.

Fills:

^SCTIME

Description: 20/30
Instruction:
If ASTAT=1 and SAMEFAM_FLG=1, fill: 20 Else, fill: 30

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17 and interviewer is conducting a telephone interview with new respondent who is not driving

Skip Instructions:

1 if HHRESPSC_FLG ne 1 [goto AVAIL_C]
else if HHRESPSC_FLG=1 and LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS[goto RELTIV_C]
else [goto VFYALL_C]

Question ID: VFY.0130.00.1
Variable: AVAIL_C
Interview Module: Child
Content Type: Annual Core
Question text:

I have recorded that you are knowledgeable about and responsible for ^SCNAME's health care. Is
that correct?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused

Universe:

Sample Children 0-17 and at least one knowledgeable person is still eligible for section AND initial respondent wasn't the HH Resp and is knowledgeable OR picked a new respondent and respondent is not driving

Skip Instructions:

1If (LNO_SCRESP not in Roster.bREL.bPerson[PX_C].PARENTS) {respondent is not a parent} [goto
RELTIV_C]
Else If Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) {Sample Child is on campus} [goto
VFYONCAMP_C]
Else [goto VFYALL_C]
2 if KNOAVAIL_Count gt 0 [goto KNOAVAIL_C]
Else [goto NOMORE_C]
RF if CBSTAT_A=1[goto BCK.THANKS_CB]
else if OUTCOME=215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

Question ID: VFY.0150.00.1
Variable: RELTIV_C
Interview Module: Child
Content Type: Annual Core
Question text:

What is your relationship to ^SCNAME?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

01 - Parent (Biological, adoptive, or step)
02 - Grandparent
03 - Aunt/Uncle
04 - Brother/Sister
05 - Other relative
06 - Legal guardian
07 - Foster parent
08 - Other non-relative
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 where the current respondent has not refused AND at least one person is knowledgeable about and responsible for the sample child AND the respondent is not driving while on the telephone AND the respondent has not refused or said he/she is not available AND the respondent was not identified as a parent in the roster section

Skip Instructions:

9 [goto ERR_RELTIV_C]
4,5,8,RF,DK [goto VFYRESP_C]
1,2,3,6,7 if Roster.tblNAME.bPerson.[PX.C].ONOFFCAMPUS IN (1,RF,DK) and HHRESPSC_FLG ne 1
[goto VFYONCAMP_C]
Else [goto VFYALL_C]

Soft Edit:

Check Text: ERR_RELTIV_C
Check Description: RELTIV_C soft edit
Check Text: {signal ERR_RELTIV_C} The spouse or partner of the Sample Child cannot answer questions about him/her.

Question ID: VFY.0180.00.1
Variable: VFYRESP_C
Interview Module: Child
Content Type: Annual Core
Question text:

To confirm, are you RESPONSIBLE FOR ^SCNAME's health care?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where person identified as Child respondent is Brother/Sister, Other Relative, Other Non-relative, refused or don't know

Skip Instructions:

2,RF,DKif KNOAVAIL_Count > 0 [goto KNOAVAIL_C]
else [goto NOMORE_C]
1 if Roster.tblName.bPerson[PX_C].ONOFFCAMPUS in (1,RF,DK) [goto VFYONCAMP_C]
Else [goto VFYALL_C]

Question ID: VFY.0190.00.1
Variable: VFYONCAMP_C
Interview Module: Child
Content Type: Annual Core
Question text:

I want to confirm some information.
Does ^SCNAME live in on-campus housing or off-campus housing?
*Read if necessary: On-campus housing includes residence halls and dorms where students live
together. It also includes buildings that are owned, leased, or managed by the school.
Fraternities and sororities are on-campus housing.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - On campus
2 - Off campus
7 - Refused
9 - Don't Know

Universe:

A person who is knowledgeable or responsible for the sample child's health is available and the Sample Child is living in on-campus housing and the Sample Child respondent is not the household respondent and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1,RF,DK [goto VFYALL_C]
2 [goto NOMORE_C]

Question ID: VFY.0200.00.1
Variable: VFYALL_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Please verify the following information about the sample child before proceeding:
I have recorded ^childvsex, ^AGE_C, ^NATORG_C, and ^RACE_C. Would you like to make any changes
to this ^additionalinfo_C?
^RACEVRBATvalue_C
* If respondent "refuses" or says "don't know", enter "2" for "no."

Fills:

^childvsex

Description: ^SCNAME is male/^SCNAME is female/^SCNAME's sex is not known/^SCNAME's sex was not provided
Instruction:
If SEX_FINAL=1, fill: "^SCNAME is male" If SEX_FINAL=2, fill: "^SCNAME is female"
If SEX_FINAL=DK, fill: "^SCNAME's sex is not known"
If SEX_FINAL=RF, fill: "^SCNAME's sex was not provided"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^AGE_C

Description: ^SCNAME is ^AGENO_C ^AGETP_C old/^SCNAME is under 18
Instruction:
If AGE_FINAL NE ('RF', 'DK'), fill: "^SCNAME is ^AGENO_C ^AGETP_C old"
If AGE_FINAL IN ('RF', 'DK'), fill: "^SCNAME is under 18"

^AGENO_C

Description: {Value of AGENO}
Instruction:
Insert value from Roster.HHC.AGENO[PX]

^AGETP_C

Description: {Value of AGETP}
Instruction:
Fill in value from Roster.HHC.AGETP[PX]

^NATORG_C

Description: Verify Hispanic or Latino origin
Instruction:
If NATO_FINAL=1 fill: "^SCNAME is of Hispanic or Latino Origin"
If NATO_FINAL=2 fill: "^SCNAME is not of Hispanic or
Latino Origin"
If NATO_FINAL=DK fill: "whether ^SCNAME is of Hispanic or
Latino Origin is not known"
If NATO_FINAL=RF fill: "information about whether ^SCNAME
is of Hispanic or Latino Origin was not provided"

^RACE_C

Description: ^SCNAME is ^RACEFILLAND_C/^SCNAME's race is not known/^SCNAME's race was not provided
Instruction:
If GEN.RACE_FINAL[PX_C].RACE_FINAL NE 'RF' OR 'DK', fill: "^SCNAME is ^RACEFILLAND_C."
If GEN.RACE_FINAL[PX_C].RACE_FINAL='DK', fill: ^SCNAME's
race is not known"
If GEN.RACE_FINAL[PX_C].RACE_FINAL='RF', fill: ^SCNAME's
race was not provided"

^RACEFILLAND_C

Description: Categories selected at the RACE screen
Instruction:
Fill categories selected at the GEN.RACE_FINAL [PX_C].RACE_FINAL screen. If more than two categories
separate the categories with commas. Add the word "and"
before the last category.
For category 8 (GEN.RACE_FINAL[PX_C].RACE_FINAL=8),
if GEN.RACE_FINAL[PX_C].RACE_SP_FINAL not in ['ZZ',RF,DK]
display picklist selection from
GEN.RACE_FINAL[PX_C].RACE_SP_FINAL
elseif HHRESPSC_FLG=1 display GEN.RACE_FINAL
[PX_C].RACE_VRBAT_FINAL
else display "some other race"

^additionalinfo_C

Description: if any information is missing "or provide additiona information about"
Instruction:
Instruction See attachment for fill instructions

^RACEVRBATvalue_C

Description: Information collected at RACE_VRBAT for Sample Child
Instruction:
IF GEN.HHRESPSC_FLG ne 1 and GEN.RACE_FINAL [PX_C].RACE_VRBAT_FINAL ne (empty,RF,DK), fill "* If
respondent wants information on which other race ^SCNAME
is listed as, say ^RACE_VRBAT."

^RACE_VRBAT

Description: {Value of RACE_VRBAT_FINAL}
Instruction:
fill with value from GEN.RACE_FINAL[PX].RACE_VRBAT_FINAL

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1 [goto VFYDEM_C]
2 if GEN.SEX_FINAL[PX_C] IN (RF,DK) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0210.00.1
Variable: VFYDEM_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: What should I change?
* Enter all that apply, separate with commas.

Response:

1 - Sex
2 - Age
3 - Hispanic or Latino Origin
4 - Race
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 would like to change demographic information

Skip Instructions:

If 1 NOT IN VFYDEM_C and GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto SEXGUESS_C]
elseif 1 IN VFYDEM_C [goto NEWSEX_C]
elseif 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
RF,DK If GEN.SEX_FINAL[PX_C] IN (DK,RF) [goto SEXGUESS_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0220.00.1
Variable: NEWSEX_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is ^SCNAME male or female?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Male
2 - Female
7 - Refused
9 - Don't Know

Universe:

Respondent said sample child's sex is not correct

Skip Instructions:

if GEN.SEX_FINAL[PX_C]=RF,DK and NEWSEX_C=RF,DK [goto SEXGUESS_C]
elseif 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0230.00.1
Variable: SEXGUESS_C
Interview Module: Child
Content Type: Annual Core
Question text:

*Enter your best guess of ^SCNAME's sex

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Male
2 - Female

Universe:

Sample children for whom there is no sex provided by the household respondent and did not give a sex when asked to verify information and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1,2
if 2 IN VFYDEM_C [goto NEWAGENO_C]
elseif 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0240.01.1
Variable: NEWAGENO_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 1 of 2
How old is ^SCNAME?
* Enter number for age.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

001-120 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Children 0-17 whose age is not correct

Skip Instructions:

goto [NEWAGETP_C]

Question ID: VFY.0240.02.1
Variable: NEWAGETP_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 2 of 2
* Enter number for age time period.

Response:

1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)

Universe:

Valid number entered at NEWAGENO_C

Skip Instructions:

1,2,3,4 if 3 IN VFYDEM_C [goto NEWNATORG_C]
elseif 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0260.00.1
Variable: NEWNATORG_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is ^SCNAME Hispanic or Latino?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 whose Hispanic Origin is not correct

Skip Instructions:

1,2,RF,DK if 4 IN VFYDEM_C [goto NEWRACE_C]
elseif NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0270.00.1
Variable: NEWRACE_C
Interview Module: Child
Content Type: Annual Core
Question text:

What race or races is ^SCNAME? Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific
Islander, Asian, or some other race?
Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
05 - Native Hawaiian
06 - Other Pacific Islander
07 - Asian
08 - Some other race
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 whose race is not correct

Skip Instructions:

if NATO_FINAL=1 [goto HISPTYPE_C]
elseif RACE_FINAL=6 [goto PITYPE_C]
elseif RACE_FINAL=7 [goto ASIANTYPE_C]
elseif RACE_FINAL=8 [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0280.00.1
Variable: HISPTYPE_C
Interview Module: Child
Content Type: Annual Core
Question text:

What is ^SCNAME's Hispanic or Latino ancestry or origin, such as Mexican, Mexican American,
^CHICANOA, Central or South American, Puerto Rican, Cuban, Dominican (Republic), or Other
Hispanic, ^LATINOA, or Spanish -- and if ^SCNAME has more than one, tell me all of them.
* Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^CHICANOA

Description: Chicano/Chicano or Chicana
Instruction:
If SEX_FINAL = 1 fill: "Chicano" if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"

^LATINOA

Description: Latino/Latino or Latina
Instruction:
If SEX_FINAL= 1 fill: "Latino" if SEX_FINAL = 2,DK,RF fill "Latino or Latina"

Response:

Universe:

Sample Children 0-17 are of Hispanic Origin and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

7 [goto HISPOTHER_C]
1-6,RF,DK
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (HHRESPSC_FLG ne 1 and RACE_SP[PX_C] in
(ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0290.00.1
Variable: HISPOTHER_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
What is ^SCNAME's Hispanic or Latino ancestry or origin? If ^SCNAME has more than one, tell me
all of them.
Start typing and then select from list. If Hispanic or Latino ancestry is not on the list, type
"ZZ" and enter verbatim.
If any of the following are mentioned, backup to previous screen and correct the entry.
Mexican
Mexican American
Chicano/Chicana
Central American (REFER TO HELP SCREEN)
South American (REFER TO HELP SCREEN)
Puerto Rican (Boricua)
Cuban/Cuban American
Dominican (Republic)
* If respondent provides more than one other Hispanic or Latino ancestry or origin, select 'ZZ'
from the lookup table. At the next question, enter ALL the other Hispanic or Latino ancestries
or origins in the verbatim field.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Sample Child is of Other Hispanic Origin

Skip Instructions:

ZZ [goto HISPVRBAT_C]
lookup table selection,RF,DK
if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0300.00.1
Variable: HISPVRBAT_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: What is ^SCNAME's Hispanic or Latino ancestry or origin? If ^SCNAME has
more than one, tell me all of them.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Child 0-17 where some other Hispanic Ancestry is reported and this is not chosen from the picklist

Skip Instructions:

allow 80,RF,DK if GEN.RACE_FINAL[PX_C]=6 [goto PITYPE_C]
elseif GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0310.00.1
Variable: PITYPE_C
Interview Module: Child
Content Type: Annual Core
Question text:

I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group or groups is
^SCNAME-- such as Guamanian or Chamorro, Samoan, or other Pacific Islander? If ^SCNAME is more
than one, tell me all of them.
Enter all that apply, separate with comma

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Guamanian or Chamorro
2 - Samoan
3 - Other Pacific Islander
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 identified as Pacific Islanders and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

3 [goto PIOTHER_C]
1,2,RF,DK if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0320.00.1
Variable: PIOTHER_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific ethnic
group or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of them.
* Start typing and then select from list. If Pacific Islander ethnic group is not on the list,
type "ZZ" and enter verbatim.
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Sample Child who is "Other Pacific Islander"

Skip Instructions:

ZZ [goto PIVRBAT_C]
lookup table selection, RF, DK
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0330.00.1
Variable: PIVRBAT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Read if necessary: I have recorded that ^SCNAME is Pacific Islander. What specific ethnic group
or groups is ^SCNAME? If ^SCNAME is more than one, tell me all of them.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Child are some other group of Pacific Islander and this is not chosen from the picklist

Skip Instructions:

allow 80,RF,DK
if GEN.RACE_FINAL[PX_C]=7 [goto ASIANTYPE_C]
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0340.00.1
Variable: ASIANTYPE_C
Interview Module: Child
Content Type: Annual Core
Question text:

I have recorded that ^SCNAME is Asian. What specific ethnic group or groups is ^SCNAME-- such as
Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or Other Asian? If ^SCNAME is
more than one, tell me all of them.
Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

01 - Asian Indian
02 - Chinese
03 - Filipino
04 - Japanese
05 - Korean
06 - Vietnamese
07 - Other Asian
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 identified as Asian and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

7 [goto ASIANOTHER_C]
1-6,RF,DK
elseif GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (GEN.HHRESPSC_FLG ne 1 and Roster.HHC.RACE_SP
[PX_C] in (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0350.00.1
Variable: ASIANOTHER_C
Interview Module: Child
Content Type: Annual Core
Question text:

What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has more than one, tell me
all of them.
Start typing and then select from list. If Asian ethnic group is not on the list, type "ZZ" and
enter verbatim.
If any of the following are mentioned, backup to previous screen and correct the entry.
(Asian) Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
* If respondent provides more than one ethnic group, select 'ZZ' from the lookup table. At the
next question, enter ALL the ethnic groups in the verbatim field.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Sample Child who is "other Asian"

Skip Instructions:

ZZ [goto ASIANVRBAT_C]
lookup table selection,RF,DK
if GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG ne 1 and
ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0360.00.1
Variable: ASIANVRBAT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Read if necessary: What is ^SCNAME's specific Asian ethnic group or groups? If ^SCNAME has more
than one, tell me all of them.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Child is some other ethnic group of Asian and this is not chosen from the picklist

Skip Instructions:

allow 80,RF,DK
if GEN.RACE_FINAL[PX_C]=8 and (NEWRACE_C=8 or (NEWRACE_C=EMPTY and GEN.HHRESPSC_FLG ne 1 and
ROSTER.HHC.RACE_SP[PX_C] IN (ZZ,RF,DK))) [goto RACEOTHER_C]
else [goto BMONTH_C]

Question ID: VFY.0370.00.1
Variable: RACEOTHER_C
Interview Module: Child
Content Type: Annual Core
Question text:

What other race or races is ^SCNAME?
Start typing and then select from list. If race is not on the list, type "ZZ" and enter
verbatim.
* If respondent provides more than one other race, select 'ZZ' from the lookup table. At the
next question, enter ALL the other races in the verbatim field.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - values
ZZ - Other
97 - Refused
99 - Don't Know

Universe:

Sample Child's race was changed to "some other race" in verification section or where the Sample Child respondent is not the Household respondent and were identified by the household respondent as being "some other race" not on the roster other race picklist and a person who is knowledgeable or responsible for the sample child's health has been identified and that knowledgeable person has not refused and the Sample Child lives on campus or refused or don't know and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

ZZ [goto RACEVRBAT_C]
lookup table selection, RF,DK [goto BMONTH_C]

Question ID: VFY.0380.00.1
Variable: RACEVRBAT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Read if necessary: What other race or races is ^SCNAME?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Child's race was change to include "some other race" in verification section or where the Sample Child respondent is not the Household respondent and were identified by the household respondent as being "some other race" not on the roster other race picklist and the Sample Child Respondent did not select it from the Sample Adult other race picklist.

Skip Instructions:

verbatim,RF,DK [goto BMONTH_C]

Question ID: VFY.0410.01.1
Variable: BMONTH_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 1 of 3
What is ^SCNAME's date of birth?
Please give month, day, and year for the date of birth.
* Enter month of birth.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

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

Universe:

A person who is knowledgeable or responsible for the sample child's health is available or there is only one parent over 18 and no other adults in the child's family or there are more than two adults and one of them is a parent who was identified as available at AVAIL_C AND date of birth was verified as incorrect fewer than 2 times and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1-12,RF,DK [goto BDAY_C]

Question ID: VFY.0410.02.1
Variable: BDAY_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 2 of 3
* Enter day of birth.

Response:

01-31 - Range of values
97 - Refused
99 - Don't Know

Universe:

Skip Instructions:

1-31,RF,DK Only allow valid days for month entered. if days not valid [goto ERR_BDAY_C]
else [goto BYEAR_C]

Hard Edit:

Check Text: ERR_BDAY_C
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAY_C}
^BDAY_C is not a valid day for ^BMONTH_C.

Question ID: VFY.0410.03.1
Variable: BYEAR_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 3 of 3
* Enter year of birth.

Response:

1900-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Skip Instructions:

1900-current year,RF,DK
if (BYEAR_C gt current year) or (BYEAR_C=current year and BMONTH_C gt current month) or
(BYEAR_C=current year and BMONTH_C=current month and BDAY_C gt current day) [goto ERR_BYEAR_C]
elseif BDAY_C=29 and BMONTH_C=2 and (BYEAR=2000 or BYEAR_C/4 remainder ne 0) [goto
ERR_BDAYLEAP_C]
elseif AGETEMP_C in (RF,DK) AND BYEAR_C in (RF,DK) [goto NOMORE_C]
elseif ((BYEAR_C not IN (RF,DK) and AGETEMP_C not IN (RF,DK) and AGETEMP_C ne AGE_CALC_C) AND
(AGETEMP_C not IN (RF,DK) and AGETEMP_C ne AGE_CALCMINUS1_C)) and DOB_COUNT_C ne 1 [goto
VFYDOB_C]
elseif (AGETEMP_C eq AGE_CALC_C or AGE_CALCMINUS1_C) or DOB_COUNT_C=1
if AGE_FINAL ge 18 [goto NOMORE_C]
else [goto next section]

Hard Edit:

Check Text: ERR_BYEAR_C
Check Description:
Check Text: {check ERR_BYEAR_C} Future date invalid.
Check Text: ERR_BDAYLEAP_C
Check Description: Invalid day for selected month hard edit
Check Text: {check ERR_BDAYLEAP_C}
^BDAY_C is not a valid day for ^BMONTH_C.

Question ID: VFY.0430.00.1
Variable: VFYDOB_C
Interview Module: Child
Content Type: Annual Core
Question text:

There is a difference between the age the computer calculated from ^SCNAME's date of birth of
^AGEDOB_C_fill and the age I had previously recorded of ^TEMPAGE_C.
I recorded ^SCNAME's ^dateofbirth_C

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^AGEDOB_C_fill

Description: Age(s) calculated from Date of Birth for SC
Instruction:
Fill one age calculated from AGE_CALC_C as "(age) year(s) old"
Fill two ages calculated from AGE_CALC_C and
AGE_CALCMINUS1_C as "(age) or (age) year(s) old"
If AGE_CALC_C or AGE_CALCMINUS1_C is equal to 0, then
display as "less than 1"

^TEMPAGE_C

Description: {Value of AGETEMP_C} year(s) old/less than 1
Instruction:
fill value of AGETEMP_C as "(age) year(s) old" If AGETEMP_C is equal to 0, then display as "less than 1"

^dateofbirth_C

Description: date of birth when any of BDAY_C, BMONTH_C or BYEAR_C are not valid
Instruction:
If BDAY_C, BMONTH_C and BYEAR_C are all valid, fill: "date of birth as ^BMONTH_C ^BDAY_C, ^BYEAR_C, is that correct?"
If only BMONTH_C and BYEAR_C are valid, fill: "date of
birth as ^BMONTH_C ^BYEAR_C, is that correct?"
If only BDAY_C and BYEAR_C are valid, fill: "year of birth
as ^BYEAR_C, is that correct?"
If only BYEAR_C is valid, fill: "year of birth as
^BYEAR_C, is that correct?"

^BMONTH_C

Description: {Value of BMONTH_C}
Instruction:
Fill value from BMONTH_C

^BDAY_C

Description: {Value of BDAY_C}
Instruction:
Fill value from BDAY_C

^BYEAR_C

Description: {Value of BYEAR_C}
Instruction:
Fill with value in BYEAR_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children whose age provided in either HHC or NEWAGE_C does not match either age calculated from date of birth information and the Sample Child's spouse or partner is not the respondent

Skip Instructions:

1,RF,DK if GEN.AGE_FINAL[PX_C] gt 18 [goto NOMORE_C]
else [goto next section]
2 if DOB_COUNT_C le 1 [goto BMONTH_C]
elseif GEN.AGE_FINAL[PX_C] gt 18 [goto NOMORE_C]
else [goto next section]

Question ID: VFY.0440.00.1
Variable: NOMORE_C
Interview Module: Child
Content Type: Annual Core
Question text:

* ^SCNAME no longer meets the requirements to be sample child for this family. End this
interview and begin the Sample Adult Interview. If there is no Sample Adult or the Sample Adult
interview has been completed, EXIT
^auxNoMore
Not everyone in our survey is asked all questions. I have all the information that I need from
you about ^SCNAME.
* Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^auxNoMore

Description: If there is still a knowledgeable respondent available, back up and select that person.
Instruction:
IF KNOAVAIL_Count = 0, fill "* If there is still a knowledgeable respondent available, back up and select
that person."

