FLDEPRES
Functional limitation from: Depression/anxiety/emotional problem
Codes and Frequencies
An 'X' indicates the category is available for that sample
| Code | Label |
18
|
17
|
16
|
15
|
14
|
13
|
12
|
11
|
10
|
09
|
08
|
07
|
06
|
05
|
04
|
03
|
02
|
01
|
00
|
99
|
98
|
97
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | NIU | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 1 | Not mentioned | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 2 | Mentioned | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 6 | No condition at all | · | · | · | · | · | · | · | · | · | · | · | · | · | · | · | · | · | X | X | X | X | X |
| 7 | Unknown-refused | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 8 | Unknown-not ascertained | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 9 | Unknown-don't know | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
Can't find the category you are looking for? Try the Detailed codes
Description
For sample adults age 18+ who, without using special equipment, had any difficulty with one or more functional activities (FLANY), FLDEPRES reports whether the respondent selected, from an interviewer-provided flashcard listing possible causes of functional activity limitations, depression, anxiety, or an emotional problem as a cause of a functional activity limitation.
Data Collection
FLDEPRES 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 depression, anxiety, or an emotional 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."
[show more]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 a functional activity limitation, listed on the flashcard provided to respondents, were:
- Vision/problem seeing (FLVISION)
- Hearing problem (FLHEAR)
- Arthritis/rheumatism (FLARTH)
- Back or neck problem (FLBACK)
- Fractures, bone/joint injury (FLFRACT)
- Other injury (FLOTHINJ)
- Heart problem (FLHEART)
- Stroke problem (FLSTROKE)
- Hypertension/high blood pressure (FLHYPER)
- Diabetes (FLDIABET)
- Lung/Breathing problem (FLLUNG)
- Cancer (FLCANCER)
- Birth defect (FLBIRTH)
- Mental retardation (FLRET)
- Other developmental problem (e.g., cerebral palsy) (FLOTHDEV)
- Senility (FLSENILE)
- Weight problem (FLWEIGHT)
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)
- Benign tumor (FLBENIGN)
- Blood problem (FLBLOOD)
- Circulatory problem (FLCIRC)
- Digestive problem (FLDIGEST)
- Endocrine problem (FLENDO)
- Other mental problem (FLMENTAL)
- Fatigue (FLFATIG)
- Genitourinary problem (FLGENITO)
- Missing limb or finger (FLLIMB)
- Musculoskeletal problem (FLMUSCLE)
- Nervous system condition (FLNERVES)
- Old age (FLOLDAGE)
- Pregnancy (FLPREG)
- Skin problem (FLSKIN)
- Surgical after-effects (FLSURGRY)
- 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."
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.
[show more]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.
[show more]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
Survey Text
| 2018 | 2012 | 2006 | 2000 |
| 2017 | 2011 | 2005 | 1999 |
| 2016 | 2010 | 2004 | 1998 |
| 2015 | 2009 | 2003 | 1997 |
| 2014 | 2008 | 2002 | |
| 2013 | 2007 | 2001 |
2018
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
Questionnaire File Name: Sample Adult
Question Text:
Questionnaire File Name: Sample Adult
Question Text:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
Universe Text: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile; walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours; stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10 pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
Skip Instructions:
Skip Instructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
2015
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7 What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile; walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours; stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Question ID: AHS.201_90.000
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least one condition not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL90N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Question ID: AHS.201_91.000
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more than one condition that is not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL91N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
2014
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7 What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile; walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours; stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Question ID: AHS.201_90.000
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least one condition not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL90N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Question ID: AHS.201_91.000
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more than one condition that is not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL91N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
2013
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7 What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile; walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours; stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Question ID: AHS.201_90.000
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least one condition not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL90N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Question ID: AHS.201_91.000
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more than one condition that is not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL91N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
2012
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7 What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile; walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours; stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Question ID: AHS.201_90.000
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least one condition not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL90N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Question ID: AHS.201_91.000
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more than one condition that is not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL91N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
2011
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7 What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(for example, asthma and emphysema)
12 Cancer
13 Birth defect
14 Intellectual disability, also known as mental retardation
15 Other developmental problem (for example, cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile; walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours; stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Question ID: AHS.201_90.000
(13) store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90) [goto AFLHCA_S1]
(91) [goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
( R,D) [goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least one condition not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL90N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Question ID: AHS.201_91.000
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical order, as specified in AFLHCA
Hard Edit: $ You should enter something specific.
