Survey Text

2022 2007 1992 1977
2021 2006 1991 1976
2020 2005 1990 1975
2019 2004 1989 1974
2018 2003 1988 1973
2017 2002 1987 1972
2016 2001 1986 1971
2015 2000 1985 1970
2014 1999 1984 1969
2013 1998 1983 1968
2012 1997 1982 1967
2011 1996 1981 1966
2010 1995 1980 1965
2009 1994 1979 1964
2008 1993 1978 1963
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2022

No questionnaire text is available for this sample.


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2021

No questionnaire text is available for this sample.


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2020

No questionnaire text is available for this sample.


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2019
Survey form view entire document:  text  image
Question ID: HCC.0220.01.1
Variable: AGENO
Interview Module: Roster
Content Type: Annual Core

Question Text:

1 of 2

What is ^yourALIAS age?

Enter number for age.
Fills:
^yourALIAS
Description: your/^ALIASNAME?s
Instruction: If PX=LNO_RESP fill "your"; else fill "^ALIASNAME's"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
Response:
001-120 - Range of values
997 - Refused
999 - do not know
Universe:
All nondeleted persons
Skip Instructions:
001-120 = [goto AGETP]
RF,DK = [goto AGE18]
Question ID: HCC.0220.02.1
Variable: AGETP
Interview Module: Roster
Content Type: Annual Core

Question Text:

2 of 2

Enter number for age time period.
Response:
1 - Day(s)
2 - Week(s)
3 - Month(s)
4 - Year(s)
Universe:
Valid number entered at AGENO[PX]
Skip Instructions:
If last non-deleted person on roster AND ((AGENO = RF, DK and AGE18 =1) or AGE LT 018 for everyone) then [goto Exit]
elseif last non-deleted person on roster [goto NATORG] else [goto AGENO for next non-deleted person on roster]
Question ID: HCC.0230.00.1
Variable: AGE18
Interview Module: Roster
Content Type: Annual Core

Question Text:

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

^youALIAS
Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
^AreIs
Description: Are/Is
Instruction: If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"
Response:
1 - Less than 18
2 - 18 or older
7 - Refused
9 - Do not know
Universe:
Refused or did not know age
Skip Instructions:
RF,DK = [goto AGEGUESS]
2 = [goto AGE65]
1 = If last non-deleted person on roster AND ((AGENO=RF,DK and AGE18=1) or AGE LT 018 for everyone then [goto Exit]
Else if last non-deleted person on roster [goto NATORG] Else [goto AGENO for next non-deleted person on roster]
Question ID: HCC.0240.00.1
Variable: AGE65
Interview Module: Roster
Content Type: Annual Core

Question Text:

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

?

Fills:

^youALIAS
Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you"; else if subject ne respondent, fill "^ALIASNAME"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
^AreIs
Description: Are/Is
Instruction: If subject=respondent, fill "Are", else if subject NE respondent, fill "Is"
Response:
1 - Less than 65
2 - 65 or older
7 - refused
9 - do not know
Universe:
Sample Adults 18+
Skip Instructions:
1,2,RF,DK = if last non-deleted person on roster [goto NATORG] else [goto AGENO for next non-deleted person on roster]

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2018

No questionnaire text is available for this sample.


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2017

No questionnaire text is available for this sample.


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2016
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2015
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2014
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2013
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2012
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2011
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2010
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2009
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2008
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2007
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2006
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2005
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2004
Survey form view entire document:  text  image
Question ID: HHC.120_01.000

Instrument Variable Name: AGEDOB_1
QuestionText:
1 of 5 What is [fill: your/ALIAS's] age?
* Enter number for age.
01-120 Age in years
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(001-120) [go to AGEDOB_2]
(R,D) [go to AGEDOB_3]
Question ID: HHC.120_02.000

Instrument Variable Name: AGEDOB_2
QuestionText:
2 of 5 * Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
UniverseText: Valid age - number entered
SkipInstructions:
(1-4) [go to AGEDOB_3]
Question ID: HHC.120_03.000

Instrument Variable Name: AGEDOB_3
QuestionText:
3 of 5 And what is [fill: your/ALIAS's] date of birth? Please give month, day, and year for the date of birth.
* Enter month of birth.
01 January
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-12,R,D) [go to AGEDOB_4]
Question ID: HHC.120_04.000

Instrument Variable Name: AGEDOB_4
QuestionText:
4 of 5 * Enter day of birth
01-31 Day of the month
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [go to ERR_AGEDOB_4]
ELSE [go to AGEDOB_5]