Response:

1 - Enter 1 to Continue

Universe:

Sample child whose age is now over 17 or whose age is refused or don't know or who lives offcampus or there is no knowledgeable sample child respondent

Skip Instructions:

If there is a callback set for Sample Adult [goto BCK.THANKS_CB]
else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]

2020 National Health Interview Survey (NHIS) Questionnaire
HIS: Health Status
Question ID: HIS.0010.00.1
Variable: PHSTAT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Would you say ^SCNAME's health in general is excellent, very good, good, fair, or poor?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Excellent
2 - Very Good
3 - Good
4 - Fair
5 - Poor
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1-5,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
AST: Asthma
Question ID: AST.0010.00.1
Variable: ASTINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

Now I am going to ask you about certain medical conditions.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto ASEV_C]

Question ID: AST.0020.00.1
Variable: ASEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has a doctor or other health professional EVER told you that ^SCNAME had asthma?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto ASTILL_C]
2,RF,DK [goto next section]

Question ID: AST.0030.00.1
Variable: ASTILL_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME still have asthma?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who were ever told they have asthma

Skip Instructions:

1,2,RF,DK [goto ASAT12M_C]

Question ID: AST.0040.00.1
Variable: ASAT12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, has ^SCNAME had an episode of asthma or an asthma attack?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who were ever told they had asthma

Skip Instructions:

1,2,RF,DK [goto ASER12M_C]

Question ID: AST.0050.00.1
Variable: ASER12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, did ^SCNAME have to visit an emergency room or urgent care center
because of ^hisher_C asthma?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who were ever told they had asthma

Skip Instructions:

1,2,RF,DK if ASTILL_C=1 or ASAT12M_C=1 [goto ASHOSP12M_C]
else [goto next section]

Question ID: AST.0060.00.3
Variable: ASHOSP12M_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

During the past 12 months, has ^SCNAME stayed overnight in a hospital because of ^hisher_C
asthma?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1,2,RF,DK [goto ASDAYS12M_C]

Question ID: AST.0070.00.3
Variable: ASDAYS12M_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

During the past 12 months, how many days of ^DAYCARESCHOOL did ^SCNAME miss because of ^hisher_C
asthma?

Response:

000-365 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample children 0-17 who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

0-99,RF,DK [goto ASINHALE3M_C]
100-365 [goto ERR1_ASDAYS12M_C]

Soft Edit:

Check Text: ERR1_ASDAYS12M_C
Check Description: Soft edit for 100-365 days of missed school
Check Text: {signal ERR1_ASDAYS12M_C}
^ASDAYS12M_C is an unusually large number, did ^SCNAME miss ^ASDAYS12M_C days of school because of illness, injury, or disability? Please verify.

Question ID: AST.0080.00.3
Variable: ASINHALE3M_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

During the past 3 months, has ^SCNAME used the kind of PRESCRIPTION asthma inhaler that gives
QUICK relief from asthma symptoms during an attack?
*Read if necessary: Include only medication prescribed by a doctor or health professional.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1,2,RF,DK [goto ASPREVR_C]

Question ID: AST.0090.00.3
Variable: ASPREVR_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

Is ^SCNAME NOW taking a preventive asthma medication every day, some days, most days, or never?

Response:

1 - Every day
2 - Most days
3 - Some days
4 - Never
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who still have asthma or had an asthma attack in the past 12 months

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DIB: Diabetes
Question ID: DIB.0010.00.1
Variable: PREDIB_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has a doctor or other health professional EVER told you that ^SCNAME had prediabetes or
borderline diabetes?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17

Skip Instructions:

1,2,RF,DK [goto DIBEV_C]

Question ID: DIB.0020.00.1
Variable: DIBEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

^NOTPRED a doctor or other health professional EVER told you that ^SCNAME had diabetes?

Fills:

^NOTPRED

Description: Not including prediabetes, has/Has
Instruction:
If PREDIB_C=1: "Not including prediabetes, has" If PREDIB_C IN ('2','DK','RF'): "Has"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DLD: Developmental and Learning Disabilities
Question ID: DLD.0010.00.1
Variable: ADHDEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has a doctor or other health professional ever told you that ^SCNAME had AttentionDeficit/Hyperactivity Disorder or ADHD or Attention-Deficit Disorder or ADD?
* Read if necessary: Health professionals can include school psychologists and school nurses.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1 [goto ADHDNW_C]
2,RF,DK [goto IDEV_C]

Question ID: DLD.0020.00.1
Variable: ADHDNW_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME currently have Attention-Deficit/Hyperactivity Disorder or ADHD or AttentionDeficit Disorder or ADD?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17 who had an ADHD diagnosis

Skip Instructions:

1,2,RF,DK [goto IDEV_C]

Question ID: DLD.0030.00.1
Variable: IDEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has a doctor or other health professional ever told you that ^SCNAME had an intellectual
disability, also known as mental retardation?
* Read if necessary: Health professionals can include school psychologists and school nurses.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto IDNW_C]
2,RF,DK [goto ASDEV_C] if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17, else [goto
DDEV_C]

Question ID: DLD.0040.00.1
Variable: IDNW_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME currently have an intellectual disability, also known as mental retardation?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who had an intellectual disability diagnosis

Skip Instructions:

1,2,RF,DK if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto ASDEV_C]
else [goto DDEV_C]

Question ID: DLD.0050.00.1
Variable: ASDEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has a doctor or other health professional ever told you that ^SCNAME had Autism, Asperger's
disorder, pervasive developmental disorder, or autism spectrum disorder?
* Read if necessary: Health professionals can include school psychologists and school nurses.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1 [goto ASDNW_C]
2,RF,DK [goto DDEV_C]

Question ID: DLD.0060.00.1
Variable: ASDNW_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME currently have Autism, Asperger's disorder, pervasive developmental disorder, or
autism spectrum disorder?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17 who had an autism spectrum disorder diagnosis

Skip Instructions:

1,2,RF,DK [goto DDEV_C]

Question ID: DLD.0070.00.1
Variable: DDEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

^NOTEVER a doctor or other health professional ever told you that ^SCNAME had any other
developmental delay?
* Read if necessary: Health professionals can include school psychologists and school nurses.
* Read if necessary: Developmental delays are significant delays in a child's development.
Examples include cognitive, motor, speech, social, emotional and behavioral delays.

Fills:

^NOTEVER

Description: Has/Not including (ADHD, intellectual disability, autism spectrum disorder), has
Instruction:
If ADHDEV_C ne 1 AND IDEV_C ne 1 and ASDEV_C ne 1 fill: "Has"
If ADHDEV_C=1 AND IDEV_C ne 1 and ASDEV_C ne 1 fill: "Not
including ADHD, has"
If ADHDEV_C ne 1 AND IDEV_C=1 and ASDEV_C ne 1 fill: "Not
including an intellectual disability, has"
If ADHDEV_C ne 1 AND IDEV_C ne 1 and ASDEV_C=1 fill: "Not
including autism spectrum disorder, has"
If ADHDEV_C=1 AND IDEV_C=1 and ASDEV_C ne fill: "Not
including ADHD or an intellectual disability, has"
If ADHDEV_C=1 AND IDEV_C ne 1 and ASDEV_C=1 fill: "Not
including ADHD or autism spectrum disorder, has"
If ADHDEV_C ne 1 AND IDEV_C=1 and ASDEV_C=1 fill: "Not
including an intellectual disability or autism spectrum
disorder, has"
If ADHDEV_C=1 AND IDEV_C=1 and ASDEV_C=1 fill: "Not
including ADHD, an intellectual disability or autism
spectrum disorder, has"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto DDNW_C]
2,RF,DK if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto LDEV_C]
else [goto next section]

Question ID: DLD.0080.00.1
Variable: DDNW_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME still have this other developmental delay?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who had any other developmental delay diagnosis

Skip Instructions:

1,2,RF,DK if GEN.AGE_FINAL[PX_C] ge 2 and GEN.AGE_FINAL[PX_C] le 17 [goto LDEV_C]
else [goto next section]

Question ID: DLD.0090.00.1
Variable: LDEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has a representative from a school or a health professional ever told you that ^SCNAME had a
learning disability?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1 [goto LDNW_C]
2,RF,DK [goto next section]

Question ID: DLD.0100.00.1
Variable: LDNW_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME currently have a learning disability?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17 who had a learning disability diagnosis

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
BMI: Height and Weight - Rotate
Question ID: BMI.0010.01.2
Variable: HEIGHTFT_C
Interview Module: Child
Content Type: Rotating Core
Question text:

How tall is ^SCNAME without shoes?
* Enter feet.
* If the child's height is given in inches, press '0' at feet and enter the measure in inches
(36 inches maximum).
* Enter 'M' to record metric measurements.

Response:

00 - 0 feet
01 - 1 foot
02 - 2 feet
03 - 3 feet
04 - 4 feet
05 - 5 feet
06 - 6 feet
07 - 7 feet
M - Answered in Metric
97 - Refused
99 - Don't Know

Universe:

Sample Children 10-17

Skip Instructions:

if HEIGHTFT_C ne 0-7,RF,DK,M [goto ERR1_HEIGHTFT_C]
0-7 [goto HEIGHTIN_C]
RF,DK [goto WEIGHTLB_C]
M [goto HEIGHTM_C]

Hard Edit:

Check Text: ERR1_HEIGHTFT_C
Check Description: Hard edit for height in feet
Check Text: {check ERR1_HEIGHTFT_C}
Only 0-7, Don't know/Refused, or M allowed in this field. Please correct.

Question ID: BMI.0010.02.2
Variable: HEIGHTIN_C
Interview Module: Child
Content Type: Rotating Core
Question text:

* Enter inches.
* Enter '0' if exactly ^HEIGHTFT_C feet tall.

Response:

00-36 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Children 10-17 whose height in feet is 0-7

Skip Instructions:

If (HEIGHTFT_C=0) and (HEIGHTIN_C=0) [goto ERR1_HEIGHTIN_C]
elseif HEIGHTFT_C=1-7 and HEIGHTIN_C ge 12 [goto ERR2_HEIGHTIN_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (CHTINCH_C lt 50 or CHTINCH_C gt 60)) or
(GEN.AGE_FINAL=011 and (CHTINCH_C lt 52 or CHTINCH_C gt 62)) or
(GEN.AGE_FINAL=012 and (CHTINCH_C lt 53 or CHTINCH_C gt 64)) or
(GEN.AGE_FINAL=013 and (CHTINCH_C lt 56 or CHTINCH_C gt 67)) or
(GEN.AGE_FINAL=014 and (CHTINCH_C lt 58 or CHTINCH_C gt 70)) or
(GEN.AGE_FINAL=015 and (CHTINCH_C lt 61 or CHTINCH_C gt 72)) or
(GEN.AGE_FINAL=016 and (CHTINCH_C lt 63 or CHTINCH_C gt 74)) or
(GEN.AGE_FINAL=017 and (CHTINCH_C lt 63 or CHTINCH_C gt 74))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (CHTINCH_C lt 50 or CHTINCH_C gt 60)) or
(GEN.AGE_FINAL=011 and (CHTINCH_C lt 51 or CHTINCH_C gt 62)) or
(GEN.AGE_FINAL=012 and (CHTINCH_C lt 54 or CHTINCH_C gt 65)) or
(GEN.AGE_FINAL=013 and (CHTINCH_C lt 57 or CHTINCH_C gt 67)) or
(GEN.AGE_FINAL=014 and (CHTINCH_C lt 58 or CHTINCH_C gt 68)) or
(GEN.AGE_FINAL=015 and (CHTINCH_C lt 59 or CHTINCH_C gt 69)) or
(GEN.AGE_FINAL=016 and (CHTINCH_C lt 59 or CHTINCH_C gt 69)) or
(GEN.AGE_FINAL=017 and (CHTINCH_C lt 59 or CHTINCH_C gt 69))) [goto ERR3_HEIGHTIN_C]
else 0-36,RF,DK [goto WEIGHTLB_C]

Hard Edit:

Check Text: ERR2_HEIGHTIN_C
Check Description: Hard edit for height in inches
Check Text: {check ERR2_HEIGHTIN_C}
Number of inches exceeds maximum allowed. Please correct.
Check Text: ERR1_HEIGHTIN_C
Check Description: Hard edit for height in inches
Check Text: {check ERR1_HEIGHTIN_C}
Must enter an answer in at least the inches item. Please correct.

Soft Edit:

Check Text: ERR3_HEIGHTIN_C
Check Description: Soft edit for height in inches
Check Text: {signal ERR3_HEIGHTIN_C}
Please verify that the height was entered correctly. Probe only if necessary.

Question ID: BMI.0010.04.2
Variable: HEIGHTM_C
Interview Module: Child
Content Type: Rotating Core
Question text:

How tall is ^SCNAME without shoes?
* Enter height in metric.
* If the child's height is given in centimeters, press '0' at meters and enter the measure in
centimeters (241 centimeters maximum).

Response:

0 - 0 meters
1 - 1 meter
2 - 2 meters
7 - Refused
9 - Don't Know

Universe:

Sample Children 10-17 whose current height will be entered in metric

Skip Instructions:

0-2 [goto HEIGHTCM_C]
RF,DK [goto WEIGHTLB_C]

Question ID: BMI.0010.05.2
Variable: HEIGHTCM_C
Interview Module: Child
Content Type: Rotating Core
Question text:

* Enter height in centimeters.

Response:

000-241 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Children 10-17 whose height will be entered in metric, and who entered 0-2 for height in meters

Skip Instructions:

If (HEIGHTM_C IN (0)) and (HEIGHTCM_C IN (0)) [goto ERR1_HEIGHTCM_C]
elseif (HEIGHTM_C=2 and HEIGHTCM_C gt 41) or (HEIGHTM_C=1 and HEIGHTCM_C gt 141) [goto
ERR2_HEIGHTCM_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (CHTCM_C lt 127 or CHTCM_C gt 152)) or
(GEN.AGE_FINAL=011 and (CHTCM_C lt 131 or CHTCM_C gt 157)) or
(GEN.AGE_FINAL=012 and (CHTCM_C lt 136 or CHTCM_C gt 164)) or
(GEN.AGE_FINAL=013 and (CHTCM_C lt 142 or CHTCM_C gt 171)) or
(GEN.AGE_FINAL=014 and (CHTCM_C lt 149 or CHTCM_C gt 179)) or
(GEN.AGE_FINAL=015 and (CHTCM_C lt 155 or CHTCM_C gt 184)) or
(GEN.AGE_FINAL=016 and (CHTCM_C lt 159 or CHTCM_C gt 187)) or
(GEN.AGE_FINAL=017 and (CHTCM_C lt 161 or CHTCM_C gt 189))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (CHTCM_C lt 126 or CHTCM_C gt 151)) or
(GEN.AGE_FINAL=011 and (CHTCM_C lt 131 or CHTCM_C gt 158)) or
(GEN.AGE_FINAL=012 and (CHTCM_C lt 137 or CHTCM_C gt 165)) or
(GEN.AGE_FINAL=013 and (CHTCM_C lt 144 or CHTCM_C gt 170)) or
(GEN.AGE_FINAL=014 and (CHTCM_C lt 148 or CHTCM_C gt 173)) or
(GEN.AGE_FINAL=015 and (CHTCM_C lt 150 or CHTCM_C gt 174)) or
(GEN.AGE_FINAL=016 and (CHTCM_C lt 150 or CHTCM_C gt 175)) or
(GEN.AGE_FINAL=017 and (CHTCM_C lt 151 or CHTCM_C gt 175))) [goto ERR3_HEIGHTCM_C]
0-241,RK,DK [goto WEIGHTLB_C]

Hard Edit:

Check Text: ERR1_HEIGHTCM_C
Check Description: Hard edit for height in centimeters
Check Text: {check ERR1_HEIGHTCM_C}
Must enter an answer at least in centimeters item. Please correct.
Check Text: ERR2_HEIGHTCM_C
Check Description: Hard edit for height in centimeters
Check Text: {check ERR2_HEIGHTCM_C}
Total height exceeds maximum allowed. Please correct.

Soft Edit:

Check Text: ERR3_HEIGHTCM_C
Check Description: Soft edit for height in centimeters
Check Text: {signal ERR3_HEIGHTCM_C}
Please verify that the height was entered correctly. Probe only if necessary.

Question ID: BMI.0020.01.2
Variable: WEIGHTLB_C
Interview Module: Child
Content Type: Rotating Core
Question text:

How much does ^SCNAME weigh now?
* Enter 'M' to record metric measurements.
* Enter '500' if 500 pounds or more.

Response:

001-500 - Range of values
M - Answered in Metric
997 - Refused
999 - Don't Know

Universe:

Sample Children 10-17

Skip Instructions:

if WEIGHTLB_C lt 1 or WEIGHTLB_C gt 500 [goto ERR1_WEIGHTLB_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (WEIGHTLB_C lt 53 or WEIGHTLB_C gt 109)) or
(GEN.AGE_FINAL=011 and (WEIGHTLB_C lt 59 or WEIGHTLB_C gt 124)) or
(GEN.AGE_FINAL=012 and (WEIGHTLB_C lt 65 or WEIGHTLB_C gt 140)) or
(GEN.AGE_FINAL=013 and (WEIGHTLB_C lt 73 or WEIGHTLB_C gt 155)) or
(GEN.AGE_FINAL=014 and (WEIGHTLB_C lt 82 or WEIGHTLB_C gt 170)) or
(GEN.AGE_FINAL=015 and (WEIGHTLB_C lt 92 or WEIGHTLB_C gt 184)) or
(GEN.AGE_FINAL=016 and (WEIGHTLB_C lt 101 or WEIGHTLB_C gt 196)) or
(GEN.AGE_FINAL=017 and (WEIGHTLB_C lt 109 or WEIGHTLB_C gt 207))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (WEIGHTLB_C lt 53 or WEIGHTLB_C gt 113)) or
(GEN.AGE_FINAL=011 and (WEIGHTLB_C lt 59 or WEIGHTLB_C gt 129)) or
(GEN.AGE_FINAL=012 and (WEIGHTLB_C lt 66 or WEIGHTLB_C gt 145)) or
(GEN.AGE_FINAL=013 and (WEIGHTLB_C lt 74 or WEIGHTLB_C gt 160)) or
(GEN.AGE_FINAL=014 and (WEIGHTLB_C lt 81 or WEIGHTLB_C gt 171)) or
(GEN.AGE_FINAL=015 and (WEIGHTLB_C lt 87 or WEIGHTLB_C gt 180)) or
(GEN.AGE_FINAL=016 and (WEIGHTLB_C lt 92 or WEIGHTLB_C gt 186)) or
(GEN.AGE_FINAL=017 and (WEIGHTLB_C lt 96 or WEIGHTLB_C gt 190))) [goto ERR2_WEIGHTLB_C]
1-500,RF,DK [goto next section]
M [goto WEIGHTKG_C]

Hard Edit:

Check Text: ERR1_WEIGHTLB_C
Check Description: Hard error for weight in pounds
Check Text: {check ERR1_WEIGHTLB_C}
Weight is out of range (1-500). Please correct.

Soft Edit:

Check Text: ERR2_WEIGHTLB_C
Check Description: Soft edit for weight in pounds
Check Text: {signal ERR2_WEIGHTLB_C}
Please verify that the weight was entered correctly. Probe only if necessary.

Question ID: BMI.0020.02.2
Variable: WEIGHTKG_C
Interview Module: Child
Content Type: Rotating Core
Question text:

How much does ^SCNAME weigh now?
* Enter weight in kilograms.
* Enter '226' if 226 kilograms or more.

Response:

001-226 - Range of values
997 - Refused
999 - Don't Know

Universe:

Sample Children 10-17 whose weight will be entered in metric

Skip Instructions:

if WEIGHTKG_C lt 1 or WEIGHTKG_C gt 226 [goto ERR1_WEIGHTKG_C]
elseif (GEN.SEX_FINAL=1 and
(GEN.AGE_FINAL=010 and (WEIGHTKG_C lt 24 or WEIGHTKG_C gt 49)) or
(GEN.AGE_FINAL=011 and (WEIGHTKG_C lt 27 or WEIGHTKG_C gt 56)) or
(GEN.AGE_FINAL=012 and (WEIGHTKG_C lt 29 or WEIGHTKG_C gt 63)) or
(GEN.AGE_FINAL=013 and (WEIGHTKG_C lt 33 or WEIGHTKG_C gt 70)) or
(GEN.AGE_FINAL=014 and (WEIGHTKG_C lt 37 or WEIGHTKG_C gt 77)) or
(GEN.AGE_FINAL=015 and (WEIGHTKG_C lt 42 or WEIGHTKG_C gt 83)) or
(GEN.AGE_FINAL=016 and (WEIGHTKG_C lt 46 or WEIGHTKG_C gt 89)) or
(GEN.AGE_FINAL=017 and (WEIGHTKG_C lt 49 or WEIGHTKG_C gt 94))) or
(GEN.SEX_FINAL=2 and
(GEN.AGE_FINAL=010 and (WEIGHTKG_C lt 24 or WEIGHTKG_C gt 51)) or
(GEN.AGE_FINAL=011 and (WEIGHTKG_C lt 27 or WEIGHTKG_C gt 59)) or
(GEN.AGE_FINAL=012 and (WEIGHTKG_C lt 30 or WEIGHTKG_C gt 66)) or
(GEN.AGE_FINAL=013 and (WEIGHTKG_C lt 33 or WEIGHTKG_C gt 72)) or
(GEN.AGE_FINAL=014 and (WEIGHTKG_C lt 37 or WEIGHTKG_C gt 78)) or
(GEN.AGE_FINAL=015 and (WEIGHTKG_C lt 40 or WEIGHTKG_C gt 82)) or
(GEN.AGE_FINAL=016 and (WEIGHTKG_C lt 42 or WEIGHTKG_C gt 84)) or
(GEN.AGE_FINAL=017 and (WEIGHTKG_C lt 43 or WEIGHTKG_C gt 86))) [goto ERR2_WEIGHTKG_C]
1-226,RF,DK [goto next section]

Hard Edit:

Check Text: ERR1_WEIGHTKG_C
Check Description: Hard edit for weight in kilograms
Check Text: {check ERR1_WEIGHTKG_C}
Weight is out of range (1-226). Please correct.