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more than one condition that is not listed in AFLHCA
SkipInstructions:
SkipInstructions:
(50 chars) [goto AHCL91N]
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
)ENTER( only with no description [goto ERR1_AFLHCA_S1]
Hard Edit: $ You should enter something specific.
2010
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2009
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2008
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2007
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2006
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2005
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2004
Survey form
view entire document:
text
image
Question ID: AHS.200_00.000
Instrument Variable Name: AFLHCA
QuestionText:
QuestionText:
(book) A7
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
What condition or health problem causes you to have difficulty with [fill1: condition 1, condition 2 or condition 3 (as
specified in AHS.091_1 through AHS.171_3)][fill2: these activities]?
* Enter condition number for all that apply, separate with commas.
* Do not probe, except to clarify answer.
01 Vision/problem seeing
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
02 Hearing problem
03 Arthritis/rheumatism
04 Back or neck problem
05 Fracture, bone/joint injury
06 Other injury
07 Heart problem
08 Stroke problem
09 Hypertension/high blood pressure
10 Diabetes
11 Lung/breathing problem(e.g., asthma and emphysema)
12 Cancer
13 Birth defect
14 Mental retardation
15 Other developmental problem (e.g., cerebral palsy)
16 Senility
17 Depression/anxiety/emotional problem
18 Weight problem
19 Missing limbs (fingers, toes or digits), amputee
20 Kidney, bladder or renal problems
21 Circulation problems (including blood clots)
22 Benign Tumors, Cysts
23 Fibromyalgia, lupus
24 Osteoporosis, tendinitis
25 Epilepsy, seizures
26 Multiple Sclerosis (MS), Muscular Dystrophy (MD)
27 Polio(myelitis), paralysis, para/quadriplegia
28 Parkinson's disease, other tremors
29 Other nerve damage, including carpal tunnel syndrome
30 Hernia
31 Ulcer
32 Varicose veins, hemorrhoids
33 Thyroid problems, Grave's disease, gout
34 Knee problems (not arthritis (03), not joint injury(05))
35 Migraine headaches (not just headaches)
90 Other impairment/problem (Specify one)
91 Other impairment/problem (Specify one)
97 Refused
99 Don't know/Not sure
UniverseText: Sample adults 18+ who, without using special equipment, have at least a little difficulty walking a quarter mile;
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
walking up 10 steps without resting; standing/being on feet for about 2 hours; sitting for about 2 hours;
stooping/bending/kneeling; reaching up over head; using fingers to grasp/handle small objects; lifting/carrying 10
pounds; pushing/pulling large objects; going out for things (shopping/movies); participating in social activities; or
relaxing at home (reading/sewing).
SkipInstructions:
[1- 12, 14 - 35] goto the appropriate follow up question AHCL01N-AHCL12N, AHCL14N-AHCL35N], in
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Question ID: AHS.201_90.000
numerical order
(13)store "96" in AHCL13N and "6" IN AHCL13T[goto SMKEV ]
(90)[goto AFLHCA_S1]
(91)[goto AFLHCA_S2]
Roster through all AFLHCA entries. Once exhausted goto SMKEV (next section)
(R,D)[goto SMKEV (next section)]
Instrument Variable Name: AFLHCA_S1
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulties performing activities listed in FLWALK through FLRELAX is due to at least
one condition not listed in AFLHCA
SkipInstructions:
one condition not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL90N]
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Question ID: AHS.201_91.000
only with no description [goto ERR1_AFLHCA_S1]
Else goto the appropriate follow-up questions AHCL01N-AHCL12N, AHCL14N-AHCL35N], in numerical
order, as specified in AFLHCA
Instrument Variable Name: AFLHCA_S2
QuestionText:
QuestionText:
* Enter other impairment/problem.
Verbatim Verbatim response
7 Refused
9 Don't know
7 Refused
9 Don't know
UniverseText: Sample adults 18+ whose difficulty performing activities listed in FLWALK through FLRELAX is due to more
than one condition that is not listed in AFLHCA
SkipInstructions:
than one condition that is not listed in AFLHCA
SkipInstructions:
(50 chars)[goto AHCL91N]
2003
Survey form
view entire document:
text
image
Check item AHSCCI3: If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; else go to the next section -HEALTH BEHAVIORS.
AHS.200
[IF 3 OR LESS CONDITIONS MENTIONED]
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
[Else]
What condition or health problem causes you to have difficulty with these activities?