Hard Edit: ERR_AGEDOB_4

[fill1: AGEDOB_4] is not a valid day for [fill2: AGEDOB_3].
Question ID: HHC.120_05.000

Instrument Variable Name: AGEDOB_5
QuestionText:
5 of 5 * Enter year of birth.
1880-2030 Year of birth
9997 Refused
UniverseText: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
SkipInstructions:
(1880 - 2030, R,D) [go to AGECAL]

Hard Edit: ERR1_AGEDOB_5

Future month invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR2_AGEDOB_5
Future day invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR3_AGEDOB_5
Invalid date:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5
ERR4_AGEDOB_5
Future year invalid:(space)AGEDOB_3(space)AGEDOB_4(,)(space) AGEDOB_5

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2003
Survey form view entire document:  text  image
HHC.120

What is {your/name} age and date of birth? Please give month, day, and year for the date of birth.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
(97) Refused
(99) Don't know

Age:
AGEDOB_1 [ ] Number
AGEDOB_2 [ ] Time Period
(1) Day(s)
(2) Week(s)
(3) Month(s)
(4) Year(s)

Date of Birth:
DOB_M MONTH: ______________________
DOB_BDAY DAY: ______________________
DOB_Y_P YEAR: ______________________

Check item AGECAL:AGE1 takes information entered in AGEDOB_1 and AGEDOB_2 and calculates an age.
AGE2 takes the date-of-birth information entered in AGEDOB and calculates an age.
AGE3 = current year - birth year -1, AGE4 = AGE3 + 1. If not enough DOB information was given to calculate an age,AD@ will be assigned to AGE2.

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2002
Survey form view entire document:  text  image
HHC.120

What is {your/name} age and date of birth? Please give month, day, and year for the date of birth.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
(97) Refused
(99) Don't know

Age:
AGEDOB_1 [ ] Number
AGEDOB_2 [ ] Time Period
(1) Day(s)
(2) Week(s)
(3) Month(s)
(4) Year(s)

Date of Birth:
DOB_M MONTH: ______________________
DOB_BDAY DAY: ______________________
DOB_Y_P YEAR: ______________________

Check item AGECAL:AGE1 takes information entered in AGEDOB_1 and AGEDOB_2 and calculates an age.
AGE2 takes the date-of-birth information entered in AGEDOB and calculates an age.
AGE3 = current year - birth year -1, AGE4 = AGE3 + 1. If not enough DOB information was given to calculate an age,AD@ will be assigned to AGE2.

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2001
Survey form view entire document:  text  image
HHC.120

What is {your/name} age and date of birth? Please give month, day, and year for the date of birth.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
(97) Refused
(99) Don't know

Age:
AGEDOB_1 [ ] Number
AGEDOB_2 [ ] Time Period
(1) Day(s)
(2) Week(s)
(3) Month(s)
(4) Year(s)

Date of Birth:
DOB_M MONTH: ______________________
DOB_BDAY DAY: ______________________
DOB_Y_P YEAR: ______________________

Check item AGECAL:AGE1 takes information entered in AGEDOB_1 and AGEDOB_2 and calculates an age.
AGE2 takes the date-of-birth information entered in AGEDOB and calculates an age.
AGE3 = current year - birth year -1, AGE4 = AGE3 + 1. If not enough DOB information was given to calculate an age,AD@ will be assigned to AGE2.

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2000
Survey form view entire document:  text  image
HHC.120

What is {your/name} age and date of birth? Please give month, day, and year for the date of birth.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
(97) Refused
(99) Don't know

Age:
AGEDOB_1 [ ] Number
AGEDOB_2 [ ] Time Period
(1) Day(s)
(2) Week(s)
(3) Month(s)
(4) Year(s)

Date of Birth:
DOB_M MONTH: ______________________
DOB_BDAY DAY: ______________________
DOB_Y_P YEAR: ______________________

Check item AGECAL:AGE1 takes information entered in AGEDOB_1 and AGEDOB_2 and calculates an age.
AGE2 takes the date-of-birth information entered in AGEDOB and calculates an age.
AGE3 = current year - birth year -1, AGE4 = AGE3 + 1. If not enough DOB information was given to calculate an age,AD@ will be assigned to AGE2.