Soft Edit:

Check Text: ERR2_WEIGHTKG_C
Check Description: Soft edit for weight in kilograms
Check Text: {signal ERR2_WEIGHTKG_C}
Please verify that the weight was entered correctly. Probe only if necessary.

2020 National Health Interview Survey (NHIS) Questionnaire
VIS: Vision
Question ID: VIS.0010.00.1
Variable: VISINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

I would like to ask you some questions about difficulties ^SCNAME may have.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 2-17

Skip Instructions:

1 [goto WEARGLSS_C]

Question ID: VIS.0020.00.1
Variable: WEARGLSS_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME wear glasses ^CONTACTS?
* Read if necessary: Persons who wear glasses to read or to do other occasional tasks should
answer yes to this question.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^CONTACTS

Description: or contact lenses
Instruction:
If AGE=5-17 fill "or contact lenses"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto VISIONDF_C]

Question ID: VIS.0030.00.1
Variable: VISIONDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

^GLASSCONTACT ^SCNAME have difficulty seeing? Would you say ^SCNAME has: no difficulty, some
difficulty, a lot of difficulty, or ^heshe_C cannot do this at all?

Fills:

^GLASSCONTACT

Description: When wearing glasses ^CONTACTS does/Does
Instruction:
If WEARGLSS_C=1 fill "When wearing glasses ^CONTACTS does" else if WEARGLSS_C ne 1 "Does"

^CONTACTS

Description: or contact lenses
Instruction:
If AGE=5-17 fill "or contact lenses"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
HEA: Hearing
Question ID: HEA.0010.00.1
Variable: HEARAID_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME use a hearing aid?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto HEARINGDF_C]

Question ID: HEA.0020.00.1
Variable: HEARINGDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

^USEHRAID_C ^SCNAME have difficulty hearing sounds like people's voices or music? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?

Fills:

^USEHRAID_C

Description: When using ^hisher_C hearing aid(s) does/Does
Instruction:
If HEARAID_C=1 fill "When using ^hisher_C hearing aid(s) does " else fill "Does "

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
MOB: Mobility
Question ID: MOB.0010.00.1
Variable: EQUIP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME use any equipment or receive assistance for walking?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1 if GEN.AGE_FINAL[PX_C]=2-4 [goto NOEQWLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto NOEQWLK100_C]
2,RF,DK if GEN.AGE_FINAL[PX_C]=2-4 [goto WLKDF_C]
else if GEN.AGE_FINAL[PX_C] ge 5 [goto WLK100_C]

Question ID: MOB.0020.00.1
Variable: NOEQWLKDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

Without using ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking? Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this
at all?

Fills:

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4 who use equipment or assistance for walking

Skip Instructions:

1-4,RF,DK [goto EQWLKDF_C]

Question ID: MOB.0030.00.1
Variable: EQWLKDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

When using ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4 who use equipment or assistance for walking

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: MOB.0040.00.1
Variable: WLKDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty walking? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4 who do not use equipment or assistance for walking or Refused or Don't Know

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: MOB.0050.00.1
Variable: NOEQWLK100_C
Interview Module: Child
Content Type: Annual Core
Question text:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking 100 yards
on level ground? That would be about the length of 1 football field or 1 city block. Would you
say ^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this
at all?

Fills:

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking

Skip Instructions:

1-3,RF,DK [goto NOEQWLK13M_C]
4 [goto EQWLK100_C]

Question ID: MOB.0060.00.1
Variable: NOEQWLK13M_C
Interview Module: Child
Content Type: Annual Core
Question text:

WITHOUT USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking a third of
a mile on level ground? That would be about the length of 5 football fields or 5 city blocks.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking and have no, some or a lot difficulty walking 100 yards when not using their equipment/assistance or Refused or Don't Know

Skip Instructions:

1-4,RF,DK [goto EQWLK100_C]

Question ID: MOB.0070.00.1
Variable: EQWLK100_C
Interview Module: Child
Content Type: Annual Core
Question text:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking 100 yards on
level ground? That would be about the length of 1 football field or 1 city block.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking.

Skip Instructions:

1-3,RF,DK [goto EQWLK13M_C]
4 [goto next section]

Question ID: MOB.0080.00.1
Variable: EQWLK13M_C
Interview Module: Child
Content Type: Annual Core
Question text:

WHEN USING ^hisher_C equipment or assistance, does ^SCNAME have difficulty walking a third of a
mile on level ground? That would be about the length of 5 football fields or 5 city blocks.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17 who use equipment or assistance for walking and have no, some or a lot of difficulty walking 100 yards when using their equipment/assistance or Refused or Don't Know

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: MOB.0090.00.1
Variable: WLK100_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty walking 100 yards on level
ground? That would be about the length of 1 football field or 1 city block. Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17 who do not use equipment or assistance for walking or Refused or Don't Know

Skip Instructions:

1-3,RF,DK [goto WLK13M_C]
4 [goto next section]

Question ID: MOB.0100.00.1
Variable: WLK13M_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty walking a third of a mile
on level ground? That would be about the length of 5 football fields or 5 city blocks.
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17 who do not use equipment or assistance for walking and have no difficulty, some difficulty, or a lot of difficulty walking 100 yards or Refused or Don't Know

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
UPP: Upper Body, Motor skills and self care
Question ID: UPP.0010.00.1
Variable: PICKUPDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty picking up small objects
with ^hisher_C hands?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: UPP.0020.00.1
Variable: SELFCAREDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have difficulty with self care, such as eating or dressing?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
COM: Communication
Question ID: COM.0010.00.1
Variable: UNDRSTYOU_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have difficulty understanding you?
*Read if necesary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK [goto UNDRSTCHD_C]

Question ID: COM.0020.00.1
Variable: UNDRSTCHD_C
Interview Module: Child
Content Type: Annual Core
Question text:

When ^SCNAME speaks, do you have difficulty understanding ^himherthem_C?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^himherthem_C

Description: him/her/them
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "him"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "them"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: COM.0030.00.1
Variable: UNDRSTIHH_C
Interview Module: Child
Content Type: Annual Core
Question text:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being understood by people inside of
this household?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^doesheshedothey_C

Description: does he/does she/do they
Instruction:
If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto UNDRSTOHH_C]

Question ID: COM.0040.00.0
Variable: UNDRSTOHH_C
Interview Module: Child
Content Type: Annual Core
Question text:

When ^SCNAME speaks, ^doesheshedothey_C have difficulty being understood by people outside of
this household?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^doesheshedothey_C

Description: does he/does she/do they
Instruction:
If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('RF','DK') fill: "do they"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
COG: Cognition
Question ID: COG.0010.00.1
Variable: LEARNDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty learning things?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto REMEMBERDF_C]

Question ID: COG.0020.00.1
Variable: REMEMBERDF_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty remembering things?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ANX: Anxiety
Question ID: ANX.0010.00.1
Variable: ANXFREQ_C
Interview Module: Child
Content Type: Annual Core
Question text:

How often does ^SCNAME seem very anxious, nervous, or worried? Would you say: daily, weekly,
monthly, a few times a year, or never?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-5,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DEP: Depression
Question ID: DEP.0010.00.1
Variable: DEPFREQ_C
Interview Module: Child
Content Type: Annual Core
Question text:

How often does ^SCNAME seem very sad or depressed? Would you say: daily, weekly, monthly, a few
times a year, or never?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Daily
2 - Weekly
3 - Monthly
4 - A few times a year
5 - Never
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-5,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
BEH: Behavior
Question ID: BEH.0010.00.1
Variable: BEHDFPLYG_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty playing? Would you say
^SCNAME has: no difficulty, some difficulty, a lot of difficulty, or ^heshe_C cannot do this at
all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK [goto BEHKBHYG_C]

Question ID: BEH.0020.00.1
Variable: BEHKBHYG_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, how much does ^SCNAME kick, bite, or hit other children
or adults? Would you say: not at all, the same or less, more, or a lot more?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - The same or less
3 - More
4 - A lot more
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-4

Skip Instructions:

1-4,RF,DK [goto next section]

Question ID: BEH.0030.00.1
Variable: BEHDFCNTR_C
Interview Module: Child
Content Type: Annual Core
Question text:

Compared with children of the same age, does ^SCNAME have difficulty controlling ^hisher_C
behavior?
Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto BEHDFFCS_C]

Question ID: BEH.0040.00.1
Variable: BEHDFFCS_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have difficulty concentrating on an activity that ^heshe_C enjoy^s doing?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Description: s
Instruction:
if SEX_FINAL[PX_C]=1,2 fill "s" else fill blank

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto BEHDFCHG_C]

Question ID: BEH.0050.00.1
Variable: BEHDFCHG_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have difficulty accepting changes in ^hisher_C routine?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto BEHDFMKFR_C]

Question ID: BEH.0060.00.1
Variable: BEHDFMKFR_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have difficulty making friends?
*Read if necessary: Would you say ^SCNAME has: no difficulty, some difficulty, a lot of
difficulty, or ^heshe_C cannot do this at all?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - No difficulty
2 - Some difficulty
3 - A lot of difficulty
4 - Cannot do at all
7 - Refused
9 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
BSC: Baby Pediatric Symptom Checklist
Question ID: BSC.0010.00.1
Variable: BSCINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

* The following statements are not to be read to the respondent. They are displayed and included
here for legal reasons.
* The Baby Pediatric Symptom Checklist is part of the larger Survey of Well-being of Young
Children, copyrighted by Tufts Medical Center. For more information go to
https://www.floatinghospital.org/The-Survey-of-Wellbeing-of-Young-Children/Overview.aspx
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children under 2 years

Skip Instructions:

1 [goto BSCNWPPL_C]

Question ID: BSC.0020.00.1
Variable: BSCNWPPL_C
Interview Module: Child
Content Type: Annual Core
Question text:

These next questions are about ^SCNAME's behavior. Think about what you would expect of other
children the same age, and tell me how much each statement applies to ^SCNAME.
Does ^SCNAME have a hard time being with new people? Would you say not at all, somewhat, or very
much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCNWPLCS_C]

Question ID: BSC.0030.00.1
Variable: BSCNWPLCS_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have a hard time in new places? Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCCHG_C]

Question ID: BSC.0040.00.1
Variable: BSCCHG_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have a hard time with change?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCHLOPPL_C]

Question ID: BSC.0050.00.1
Variable: BSCHLOPPL_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME mind being held by other people?
Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCCRYALT_C]

Question ID: BSC.0060.00.1
Variable: BSCCRYALT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME cry a lot?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCCLMDWN_C]

Question ID: BSC.0070.00.1
Variable: BSCCLMDWN_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have a hard time calming down?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCFUSSY_C]

Question ID: BSC.0080.00.1
Variable: BSCFUSSY_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is ^SCNAME fussy or irritable?
Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCSTHE_C]

Question ID: BSC.0090.00.1
Variable: BSCSTHE_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is it hard to comfort ^SCNAME?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCSCHD_C]

Question ID: BSC.0100.00.1
Variable: BSCSCHD_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is it hard to keep ^SCNAME on a schedule or routine?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCPTSLP_C]

Question ID: BSC.0110.00.1
Variable: BSCPTSLP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is it hard to put ^SCNAME to sleep?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCSTYSLP_C]

Question ID: BSC.0120.00.1
Variable: BSCSTYSLP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME have trouble staying asleep?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto BSCPRLKSL_C]

Question ID: BSC.0130.00.1
Variable: BSCPRLKSL_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is it hard for ^youmembersoffamily to get enough sleep because of ^SCNAME?
* Read if necessary: Would you say not at all, somewhat, or very much?

Fills:

^youmembersoffamily

Description: you/members of your family
Instruction:
If PCNT='2' fill "you" else fill "members of your family"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Not at all
2 - Somewhat
3 - Very much
7 - Refused
9 - Don't Know

Universe:

Sample Children with Age under 2 years

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SCH: Schooling
Question ID: SCH.0010.00.1
Variable: SCHDYSMSS_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, about how many days of school did ^SCNAME miss because ^HeShe_C had
an illness, injury, or disability?
* Enter '996' if child did not go to school in the past 12 months.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

000-365 - Range of values
996 - No school in past 12 months
997 - Refused
999 - Don't Know

Universe:

Sample Children 5-17

Skip Instructions:

0-99,996,RF,DK [goto SCHSPEDEV_C]
100-365 [goto ERR1_SCHDYSMSS_C]
366-995 [goto ERR2_SCHDYSMSS_C]

Hard Edit:

Check Text: ERR2_SCHDYSMSS_C
Check Description: hard check for days of missed school
Check Text: {check ERR2_SCHDYSMSS_C}
"366-995" days not allowed in this field.

Soft Edit:

Check Text: ERR1_SCHDYSMSS_C
Check Description: soft edit for 100-365 days of missed school
Check Text: {signal ERR1_SCHDYSMSS_C}
^SCHDYSMSS_C is an unusually large number, did ^SCNAME miss ^SCHDYSMSS_C days of school because of illness, injury, or disability? Please verify.

Question ID: SCH.0020.00.1
Variable: SCHSPEDEV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Has ^SCNAME ever had a special education or early intervention plan, such as an Individualized
Education Plan, an IEP, or an Individualized Family Service Plan, an IFSP?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto SCHSPED_C]
2,RF,DK [goto next section]

Question ID: SCH.0030.00.1
Variable: SCHSPED_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME currently have a special education or early intervention plan?
*Read if necessary: Consider special education or early intervention plans received during the
past school year.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who ever received special education services

Skip Instructions:

1 [goto SCHSPEDEM_C]
2,RF,DK [goto next section]

Question ID: SCH.0040.00.1
Variable: SCHSPEDEM_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME receive these services to help with ^hisher_C emotions, concentration, behavior, or
mental health?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have received services in the past 12 months

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
INS: Health Insurance
Question ID: INS.0010.00.1
Variable: HICOV_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
The next questions are about health insurance. Include health insurance obtained through
employment or purchased directly as well as government programs like Medicare, Medicaid, and the
Children's Health Insurance Program that provide medical care or help pay medical bills. Is
^SCNAME covered by any kind of health insurance or some other kind of health care plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,R,D [goto HIKIND_C]
2 [goto MCAIDPRB_C]

Question ID: INS.0020.00.1
Variable: HIKIND_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
What kinds of health insurance or health care coverage does ^SCNAME have? Is it...Private health
insurance, Medicare, Medicare supplement, Medicaid, Children's Health Insurance Program or CHIP,
military related health care including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian
Health Service, state-sponsored health plan, or an other government program?
* Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample Children 0-17 covered by any kind of health insurance or health care coverage or refused/don't know if they have insurance or health care coverage.

Skip Instructions:

if 1 answer selected and (10> in HIKIND_C) [goto ERR1_HIKIND_C]
else if HIKIND_C=RF,DK or (10 in HIKIND_C) [goto MCAIDPRB_C]
else [goto SINCOVDE_C]

Hard Edit:

Check Text: ERR1_HIKIND_C
Check Description: Selecting no coverage and other categories hard edit
Check Text: {check ERR1_HIKIND_C}
Cannot mark "no coverage of any kind" and another type. Please correct.

Question ID: INS.0030.00.1
Variable: MCAIDPRB_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
There is a program called Medicaid that pays for health care for persons in need. ^STATEMA Is
^SCNAME covered by Medicaid?

Fills:

^STATEMA

Description: In ^STATENAME it is also called ^STMEDICAID.
Instruction:
if STMEDICAID ne empty, fill: "In ^STATENAME it is also called ^STMEDICAID."
else fill: blank

^STATENAME

^STMEDICAID

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
- 7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have indicated they are uninsured, refused, or don't know if they are insured

Skip Instructions:

1,2,RF,DK [goto SINCOVDE_C]

Question ID: INS.0040.00.1
Variable: SINCOVDE_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
^INADDITIONIS ^SCNAME covered by a SEPARATE plan that only pays for dental services?

Fills:

^INADDITIONIS

Description: In addition to ^HITYPECNOSS, is/Is
Instruction:
If (HIKIND_C=1-9 or MCAIDPRB_C=1), fill "In addition to ^HITYPECNOSS, is"
else fill "Is"

^HITYPECNOSS

Description: Type of health care plans without single service plans
Instruction:
fill coverage types from HIKIND_C, except HIKIND_C=10, HIKIND_C=1 fill: "private health insurance"
HIKIND_C=2 fill: "Medicare"
HIKIND_C=3 fill: "Medicare Supplement or Medigap"
HIKIND_C=4 fill: "Medicaid"
HIKIND_C=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_C=6 fill: "military related health care"
HIKIND_C=7 fill: "Indian Health Service"
HIKIND_C=8 fill: "a state-sponsored health plan"
HIKIND_C=9 fill: "an other government program"
if MCAIDPRB_C=1, fill "Medicaid"
separate choices with a comma and seperate the last two
choices with "and"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto SINCOVVS_C]

Question ID: INS.0050.00.1
Variable: SINCOVVS_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is ^SCNAME covered by a SEPARATE plan that only pays for vision services?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto SINCOVRX_C]

Question ID: INS.0060.00.1
Variable: SINCOVRX_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is ^SCNAME covered by a SEPARATE plan that only pays for prescriptions?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto HICHANGE_C]

Question ID: INS.0070.00.1
Variable: HICHANGE_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
I have recorded ^SCNAME is ^COVEREDC. Is this correct?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^COVEREDC

Description: not covered by health insurance/covered by ^HITYPEC
Instruction:
if HIKIND_C=10,R,D and MCAIDPRB_C=2,R,D and SINCOVDE_C=2,R,D and SINCOVVS_C=2,R,D and SINCOVRX_C=2,R,D
fill: "not covered by health insurance"
else fill: "covered by ^HITYPEC"

^HITYPEC

Description: Type of health care plans with single service plans
Instruction:
fill coverage types from HIKIND_C, except HIKIND_C=10, HIKIND_C=1 fill: "private health insurance"
HIKIND_C=2 fill: "Medicare"
HIKIND_C=3 fill: "Medicare Supplement or Medigap"
HIKIND_C=4 fill: "Medicaid"
HIKIND_C=5 fill: "Children's Health Insurance Program
(CHIP)"
HIKIND_C=6 fill: "military related health care"
HIKIND_C=7 fill: "Indian Health Service"
HIKIND_C=8 fill: "a state-sponsored health plan"
HIKIND_C=9 fill: "an other government program"
if MCAIDPRB_C=1, fill "Medicaid"
If SINCOVDE_C=1 and SINCOVRX_C=2,RF,DK and
SINCOVVS_C=2,RF,DK, fill: "a single service dental plan"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=1 and
SINCOVVS_C=2,RF,DK, fill: "a single service prescription
plan"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=2,RF,DK and
SINCOVVS_C=1, fill: "a single service vision plan"
If SINCOVDE_C=1 and SINCOVRX_C=1 and SINCOVVS_C=2,RF,DK,
fill: "single service dental and prescription plans"
If SINCOVDE_C=1 and SINCOVRX_C=2,RF,DK and SINCOVVS_C=1,
fill: "single service dental and vision plans"
If SINCOVDE_C=2,RF,DK and SINCOVRX_C=1 and SINCOVVS_C=1,
fill: "single service vision and prescription plans"
If SINCOVDE_C=1 and SINCOVRX_C=1 and SINCOVVS_C=1, fill:
"single service dental, vision, and prescription plans"
separate choices with a comma and separate the last two
choices with "and"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,RF,DK
if 2 in HIKIND_C [goto MCPART_C]
else if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C]
else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else if 7 in HIKIND_C [goto HINOTYR_C]
else if 10 in HIKIND_C and MCAIDPRB_C IN (2,RF,DK) [goto HILAST_C]
else [goto FINISH_C]
2 [goto ERR1_HICHANGE_C]

Hard Edit:

Check Text: ERR1_HICHANGE_C
Check Description:
Check Text: {check ERR1_HICHANGE_C}Press Enter to go back to HIKIND_C and update coverage.

Question ID: INS.0080.00.1
Variable: MCPART_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
What type of Medicare coverage does ^SCNAME have? Is it Part A - hospital insurance, Part B -
medical insurance, or both?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Part A- hospital only
2 - Part B- medical only
3 - Both Part A and Part B
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicare

Skip Instructions:

2,3,RF,DK [goto MCCHOICE_C] less than 1> [goto MCPARTD_C]

Question ID: INS.0090.00.1
Variable: MCCHOICE_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is ^SCNAME enrolled in a Medicare Advantage plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicare part B only or both parts A and B

Skip Instructions:

1,2,RF,DK [goto MCHMO_C]

Question ID: INS.0100.00.1
Variable: MCHMO_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is ^SCNAME under a Medicare managed care arrangement, such as an HMO, that is, a Health
Maintenance Organization?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicare part B only or both parts A and B

Skip Instructions:

1 [goto MCANAME_C]
2,RF,DK if MCCHOICE_C=1 [goto MCANAME_C]
else if MCCHOICE_C=2,RF,DK, [goto MCPARTD_C]

Question ID: INS.0110.00.1
Variable: MCANAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
What is the name of ^SCNAME's Medicare Advantage or Medicare HMO plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with a Medicare Advantage plan or a Medicare managed care arrangement

Skip Instructions:

verbatim, RF, DK [goto MCPARTD_C]

Question ID: INS.0120.00.1
Variable: MCPARTD_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is ^SCNAME enrolled in Medicare Part D, also known as the Medicare Prescription Drug Plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicare

Skip Instructions:

1,2,RF,DK
if 4 in HIKIND_C or MCAIDPRB_C=1[goto MACHMN_C]
else if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0130.00.1
Variable: MACHMN_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
The next questions are about Medicaid coverage. What is the name of ^SCNAME's Medicaid health
plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

allow 80, RF, DK [goto MAXCHNG_C]

Question ID: INS.0140.00.1
Variable: MAXCHNG_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Was ^SCNAME's Medicaid obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

1,2,RF,DK [goto MAPREM_C]

Question ID: INS.0150.00.1
Variable: MAPREM_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this Medicaid plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

1,2,RF,DK [goto MADEDUC_C]

Question ID: INS.0160.00.1
Variable: MADEDUC_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's Medicaid plan have an
annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicaid coverage

Skip Instructions:

1 [goto MAHDHP_C]
2,RF,DK
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0170.00.1
Variable: MAHDHP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with Medicaid coverage who have a deductible

Skip Instructions:

1,2,RF,DK
if 1 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 3 in HIKIND_C [goto SET_INSPRI_FLAG]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0260.00.1
Variable: PLANNAME1_C
Interview Module: Child
Content Type: Annual Core
Question text:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by ^HIPNAM1_A. Is ^SCNAME covered by this
same plan as ^YOUSANAME?