FR: SHOW FLASHCARD A7. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (M) FOR CONDITIONS NOT ON THE FLASHCARD. ENTER (N) FOR NO MORE.
Card A7
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
[Else]
What condition or health problem causes you to have difficulty with these activities?
FR: SHOW FLASHCARD A7. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (M) FOR CONDITIONS NOT ON THE FLASHCARD. ENTER (N) FOR NO MORE.
You may choose more than one.
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA1 (1) Vision/problem seeing
AFLHCA2 (2) Hearing problem
AFLHCA3 (3) Arthritis/rheumatism
AFLHCA4 (4) Back or neck problem
AFLHCA5 (5) Fractures, bone/joint injury
AFLHCA6 (6) Other injury
AFLHCA7 (7) Heart problem
AFLHCA8 (8) Stroke problem
AFLHCA9 (9) Hypertension/high blood pressure
AFLHCA10 (10) Diabetes
AFLHCA11 (11) Lung/breathing problem (e.g. asthma and emphysema)
AFLHCA12 (12) Cancer
AFLHCA13 (13) Birth defect
AFLHCA14 (14) Mental retardation
AFLHCA15 (15) Other developmental problem (e.g. cerebral palsy)
AFLHCA16 (16) Senility
AFLHCA17 (17) Depression/anxiety/emotional problem
AFLHCA18 (18) Weight problem
AFLHCA2 (2) Hearing problem
AFLHCA3 (3) Arthritis/rheumatism
AFLHCA4 (4) Back or neck problem
AFLHCA5 (5) Fractures, bone/joint injury
AFLHCA6 (6) Other injury
AFLHCA7 (7) Heart problem
AFLHCA8 (8) Stroke problem
AFLHCA9 (9) Hypertension/high blood pressure
AFLHCA10 (10) Diabetes
AFLHCA11 (11) Lung/breathing problem (e.g. asthma and emphysema)
AFLHCA12 (12) Cancer
AFLHCA13 (13) Birth defect
AFLHCA14 (14) Mental retardation
AFLHCA15 (15) Other developmental problem (e.g. cerebral palsy)
AFLHCA16 (16) Senility
AFLHCA17 (17) Depression/anxiety/emotional problem
AFLHCA18 (18) Weight problem
(97) Refused
(99) Don't know
(M) More conditions (AHS.205)
(99) Don't know
(M) More conditions (AHS.205)
AHS.200
(19) Missing limbs (fingers, toes or digits), amputee
(20) Kidney, bladder or renal problems
(21) Circulation problems (including blood clots)
(22) Benign tumors, cysts
(23) Fibromyalgia, lupus
(24) Osteoporosis, tendonitis
(25) Epilepsy, seizures
(26) Multiple Sclerosis (MS), Muscular Dystrophy (MD)
(27) Polio (myelitis), paralysis, Para/quadriplegia
(28) Parkinson=s disease, other tremors
(29) Other nerve damage, including carpal tunnel syndrome
(30) Hernia
(31) Ulcer
(32) Varicose veins, hemorrhoids
(33) Thyroid problems, Graves=disease, gout
(34) Knee problems [(not arthritis (03), not joint injury (05)]
(35) Migraine headaches (not just headaches)
(36) Other impairment/problem (specify one)
(37) Other impairment/problem (specify one)
(97) Refused
(99) Don't know
If answers = 1-37 then go to AHS.300; Else go to end of section.
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
(20) Kidney, bladder or renal problems
(21) Circulation problems (including blood clots)
(22) Benign tumors, cysts
(23) Fibromyalgia, lupus
(24) Osteoporosis, tendonitis
(25) Epilepsy, seizures
(26) Multiple Sclerosis (MS), Muscular Dystrophy (MD)
(27) Polio (myelitis), paralysis, Para/quadriplegia
(28) Parkinson=s disease, other tremors
(29) Other nerve damage, including carpal tunnel syndrome
(30) Hernia
(31) Ulcer
(32) Varicose veins, hemorrhoids
(33) Thyroid problems, Graves=disease, gout
(34) Knee problems [(not arthritis (03), not joint injury (05)]
(35) Migraine headaches (not just headaches)
(36) Other impairment/problem (specify one)
(37) Other impairment/problem (specify one)
(97) Refused
(99) Don't know
If answers = 1-37 then go to AHS.300; Else go to end of section.
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
AFLSPEC1 Condition: __________________________________________
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
AFLSPEC2 Condition: ___________________________________________
2002
Survey form
view entire document:
text
image
Check item AHSCCI3: If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; else go to the next section -HEALTH BEHAVIORS.
