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FLBACK
Functional limitation from: Back/neck problem
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Codes and Frequencies



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Description

For sample adults age 18+ who, without using special equipment, had any difficulty with one or more functional activities (FLANY), FLBACK reports whether the respondent selected, from an interviewer-provided flashcard listing possible causes of activity limitations, a back or neck problem as a cause of a functional activity limitation.

Data Collection

FLBACK is one of a set of variables in the Health Status and Limitation of Activities section of the NHIS Sample Adult Core. The question, "What condition or health problem causes you to have difficulty with these activities?," (with a back or neck problem as one of the possible conditions on the interviewer-provided flashcard) is asked of sample adults, age 18+, only if at least one question relating to activities of daily living is answered with "only a little difficult," "somewhat difficult," "very difficult," or "can't do at all."

 

These questions on activities of daily living are:

"By yourself, and without using any special equipment, how difficult is it for you to walk a quarter of a mile -- about 3 city blocks?" (FLWALK3BL)
"By yourself, and without using any special equipment, how difficult is it for you to walk up 10 steps without resting?" (FLCLIMB)
"By yourself, and without using any special equipment, how difficult is it for you to stand or be on your feet for about 2 hours?" (FLSTAND2HR)
"By yourself, and without using any special equipment, how difficult is it for you to sit for about 2 hours?" (FLSIT2HR)
"By yourself, and without using any special equipment, how difficult is it for you to stoop, bend, or kneel?" (FLSTOOP)
"By yourself, and without using any special equipment, how difficult is it for you to reach up over your head?" (FLREACH)
"By yourself, and without using any special equipment, how difficult is it for you to use your fingers to grasp or handle small objects?" (FLGRASP)
"By yourself, and without using any special equipment, how difficult is it for you to lift or carry something as heavy as 10 pounds such as a full bag of groceries?" (FLCARRY)
"By yourself, and without using any special equipment, how difficult is it for you to push or pull large objects like a living room chair?" (FLPUSHLAR)
"By yourself, and without using any special equipment, how difficult is it for you to go out to things like shopping, movies, or sporting events?" (FLGOOUT)
"By yourself, and without using any special equipment, how difficult is it for you to participate in social activities such as visiting friends, attending clubs and meetings, going to parties...?" (FLSOCIAL)
"By yourself, and without using any special equipment, how difficult is it for you to do things to relax at home or for leisure (reading, watching TV, sewing, listening to music...)?" (FLRELAX)

Other Possible Causes of Activity Limitations 

Other possible causes of a functional activity limitation, listed on the flashcard provided to respondents, were:

  • Arthritis/rheumatism (FLARTH)
  • Fractures, bone/joint injury (FLFRACT)
  • Hypertension/high blood pressure (FLHYPER)
  • Lung/Breathing problem (FLLUNG)
  • Mental retardation (FLRET)
  • Other developmental problem (e.g., cerebral palsy) (FLOTHDEV)
  • Depression/anxiety/emotional problem (FLDEPRES)

Possible causes of functional activity limitations not listed on the flashcard provided to respondents, but used by the National Center for Health Statistics (NCHS) to recode, ad hoc, an "other" verbatim respondent answer to the question, "What condition or health problem causes you to have difficulty with these activities?," include:

  • Alcohol or drug problem (FLALC)
  • Circulatory problem (FLCIRC)
  • Missing limb or finger (FLLIMB)
  • First unclassified problem (FLNEC1)
  • Second unclassified problem (FLNEC2)

The 1997 forward NHIS Survey Descriptions caution that the ad hoc classified condition categories were not included on flashcards given to respondents during the course of the interview. Thus, the NCHS recommends that "these variables should be analyzed with care."

Definitions 

The following definitions provide information about various concepts used in the sequence of questions identified above:

"Health Problem": According to the Field Representative's Manuals for 1997 forward, a "health problem" is respondent defined. The 2001 forward Manuals go on to state that, generally speaking, "it is any condition, physical, mental, or emotional, which causes limitation in activity." Moreover, the Manuals say that it is not important for the respondent to differentiate between a "condition" and a "health problem."
"Condition": According to the Field Representative's Manuals for 1997 forward, the presence of a condition is determined by the respondent's perception of a health problem of any kind. The 2001 forward Manuals go on to add that a condition is "a departure from physical, mental or emotional well-being," and that such departures "are specific health problems such as missing an extremity or organ, the name of a disease, a symptom, the result of an accident or some other type of impairment. Also included are vague disorders and health problems not always thought of as 'illnesses,' such as alcoholism, drug-related problems, senility, depression, [or] anxiety."
"Special Equipment": According to the Field Representative's Manuals for 1997 forward, special equipment includes "any device, tool, utensil, instrument, implement, etc. used as an aid in performing an activity because of a physical, mental or emotional problem."
"By yourself": According to the Field Representative's Manuals for 2001 forward, "by yourself" is "considered to be without the help from another person or without hands-on assistance with performing an activity." The Manuals go on to state that "another person" could be "a friend, relative, paid helper, volunteer from an agency or organization or anyone else who helps the family member in doing the activities mentioned. He or she may be a household member or a non-household member."

Comparability

For 2002 forward, the variable is completely comparable.

For 1997-2001, a small number of cases were coded as "no condition at all" (IPUMS NHIS code 6) for the cause of functional activity limitation.

 

If researchers are interested in only sample adults age 18+ with at least one condition causing a functional activity limitation, then the response of "no condition at all" can be recoded as "not in universe" (IHIS code 0). Using this recode, the variable is completely comparable for 1997 forward.

Additionally, for 1997-1999, several of the variables that asked about degrees of functional activity limitation were recoded by the NCHS in the course of their data editing.

 

For three activities (shopping FLGOOUT, participating in social activities FLSOCIAL, and relaxing at home FLRELAX), respondents could indicate that they "do not do this activity." For all other activities, respondents were not permitted to answer that they "do not do this activity," but could be assigned to the category by the NCHS in the course of data editing based on information obtained by the interviewer.

Universe

  • 1997-2013; 2014 2015 2016 2017 2018: Sample adults age 18+ who, without using special equipment, have at least a little difficulty with one or more functional activity.

Availability

  • 1997-2018

Weights