Fills:

^YOUSANAME

Description: you/^SANAME
Instruction:
If GEN.SARESPSC_FLG=1, fill "you" else fill "^SANAME"

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

^WEREWAS

Description: were/was
Instruction:
If SARESPSC_FLG=1, fill "were", else "was"

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage, where the Sample Adult interview has already been conducted, the Sample Adult is in the same family, and the Sample Adult also had private health insurance, and the first private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.

Skip Instructions:

1 if Adult.INS.bPlan[1].POLHLD_A ne 1 [goto POLHLDA1_C],
if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1 [goto
PLANNAME2_C] else [goto MORPLAN_C]
2,RF,DK if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1
[goto PLANNAME2_C] else [goto HIPNAM1_C]

Question ID: INS.0270.00.1
Variable: POLHLDA1_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Health insurance plans are usually obtained in one person's name even if other family members
are covered by that plan. That person is called the policyholder. Is ^SCNAME the policyholder
for ^HIPNAM1_A?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^HIPNAM1_A

Description: {Value of HIPNAM1_A}
Instruction:
Fill value from Adult.INS.HIPNAM1_A.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a shared private health plan with the Sample Adult, where the Sample Adult is not the policyholder for their first private plan or refused or don't know.

Skip Instructions:

1,2,RF,DK if INSPRI2_FLG2_C=1 and INSPRI2_FLG3_C=1 and INSPRI2_FLG4_C=1 and INSPRI2_FLG5_C=1
[goto PLANNAME2_C]
else [goto MORPLAN_C]

Question ID: INS.0280.00.1
Variable: PLANNAME2_C
Interview Module: Child
Content Type: Annual Core
Question text:

Earlier I recorded that ^YOUSANAME ^WEREWAS covered by a second plan ^HIPNAM2_A. Is ^SCNAME
covered by this same plan as ^YOUSANAME?

Fills:

^YOUSANAME

Description: you/^SANAME
Instruction:
If GEN.SARESPSC_FLG=1, fill "you" else fill "^SANAME"

^SANAME

Description: Sample Adult's name
Instruction:
Sample Adult's name

^WEREWAS

Description: were/was
Instruction:
If SARESPSC_FLG=1, fill "were", else "was"

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A.

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage, where the Sample Adult interview has already been conducted, the Sample Adult is in the same family, and the Sample Adult also had private health insurance, and listed two plans. The second private plan is not self only coverage, a plan name was not don't know or refused, and the source and who pays for the coverage is not don't know or refused.

Skip Instructions:

1 if Adult.INS.bPlan[2].POLHLD_A ne 1 [goto POLHLDA2_C],
else if PLANNAME1_C IN(2,RF,DK) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
2,RF,DK if PLANNAME1_C IN (2,RF,DK,empty) [goto HIPNAM1_C]
else [goto MORPLAN_C]

Question ID: INS.0290.00.1
Variable: POLHLDA2_C
Interview Module: Child
Content Type: Annual Core
Question text:

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^HIPNAM2_A

Description: {Value of HIPNAM2_A}
Instruction:
Fill value from Adult.INS.HIPNAM2_A.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a shared private health plan with the Sample Adult, where the adult is not the policyholder for their second private plan or refused or don't know

Skip Instructions:

1,2,RF,DK if PLANNAME1_C IN(2,RF,DK,empty) [goto MORPLAN_C]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0300.00.1
Variable: HIPNAM1_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
It is important that we record the complete and accurate name of each private health insurance
plan. What is the COMPLETE name of ^SCNAME's plan? Do NOT include plans that only provide extra
cash while in the hospital or plans that pay for only one type of service such as long term
care, accidents, or dental care.
*Read if necessary: Do you have a health plan card or something with the plan name on it?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 enrolled in a Medigap plan or private health insurance and the sample child did not share or refused or did not know if they shared or did not have a value for both of the two listed private plans for the sample adult

Skip Instructions:

allow 80,RF,DK [goto MORPLAN_C]

Question ID: INS.0310.00.1
Variable: MORPLAN_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is ^SCNAME covered by any other private health insurance plans?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 enrolled in a private health plan where the name of the plan was given or don't know or refused or the sample child only shared one private plan with the Sample Adult

Skip Instructions:

1 [goto HIPNAM2_C]
2,RF,DK
if (PLANNAME1_C = 1 or PLANNAME2_C = 1) then
if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]
else [goto bPlan[1].POLHLD_C]

Question ID: INS.0320.00.1
Variable: HIPNAM2_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
What is the name of that private health insurance plan?
* Read if necessary: Do you have a health plan card or something with the plan name on it?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with a second private health insurance plan

Skip Instructions:

allow 80,RF,DK [goto bPlan[1].POLHLD_C]

Question ID: INS.0340.00.1
Variable: POLHLD_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
I am going to ask you some questions about ^FIRSTPLANC. Health insurance plans are usually
obtained in one person's name even if other family members are covered by that plan. That person
is called the policyholder. Is ^SCNAME the policyholder for ^THISPLANC?

Fills:

^FIRSTPLANC

Description: this plan/this first plan/this ^HIPNAM1_C plan/this second plan/this ^HIPNAM2_C plan
Instruction:
If PlanNum = 1 then if HIPNAM1_C IN (RF,DK) AND HIPNAM2_C=empty fill: "this
plan"
elseif HIPNAM1_C IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_C plan"
if PlanNum = 2 then
if HIPNAM2_C IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_C plan"

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^THISPLANC

Description: this plan/^HIPNAM1_C/^HIPNAM2_C
Instruction:
if PlanNum=1 then if HIPNAM1_C IN('RF','DK') fill: 'this plan'
Else fill: '^HIPNAM1_C'
if PlanNum=2 then
if HIPNAM2_C IN('RF','DK') fill: 'this plan'
Else fill: '^HIPNAM2_C'

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know.

Skip Instructions:

1,RF,DK [goto PRPLCOV_C]
2 [goto PLNWRK_C]

Question ID: INS.0350.00.1
Variable: PRPLCOV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does this plan cover someone other than ^SCNAME?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and where the Sample Child is the policyholder or refused or don't know.

Skip Instructions:

1,2,RF,DK [goto PLNWRK_C]

Question ID: INS.0360.00.1
Variable: PLNWRK_C
Interview Module: Child
Content Type: Annual Core
Question text:

Response:

Universe:

Sample Children with private health insurance coverage where a plan name was given or refused or don't know.

Skip Instructions:

1,3 [goto PLNPAY_C]
2,4,RF,DK [goto PLNEXCHG_C]
5 [goto PLNWKSP_C]

Question ID: INS.0370.00.1
Variable: PLNWKSP_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: How was this plan obtained?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and private health insurance coverage was obtained from an other source

Skip Instructions:

allow 80,RF,DK [goto PLNEXCHG_C]

Question ID: INS.0380.00.1
Variable: PLNEXCHG_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and who have private coverage that is directly purchased, or obtained through a state, local, government or community program, or obtained another way, or refused/don't know how obtained

Skip Instructions:

1,2,RF,DK [goto PLNPAY_C]

Question ID: INS.0390.00.1
Variable: PLNPAY_C
Interview Module: Child
Content Type: Annual Core
Question text:

Who pays for this health insurance plan?
* Enter all that apply, separate with commas.

Response:

1 - ^SCNAME or family (living in the household)
2 - Employer or union
3 - Someone outside the household
4 - Medicare
5 - Medicaid
6 - Other government program

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know and were enrolled in a private health plan where a plan name was given or refused or don't know.

Skip Instructions:

1-6,RF,DK if 1 IN PLNPAY_C [goto HICOSTN_C]
else [goto PRDEDUC_C]

Question ID: INS.0400.01.1
Variable: HICOSTN_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
How much does ^SCNAME's family currently spend for health insurance premiums for ^FIRSTPLANC?
Please include payroll deductions for premiums.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^FIRSTPLANC

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

Response:

00001-99995 - Range of values
99997 - Refused
99999 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know who paid for by self or family

Skip Instructions:

20000-99995 [goto ERR1_HICOSTN_C]
1-19999 [goto HICOSTT_C]
RF,DK [goto PRDEDUC_C]

Soft Edit:

Check Text: ERR1_HICOSTN_C
Check Description: Premium unusually high soft edit
Check Text: {signal ERR1_HICOSTN_C}
[^HICOSTN_C] is unusually high. Please verify. Make corrections if necessary.

Question ID: INS.0400.02.1
Variable: HICOSTT_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
* Enter time period for premium payments.

Response:

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know who gave a premium amount.

Skip Instructions:

1-8,RF,DK [goto PRDEDUC_C]

Question ID: INS.0410.00.1
Variable: PRDEDUC_C
Interview Module: Child
Content Type: Annual Core
Question text:

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance plans where a plan name was given or refused or don't know.

Skip Instructions:

1 [goto PRHDHP_C]
2,RF,DK [goto INTROCOV_C]

Question ID: INS.0420.00.1
Variable: PRHDHP_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Is the ^FAM_C annual deductible for medical care for this plan less than ^HDHPAMT_C, or
^HDHPAMT_C or more? If there is a separate deductible for prescription drugs, hospitalization,
or out-of-network care, do not include those deductible amounts here.

Fills:

^FAM_C

Description: family
Instruction:
if POLHLD_C=2 or PRPLCOV_C=1, fill 'family'. Else no fill.

^HDHPAMT_C

Description: ^HDHPDED_family/^HDHPDED
Instruction:
if POLHLD_C=2 or PRPLCOV_C=1, fill '^HDHPDED_family' Else fill '^HDHPDED'.

^HDHPDED_family

Description: Family deductible threshold (may change in future year)
Instruction:
fill: $2,700

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPAMT_C
2 - ^HDHPAMT_C or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know with a deductible

Skip Instructions:

1 [goto INTROCOV_C]
2,RF,DK [goto HSAHRA_C]

Question ID: INS.0430.00.1
Variable: HSAHRA_C
Interview Module: Child
Content Type: Annual Core
Question text:

Response:

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know with a high deductible

Skip Instructions:

1,2,RF,DK [goto INTROCOV_C]

Question ID: INS.0435.00.1
Variable: INTROCOV_C
Interview Module: Child
Content Type:
Question text:

The next three questions are about services ^FIRSTPLANC may cover.
Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know

Skip Instructions:

1 [goto PRRXCOV_C]

Question ID: INS.0440.00.1
Variable: PRRXCOV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^FIRSTPLANC pay for any of the costs for medications prescribed by a doctor?
* Read if necessary: Even if ^SCNAME has not used this benefit, please answer if this plan would
cover at least some of the costs if ^SCNAME were prescribed medications.

Fills:

^FIRSTPLANC

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where the name of the plan was given or refused or don't know.

Skip Instructions:

1,2,RF,DK [goto PRDNCOV_C]

Question ID: INS.0450.00.1
Variable: PRDNCOV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^FIRSTPLANC pay for any of the costs for dental care?
* Read if necessary: Even if ^SCNAME has not used this benefit, please answer if this plan would
cover at least some of the costs if ^SCNAME did have dental care.

Fills:

^FIRSTPLANC

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where the plan name was given or refused or don't know.

Skip Instructions:

1,2,RF,DK [goto PRVSCOV_C]

Question ID: INS.0460.00.1
Variable: PRVSCOV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^FIRSTPLANC pay for any of the costs for routine vision care, such as glasses and contact
lenses?
* Read if necessary: Even if ^SCNAME has not used this benefit, please answer if this plan would
cover at least some of the costs if ^SCNAME did have vision care.

Fills:

^FIRSTPLANC

^HIPNAM1_C

Description: {Value of HIPNAM1_C}
Instruction:
fill value from Child.INS.HIPNAM1_C

^HIPNAM2_C

Description: {Value of HIPNAM2_C}
Instruction:
fill value from Child.INS.HIPNAM2_C

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with private health insurance coverage where a plan name was given or refused or don't know.

Skip Instructions:

1,2,RF,DK If there is another plan [goto bPlan for next plan]
else if 5 in HIKIND_C [goto CHNAME_C]
else if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0470.00.1
Variable: CHNAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by the Children's Health Insurance Program or CHIP.
What is the name of the plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

allow 80,RF,DK [goto CHXCHNG_C]

Question ID: INS.0480.00.1
Variable: CHXCHNG_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Was ^SCNAME's CHIP plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

1,2,RF,DK [goto CHPREM_C]

Question ID: INS.0490.00.1
Variable: CHPREM_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this CHIP plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

1,2,RF,DK [goto CHDEDUC_C]

Question ID: INS.0500.00.1
Variable: CHDEDUC_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's CHIP plan have an
annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a CHIP plan

Skip Instructions:

1 [goto CHHDHP_C]
2,RF,DK if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0510.00.1
Variable: CHHDHP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Children with a CHIP plan who have a deductible

Skip Instructions:

1,2,RF,DK if 8 in HIKIND_C [goto OPNAME_C]
else if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0520.00.1
Variable: OPNAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by a state-sponsored plan. What is the name of the
plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

verbatim,RF,DK [goto OPXCHNG_C]

Question ID: INS.0530.00.1
Variable: OPXCHNG_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Was ^SCNAME's state-sponsored plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

1,2,RF,DK [goto OPPREM_C]

Question ID: INS.0540.00.1
Variable: OPPREM_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this state-sponsored plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

1,2,RF,DK [goto OPDEDUC_C]

Question ID: INS.0550.00.1
Variable: OPDEDUC_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's state-sponsored plan
have an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a state-sponsored plan

Skip Instructions:

1[goto OPHDHP_C]
2,RF,DK if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0560.00.1
Variable: OPHDHP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with a state-sponsored plan with a deductible

Skip Instructions:

1,2,RF,DK if 9 in HIKIND_C [goto OGNAME_C]
else if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0570.00.1
Variable: OGNAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by an other government program. What is the name of
the plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 who have an other government plan

Skip Instructions:

allow 80,RF,DK [goto OGXCHNG_C]

Question ID: INS.0580.00.1
Variable: OGXCHNG_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Was ^SCNAME's other government plan obtained through Healthcare.gov or the ^MARKETPLACE?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^MARKETPLACE

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have an other government plan

Skip Instructions:

1,2,RF,DK [goto OGPREM_C]

Question ID: INS.0590.00.1
Variable: OGPREM_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A health insurance premium is the amount ^SCNAME or a family member pays each month for health
care coverage. Does ^SCNAME or a family member pay a premium for this other government plan?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have an other government plan

Skip Instructions:

1,2,RF,DK [goto OGDEDUC_C]

Question ID: INS.0600.00.1
Variable: OGDEDUC_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
A deductible is the amount you have to pay for health care before your health insurance or
health coverage plan will start paying your medical bills. Does ^SCNAME's other government plan
have an annual deductible?
* Read if necessary: A deductible is different from a copay (copayment).

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with an other government plan

Skip Instructions:

1 [goto OGHDHP_C]
2,RF,DK if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0610.00.1
Variable: OGHDHP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Fills:

^HDHPDED

Description: Deductible threshold (may change in future year)
Instruction:
fill: $1,350

Response:

1 - Less than ^HDHPDED
2 - ^HDHPDED or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with an other government plan with a deductible

Skip Instructions:

1,2,RF,DK if 6 in HIKIND_C [goto MILSPC_C]
else [goto HINOTYR_C]

Question ID: INS.0620.00.1
Variable: MILSPC_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Earlier I recorded that ^SCNAME is covered by military related health care. What types of
military related health care ^areisSEX_C ^heshe_C covered by?
* Enter all that apply, separate with commas.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^areisSEX_C

Description: is/are
Instruction:
if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is" elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

2 - TRICARE (CHAMPUS)
3 - CHAMP-VA (do not include CHAMPUS)
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with military related health care

Skip Instructions:

2-3,RF,DK [goto HINOTYR_C]

Question ID: INS.0630.00.1
Variable: HILAST_C
Interview Module: Child
Content Type: Annual Core
Question text:

How long has it been since ^SCNAME last had health care coverage that paid for doctor's visits
or hospital stays?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.

Skip Instructions:

1 [goto HILASTMY_C]
2,3 [goto HISTOPJOB_C]
4,5,6,0,RF,DK [goto RSNHICOST_C]

Question ID: INS.0640.00.1
Variable: HILASTMY_C
Interview Module: Child
Content Type: Annual Core
Question text:

In the past 12 months, how many months was ^SCNAME without coverage?
* If less than 1 month, enter '1'.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

01-12 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 without known health insurance who last had insurance at some time within the last 12 months

Skip Instructions:

1-12,RF,DK [goto HISTOPJOB_C]

Question ID: INS.0650.00.1
Variable: HISTOPJOB_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Think about the last time that ^SCNAME did have health care coverage. I am going to read a list
of reasons why someone might no longer be enrolled in coverage. Please tell me, yes or no, if
this is a reason why ^SCNAME is no longer enrolled in ^hisher_C last health care plan.
The policyholder retired, lost a job, or changed employer?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPMISS_C]

Question ID: INS.0660.00.1
Variable: HISTOPMISS_C
Interview Module: Child
Content Type: Annual Core
Question text:

*Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
A deadline was missed for signing up or paying for ^hisher_C coverage?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPAGE_C]

Question ID: INS.0670.00.1
Variable: HISTOPAGE_C
Interview Module: Child
Content Type: Annual Core
Question text:

*Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
^HeShe_C became ineligible because of ^hisher_C age or because ^heshe_C left school?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^HeShe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPCOST_C]

Question ID: INS.0680.00.1
Variable: HISTOPCOST_C
Interview Module: Child
Content Type: Annual Core
Question text:

Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
The cost for the coverage increased?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto HISTOPELIG_C]

Question ID: INS.0690.00.1
Variable: HISTOPELIG_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
* Read if necessary: Is ^SCNAME no longer enrolled in ^hisher_C last health care plan because...
^HeShe_C had Medicaid, CHIP, or other public coverage, but ^werewas_C no longer eligible?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^HeShe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

^werewas_C

Description: was/were
Instruction:
If SEX_FINAL_C=1,2 fill "was" else if SEX_FINAL_C=DK, RF fill "were"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been uninsured for less than 3 years

Skip Instructions:

1,2,RF,DK [goto RSNHICOST_C]

Question ID: INS.0700.00.1
Variable: RSNHICOST_C
Interview Module: Child
Content Type: Annual Core
Question text:

^INSREASONS_C Is ^SCNAME currently uninsured because coverage is not affordable?

Fills:

^INSREASONS_C

Description: RSNHICOST_C Introduction
Instruction:
If HILAST_C=0,4,5,6,RF,DK, fill: "There are many reasons why people do not have health insurance coverage."
If HILAST_C=1,2,3, fill: "We just discussed reasons you
lost coverage, now I am going to ask you some questions
about why ^SCNAME hasn't obtained coverage."

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.

Skip Instructions:

1,2,RF,DK [goto RSNHIWANT_C]

Question ID: INS.0710.00.1
Variable: RSNHIWANT_C
Interview Module: Child
Content Type: Annual Core
Question text:

There are other reasons that people do not have health insurance coverage. ^PLUSCOSTC ^SCNAME
currently uninsured because...
...your family does not need or want coverage for ^SCNAME?

Fills:

^PLUSCOSTC

Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.

Skip Instructions:

1,2,RF,DK [goto RSNHIELIG_C]

Question ID: INS.0720.00.1
Variable: RSNHIELIG_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...^heshe_C ^areisSEX_C not eligible for coverage?

Fills:

^PLUSCOSTC

Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

^areisSEX_C

Description: is/are
Instruction:
if GEN.SEX_FINAL[PX_C] in (1,2) fill: "is" elseif GEN.SEX_FINAL[PX_C] in (DK,RF) fill: "are"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe

Skip Instructions:

1,2,RF,DK [goto RSNHICONF_C]

Question ID: INS.0730.00.1
Variable: RSNHICONF_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...the process of signing up for coverage for ^SCNAME is too difficult or confusing?

Fills:

^PLUSCOSTC

Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe

Skip Instructions:

1,2,RF,DK [goto RSNHIMEET_C]

Question ID: INS.0740.00.1
Variable: RSNHIMEET_C
Interview Module: Child
Content Type: Annual Core
Question text:

*Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...your family cannot find a plan that meets ^SCNAME's needs?

Fills:

^PLUSCOSTC

Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe

Skip Instructions:

1,2,RF,DK [goto RSNHIWAIT_C]

Question ID: INS.0750.00.1
Variable: RSNHIWAIT_C
Interview Module: Child
Content Type: Annual Core
Question text:

*Read if necessary: There are other reasons that people do not have health insurance coverage.
^PLUSCOSTC ^SCNAME currently uninsured because...
...you applied for coverage for ^SCNAME but it has not started yet?

Fills:

^PLUSCOSTC

Description: In addition to cost, is/Is
Instruction:
if REASNHICOST_C = 1 then fill 'In addition to cost, is'. Else fill 'Is'

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe

Skip Instructions:

1,2,RF,DK [goto RSNHIOTH_C]

Question ID: INS.0760.00.1
Variable: RSNHIOTH_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is there another reason that ^SCNAME currently does not have health insurance coverage?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe

Skip Instructions:

1 [goto RSNHIOTHSP_C]
2,RF,DK [goto FINISH_C]

Question ID: INS.0770.00.1
Variable: RSNHIOTHSP_C
Interview Module: Child
Content Type: Annual Core
Question text:

What is the other reason for not having coverage?