AHS.200
[IF 3 OR LESS CONDITIONS MENTIONED]
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
[Else]
What condition or health problem causes you to have difficulty with these activities?
FR: SHOW FLASHCARD A7. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (M) FOR CONDITIONS NOT ON THE FLASHCARD. ENTER (N) FOR NO MORE.
Card A7
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
[Else]
What condition or health problem causes you to have difficulty with these activities?
FR: SHOW FLASHCARD A7. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (M) FOR CONDITIONS NOT ON THE FLASHCARD. ENTER (N) FOR NO MORE.
You may choose more than one.
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA1 (1) Vision/problem seeing
AFLHCA2 (2) Hearing problem
AFLHCA3 (3) Arthritis/rheumatism
AFLHCA4 (4) Back or neck problem
AFLHCA5 (5) Fractures, bone/joint injury
AFLHCA6 (6) Other injury
AFLHCA7 (7) Heart problem
AFLHCA8 (8) Stroke problem
AFLHCA9 (9) Hypertension/high blood pressure
AFLHCA10 (10) Diabetes
AFLHCA11 (11) Lung/breathing problem (e.g. asthma and emphysema)
AFLHCA12 (12) Cancer
AFLHCA13 (13) Birth defect
AFLHCA14 (14) Mental retardation
AFLHCA15 (15) Other developmental problem (e.g. cerebral palsy)
AFLHCA16 (16) Senility
AFLHCA17 (17) Depression/anxiety/emotional problem
AFLHCA18 (18) Weight problem
AFLHCA2 (2) Hearing problem
AFLHCA3 (3) Arthritis/rheumatism
AFLHCA4 (4) Back or neck problem
AFLHCA5 (5) Fractures, bone/joint injury
AFLHCA6 (6) Other injury
AFLHCA7 (7) Heart problem
AFLHCA8 (8) Stroke problem
AFLHCA9 (9) Hypertension/high blood pressure
AFLHCA10 (10) Diabetes
AFLHCA11 (11) Lung/breathing problem (e.g. asthma and emphysema)
AFLHCA12 (12) Cancer
AFLHCA13 (13) Birth defect
AFLHCA14 (14) Mental retardation
AFLHCA15 (15) Other developmental problem (e.g. cerebral palsy)
AFLHCA16 (16) Senility
AFLHCA17 (17) Depression/anxiety/emotional problem
AFLHCA18 (18) Weight problem
(97) Refused
(99) Don't know
(M) More conditions (AHS.205)
(99) Don't know
(M) More conditions (AHS.205)
AHS.200
(19) Missing limbs (fingers, toes or digits), amputee
(20) Kidney, bladder or renal problems
(21) Circulation problems (including blood clots)
(22) Benign tumors, cysts
(23) Fibromyalgia, lupus
(24) Osteoporosis, tendonitis
(25) Epilepsy, seizures
(26) Multiple Sclerosis (MS), Muscular Dystrophy (MD)
(27) Polio (myelitis), paralysis, Para/quadriplegia
(28) Parkinson=s disease, other tremors
(29) Other nerve damage, including carpal tunnel syndrome
(30) Hernia
(31) Ulcer
(32) Varicose veins, hemorrhoids
(33) Thyroid problems, Graves=disease, gout
(34) Knee problems [(not arthritis (03), not joint injury (05)]
(35) Migraine headaches (not just headaches)
(36) Other impairment/problem (specify one)
(37) Other impairment/problem (specify one)
(97) Refused
(99) Don't know
If answers = 1-37 then go to AHS.300; Else go to end of section.
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
(20) Kidney, bladder or renal problems
(21) Circulation problems (including blood clots)
(22) Benign tumors, cysts
(23) Fibromyalgia, lupus
(24) Osteoporosis, tendonitis
(25) Epilepsy, seizures
(26) Multiple Sclerosis (MS), Muscular Dystrophy (MD)
(27) Polio (myelitis), paralysis, Para/quadriplegia
(28) Parkinson=s disease, other tremors
(29) Other nerve damage, including carpal tunnel syndrome
(30) Hernia
(31) Ulcer
(32) Varicose veins, hemorrhoids
(33) Thyroid problems, Graves=disease, gout
(34) Knee problems [(not arthritis (03), not joint injury (05)]
(35) Migraine headaches (not just headaches)
(36) Other impairment/problem (specify one)
(37) Other impairment/problem (specify one)
(97) Refused
(99) Don't know
If answers = 1-37 then go to AHS.300; Else go to end of section.