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 who have another reason for not having coverage

Skip Instructions:

allow 80,RF,DK [goto FINISH_C]

Question ID: INS.0780.00.1
Variable: HINOTYR_C
Interview Module: Child
Content Type: Annual Core
Question text:

In the past 12 months, was there any time when ^SCNAME did NOT have ANY health insurance or
coverage?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with known health insurance coverage or responded yes to the medicaid probe

Skip Instructions:

1 [goto HINOTMYR_C]
2,RF,DK [goto FINISH_C]

Question ID: INS.0790.00.1
Variable: HINOTMYR_C
Interview Module: Child
Content Type: Annual Core
Question text:

In the past 12 months, about how many months was ^SCNAME without coverage?
* If less than 1 month, enter '1'.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

01-12 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 with known health insurance coverage and did not have health insurance for some period of time in the past 12 months

Skip Instructions:

1-12,RF,DK [goto FINISH_C]

Question ID: INS.0800.00.1
Variable: FINISH_C
Interview Module: Child
Content Type: Annual Core
Question text:

* The Sample Child health insurance section is now complete.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PAY: Difficulty Paying for Health Care
Question ID: PAY.0010.00.1
Variable: PAYINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
Now I am going to ask you about your family's medical bills. Include bills for doctors,
dentists, hospitals, therapists, medication, equipment, and nursing home or home care.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17 living in same family as the Sample Adult when the PAY section of the Sample Adult has not been completed or Sample Children living in same family as Sample Adult when the Sample Child respondent is not the Sample Adult and the Sample Adult answered don't or refused to PAYBLL12M_A and PAYNOBLLNW_A or Sample children living in different families than the Sample Adult.

Skip Instructions:

1 [goto PAYBILL12M_C]
Replicate To: PAYINTRO_A

Question ID: PAY.0020.00.1
Variable: PAYBLL12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
In the past 12 months did anyone in your family have problems paying or were unable to pay any
medical bills?
* Read if necessary: Include bills for doctors, dentists, hospitals, therapists, medication,
equipment, nursing home or home care.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 living in same family as the Sample Adult when the PAY section of the Sample Adult has not been completed or Sample Children living in same family as Sample Adult when the Sample Child respondent is not the Sample Adult and the Sample Adult answered don't or refused to PAYBILL12M_A and PAYNOBLLNW_A or Sample children living in different families than the Sample Adult.

Skip Instructions:

1,RF,DK [goto PAYNOBLLNW_C]
2 [goto PAYWORRY_C]
Replicate To: PAYBLL12M_A

Question ID: PAY.0030.00.1
Variable: PAYNOBLLNW_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does anyone in your family currently have any medical bills that you are unable to pay at all?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who said someone in their family had trouble paying bills and Sample Adult and Sample Child are in the same family and Sample Adult PAY section has not been completed OR the Sample Child and Sample Adult are not in the same family AND said anyone in the their family had problems paying medical bills in the past 12 months or refused or didn't know if they had problems paying medical bills.

Skip Instructions:

1,2,RF,DK [goto PAYWORRY_C]
Replicate To: PAYNOBLLNW_A

Question ID: PAY.0040.00.1
Variable: PAYWORRY_C
Interview Module: Child
Content Type: Annual Core
Question text:

If ^SCNAME gets sick or has an accident, how worried are you that your family will be able to
pay ^hisher_C medical bills? Are you very worried, somewhat worried, or not at all worried?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Very worried
2 - Somewhat worried
3 - Not at all worried
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
CVD: Positive COVID-19 Diagnosis
Question ID: CVD.0010.00.4
Variable: CVDINTRO_C
Interview Module: Child
Content Type: Emerging Content
Question text:

The next set of questions are about coronavirus or COVID-19.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto CVDDIAG_C]

Question ID: CVD.0020.00.4
Variable: CVDDIAG_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Has a doctor or other health professional ever told you that ^SCNAME had or likely had
coronavirus or COVID-19?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto COVIDTEST_C]

Question ID: CVD.0030.00.4
Variable: COVIDTEST_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Has ^SCNAME ever been tested for coronavirus or COVID-19?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto CVDRSLT_C]
2,RF,DK if CVDDIAG_C=1 [goto CVDSEV_C]
else [goto next section]

Question ID: CVD.0040.00.4
Variable: CVDRSLT_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Did the test find that ^SCNAME had coronavirus or COVID-19?
* If any test has shown that ^SCNAME had COVID-19, enter '1' for yes.
* If the respondent indicates they are waiting for ^SCNAME's results, enter '3' for Did not
receive results.
* If the respondent indicates the test was inconclusive, enter 'CTRL-D' for Don't Know.

Response:

1 - Yes
2 - No
3 - Did not receive results
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been tested for COVID-19

Skip Instructions:

1 [goto CVDSEV_C]
2-3,RF,DK if CVDDIAG_C=1 [goto CVDSEV_C]
else [goto next section]

Question ID: CVD.0050.00.4
Variable: CVDSEV_C
Interview Module: Child
Content Type: Emerging Content
Question text:

How would you describe ^SCNAME's coronavirus symptoms when they were at their worst? Would you
say no symptoms, mild symptoms, moderate symptoms, or severe symptoms?

Response:

1 - No symptoms
2 - Mild symptoms
3 - Moderate symptoms
4 - Severe symptoms
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have been told by a doctor or other health professional that they had or likely had coronavirus or COVID-19 or tested positive for COVID-19

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
DNC: Dental Care - Rotate
Question ID: DNC.0010.00.2
Variable: DNCINTRO_C
Interview Module: Child
Content Type: Rotating Core
Question text:

These next questions ask about ^SCNAME's dental care.
* Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

Sample children 1-17

Skip Instructions:

1 [goto DENPREV_C]

Question ID: DNC.0020.00.2
Variable: DENPREV_C
Interview Module: Child
Content Type: Rotating Core
Question text:

About how long has it been since ^SCNAME last had a dental examination or cleaning?
* Read if necessary: Include cleanings from all types of dental care providers such as dentists,
orthodontists, oral surgeons, dental hygienists, and all other dental specialists.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Universe:

Sample Children 1-17

Skip Instructions:

0-6,RF,DK [goto DENDL12M_C]

Question ID: DNC.0030.00.2
Variable: DENDL12M_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, has ^SCNAME been DELAYED in getting dental care because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 1-17

Skip Instructions:

1,2,RF,DK [goto DENNG12M_C]

Question ID: DNC.0040.00.2
Variable: DENNG12M_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, was there any time when ^SCNAME needed dental care, but DID NOT GET
IT because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 1-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
UTZ: Utilization
Question ID: UTZ.0010.00.1
Variable: UTZINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

^UTZINTRO_C
* Enter '1' to continue.

Fills:

^UTZINTRO_C

Description: UTZ Introduction
Instruction:
If AGE LT 1 fill "I would like to ask you about ^SCNAME's health care." else fill "Now that we finished talking
about dental care, I would like to ask you about ^SCNAME's
other health care."

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto LASTDR_C]

Question ID: UTZ.0020.00.1
Variable: LASTDR_C
Interview Module: Child
Content Type: Annual Core
Question text:

About how long has it been since ^SCNAME last saw a doctor or other health professional about
^hisher_C health?
* Read if necessary: Include doctors seen while a patient in a hospital.
* Read if necessary: Do not include dental care.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

Universe:

Sample Children 0-17

Skip Instructions:

1-6 [goto WELLNESS_C]
0,RF,DK [goto USUALPL_C]

Question ID: UTZ.0030.00.1
Variable: WELLNESS_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was this a well ^babychild visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: height and weight measurements,
vaccinations, and vision or hearing checks. The doctor or other health professional may also
discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and
exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur
when ^hesheistheyare_C not sick.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.

Fills:

^babychild

Description: baby/child
Instruction:
If AGE LE 2 fill "baby"; else if AGE GE 3 or AGE IN ('DK','RF') fill "child"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who have seen a doctor

Skip Instructions:

1 [goto USUALPL_C]
2,RF,DK [goto WELLVIS_C]

Question ID: UTZ.0040.00.1
Variable: WELLVIS_C
Interview Module: Child
Content Type: Annual Core
Question text:

About how long has it been since ^SCNAME last saw a doctor or other health professional for a
well ^babychild visit, physical, or general purpose check-up?
* Read if necessary: This kind of visit typically includes: height and weight measurements,
vaccinations, and vision or hearing checks. The doctor or other health professional may also
discuss topics related to ^SCNAME's health such as ^hisher_C growth and development, diet and
exercise, safety, and sleep patterns. These visits are usually scheduled in advance and occur
when ^hesheistheyare_C not sick.
* Read if necessary: If a wellness exam was combined with a sick care visit, include this visit.
* Read if necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^babychild

Description: baby/child
Instruction:
If AGE LE 2 fill "baby"; else if AGE GE 3 or AGE IN ('DK','RF') fill "child"

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

^hesheistheyare_C

Description: he is/she is/they are
Instruction:
If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"

Response:

Universe:

Sample Children 0-17 who did not have a baby/child visit, physical, or general purpose check-up, or who dont' know or refused.

Skip Instructions:

0,1,2,3,4,5,6,RF,DK [goto USUALPL_C]

Question ID: UTZ.0050.00.1
Variable: USUALPL_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is there a place that ^SCNAME USUALLY goes to if ^hesheistheyare_C sick and needs health care?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hesheistheyare_C

Description: he is/she is/they are
Instruction:
If SEX_FINAL_C=1 fill: "he is" If SEX_FINAL_C=2 fill: "she is"
If SEX_FINAL_C =blank fill: "they are"

Response:

1 - Yes
2 - There is NO place
3 - There is MORE THAN ONE place
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,3,RF,DK [goto USPLKIND_C]
2[goto URGENT12M_C]

Question ID: UTZ.0060.00.1
Variable: USPLKIND_C
Interview Module: Child
Content Type: Annual Core
Question text:

What kind of place ^isitgomostoften - a doctor's office or health center; an urgent care center,
a clinic in a drug store or grocery store; a hospital emergency room; or some other place?
* Read if necessary: A doctor's office or health center is a place where ^heshe_C see^s the same
doctor or the same group of doctors every visit, where you usually need to make an appointment
ahead of time, and where ^hisher_C medical records are on file.
* Read if necessary: Urgent care centers, and clinics in a drug store or grocery store are
places where you do not need to make an appointment ahead of time, and do not usually see the
same health care provider at each visit.

Fills:

^isitgomostoften

Description: is it/^doesheshedothey go to most often
Instruction:
If USUALPL_C=1, fill: "is it" else fill: "^doesheshedothey go to most often"

^doesheshedothey

Description: does he/does she/do they
Instruction:
If SEX=1 fill: "does he" If SEX=2 fill: "does she"
If SEX IN ('DK','RF") fill: "do they"

^heshe_C

Description: He/She/They
Instruction:
If SEX_FINAL_C=1 fill "He" else if SEX_FINAL_C=2 fill "She" elseif SEX_FINAL_C =blank: fill "They"

Description: s
Instruction:
if SEX_FINAL[PX_C]=1,2 fill "s" else fill blank

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - A doctor's office or health center
2 - Urgent care center or clinic in a drug store or grocery store
3 - Hospital emergency room
4 - Some other place
5 - Does not go to one place most often
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with 1+ usual place of care or who don't know or refused to answer if they have a usual place of care

Skip Instructions:

1-5,RF,DK [goto URGENT12M_C]

Question ID: UTZ.0070.00.1
Variable: URGENT12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, how many times has ^SCNAME gone to an urgent care center or clinic in
a drug store or grocery store about ^hisher_C health?
* Enter '96' if number is 96 or greater.
* Read if necessary: Urgent care centers and clinics in drug stores or grocery stores are places
where you do not need to make an appointment ahead of time, and do not usually see the same
health care provider at each visit.
* Read if necessary: This is different from a hospital emergency room.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

00-96 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

0-39,RF,DK [goto EMERGE12M_C]
40-96 [goto ERR1_URGENT12M_C]

Soft Edit:

Check Text: ERR1_URGENT12M_C
Check Description: Urgent care 40-96 times
Check Text: {signal ERR1_URGENT12M_C}^URGENT12M_C is an unusually large number. Did ^SCNAME visit an urgent care center or clinic in a drug store or grocery store about ^hishertheir health ^URGENT12M_C times in the past 12 months? Please verify.

Question ID: UTZ.0080.00.1
Variable: EMERGE12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, how many times has ^SCNAME gone to a hospital emergency room about
^hisher_C health?
* Read if necesary: This includes emergency room visits that resulted in a hospital admission.
* Enter '96' if number is 96 or more.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

00-96 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

0-39,RF,DK if GEN.AGE_FINAL GE 001 [goto HOSPONGT_C]
else [goto MEDDL12M_C]
40-96 [goto ERR1_EMERGE12M_C]

Soft Edit:

Check Text: ERR1_EMERGE12M_C
Check Description: ER 40-96 times
Check Text: {signal ERR1_EMERGE12M_C}^EMERGE12M_C is an unusually large number. Did ^SCNAME visit a hospital emergency room about ^hishertheir health ^EMERGE12M_C times in the past 12 months? Please verify.

Question ID: UTZ.0090.00.1
Variable: HOSPONGT_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, has ^SCNAME been hospitalized overnight? ^PAST12MER_C

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^PAST12MER_C

Description: Do not include an overnight stay in the emergency room.
Instruction:
If ((EMERGE12M_C GE '01' and EMERGE12M_C LE '96') or EMERGE12M_C='RF','DK'): Fill: "Do not include an overnight
stay in the emergency room."

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 1-17

Skip Instructions:

1,2,RF,DK [goto MEDDL12M_C]

Question ID: UTZ.0100.00.1
Variable: MEDDL12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, has medical care BEEN DELAYED for ^SCNAME because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto MEDNG12M_C]

Question ID: UTZ.0110.00.1
Variable: MEDNG12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, was there any time when ^SCNAME needed medical care, but DID NOT GET
IT because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
ACC: Access to Care
Question ID: ACC.0010.00.4
Variable: DLYCARE_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Was there any time when ^SCNAME DELAYED getting medical care because of the coronavirus
pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto DNGCARE_C]

Question ID: ACC.0020.00.4
Variable: DNGCARE_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Was there any time when ^SCNAME needed medical care for something other than coronavirus, but
DID NOT GET IT because of the coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto VIRAPP12M_C]

Question ID: ACC.0030.00.4
Variable: VIRAPP12M_C
Interview Module: Child
Content Type: Emerging Content
Question text:

In the past 12 months, has ^SCNAME had an appointment with a doctor, nurse, or other health
professional by video or by phone?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto VIRAPPCVD_C]
2,RF,DK [goto next section]

Question ID: ACC.0040.00.4
Variable: VIRAPPCVD_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Were any of ^SCNAME's appointments done by video or by phone because of reasons related to the
coronavirus pandemic?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have had a virtual medical appointment

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PMD: Prescription medications
Question ID: PMD.0010.00.1
Variable: RX12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

At any time in the past 12 months, did ^SCNAME take prescription medication?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto RXDL12M_C]
2,RF,DK [goto RXDG12M_C]

Question ID: PMD.0020.00.1
Variable: RXDL12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, did you DELAY filling a prescription for ^SCNAME to save money?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who had been prescribed medication in the past 12 months

Skip Instructions:

1,2,RF,DK [goto RXDG12M_C]

Question ID: PMD.0030.00.1
Variable: RXDG12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, was there any time when ^SCNAME needed prescription medication, but
DID NOT GET IT because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
IMM: Immunization
Question ID: IMM.0010.00.1
Variable: SHTFLU12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

There are two types of flu vaccinations. One is a shot and the other is a spray, mist, or drop
in the nose. During the past 12 months, has ^SCNAME had a flu vaccination?
* Read if necessary: A flu vaccination is usually given in the fall and protects against
influenza for the flu season.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto SHTFLUNUM_C]
2,RF,DK [goto next section]

Question ID: IMM.0020.00.1
Variable: SHTFLUNUM_C
Interview Module: Child
Content Type: Annual Core
Question text:

During the past 12 months, how many flu vaccinations has ^SCNAME received?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - 1 vaccination
2 - 2 or more vaccinations
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have had a flu shot in the past 12 months

Skip Instructions:

1,2 [goto FLUVAC1M_C]
RF,DK [goto next section]

Question ID: IMM.0030.01.1
Variable: FLUVAC1M_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 1 of 2
During what month and year did ^SCNAME receive ^hisher_C most recent flu vaccine?
* Enter month of most recent flu vaccine.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

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

Universe:

Sample Children 0-17 who have had one or more shots in the past 12 months

Skip Instructions:

1-12,DK [goto FLUVAC1Y_C]
RF if SHTFLUNUM_C=2 [goto FLUVAC2M_C]
else if SHTFLUNUM_C=1 [goto next section]

Question ID: IMM.0030.02.1
Variable: FLUVAC1Y_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 2 of 2
* Enter year of most recent flu vaccine.

Response:

2000-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Children 0-17 who have had one or more shots in the past 12 months and gave month/don't know month of flu shot

Skip Instructions:

current year, current year-1,RF,DK and SHTFLUNUM_C = 2 [goto FLUVAC2M_C]
else [goto next section]
if FLUVAC1M_C and FLUVAC1Y_C = a future date [goto ERR1_FLUVAC1Y_C];
if FLUVAC1M_C and FLUVAC1Y_C = a date prior to birth [goto ERR2_FLUVAC1Y_C];
if FLUVAC1M_C and FLUVAC1Y_C = a date prior to 12 months ago [goto ERR3_FLUVAC1Y_C]

Hard Edit:

Check Text: ERR2_FLUVAC1Y_C
Check Description: 1st flu vaccine before dob
Check Text: {check ERR2_FLUVAC1Y_C}Date prior to birth
Check Text: ERR1_FLUVAC1Y_C
Check Description: 1st flu vaccine in future
Check Text: {check ERR1_FLUVAC1Y_C}Future date invalid
Check Text: ERR3_FLUVAC1Y_C
Check Description: 1st flu vaccine before 12 mos
Check Text: {check ERR3_FLUVAC1Y_C}
Date before 12 months ago

Question ID: IMM.0040.01.1
Variable: FLUVAC2M_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 1 of 2
During what month and year did ^SCNAME receive the flu vaccine before that one?
* Enter month of the flu vaccine.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

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

Universe:

Sample Children 0-17 who have had two or more flu shots in the past 12 months

Skip Instructions:

1-12,DK [goto FLUVAC2Y_C]
RF [goto next section]

Question ID: IMM.0040.02.1
Variable: FLUVAC2Y_C
Interview Module: Child
Content Type: Annual Core
Question text:

* 2 of 2
* Enter year of next most recent flu vaccine.

Response:

2000-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Children 0-17 who have had two or more flu shots and gave month/don't know month of 2nd vaccine dose

Skip Instructions:

current year, current year-1,RF,DK [goto next section]
If FLUVAC2M_C and FLUVAC2Y_C = a date in the future [goto ERR1_FLUVAC2Y_C]
If FLUVAC2M_C and FLUVAC2Y_C = a date prior to birth [goto ERR2_FLUVAC2Y_C]
If FLUVAC2M_C and FLUVAC2Y_C = a date prior to 12 months ago [goto ERR3_FLUVAC2Y_C]
If FLUVAC2M_C and FLUVAC2Y_C = a date more recent than answer given in (FLUVAC1M_C and
FLUVA1Y_C) [goto ERR4_FLUVAC2Y_C]

Hard Edit:

Check Text: ERR2_FLUVAC2Y_C
Check Description: 2nd flu vaccine before dob
Check Text: {check ERR2_FLUVAC2Y_C} Date prior to birth
Check Text: ERR1_FLUVAC2Y_C
Check Description: 2nd flu vaccine in future
Check Text: {check ERR1_FLUVAC2Y_C} Future date invalid
Check Text: ERR3_FLUVAC2Y_C
Check Description: 2nd flu vaccine before 12 mos
Check Text: {check ERR3_FLUVAC2Y_C}
Date before 12 months ago

Soft Edit:

Check Text: ERR4_FLUVAC2Y_C
Check Description: 2nd flu vaccine after 1st flu vaccine
Check Text: {check ERR4_FLUVAC2Y_C}
The date entered for the second most recent flu vaccine is after the date of the most recent flu vaccine. Please verify.

2020 National Health Interview Survey (NHIS) Questionnaire
PTC: Physical and other therapeutic care - Rotate
Question ID: PTC.0010.00.2
Variable: EYEEX12M_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, has ^SCNAME had an eye exam from an eye specialist such as an
optometrist, ophthalmologist, or eye doctor?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto THERA12M_C]

Question ID: PTC.0020.00.2
Variable: THERA12M_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, did ^SCNAME receive physical therapy, speech therapy, rehabilitative
therapy, or occupational therapy?
*Do not include mental health therapy

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto HOMEHC12M_C]

Question ID: PTC.0030.00.2
Variable: HOMEHC12M_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, did ^SCNAME receive care at home from a nurse or other health
professional?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
MHC: Mental health care - Rotate
Question ID: MHC.0010.00.2
Variable: MHRX_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, did ^SCNAME take any prescription medication to help with ^hisher_C
emotions, concentration, behavior or mental health?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto MHTHRPY_C]

Question ID: MHC.0020.00.2
Variable: MHTHRPY_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, did ^SCNAME receive counseling or therapy from a mental health
professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto MHTHDLY_C]

Question ID: MHC.0030.00.2
Variable: MHTHDLY_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, has ^SCNAME been DELAYED in getting counseling or therapy from a
mental health professional because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto MHTHND_C]

Question ID: MHC.0040.00.2
Variable: MHTHND_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 12 months, was there any time when ^SCNAME needed counseling or therapy from a
mental health professional, but DID NOT GET IT because of the cost?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
INJ: Injury
Question ID: INJ.0010.00.2
Variable: INJINTRO_C
Interview Module: Child
Content Type: Rotating Core
Question text:

The next set of questions asks about all types of injuries. People can be injured accidentally
or on purpose. They may hurt themselves or others may cause them to be hurt.
Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Sample children 0-17

Skip Instructions:

1 [goto ANYINJURY_C]

Question ID: INJ.0020.00.2
Variable: ANYINJURY_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^SCNAME have an accident or an injury where any part of ^hisher_C
body was hurt?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17

Skip Instructions:

1 [goto INJLIMIT_C]
2,RF,DK [goto next section]

Question ID: INJ.0030.00.2
Variable: INJLIMIT_C
Interview Module: Child
Content Type: Rotating Core
Question text:

Did any of these injuries limit ^SCNAME's usual activities for at least 24 hours after the
injury occurred?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who had an injury in past 3 months

Skip Instructions:

1 [goto NUMINJ_C]
2,RF,DK [goto next section]

Question ID: INJ.0040.00.2
Variable: NUMINJ_C
Interview Module: Child
Content Type: Rotating Core
Question text:

For the next questions, please think only about the significant injuries that occurred during
the past 3 months. By significant, I mean those injuries that limited ^SCNAME's usual activities
for at least 24 hours after the injury occured.
During the past 3 months, how many times did ^SCNAME have a significant injury?
* Enter '96' if number is 96 or greater.

Response:

01-96 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 reported injuries in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1-9,RF,DK [goto INJHOME_C]
10-96 [goto ERR1_NUMINJ_C]

Soft Edit:

Check Text: ERR1_NUMINJ_C
Check Description: High number of injuries
Check Text: {signal ERR1_NUMINJ_C} ^NUMINJ_C is an unusually large number. Please verify.

Question ID: INJ.0050.00.2
Variable: INJHOME_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_C occur while ^SCNAME was at ^hisher_C home?
* Read if necessary: Include the yards, garage, basement, and other places on the home property.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 reported injuries in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 if NUMINJ_C=1 and GEN.AGE_FINAL le 2 [goto INJFALL_C]
elseif NUMINJ_C=1 and GEN.AGE_FINAL ge 3 [goto INJSPORTS_C]
elseif (NUMINJ_C gt 1 OR NUMINJ_C IN (RF,DK)) [goto INJSCHOOL_C]
2,RF,DK [goto INJSCHOOL_C]

Question ID: INJ.0060.00.2
Variable: INJSCHOOL_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_C occur while ^SCNAME was at ^DAYCARESCHOOL?
* Read if necessary: Include classrooms, playgrounds, sports fields, swimming pools, parking
lots and other places on school or daycare property.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who had more than one injury or didn't know or refused or who had one injury that did not occur at home

Skip Instructions:

1,2,RF,DK if GEN.AGE_FINAL lt 3 [goto INJFALL_C]
elseif GEN.AGE_FINAL ge 3 [goto INJSPORTS_C]

Question ID: INJ.0070.00.2
Variable: INJSPORTS_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_C occur while ^SCNAME was playing sports or exercising,
including walking, biking, or running, playing baseball, basketball, football or doing any other
physical activity?
* Read if necessary: Include recreational sports such as skating, skiing, tennis, golf, bowling,
or fishing.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 3-17 with injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1,2,RF,DK [goto INJFALL_C]

Question ID: INJ.0080.00.2
Variable: INJFALL_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_C occur as a result of a fall or falling?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 with injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 if NUMINJ_C=1 [goto INJMOTOR_C]
elseif NUMINJ_C gt 1 or NUMINJ_C IN (RF,DK) and INJHOME_C=1 [goto INJFALLHOM_C]
elseif NUMINJ_C gt 1 or NUMINJ_C IN (RF,DK) and INJSCHOOL_C=1 [goto INJFALLSCH_C]
else [goto INJMOTOR_C]
2,RF,DK [goto INJMOTOR_C]

Question ID: INJ.0090.00.2
Variable: INJFALLHOM_C
Interview Module: Child
Content Type: Rotating Core
Question text:

Did any fall occur while ^SCNAME was at ^hisher_C home?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who had more than 1 significant injury or refused or don't know, and were injured as a result of a fall or falling, and who were also injured at home

Skip Instructions:

1,2,RF,DK if INJSCHOOL_C=1 [goto INJFALLSCH_C]
else [goto INJMOTOR_C]

Question ID: INJ.0100.00.2
Variable: INJFALLSCH_C
Interview Module: Child
Content Type: Rotating Core
Question text:

Did any fall occur while ^SCNAME was at ^DAYCARESCHOOL?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who had more than 1 significant injury or refused or don't know, and were injured as a result of a fall or falling, and who were also injured at school

Skip Instructions:

1,2,RF,DK [goto INJMOTOR_C]

Question ID: INJ.0110.00.2
Variable: INJMOTOR_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^siginj_C occur as a result of being in a motor vehicle crash or
being hit by a motor vehicle while walking or biking?
* Read if necessary: Motor vehicles include cars, trucks, vans, buses, motorcycles, motorized
scooters, motorized wheelchairs, motorized carts, tractors, ATVs, snowmobiles, dune buggies, and
other motorized vehicles.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 with injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 [goto INJMVTYPE_C]
2,RF,DK [goto INJSAWDOC_C]

Question ID: INJ.0120.00.2
Variable: INJMVTYPE_C
Interview Module: Child
Content Type: Rotating Core
Question text:

Was ^SCNAME a ^DRIVER passenger, bicyclist, pedestrian, or doing something else when this
occurred?
Enter all that apply, separate with commas.

Response:

1 - ^INJDRIVER
2 - Passenger
3 - Bicyclist
4 - Pedestrian
5 - Something else
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 with a motor vehicle injury

Skip Instructions:

If GEN.AGE_FINAL[PX_C] lt 6 and INJMVTYPE_C=1 [goto ERR1_INJMVTYPE_C]
1-5,RF,DK [goto INJSAWDOC_C]

Hard Edit:

Check Text: ERR1_INJMVTYPE_C
Check Description: Driver selected for child under 6 years old
Check Text: {check ERR1_INJMVTYPE_C}
Verify. "Driver" is unavailable for children under 6 years old.

Question ID: INJ.0130.00.2
Variable: INJSAWDOC_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^SCNAME see a doctor or other health professional about ^siginj_C?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 with injury in past 3 months which limited activities for at least 24 hours

Skip Instructions:

1 if UTZ.EMERGE12M_C IN (1-96,RF,DK) [goto INJER_C]
elseif UTZ.EMERGE12M_C=0 and UTZ.HOSPONGT_C IN (1,RF,DK) [goto INJHOSP_C]
else [goto INJBONES_C]
2,RF,DK [goto INJSCHDAYS_C]

Question ID: INJ.0140.00.2
Variable: INJER_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^SCNAME go to an emergency room because of ^siginj_C?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who saw doctor about their injuries and either went to the ER in the past year or didn't know or refused if they went to the ER

Skip Instructions:

1,2,RF,DK if UTZ.HOSPONGT_C IN (1,RF,DK) [goto INJHOSP_C]
else [goto INJBONES_C]

Question ID: INJ.0150.00.2
Variable: INJHOSP_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, was ^SCNAME hospitalized overnight for ^siginj_C?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who saw a doctor for their injuries and were hospitalized overnight in the past year or didn't know or refused

Skip Instructions:

1,2,RF,DK [goto INJBONES_C]

Question ID: INJ.0160.00.2
Variable: INJBONES_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^SCNAME have any broken bones as a result of ^siginj_C?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who saw a doctor about an injury

Skip Instructions:

1,2,RF,DK [goto INJSTITCH_C]

Question ID: INJ.0170.00.2
Variable: INJSTITCH_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, did ^SCNAME get any stitches or staples because of ^siginj_C?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who saw a doctor about an injury

Skip Instructions:

1,2,RF,DK [goto INJSCHDAYS_C]

Question ID: INJ.0180.00.2
Variable: INJSCHDAYS_C
Interview Module: Child
Content Type: Rotating Core
Question text:

During the past 3 months, how many days of ^DAYCARESCHOOL did ^SCNAME miss because of ^siginj_C?
* Enter '90' if ^SCNAME missed every day of daycare or school in the past 3 months

Response:

00-90 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample children 0-17 who had an injury that limited their activities for at least 24 hours

Skip Instructions:

0,RF [goto next section]
1-90, DK [goto INJFUTSCH_C]

Question ID: INJ.0190.00.2
Variable: INJFUTSCH_C
Interview Module: Child
Content Type: Rotating Core
Question text:

Do you expect ^SCNAME to miss any more days of ^DAYCARESCHOOL because of ^siginj_C that occurred
during the past 3 months?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 who have missed at least one day of daycare or school due to injury in past 3 months or don't know

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
TBI: Concussions - lifetime
Question ID: TBI.0010.00.4
Variable: TBIINTRO_C
Interview Module: Child
Content Type: Emerging Content
Question text:

The next questions are about head injuries that may have occurred anytime in ^SCNAME's life.
Please think about all head injuries, for example, from playing sports, car accidents, falls, or
being hit by something or someone.

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto TBILOSTCON_C]

Question ID: TBI.0020.00.4
Variable: TBILOSTCON_C
Interview Module: Child
Content Type: Emerging Content
Question text:

As a result of a blow or jolt to the head, has ^SCNAME ever been knocked out or lost
consciousness?
* Read if necessary: Please think about all head injuries, for example, from playing sports, car
accidents, falls, or being hit by something or someone.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto TBICHKCONC_C]
2,RF,DK [goto TBIDAZED_C]

Question ID: TBI.0030.00.4
Variable: TBIDAZED_C
Interview Module: Child
Content Type: Emerging Content
Question text:

As a result of a blow or jolt to the head, has ^SCNAME ever been dazed or had a gap in ^hisher_C
memory?
* Read if necessary: Please think about all head injuries, for example, from playing sports, car
accidents, falls, or being hit by something or someone.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who did not report ever being knocked out because of blow or jolt to the head or refused or didn't know

Skip Instructions:

1,2,RF,DK [goto TBIHEADSYM_C]

Question ID: TBI.0040.00.4
Variable: TBIHEADSYM_C
Interview Module: Child
Content Type: Emerging Content
Question text:

As a result of a blow or jolt to the head, has ^SCNAME had headaches, vomiting, blurred vision,
or changes in mood or behavior?
* Read if necessary: Please think about all head injuries, for example, from playing sports, car
accidents, falls, or being hit by something or someone.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who did not report ever being knocked out because of blow or jolt to the head or refused or didn't know

Skip Instructions:

1,2,RF,DK [goto TBICHKCONC_C]

Question ID: TBI.0050.00.4
Variable: TBICHKCONC_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Has ^SCNAME ever been checked for a concussion or brain injury by a doctor, nurse, athletic
trainer, or other health professional?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,DK [goto TBIDRCONC_C]
2,RF [goto next section]

Question ID: TBI.0060.00.4
Variable: TBIDRCONC_C
Interview Module: Child
Content Type: Emerging Content
Question text:

Did a doctor, nurse, athletic trainer, or other health professional ever say that ^SCNAME had a
concussion or brain injury?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who have ever been checked for a concussion or don't know

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PHY: Physical Activity
Question ID: PHY.0010.00.2
Variable: SPORT_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In the past 12 months, did ^SCNAME play or participate on a sports team or club or take sports
lessons either at school or in the community?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1,2,RF,DK [goto PEGYM_C]

Question ID: PHY.0020.00.2
Variable: PEGYM_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In the past 12 months, did ^SCNAME take a Physical Education, PE, or gym class?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1,2,RF,DK [goto PADAYS_C]

Question ID: PHY.0030.00.2
Variable: PADAYS_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical week during the school year, how often does ^SCNAME exercise, play a sport, or
participate in physical activity for at least 60 minutes a day? Would you say never, some days,
most days, or every day?
* Read if necessary: Please include exercise in and out of school.

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1-4,RF,DK [goto STRENGTH_C]

Question ID: PHY.0040.00.2
Variable: STRENGTH_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical week during the school year, how often does ^SCNAME do exercises to strengthen or
tone ^hisher_C muscles, such as sit-ups, push-ups, or weight lifting?
Would you say never, some days, most days, or every day?
Read if necessary: Please include strengthening or toning activities in and out of school.

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample children 6-17

Skip Instructions:

1-4,RF,DK [goto WALK_C]

Question ID: PHY.0050.00.2
Variable: WALK_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical week during the school year, how often does ^SCNAME walk for at least 10 minutes at
a time?
Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample children 6-17

Skip Instructions:

1-4,RF,DK [goto BIKE_C]

Question ID: PHY.0060.00.2
Variable: BIKE_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical week during the school year, how often does ^SCNAME ride a bike for at least 10
minutes at a time?
* Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample children 6-17

Skip Instructions:

1-4,RF,DK [goto Next Section]

2020 National Health Interview Survey (NHIS) Questionnaire
NHC: Neighborhood Characteristics
Question ID: NHC.0010.00.2
Variable: SIDEWALK_C
Interview Module: Child
Content Type: Rotating Core
Question text:

The next questions are about where ^SCNAME lives. By where ^SCNAME lives we mean in ^hisher_C
neighborhood or near ^hisher_C home.
Where ^SCNAME lives, are there roads, sidewalks, paths or trails where ^SCNAME can walk or ride
a bicycle?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1,2,RF,DK [goto PARKS_C]

Question ID: NHC.0020.00.2
Variable: PARKS_C
Interview Module: Child
Content Type: Rotating Core
Question text:

* Read if necessary: Where ^SCNAME lives...
Are there parks or playgrounds close enough for ^SCNAME to walk or bike to?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1,2,RF,DK [goto TRAFFIC_C]

Question ID: NHC.0030.00.2
Variable: TRAFFIC_C
Interview Module: Child
Content Type: Rotating Core
Question text:

Where ^SCNAME lives, does traffic make it unsafe for ^SCNAME to walk or ride a bicycle, even
with an adult?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1,2,RF,DK [goto CRIME_C]

Question ID: NHC.0040.00.2
Variable: CRIME_C
Interview Module: Child
Content Type: Rotating Core
Question text:

*Read if necessary: Where ^SCNAME lives...
Does crime make it unsafe for ^SCNAME to walk or ride a bicycle, even with an adult?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 6-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SLP: Sleep - Rotate
Question ID: SLP.0010.00.2
Variable: RESTED_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical ^SCHOOLWEEK, how often does ^SCNAME wake up well-rested?
Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample children 2-17

Skip Instructions:

1-4,RF,DK [goto OUTOFBED_C]

Question ID: SLP.0020.00.2
Variable: OUTOFBED_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical ^SCHOOLWEEK, how often does ^SCNAME have difficulty getting out of bed in the
morning?
Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample children 2-17

Skip Instructions:

1-4,RF,DK [goto TIRED_C]

Question ID: SLP.0030.00.2
Variable: TIRED_C
Interview Module: Child
Content Type: Rotating Core
Question text:

* Read if necessary: In a typical ^SCHOOLWEEK...
How often does ^SCNAME complain about being tired during the day?
* Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto NAPS_C]

Question ID: SLP.0040.00.2
Variable: NAPS_C
Interview Module: Child
Content Type: Rotating Core
Question text:

* Read if necessary: In a typical ^SCHOOLWEEK...
How often does ^SCNAME nap or fall asleep during the day, such as in school, watching TV, or
riding in a car?
* Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto BEDTIME_C]

Question ID: SLP.0050.00.2
Variable: BEDTIME_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical ^SCHOOLWEEKN, how often does ^SCNAME go to bed at the same time?
* Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto WAKETIME_C]

Question ID: SLP.0060.00.2
Variable: WAKETIME_C
Interview Module: Child
Content Type: Rotating Core
Question text:

In a typical ^SCHOOLWEEKD, how often does ^SCNAME wake up at the same time?
* Read if necessary: Would you say never, some days, most days, or every day?

Response:

1 - Never
2 - Some days
3 - Most days
4 - Every day
7 - Refused
9 - Don't Know

Universe:

Sample Children 2-17

Skip Instructions:

1-4,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
SCR: Screen time
Question ID: SCR.0010.00.2
Variable: SCREENTIME_C
Interview Module: Child
Content Type: Rotating Core
Question text:

On most weekdays, does ^SCNAME spend more than 2 hours a day in front of a TV, computer,
cellphone or other electronic device watching programs, playing games, accessing the internet,
or using social media?
* Read if necessary: Do not include time spent doing school work.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
PAR: Parent Demographics
Question ID: PAR.0010.00.1
Variable: PARINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

Now I'm going to ask questions about ^SCNAME's parents living here.
* Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17 with at least one resident parent who is a biological, adoptive, or step parent.

Skip Instructions:

1 [goto tblPARREL]

Question ID: PAR.0030.00.1
Variable: RELCHPAR_C
Interview Module: Child
Content Type: Annual Core
Question text:

^AreyouIspar ^SCNAME's biological, adoptive, or step ^fathermother?

Fills:

^AreyouIspar

Description: Are you/Is {Value of ALIAS}
Instruction:
If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^fathermother

Description: father/mother/parent
Instruction:
If GEN.SEX_FINAL[PX]='1', fill: "father" If GEN.SEX_FINAL[PX]='2', fill: "mother"
If GEN.SEX_FINAL[PX]='('DK','RF')', fill: "parent"

Response:

1 - Biological
2 - Adoptive
3 - Step
4 - Other
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 with at least one resident parent who is a biological, adoptive, or step parent.

Skip Instructions:

1-4,RF,DK if last parent in GEN.PARENTS_FINAL[PX_C].NONFOST_FINAL [goto MARINTRO_C if any
parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL has MAR_FLG_A ne 1]
else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL
[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]
else [goto RELCHPAR_C for next parent listed at GEN.PARENTS_FINAL[PX_C].NONFOST_FINAL]
**Note: update skip instructions to tblPARBORN**

Question ID: PAR.0040.00.1
Variable: MARINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

The next set of questions are about marriage and cohabitation.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

At least one parent has marital flag of 3 or blank, or at least one parent has marital flag of 2 and the parent is the sample adult and not the sample child respondent

Skip Instructions:

For the first parent in GEN.PARENTS_FINAL[PX_C].PARENTS _FINAL with GEN.MAR_FLG_A ne 1,
If GEN.MAR_FLG_A=blank or (GEN.MAR_FLG_A=2 and PX=PX_A and SARESPSC_FLG ne 1) [goto
tblMAR.bParent.MARITAL_C]
Elseif GEN.MAR_FLG_A=3 [goto tblMAR.bPARENT.EVRMARRIED_C]

Question ID: PAR.0090.00.1
Variable: MARITAL_C
Interview Module: Child
Content Type: Annual Core
Question text:

^AreyouIspar married, living with a partner together as an unmarried couple, or neither?

Fills:

^AreyouIspar

Description: Are you/Is {Value of ALIAS}
Instruction:
If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]"

Response:

1 - Married
2 - Living with a partner as an unmarried couple
3 - Neither
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where parent's marital status is not determined in the Sample Adult section OR the parent's marital status is don't know or refused in the Sample adult section and the parent is the sample adult but not the sample child respondent OR the parent's marital status has not been obtained in this block

Skip Instructions:

1 [goto SPOUSLIV_C]
2 if GEN.PCNT16PLUSNOSC=1 [got ERR1_MARITAL_C] else [goto PARTNERWHO_C]
3,RF,DK [goto EVRMARRIED_C]

Soft Edit:

Check Text: ERR1_MARITAL_C
Check Description: One person eligible to be living with a partner in household soft edit
Check Text: {signal ERR1_MARITAL_C}
Respondent is the only person 16 or older on the household roster. There is no one else eligible to select.

Question ID: PAR.0100.00.1
Variable: SPOUSLIV_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^yourPARspouse currently live in the household?

Fills:

^yourPARspouse

Description: your spouse/{Value of ALIAS}'s spouse
Instruction:
if PX=LNO_SCRESP, fill: "your spouse" else fill: "ALIAS[PX]'s spouse"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where one parent is married

Skip Instructions:

1 if GEN.PCNT16PLUSNOSC=1 [goto ERR1_SPOUSLIV_C] else [goto SPOUSWHO_C]
2 [goto SPOUSEP_C]
RF,DK loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for
first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else
[goto next section]]

Question ID: PAR.0110.00.1
Variable: SPOUSEP_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^yourPAR spouse not live here because ^youPAR and ^yourPAR spouse are legally separated?

Fills:

^yourPAR

Description: your/{Value of ALIAS}'s
Instruction:
If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

^youPAR

Description: you/{Value of ALIAS}
Instruction:
If PX=LNO_SCRESP, fill: "you" else fill ALIAS[PX]

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 where parent is married and their spouse doesn't live in the household

Skip Instructions:

1,2,RF,DK loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C
for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

Question ID: PAR.0120.00.1
Variable: SPOUSWHO_C
Interview Module: Child
Content Type: Annual Core
Question text:

Which person is ^yourPAR spouse?
* Enter line number of spouse.
* Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Fills:

^yourPAR

Description: your/{Value of ALIAS}'s
Instruction:
If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

Response:

Universe:

Sample Children 0-17 where parent is married and spouse lives in the household

Skip Instructions:

1-25 if MARITAL_C=3 "Neither" for person selected at SPOUSWHO_C [goto ERR1_SPOUSWHO_C]
{person selected at SPOUSWHO_C has conflicting answer of "Neither" married or living with a
partner at MARITAL_C}
elseif SPOUSLIV_C=2 "Outside household" for person selected at SPOUSWHO_C [goto ERR2_SPOUSWHO_C]
{person selected at SPOUSWHO_C has conflicting answer of married with a spouse living outside
the household at SPOUSLIV_C}
elseif person selected at SPOUSWHO_C ((was already selected previously at SPOUSWHO_C or
PARTNERWHO_C) or (already chose a spouse/partner)) [goto ERR3_SPOUSWHO_C]
{person selected at SPOUSWHO_C is already indicated as married to someone else/a partner of
someone else}
else if GEN.SEX_FINAL[SPOUSWHO_C] IN('1','2') and GEN.SEX_FINAL[PX] IN ('1','2') [goto
SPOUSSEX_C]
else loop through table for remaining parents
else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL
[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]
0,RF,DK loop through table for remaining parents
else [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL
[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

Soft Edit:

Check Text: ERR1_SPOUSWHO_C
Check Description: Person selected has conflicting answer of "Neither" married or living with a partner
Check Text: {signal ERR1_SPOUSWHO_C}
Person selected also has answer of "Neither" married or living together as an unmarried couple. Please correct.
Check Text: ERR2_SPOUSWHO_C
Check Description: Person selected has conflicting answer of married with a spouse living outside the household
Check Text: {signal ERR2_SPOUSWHO_C}
Person selected was indicated to have a spouse living outside the household. Please correct.
Check Text: ERR3_SPOUSWHO_C
Check Description: Person selected is already indicated as married to/a partner of someone else
Check Text: {signal ERR3_SPOUSWHO_C}
Person selected is already indicated as ^marriedpartner someone else. Please correct.