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
AFLSPEC1 Condition: __________________________________________
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
AFLSPEC2 Condition: ___________________________________________
2001
Survey form
view entire document:
text
image
Check item AHSCCI3: If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; else go to the next section -HEALTH BEHAVIORS.
AHS.200
[IF 3 OR LESS CONDITIONS MENTIONED]
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
[Else]
What condition or health problem causes you to have difficulty with these activities?
FR: SHOW FLASHCARD A7. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (M) FOR CONDITIONS NOT ON THE FLASHCARD. ENTER (N) FOR NO MORE.
Card A7
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
[Else]
What condition or health problem causes you to have difficulty with these activities?
FR: SHOW FLASHCARD A7. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (M) FOR CONDITIONS NOT ON THE FLASHCARD. ENTER (N) FOR NO MORE.
You may choose more than one.
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA1 (1) Vision/problem seeing
AFLHCA2 (2) Hearing problem
AFLHCA3 (3) Arthritis/rheumatism
AFLHCA4 (4) Back or neck problem
AFLHCA5 (5) Fractures, bone/joint injury
AFLHCA6 (6) Other injury
AFLHCA7 (7) Heart problem
AFLHCA8 (8) Stroke problem
AFLHCA9 (9) Hypertension/high blood pressure
AFLHCA10 (10) Diabetes
AFLHCA11 (11) Lung/breathing problem (e.g. asthma and emphysema)
AFLHCA12 (12) Cancer
AFLHCA13 (13) Birth defect
AFLHCA14 (14) Mental retardation
AFLHCA15 (15) Other developmental problem (e.g. cerebral palsy)
AFLHCA16 (16) Senility
AFLHCA17 (17) Depression/anxiety/emotional problem
AFLHCA18 (18) Weight problem
AFLHCA2 (2) Hearing problem
AFLHCA3 (3) Arthritis/rheumatism
AFLHCA4 (4) Back or neck problem
AFLHCA5 (5) Fractures, bone/joint injury
AFLHCA6 (6) Other injury
AFLHCA7 (7) Heart problem
AFLHCA8 (8) Stroke problem
AFLHCA9 (9) Hypertension/high blood pressure
AFLHCA10 (10) Diabetes
AFLHCA11 (11) Lung/breathing problem (e.g. asthma and emphysema)
AFLHCA12 (12) Cancer
AFLHCA13 (13) Birth defect
AFLHCA14 (14) Mental retardation
AFLHCA15 (15) Other developmental problem (e.g. cerebral palsy)
AFLHCA16 (16) Senility
AFLHCA17 (17) Depression/anxiety/emotional problem
AFLHCA18 (18) Weight problem
(97) Refused
(99) Don't know
(M) More conditions (AHS.205)
(99) Don't know
(M) More conditions (AHS.205)
AHS.200
(19) Missing limbs (fingers, toes or digits), amputee
(20) Kidney, bladder or renal problems
(21) Circulation problems (including blood clots)
(22) Benign tumors, cysts
(23) Fibromyalgia, lupus
(24) Osteoporosis, tendonitis
(25) Epilepsy, seizures
(26) Multiple Sclerosis (MS), Muscular Dystrophy (MD)
(27) Polio (myelitis), paralysis, Para/quadriplegia
(28) Parkinson=s disease, other tremors
(29) Other nerve damage, including carpal tunnel syndrome
(30) Hernia
(31) Ulcer
(32) Varicose veins, hemorrhoids
(33) Thyroid problems, Graves=disease, gout
(34) Knee problems [(not arthritis (03), not joint injury (05)]
(35) Migraine headaches (not just headaches)
(36) Other impairment/problem (specify one)
(37) Other impairment/problem (specify one)
(97) Refused
(99) Don't know
If answers = 1-37 then go to AHS.300; Else go to end of section.
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
(20) Kidney, bladder or renal problems
(21) Circulation problems (including blood clots)
(22) Benign tumors, cysts
(23) Fibromyalgia, lupus
(24) Osteoporosis, tendonitis
(25) Epilepsy, seizures
(26) Multiple Sclerosis (MS), Muscular Dystrophy (MD)
(27) Polio (myelitis), paralysis, Para/quadriplegia
(28) Parkinson=s disease, other tremors
(29) Other nerve damage, including carpal tunnel syndrome
(30) Hernia
(31) Ulcer
(32) Varicose veins, hemorrhoids
(33) Thyroid problems, Graves=disease, gout
(34) Knee problems [(not arthritis (03), not joint injury (05)]
(35) Migraine headaches (not just headaches)
(36) Other impairment/problem (specify one)
(37) Other impairment/problem (specify one)
(97) Refused
(99) Don't know
If answers = 1-37 then go to AHS.300; Else go to end of section.