Question ID: PAR.0130.00.1
Variable: SPOUSSEX_C
Interview Module: Child
Content Type: Annual Core
Question text:

I have previously recorded that ^ParentX ^sex_ParentX and that ^fillSPOUSWHO_C ^sex_SPOUSWHO_C.
Is that correct?

Fills:

^ParentX

Description: you are/{Value of ALIAS} is
Instruction:
If PX=LNO_SCRESP, fill: "you are" else fill: "ALIAS[PX] is"

^sex_ParentX

Description: male/female
Instruction:
If SEX[PX]=1, fill: "male" If SEX[PX]=2, fill: "female"

^fillSPOUSWHO_C

Description: you are/{Value of ALIAS} is
Instruction:
If SPOUSWHO_C=LNO_SCRESP, fill: "you are" else fill "ALIAS[SPOUSWHO_C] is"

^sex_SPOUSWHO_C

Description: male/female
Instruction:
If SEX[SPOUSWHO_C]=1 fill: "male" If SEX[SPOUSWHO_C]=2 fill: "female"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where parent is married and spouse lives in the household and the sex of the residential parent of interest is not refused/don't know and the sex of the spouse of this parent is not refused/don't know

Skip Instructions:

1,RF,DK loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for
first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else
[goto next section]
2 [goto FIXSPOUSSEX_C]

Question ID: PAR.0140.00.1
Variable: FIXSPOUSSEX_C
Interview Module: Child
Content Type: Annual Core
Question text:

Which was not correct?
* Enter all that apply, separate with commas.

Response:

Universe:

Skip Instructions:

1-25 loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for
first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else
[goto next section]

Question ID: PAR.0150.00.1
Variable: PARTNERWHO_C
Interview Module: Child
Content Type: Annual Core
Question text:

Which person is ^yourPAR partner?
* Enter line number of partner.
* Deleted persons cannot be selected. Enter '0' if respondent wishes to select a deleted person.

Fills:

^yourPAR

Description: your/{Value of ALIAS}'s
Instruction:
If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

Response:

Universe:

Sample Children 0-17 where parent is cohabitating with a partner and there are at least two people eligible to be cohabitating in the household

Skip Instructions:

1-25 if MARITAL_C=3 "Neither" for person selected at PARTNERWHO_C [goto ERR1_PARTNERWHO_C]
{person selected at PARTNERWHO_C has conflicting answer of "Neither" married or living with a
partner at MARITAL_C}
elseif SPOUSLIV_C=2 "Outside household" for person selected at PARTNERWHO_C [goto
ERR2_PARTNERWHO_C]
{person selected at PARTNERWHO_C has conflicting answer of married with a spouse living outside
the household at SPOUSLIV_C}
elseif person selected at PARTNERWHO_C ((was already selected previously at SPOUSWHO_C or
PARTNERWHO_C) or (already chose a spouse/partner)) [goto ERR3_PARTNERWHO_C]
{person selected at PARTNERWHO_C is already indicated as married to someone else/a partner of
someone else}
elseif GEN.SEX_FINAL[PX] IN ('1','2') and GEN.SEX_FINAL[PARTNERWHO_C] IN ('1','2')[goto
PARTNERSEX_C]
else [goto EVRMARRIED_C]
0,RF,DK [goto EVRMARRIED_C]

Soft Edit:

Check Text: ERR1_PARTNERWHO_C
Check Description: Person selected has conflicting answer of "Neither" married or living with a partner
Check Text: {signal ERR1_PARTNERWHO_C}
Person selected also has answer of "Neither" married or living together as an unmarried couple. Please correct.
Check Text: ERR2_PARTNERWHO_C
Check Description: Person selected has conflicting answer of married with a spouse living outside the household
Check Text: {signal ERR2_PARTNERWHO_C}
Person selected was indicated to have a spouse living outside the household. Please correct.
Check Text: ERR3_PARTNERWHO_C
Check Description: Person selected is already indicated as married to/a partner of someone else
Check Text: {signal ERR3_PARTNERWHO_C}
Person selected is already indicated as ^marriedpartner someone else. Please correct.

Question ID: PAR.0160.00.1
Variable: PARTNERSEX_C
Interview Module: Child
Content Type: Annual Core
Question text:

I have previously recorded that ^ParentX ^sex_ParentX and that ^fillPARTNERWHO_C
^sex_PARTNERWHO_C. Is that correct?

Fills:

^ParentX

Description: you are/{Value of ALIAS} is
Instruction:
If PX=LNO_SCRESP, fill: "you are" else fill: "ALIAS[PX] is"

^sex_ParentX

Description: male/female
Instruction:
If SEX[PX]=1, fill: "male" If SEX[PX]=2, fill: "female"

^fillPARTNERWHO_C

Description: you are/{Value of ALIAS} is
Instruction:
If PARTNERWHO_C=LNO_SCRESP, fill: "you are" else fill "ALIAS[PARTNERWHO_C] is"

^sex_PARTNERWHO_C

Description: male/female
Instruction:
If GEN.SEX_FINAL[PARTNERWHO_C]=1 fill: "male" If GEN.SEX_FINAL[PARTNERWHO_C]=2 fill: "female"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where parent is cohabitating with a partner and the partner lives in the household and the sex for the residential parent is not refused or don't know and the sex for the partner is not refused or don't know

Skip Instructions:

1,RF,DK [goto EVRMARRIED_C]
2 [goto FIXPARTSEX_C]

Question ID: PAR.0170.00.1
Variable: FIXPARTSEX_C
Interview Module: Child
Content Type: Annual Core
Question text:

Which was not correct?
Enter all that apply, separate with commas.

Response:

Universe:

Sample Children 0-17 where parent is cohabitating with a partner and the partner lives in the household and the sex for the residential parent is not refused/don't and the sex for the partner is not refused/don't know, and the sex of one or both of the individuals is incorrect.

Skip Instructions:

1-25 [goto EVRMARRIED_C]

Question ID: PAR.0180.00.1
Variable: EVRMARRIED_C
Interview Module: Child
Content Type: Annual Core
Question text:

^HaveyouHasPAR ever been married?

Fills:

^HaveyouHasPAR

Description: Have you/Has {Value of ALIAS}
Instruction:
If PX=LNO_SCRESP, fill: "Have you" else, fill: "Has ALIAS[PX]"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where parent is either cohabitating or not in relationship with anyone else in the household, or the marriage/cohabitation status is refused/don't know in the Adult section or the parent is reported as cohabitating with another parent

Skip Instructions:

1 if (MARITAL_C=2 or GEN.PAR_FLG_C[PX]=3 or GEN.MAR_FLG_A[PX]=3) [goto LEGALSTAT_A]
elseif MARITAL_C=3 [goto WIDIVSEP_A]
else loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for first
parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else [goto
next section]
2,RF,DK loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C for
first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty] else
[goto next section]

Question ID: PAR.0190.00.1
Variable: LEGALSTAT_C
Interview Module: Child
Content Type: Annual Core
Question text:

What is ^yourPAR current legal marital status?

Fills:

^yourPAR

Description: your/{Value of ALIAS}'s
Instruction:
If PX=LNO_SCRESP, fill: "your" else fill ALIAS[PX] + " 's "

Response:

1 - Married
2 - Widowed
3 - Divorced
4 - Separated
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where parent has been married and is living with a partner or person selected as a cohabitating partner in PAR or person selected as a cohabitating partner in MAR

Skip Instructions:

1-4,RF,DK loop through table for remaining parents else [goto tblPARBORN.bParent.PARBORN_C
for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS_FINAL where Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

Question ID: PAR.0200.00.1
Variable: WIDIVSEP_C
Interview Module: Child
Content Type: Annual Core
Question text:

^AreyouIspar widowed, divorced, or separated?

Fills:

^AreyouIspar

Description: Are you/Is {Value of ALIAS}
Instruction:
If PX=LNO_SCRESP, fill: "Are you" else fill: "Is ALIAS[PX]"

Response:

1 - Widowed
2 - Divorced
3 - Separated
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where parent is neither living with a partner nor married, but has been married

Skip Instructions:

1-3,RF,DK loop through table for remaining parents else [goto FINISH_MAR_C]

Question ID: PAR.0210.00.1
Variable: FINISH_MAR_C
Interview Module: Child
Content Type: Annual Core
Question text:

* The Sample Child MAR section is now complete.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Skip Instructions:

1 [goto tblPARBORN.bParent.PARBORN_C for first parent in GEN.PARENTS_FINAL[PX_C].PARENTS where
Adult.NAT.NATUSBORN_A=empty]
else [goto next section]

Question ID: PAR.0230.00.1
Variable: PARBORN_C
Interview Module: Child
Content Type: Annual Core
Question text:

^WereyouWaspar born in the United States or a U.S. territory?

Fills:

^WereyouWaspar

Description: Were you/Was {Value of ALIAS}
Instruction:
If PX=LNO_SCRESP, fill: "Were you" else fill: "Was ALIAS[PX]"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where whether the parent was born in the US or US territory is unknown

Skip Instructions:

1,2,RF,DK loop through table for remaining parents else [goto next section]

Question ID: REL.0030.00.1
Variable: FOSTPAR
Interview Module: Child
Content Type: Annual Core
Question text:

Is ^ALIASNAME currently in foster care? By that I mean is there an adult living in this
household acting as a foster parent to ^ALIASNAME under the supervision of a state or county
child welfare agency?

Fills:

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Child has no parents identified

Skip Instructions:

1 [goto WHOFOST]
2,RF,DK If last non-deleted child on roster [goto next section]
else [goto WHOPAR for next non-deleted child on roster]

2020 National Health Interview Survey (NHIS) Questionnaire
NAT: Nativity
Question ID: NAT.0010.00.1
Variable: NATUSBORN_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was ^SCNAME born in the United States or a U.S. territory?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto NATSTBORN_C]
2 [goto NATUSYR_C]
RF,DK [goto next section]

Question ID: NAT.0020.00.1
Variable: NATSTBORN_C
Interview Module: Child
Content Type: Annual Core
Question text:

In what state or U.S. territory was ^SCNAME born?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17 born in the United States or U.S. terriority

Skip Instructions:

American Samoa [goto CITIZEN_C]
else [goto next section]

Question ID: NAT.0040.00.1
Variable: NATUSYR_C
Interview Module: Child
Content Type: Annual Core
Question text:

In what year did ^SCNAME come to the United States to stay?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

2000-2030 - Range of values
9997 - Refused
9999 - Don't Know

Universe:

Sample Children 0-17 not born in the United States or U.S. territory

Skip Instructions:

2000-Current Year,RF,DK
if NATUSYR_C gt current year [goto ERR1_NATUSYR_C]
if NATUSYR_C lt VFY.DEMBIRYR_C [goto ERR2_NATUSYR_C]
else [goto CITIZEN_C]

Hard Edit:

Check Text: ERR2_NATUSYR_C
Check Description: The year reported in NATUSYR_C is a year prior to child's birth
Check Text: {check ERR2_NATUSYR_C}
Year is prior to date of birth. Please correct.
Check Text: ERR1_NATUSYR_C
Check Description: The year reported in NATUSYR_C is a year in the future
Check Text: {check ERR1_NATUSYR_C}
Future year invalid. Please correct.

Question ID: NAT.0050.00.1
Variable: CITIZEN_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is ^SCNAME a citizen of the United States?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample children 0-17 not born in the United States or U.S. territory or born in American Samoa

Skip Instructions:

1 [goto NATCTZN_C]
2,RF,DK [goto next section]

Question ID: NAT.0060.00.1
Variable: NATCTZN_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was ^SCNAME born abroad to an American parent, born abroad and adopted by an American parent, or
did ^SCNAME become a U.S. citizen by naturalization?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Born abroad to American parent
2 - Born abroad and adopted by an American parent
3 - Became U.S. citizen by naturalization
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 are United States citizens

Skip Instructions:

1-3,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
FEM: Employment of family members
Question ID: FEM.0010.00.1
Variable: FEMINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

Now I have a few questions about ^youandothfam.
* Enter '1' to continue.

Fills:

^youandothfam

Description: you/other members of your family/you and other members of your family
Instruction:
IF LNO_SCRESP PX_A OR ( LNO_SCRESP = PX_A AND ( (SARESPSC_FLG 1 AND
EMP_FLG_A=2) OR (EMP_FLG_A = EMPTY) ) )THEN
fill: "you"
ENDIF
IF PCNT18UP_C >= 2 THEN
IF fill = EMPTY THEN
fill: "other members of your family"
ELSEIF (PCNT18UP_C = 2 AND ( (SAMEFAM_FLG 1) OR (
(SAMEFAM_FLG = 1) AND ( (SARESPSC_FLG 1 AND EMP_FLG_A=2)
OR (EMP_FLG_A = EMPTY) ) ) ) ) OR (PCNT18UP_C > 2)THEN
fill: "you and other members of your family"
ENDIF
ENDIF

Response:

1 - Enter 1 to Continue

Universe:

Sample Child is not in the same family as the Sample Adult OR Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has don't know/refused responses for all questions and the sample adult isn't the sample child respondent.

Skip Instructions:

[goto tblFEM_C]
Replicate To: FEMINTRO_A

Question ID: FEM.0030.00.1
Variable: FEMWORK_C
Interview Module: Child
Content Type: Annual Core
Question text:

^DoesDoyouALIASNAME work for pay at a job or business?
* If the respondent says ^heshetheywork, but not for pay, at a family-owned job or business,
enter '1' for yes.

Fills:

^DoesDoyouALIASNAME

Description: Do you/Does ^ALIASNAME
Instruction:
If PX=LNO_SCRESP, fill: "Do you" (that is if the subject of the question is the sample child respondent, fill: "Do
you")
else fill: "Does ^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^heshetheywork

Description: he works/she works/they work
Instruction:
elseif GEN.SEX_FINAL=1 fill "he works" elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL=DK,RF fill "they work"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

(Sample Child is not in the same family as the Sample Adult OR Sample Child is in same family as Sample Adult and there is one adult in family who is the Sample Adult and the Sample Adult Employment section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section has not been asked OR Sample Child is in the same family as Sample Adult and there are more than one adults in the family and the Sample Adult FEM section was asked but has don't know/refused responses for all questions and the sample adult isn't the sample child respondent.) AND Person is in Sample Child's family and over the age of 18

Skip Instructions:

1 [goto FEMWKFT_C]
2,RF,DK if there is another adult in the family [goto FEMWORK_C] for the next adult 18+
else [goto next section]
Replicate To: FEMWORK_A

Question ID: FEM.0040.00.1
Variable: FEMWKFT_C
Interview Module: Child
Content Type: Annual Core
Question text:

^DoesDoyouALIASNAME usually work 35 hours or more per week in total at ^hisheryour job or jobs?

Fills:

^DoesDoyouALIASNAME

Description: Do you/Does ^ALIASNAME
Instruction:
If PX=LNO_SCRESP, fill: "Do you" (that is if the subject of the question is the sample child respondent, fill: "Do
you")
else fill: "Does ^ALIASNAME"

^ALIASNAME

Description: {Value of ALIAS}
Instruction:
Fill value from ALIAS

^hisheryour

Description: your/his/her/their
Instruction:
If PX=LNO_SCRESP, fill: "your" (that is, if the subject of the question is the sample
child respondent, fill: "your")
else if SEX_FINAL[PX] = 1, fill "his"
else if SEX_FINAL[PX] = 2, fill "her"
else if SEX_FINAL[PX] in (DK,RF), fill "their"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK if another adult in the family [goto FEMWORK_C] for the next adult 18+
else [goto next section]
Replicate To: FEMWKFT_A

2020 National Health Interview Survey (NHIS) Questionnaire
INC: Family Income
Question ID: INC.0010.00.1
Variable: INCINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

The next questions are about your total family income in ^LASTYEAR BEFORE TAXES. Based on
questions asked earlier, we have that ^SCNAME's family consists of ^INCINTRO_C_fill.
* Read if necessary: Income is important in analyzing the health information we collect. For
example, with this information, we can learn whether persons in one income group use certain
types of medical services more or less often than those in another group. Please be assured
that, like all other information you have provided, these answers will remain confidential.
* Enter '1' to continue.

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^SCNames_fill

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 [goto INCWRKO_C]
Replicate To: INCINTRO_A

Question ID: INC.0020.00.1
Variable: INCWRKO_C
Interview Module: Child
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ^YOUFAM18YRS_C receive income from wages, salaries, commissions, bonuses,
tips, or self-employment?
* Read if necessary: For the purpose of this survey, ^SCNAME's family includes ^FAMVERSC_fill

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAM18YRS_C

Description: you/you or any family members 18 or older
Instruction:
If GEN.PCNT18UP_C=1 fill "you" else if GEN.PCNT18UP_C GT 1 fill "you or any family members 18 or older"

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^FAMVERSC_fill

Description: List of all people in Sample Child's family
Instruction:
Loop through all persons on roster and add to list of names if FAMILYC_flg = 1
Do not include Sample Child on list.
If Household Respondent (Roster.HHC.HHRESPAVAIL) is on
list of names, fill "you" for name and place name at the
beginning of the list.
If only one person on the list of names and person ne
Roster.HHC.HHRESPAVAIL, follow list with "is".
If more than one person on the list or only one person on
list and person is Household Respondent
(Roster.HHC.HHRESPAVAIL), follow list with "are".

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCINTER_C]
Replicate To: INCWRKO_A

Question ID: INC.0030.00.1
Variable: INCINTER_C
Interview Module: Child
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ANY FAMILY MEMBERS receive income from interest-bearing accounts or
investments, dividends from stocks or mutual funds, net rental income, royalty income, or income
from estates and trusts?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCSSRR_C]
Replicate To: INCINTER_A

Question ID: INC.0031.00.1
Variable: INCSSRR_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive...
Income from Social Security or Railroad Retirement?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction:
If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCSSISSDI_C]
Replicate To: INCSSRR_A

Question ID: INC.0040.00.1
Variable: INCSSISSDI_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ANY FAMILY MEMBERS receive...
Supplemental Security Income, SSI, or Social Security Disability Income, SSDI, which are
different from Social Security?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1 [goto SSISSDIBTH_C]
2,RF,DK [goto INCWELF_C]
Replicate To: INCSSISSDI_A

Question ID: INC.0050.00.1
Variable: SSISSDIBTH_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was this Supplemental Security Income, SSI, Social Security Disability Income, SSDI, or both?

Response:

1 - SSI
2 - SSDI
3 - Both SSI and SSDI
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 where someone in the family gets SSI or SSDI and Sample Child INC section has not been completed OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused OR the Sample Adult and Sample Child are not in the same family

Skip Instructions:

1-3,RF,DK [goto SSISSDIDSB_C]
Replicate To: SSISSDIBTH_A

Question ID: INC.0060.00.1
Variable: SSISSDIDSB_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was this received as a disability benefit?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 living in families where someone in the family gets SSI or SSDI and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 [goto SSISSDIP_C]
2,RF,DK [goto INCWELF_C]
Replicate To: SSISSDIDSB_A

Question ID: INC.0070.00.1
Variable: SSISSDIP_C
Interview Module: Child
Content Type: Annual Core
Question text:

In ^LASTYEAR, who received this disability benefit?
* Read if necessary: Do NOT include a benefit received on behalf of someone else.
* Enter all that apply, separate with commas.

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

Response:

Universe:

Sample Children 0-17 with more than one person in the family where someone in the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the person who answered the Sample Adult questions is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1-25,RF,DK [goto INCWELF_C]
Replicate To: SSISSDIP_A

Question ID: INC.0090.00.1
Variable: INCWELF_C
Interview Module: Child
Content Type: Annual Core
Question text:

In ^LASTYEAR, did ^YOUFAMHERE_C receive...
Any public assistance or welfare payments from the state or local welfare office?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction:
If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCRETIRE_C]
Replicate To: INCWELF_A

Question ID: INC.0100.00.1
Variable: INCRETIRE_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive...
Income from retirement, survivor, or disability pensions?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction:
If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCOTHR_C]
Replicate To: INCRETIRE_A

Question ID: INC.0110.00.1
Variable: INCOTHR_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE_C receive...
Any other sources of income such as VA payments from the Veterans Benefits Administration,
unemployment compensation, child support, or alimony?

Fills:

^LASTYEAR

Description: Last year
Instruction:
Fill year prior to current year

^YOUFAMHERE_C

Description: you/you or any family members
Instruction:
If GEN.PCNT_C=2 fill "you" else if GEN.PCNT_C GT 2 fill "you or any family members"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1,2,RF,DK [goto INCTOTAL_C]
Replicate To: INCOTHR_A

Question ID: INC.0120.00.1
Variable: INCTOTAL_C
Interview Module: Child
Content Type: Annual Core
Question text:

When answering this next question, please remember to include your income PLUS the income of all
family members living in this household.
What is your best estimate of the total income of all family members from all sources, before
taxes, in the last calendar year?
* Enter '999995' if the reported income is $999,995 or greater.

Response:

000000-999995 - Range of values
999997 - Refused
999998 - Not Ascertained
999999 - Don't Know

Universe:

Skip Instructions:

0-999 [goto ERR1_INCTOTAL_C]
250001-999995 [goto ERR2_INCTOTAL_C]
1000-250000 [goto next section]
RF,DK [goto INC250PCT_C]

Soft Edit:

Check Text: ERR2_INCTOTAL_C
Check Description: Income high soft edit
Check Text: {signal ERR2_INCTOTAL_C} Do not read to the respondent. ^INCTOTAL_C is unusually high. Make corrections if necessary.
Check Text: ERR1_INCTOTAL_C
Check Description: Income low soft edit
Check Text: {signal ERR1_INCTOTAL_C} Do not read to the respondent. ^INCTOTAL_C is unusually low. Make corrections if necessary. Replicate To: INCTOTAL_A

Question ID: INC.0140.01.1
Variable: INC250PCT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than ^250POVERTY_C or ^250POVERTY_C or more?

Fills:

^250POVERTY_C

Description: 250% of poverty threshold
Instruction:
fill value stored in Child.INC.INC250PCT_C

Response:

1 - Less than ^250POVERTY_C
2 - ^250POVERTY_C or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who don't know or refuse the total family income and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 [goto INC138PCT_C]
2 if GEN.PCNT_C=2 [goto INC75K_C];
else if GEN.PCNT_C=4 OR GEN.PCNT_C ge 7 [goto INC400PCT_C];
else if GEN.PCNT_C IN (3,5,6) [goto INC100K_C]
RF,DK [goto next section]
Replicate To: INC250PCT_A

Question ID: INC.0150.01.1
Variable: INC138PCT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than ^138POVERTY_C or ^138POVERTY_C or more?

Fills:

^138POVERTY_C

Description: 138% of poverty threshold
Instruction:
fill value stored in Child.INC.INC138PCT_C

Response:

1 - Less than ^138POVERTY_C
2 - ^138POVERTY_C or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 answered less than 250% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 [goto INC100PCT_C]
2 [goto INC200PCT_C]
RF,DK [goto next section]
Replicate To: INC138PCT_A

Question ID: INC.0160.01.1
Variable: INC100PCT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than ^100POVERTY_C or ^100POVERTY_C or more?

Fills:

^100POVERTY_C

Description: 100% of poverty threshold
Instruction:
fill value stored in Child.INC.INC100PCT_C

Response:

1 - Less than ^100POVERTY_C
2 - ^100POVERTY_C or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who answered less than 138% of poverty threshold and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: INC100PCT_A

Question ID: INC.0170.01.1
Variable: INC200PCT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than ^200POVERTY_C or ^200POVERTY_C or more?

Fills:

^200POVERTY_C

Description: 200% of poverty threshold
Instruction:
fill value stored in Child.INC.INC138PCT_C

Response:

1 - Less than ^200POVERTY_C
2 - ^200POVERTY_C or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who answered 138% of poverty or more and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: INC200PCT_A

Question ID: INC.0180.00.1
Variable: INC75K_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than $75,000 or $75,000 or more?

Response:

1 - Less than $75,000
2 - $75,000 or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who answered 250% of poverty threshold or more and is from a 2 person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 [goto INC400PCT_C]
2 [goto INC100K_C]
RF,DK [goto next section]
Replicate To: INC75K_A

Question ID: INC.0190.00.1
Variable: INC100K_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than $100,000 or $100,000 or more?

Response:

1 - Less than $100,000
2 - $100,000 or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who answered $75,000 or more OR answered 250% of poverty or more and is from a 3,5, or 6 person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 if GEN.PCNT_C IN (2,5,6) [goto next section]
else if GEN.PCNT_C=3 [goto INC400PCT_C]
2 if GEN.PCNT_C IN (2,3) [goto INC150K_C]
else if GEN.PCNT_C IN (5,6) [goto INC400PCT_C]
RF,DK [goto next section]
Replicate To: INC100K_A

Question ID: INC.0200.01.1
Variable: INC400PCT_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than ^400POVERTY_C or ^400POVERTY_C or more?

Fills:

^400POVERTY_C

Description: 400% of poverty threshold
Instruction:
fill value stored in Child.INC.INC400PCT_C

Response:

1 - Less than ^400POVERTY_C
2 - ^400POVERTY_C or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who answered less than $75,000 OR answered less than $100,000 and is from a 3 person family OR answered $100,000 or more and from a 5 or 6 person family OR answered 250% of poverty threshold or more and is from a 4 or 7+ person family and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1 if GEN.PCNT_C ge 8 [goto INC150K_C]
else [goto next section]
2 if GEN.PCNT_C IN (2,3) or GEN.PCNT_C ge 7[goto next section]
else if GEN.PCNT_C IN (4,5,6) [goto INC150K_C]
RF,DK [goto next section]
Replicate To: INC400PCT_A

Question ID: INC.0210.00.1
Variable: INC150K_C
Interview Module: Child
Content Type: Annual Core
Question text:

Was your total family income from all sources less than $150,000 or $150,000 or more?

Response:

1 - Less than $150,000
2 - $150,000 or more
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who answered $100,000 or more and is from 2 or 3 person family OR answered 400% of poverty or more and is from 4 or 5 person family OR answered less than 400% of poverty and is from a family of 8 or more persons and Sample Adult and Sample Child are in the same family and the Sample Adult INC section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and the Sample Child are in the same family and the Sample Adult is not the Sample Child respondent and every question asked in the Sample Adult income section was don't know or refused

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: INC150K_A

2020 National Health Interview Survey (NHIS) Questionnaire
FOO: Food Related Programs
Question ID: FOO.0010.00.1
Variable: FSNAP12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

At any time in the last 12 months did any family members living here receive ^FSSNAPNM?
* Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy
food.

Fills:

^FSSNAPNM

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know
-

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was not the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1 [goto FSNAP30D_C]
2,RF,DK if PCNTF1255_C GE 1 or PCNTC05_C GE 1, [goto FWIC12M_C]
else if PCNTC517_C GE 1 [goto FLUNCH12M_C]
else [goto FINISH_FOO_C]
Replicate To: FSNAP12M_A

Question ID: FOO.0020.00.3
Variable: FSNAP30D_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

Did any family members living here receive ^FSSNAPNM in the LAST 30 days?
*Read if necessary: This program puts money on a SNAP EBT card that you can only use to buy
food.

Fills:

^FSSNAPNM

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know
-

Universe:

Sample Child 0-17 and someone in the family received food stamps in the past 12 months

Skip Instructions:

1,2,RF,DK if PCNTF1255_C GE 1 or PCNTC05_C GE 1, [goto FWIC12M_C]
else if PCNTC517_C GE 1 [goto FLUNCH12M_C]
else [goto FINISH_FOO_C]
Replicate To: FSNAP30D_A

Question ID: FOO.0030.00.1
Variable: FWIC12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

At any time in the last 12 months did any family members living here receive benefits from the
WIC program, that is, the Women, Infants, and Children program?

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 living in families with females 12-55 years of age or children 0-5 years of age and Sample Adult and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1,2,RF,DK If PCNTC517_C GE 1 [goto FLUNCH12M_C]
else [goto FINISH_FOO_C]
Replicate To: FWIC12M_A

Question ID: FOO.0040.00.1
Variable: FLUNCH12M_C
Interview Module: Child
Content Type: Annual Core
Question text:

At any time in the last 12 months, did ^SCCHILDFAM_C receive free or reduced-cost breakfasts or
lunches at school?
* Read if necessary: The National School Lunch Program and the School Breakfast Program provide
cash assistance to states to operate breakfast and lunch programs in schools and residential
childcare institutions. The programs provide low-cost or free breakfasts and lunches to lowincome children in kindergarten through 12th grade.

Fills:

^SCCHILDFAM_C

Description: ^SCNAME/any child in your family
Instruction:
if PCNTC517_C=1, fill "^SCNAME", elseif PCNTC517_C gt 1, fill "any child in your family",

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children living in families with children between the ages of 5-17 and and Sample Child are in the same family and the Sample Adult FOO section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult FOO section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the FOO section with RF or DK.

Skip Instructions:

1,2,RF,DK [goto FINISH_FOO_C]
Replicate To: FLUNCH12M_A

Question ID: FOO.0050.00.1
Variable: FINISH_FOO_C
Interview Module: Child
Content Type: Annual Core
Question text:

* The Sample Child food related programs section is now complete.
* Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Skip Instructions:

1 [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
FDS: Food Security
Question ID: FDS.0010.00.3
Variable: FDSINTRO_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

These next questions are about whether you were always able to afford the food you needed in the
last 30 days. I'm going to read you several statements that people have made about their food
situation. For these statements, please tell me whether the statement was often true, sometimes
true, or never true for your family in the last 30 days.
Enter '1' to continue.

Response:

1 - Enter 1 to Continue

Universe:

Skip Instructions:

1 [goto FDSRUNOUT_C]
Replicate To: FDSINTRO_A

Question ID: FDS.0020.00.3
Variable: FDSRUNOUT_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

The first statement is "We worried whether our food would run out before we got money to buy
more." Was that often true, sometimes true, or never true for your family in the last 30 days?

Response:

1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-3,RF,DK [goto FDSLAST_C]
Replicate To: FDSRUNOUT_A

Question ID: FDS.0030.00.3
Variable: FDSLAST_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

"The food that we bought just didn't last, and we didn't have money to get more." Was that often
true, sometimes true, or never true for your family in the last 30 days?

Response:

1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-3,RF,DK [goto FDSBALANCE_C]
Replicate To: FDSLAST_A

Question ID: FDS.0040.00.3
Variable: FDSBALANCE_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

"We couldn't afford to eat balanced meals." Was that often true, sometimes true, or never true
for your family in the last 30 days?

Response:

1 - Often true
2 - Sometimes true
3 - Never true
7 - Refused
9 - Don't Know

Universe:

Skip Instructions:

1-2 [goto FDSSKIP_C]
3,RF,DK if FDSRUNOUT_C IN (1,2) OR FDSLAST_C IN (1,2) [goto FDSSKIP_C];
else [goto next section]
Replicate To: FDSBALANCE_A

Question ID: FDS.0050.00.3
Variable: FDSSKIP_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_C ever cut the size of your meals or skip meals because
there wasn't enough money for food?

Fills:

^youorother_C

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1 [goto FDSSKIPDYS_C]
2,RF,DK [goto FDSLESS_C]
Replicate To: FDSSKIP_A

Question ID: FDS.0060.00.3
Variable: FDSSKIPDYS_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, how many days did this happen?

Response:

01-30 - Range of values
97 - Refused
99 - Don't Know

Universe:

Skip Instructions:

1-30,RF,DK [goto FDSLESS_C]
Replicate To: FDSSKIPDYS_A

Question ID: FDS.0070.00.3
Variable: FDSLESS_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_C ever eat less than you felt you should because there
wasn't enough money for food?

Fills:

^youorother_C

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK [goto FDSHUNGRY_C]
Replicate To: FDSLESS_A

Question ID: FDS.0080.00.3
Variable: FDSHUNGRY_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, were ^youorother_C ever hungry but didn't eat because there wasn't enough
money for food?

Fills:

^youorother_C

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1,2,RF,DK [goto FDSWEIGHT_C]
Replicate To: FDSHUNGRY_A

Question ID: FDS.0090.00.3
Variable: FDSWEIGHT_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_C lose weight because there wasn't enough money for food?

Fills:

^youorother_C

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered often true or sometimes true that in the last 30 days they worried that food would run out before they got money to buy more, or that the food that was bought didn't last and they didn't have money to get more or couldn't afford to eat balanced meals.

Skip Instructions:

1 [goto FDSNOTEAT_C]
2,RF,DK if FDSSKIP_C=1 or FDSLESS_C=1 or FDSHUNGRY_C=1 [goto FDSNOTEAT_C]; else [goto next
section]
Replicate To: FDSWEIGHT_A

Question ID: FDS.0100.00.3
Variable: FDSNOTEAT_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, did ^youorother_C ever not eat for a whole day because there wasn't enough
money for food?

Fills:

^youorother_C

Description: you/you or other adults in your family
Instruction:
If PCNT18UP_C=1 fill "you" else fill: "you or other adults in your family"

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and respondent answered they cut the size of the meals, skipped meals, were hungry but didn't eat, or lost weight in the last 30 days because there wasn't enough money for food.

Skip Instructions:

1 [goto FDSNEDAYS_C]
2,RF,DK [goto next section]
Replicate To: FDSNOTEAT_A

Question ID: FDS.0110.00.3
Variable: FDSNEDAYS_C
Interview Module: Child
Content Type: Sponsored Content
Question text:

In the last 30 days, how many days did this happen?

Response:

01-30 - Range of values
97 - Refused
99 - Don't Know

Universe:

Sample Child 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult FDS section has not been completed OR the Sample Adult and Sample Child are not in the same family OR the Sample Adult and Sample Child are in the same family and the Sample Adult answered refused or don't know to all questions in the Sample Adult FDS section and the Sample Child respondent is not the Sample Adult respondent and adults in the family have ever not eaten for a whole day because there wasn't enough money for food in the last 30 days

Skip Instructions:

1-30,RF,DK [goto next section]
Replicate To: FDSNEDAYS_A

2020 National Health Interview Survey (NHIS) Questionnaire
HOU: Housing
Question ID: HOU.0010.00.1
Variable: HOUYRSLIV_C
Interview Module: Child
Content Type: Annual Core
Question text:

About how long has ^SCNAME lived in this house/apartment?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Less than 1 year
2 - 1 to 3 years
3 - 4 to 10 years
4 - More than 10 years
7 - Refused
9 - Don't Know

Universe:

Sample Children 1-17

Skip Instructions:

1-4,RF,DK if ((SAMEFAM_FLG=1 and HOU_FLG_A=blank) or (SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and
HOU_FLG_A=2 and SARESPSC_FLG ne 1)) [goto HOUTENURE_C]
else [goto next section]
If GEN.AGE_FINAL[PX_C] lt 11 and HOUYRSLIV_C=4 [goto ERR1_HOUYRSLIV_C]

Hard Edit:

Check Text: ERR1_HOUYRSLIV_C
Check Description: Hard check when years lived in home exceeds age
Check Text: {check ERR1_HOUYRSLIV_C}
Years in house/apartment exceed child's age. Please correct.

Question ID: HOU.0020.00.1
Variable: HOUTENURE_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is this house/apartment owned or rented by you ^SOMEFAM_C?
* If house has a mortgage, record as owned.

Fills:

^SOMEFAM_C

Description: or someone in your family
Instruction:
If PCNT_C=2 fill: blank If PCNT_C gt 2 fill: "or someone in your family"

Response:

1 - Owned or being bought
2 - Rented
3 - Other arrangement
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 and Sample Adult and Sample Child are in the same family and the Sample Adult HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult HOU section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the HOU section with RF or DK.

Skip Instructions:

1,3,RF,DK [goto next section]
2 [got HOUGVASST_C]
Replicate To: HOUTENURE_A

Question ID: HOU.0030.00.1
Variable: HOUGVASST_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is anyone in your family paying lower rent because the Federal, State, or local government is
paying part of the cost?
* Read if necessary: Federal, State, or Local government housing programs for persons with low
income may take many forms. Government housing assistance could come from monetary assistance to
help pay rent, a program called "Section 8," direct payments to landlords, vouchers, or other
types of assistance from a local housing authority. Living in public housing is considered
housing assistance from the government.

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 living in a house/apartment that is being rented and Sample Adult and Sample Child are in the same family and the Sample Adult HOU section has not been completed OR the Sample Adult and Sample Child are not in the same family OR Sample Adult and Sample Child are in the same family and Sample Adult HOU section was asked to someone other than the Sample Child respondent and this person answered all questions asked in the HOU section with RF or DK.

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: HOUGVASST_A

2020 National Health Interview Survey (NHIS) Questionnaire
REC: Child's full name
Question ID: REC.0010.00.1
Variable: LNKFNAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Ask or verify: What is ^SCNAME's full name?
* Enter first name.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK [goto LNKMNAME_C]

Question ID: REC.0020.00.1
Variable: LNKMNAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Enter middle name.
* Press "Enter" to skip to last name if child has no middle name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK [goto LNKLNAME_C]

Question ID: REC.0030.00.1
Variable: LNKLNAME_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Enter last name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
TEL: Telephone ownership
Question ID: TEL.0010.00.1
Variable: TELCURWRK_C
Interview Module: Child
Content Type: Annual Core
Question text:

Is there at least one telephone INSIDE ^SCNAME's home that is currently working and is not a
cell phone?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 who live in the same family as a sample adult, where TELCURWRK_A has not be asked OR who live in the same family as a sample adult, where TELCURWRK_A was answered don't know or refused and the sample child respondent is not the sample adult OR who do not live in the same family as the sample adult

Skip Instructions:

1,2,RF,DK [goto PHONELIVE_C]
Replicate To: TELCURWRK_A

Question ID: TEL.0020.00.1
Variable: PHONELIVE_C
Interview Module: Child
Content Type: Annual Core
Question text:

Does ^SCNAME live with anyone who has a working cell phone?

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample Children 0-17 in a family with at least one other person without working cell phones where Sample Adult does not live in same family as Sample Child or Sample Adult and Sample Child are in the same family but PHONELIVE_A has not been asked OR Sample Adult and Sample Child are in the same family, PHONELIVE_A was answered dk/rf and the Sample Adult is not the Sample Child Respondent.

Skip Instructions:

1,2,RF,DK [goto next section]
Replicate To: PHONELIVE_A

2020 National Health Interview Survey (NHIS) Questionnaire
LNK: Linkage
Question ID: LNK.0010.00.1
Variable: LNKINTRO_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
We would like the last four digits of ^SCNAME's Social Security Number. This information will
help us link ^hisher_C survey data with other health-related records of other government
agencies, and allow us to conduct additional research without taking up your time with more
questions. The National Center for Health Statistics (NCHS) uses this information for research
purposes only. Providing this information is voluntary. There will be no effect on ^SCNAME's
benefits if you do not provide this information. Federal laws authorize us to ask for this
information. Like all other answers you have provided, this information will remain
confidential.
* Read if necessary: The specific federal laws protecting ^SCNAME's privacy and the
confidentiality of ^hisher_C data are the Public Health Service Act (Title 42, U.S.C., Section
242m(d)), the Confidential Information Protection and Statistical Efficiency Act of 2018 (Title
lll, Public Law No. 115-435), and the Privacy Act of 1974 (5 U.S.C. § 552a).
* Read if necessary: NCHS collects health-related data from other government agencies, including
records from Medicare and Medicaid Services, Social Security, housing, and death certificates.
If you agree, NCHS will attempt to link records such as these with ^SCNAME's survey data to give
a fuller picture of the kinds of things that affect health. NCHS does this linkage. ^SCNAME's
name and ^hisher_C information are not given to these agencies.
* Read if necessary: If asked: ^SCNAME's data will not be linked to records from the IRS
(Internal Revenue Service) or ICE (Immigration and Customs Enforcement).
Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto SSN4_C]

Question ID: LNK.0020.00.1
Variable: SSN4_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
What are the last four digits of ^SCNAME's Social Security Number?
Read if necessary: Providing this information is voluntary. There will be no effect on ^SCNAME's
benefits if you do not provide this information. Federal laws authorize us to ask for this
information. Like all other information you have provided, these answers will remain
confidential.
Read if asked about specific laws: The specific federal laws protecting ^SCNAME's privacy and
the confidentiality of ^hisher_C data are the Public Health Service Act, which is Title 42,
U.S.C., Section 242m(d); the Confidential Information Protection and Statistical Efficiency Act
of 2018, which is Title lll, Public Law No. 115-435; and the Privacy Act of 1974, which is 5
U.S.C. § 552a.
* Enter 'N' if no Social Security Number.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

^hisher_C

Description: his/her/their
Instruction:
if GEN.SEX_FINAL[PX_C]=1 fill "his"; else if GEN.SEX_FINAL[PX_C]=2 fill "her";
else if GEN.SEX_FINAL[PX_C] in (blank,DK,RF): fill "their"

Response:

0001-9999 - Range of values
N - No Social Security Number
99997 - Refused
99999 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

if SSN4_C=Adult.LNK.SSN4_A [goto ERR1_SSN4_C]
elseif SSN4_C=000-999 [goto ERR2_SSN4_C]
elseif SSN4_C NOT IN (N,DK,RF,000-999,0001-9999) [goto ERR3_SSN4_C]
0001-9999 [goto THANKS_C]
N,RF,DK [goto RLINK_C]

Hard Edit:

Check Text: ERR2_SSN4_C
Check Description: Entered less than four digits hard edit
Check Text: {check ERR2_SSN4_C}
You must enter all four of the last four digits of the Social Security Number. Please correct.
Check Text: ERR3_SSN4_C
Check Description: SSN last four digits are 0000 or a letter other than N hard edit
Check Text: {check ERR3_SSN4_C}
The last 4 digits of a SSN may be between 0001-9999. For a respondent who does not want to provide the SSN, enter 'Ctrl D' or 'Ctrl R' for 'Don't Know' or 'Refused.' If a respondent does not have a SSN, enter 'N'. Please correct.

Soft Edit:

Check Text: ERR1_SSN4_C
Check Description: SA and SC SSN the same soft edit
Check Text: {signal ERR1_SSN4_C}
The last four digits of ^SCNAME's Social Security Number are the same as the last four digits of ^SANAME's Social Security Number. Please verify.

Question ID: LNK.0030.00.1
Variable: RLINK_C
Interview Module: Child
Content Type: Annual Core
Question text:

?[F1]
May we try to link ^SCNAME's survey data without a Social Security Number?
* Read if necessary: Any data obtained are protected by strict federal laws, including the
Public Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential
Information Protection and Statistical Efficiency Act of 2018, which is Title lll, Public Law
No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Yes
2 - No
7 - Refused
9 - Don't Know

Universe:

Sample child 0-17 where SSN was refused, don't know or not available.

Skip Instructions:

1,2,RF,DK [goto next section]

2020 National Health Interview Survey (NHIS) Questionnaire
THX: Thanks
Question ID: THX.0010.00.1
Variable: THANKS_C
Interview Module: Child
Content Type: Annual Core
Question text:

* Thank respondent for answering these questions. If there is a Sample Adult interview to
complete, ask for appropriate person to respond to these questions.
Enter '1' to continue.

Fills:

^SCNAME

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

Response:

1 - Enter 1 to Continue

Universe:

Sample Children 0-17

Skip Instructions:

1 [goto SCRESP_FNAME]

Question ID: THX.0020.01.1
Variable: SCRESP_FNAME
Interview Module: Child
Content Type: Annual Core
Question text:

* Ask or verify: In case I or someone from my office needs to get in touch with you, we need
your full name. What is your full name?
* Enter first name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK [goto SCRESP_LNAME]

Question ID: THX.0020.02.1
Variable: SCRESP_LNAME
Interview Module: Child
Content Type: Annual Core
Question text:

* Enter last name.

Response:

Verbatim - Verbatim values
97 - Refused
99 - Don't Know

Universe:

Sample Children 0-17

Skip Instructions:

allow 20,RF,DK [goto next section]

Data Cart

Your data extract

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0	samples