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
AFLSPEC1 Condition: __________________________________________
FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.
AFLSPEC2 Condition: ___________________________________________
2000
Survey form
view entire document:
text
image
Check item AHSCCI3 : If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; Else go to the next section-HEALTH BEHAVIORS.
AHS.200
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
Card A6
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
You may choose more than one
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA
(1) Vision/problem seeing
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
AHS.201
FR: THESE SHOULD BE NAMES OF SPECIFIC CONDITIONS THAT ARE NOT ON THE CONDITION LIST.
AFLSPEC1 First condition: ___________________
AFLSPEC2 Second condition: ___________________
AFLSPEC2 Second condition: ___________________
1999
Survey form
view entire document:
text
image
Check item AHSCCI3 : If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; Else go to the next section-HEALTH BEHAVIORS.
AHS.200
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
Card A6
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
You may choose more than one
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA
(1) Vision/problem seeing
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
AHS.201
FR: THESE SHOULD BE NAMES OF SPECIFIC CONDITIONS THAT ARE NOT ON THE CONDITION LIST.
AFLSPEC1 First condition: ___________________
AFLSPEC2 Second condition: ___________________
AFLSPEC2 Second condition: ___________________
1998
Survey form
view entire document:
text
image
Check item AHSCCI3 : If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; Else go to the next section-HEALTH BEHAVIORS.
AHS.200
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
Card A6
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
You may choose more than one
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA
(1) Vision/problem seeing
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
AHS.201
FR: THESE SHOULD BE NAMES OF SPECIFIC CONDITIONS THAT ARE NOT ON THE CONDITION LIST.
AFLSPEC1 First condition: ___________________
AFLSPEC2 Second condition: ___________________
AFLSPEC2 Second condition: ___________________
1997
Survey form
view entire document:
text
image
Check item AHSCCI3 : If AHS.091, AHS.141, or AHS.171 equals (1-4) go to AHS.200; Else go to the next section-HEALTH BEHAVIORS.
AHS.200
What condition or health problem causes you to have difficulty with {names of up to 3 specified activities/these activities}?
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
Card A6
FR: SHOW FLASHCARD A6. ENTER ALL THAT APPLY UP TO 5 (but do not probe). IF OLD AGE IS REPORTED, PROBE FOR SPECIFIC CONDITION(S) CAUSED BY OLD AGE. ENTER (N) FOR NO MORE.
You may choose more than one
1. Vision/problem seeing
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
2. Hearing problem
3. Arthritis/rheumatism
4. Back or neck problem
5. Fracture, bone/joint injury
6. Other injury
7. Heart problem
8. Stroke problem
9. Hypertension/high blood pressure
10. Diabetes
11. Lung/breathing problem
12. Cancer
13. Birth defect
14. Mental retardation
15. Other developmental problem (e.g., cerebral palsy)
16. Senility
17. Depression/anxiety/emotional problem
18. Weight problem
Other impairment/problem
AFLHCA
(1) Vision/problem seeing
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
(2) Hearing problem
(3) Arthritis/rheumatism
(4) Back or neck problem
(5) Fractures, bone/joint injury
(6) Other injury
(7) Heart problem
(8) Stroke problem
(9) Hypertension/high blood
(10) Diabetes
(11) Lung/breathing problem
(12) Cancer
(13) Birth defect
(14) Mental retardation
(15) Other developmental problem (as cerebral palsy)
(16) Senility
(17) Depression/anxiety/emotional problem
(18) Weight problem pressure
(19) Other impairment/problem
(20) Other impairment/problem
(97) Refused
(99) Don't know
[ ]
[ ]
[ ]
[ ]
[ ]
If answers equal (1) - (12) and (14) - (18) then go to AHS.300; if answer equals (19) and/or (20) goto AHS.201; else go to next section.
AHS.201
FR: THESE SHOULD BE NAMES OF SPECIFIC CONDITIONS THAT ARE NOT ON THE CONDITION LIST.
AFLSPEC1 First condition: ___________________
AFLSPEC2 Second condition: ___________________
AFLSPEC2 Second condition: ___________________
Weights
- 1997-2018 : SAMPWEIGHT