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1999
Survey form view entire document:  text  image
HHC.120

What is {your/name} age and date of birth? Please give month, day, and year for the date of birth.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
(97) Refused
(99) Don't know

Age:
AGEDOB_1 [ ] Number
AGEDOB_2 [ ] Time Period
(1) Day(s)
(2) Week(s)
(3) Month(s)
(4) Year(s)

Date of Birth:
DOB_M MONTH: ______________________
DOB_BDAY DAY: ______________________
DOB_Y_P YEAR: ______________________

Check item AGECAL:AGE1 takes information entered in AGEDOB_1 and AGEDOB_2 and calculates an age.
AGE2 takes the date-of-birth information entered in AGEDOB and calculates an age.
AGE3 = current year - birth year -1, AGE4 = AGE3 + 1. If not enough DOB information was given to calculate an age,AD@ will be assigned to AGE2.

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1998
Survey form view entire document:  text  image
HHC.120

What is {your/name} age and date of birth? Please give month, day, and year for the date of birth.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
(97) Refused
(99) Don't know

Age:
AGEDOB_1 [ ] Number
AGEDOB_2 [ ] Time Period
(1) Day(s)
(2) Week(s)
(3) Month(s)
(4) Year(s)

Date of Birth:
DOB_M MONTH: ______________________
DOB_BDAY DAY: ______________________
DOB_Y_P YEAR: ______________________

Check item AGECAL:AGE1 takes information entered in AGEDOB_1 and AGEDOB_2 and calculates an age.
AGE2 takes the date-of-birth information entered in AGEDOB and calculates an age.
AGE3 = current year - birth year -1, AGE4 = AGE3 + 1. If not enough DOB information was given to calculate an age,AD@ will be assigned to AGE2.

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1997
Survey form view entire document:  text  image
HHC.050

What is {FULLNAME}'s date of birth? Month, day and year, please.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
DOB_M MONTH: ____________________________
DOB_BDAY DAY: ____________________________
DOB_Y_P YEAR: ____________________________
[If the year is known at HHC.050, goto Check item HHC01; Else goto HHC.080.]
Check item HHC01: Check item HHC01: Calculate AGE by subtracting reported Birth Year (before top coded to DOB_Y_P) (HHC.050) from CURRENT YEAR. If the birth month, day, and year are valid and if current date is less than birth date - subtract 1 from AGE, and goto HHC.070. If the birth month and year are valid, day is missing, and if current month is less than birth month- subtract 1 from AGE and goto HHC.070. If the birth month is missing then AGE1 = (AGE-1) and AGE2 = (AGE) and goto HHC.060.

HHC.060

Would you say {FULLNAME}:
RPAGEPIC
(1) {AGE1} years of age? (Check item HHC02)
(2) {AGE2} years of age? (Check item HHC02)
(7) Refused (HHC.080)
(9) DK (HHC.080)
(N) Neither is correct (HHC.080)

HHC.070

That would make {FULLNAME} {AGE} years old. Is that correct?
RPAGEVER
(1) Yes (Check item HHC02)
(2) No (HHC.080)
(7) Refused (HHC.080)
(9) DK (HHC.080)

HHC.080

What is {FULLNAME}'s age?

FR: ASK IF APPROPRIATE; OTHERWISE, ENTER YOUR BEST ESTIMATE OF THE PERSON'S AGE. ENTER "0" IF UNDER 1. ENTER (C) FOR COMPUTE IF THE RESPONSE IS A RANGE OF AGES.
RPAGEGES
________________ (0-120) years old (Check Item HHC02)
(C) Compute from range (HHC.090)

HHC.090

FR: ENTER FIRST AND LAST NUMBERS OF THE RANGE.
RPRANGE1 First/lower _________________________________
RPRANGE2 Last/higher _________________________________
[Store (RPRANGE1 + RPRANGE2)/2 in RPAGEGES]
Check item HHC02:
If HHC.060 equals 1, store AGE1 in AGE; Else
If HHC.060 equals 2, store AGE2 in AGE; Else
If HHC.070 equals 1, set AGE equals AGE; Else store RPAGEGES in AGE.

Check item MORCK: If Person number (PX) less than 30: Append 1 more member into the roster, goto Check item SET; Else set HHC.240 equal to 2, and goto Check item MAXPER.

HHC.150

What is {FULLNAME}'s date of birth? Month, day and year, please.

(1) January
(2) February
(3) March
(4) April
(5) May
(6) June
(7) July
(8) August
(9) September
(10) October
(11) November
(12) December
DOB_M MONTH: ____________________________
DOB_BDAY DAY: ____________________________
DOB_Y_P YEAR: ____________________________
[If the year is know at HHC.150, goto Check item HH15; Else goto HHC.180]
Check item HH15: Calculate AGE by subtracting reported Birth Year (HHC.150) from CURRENT YEAR. If the birth month, day, and year are valid and are known, and if current month is less than birth month - subtract 1 from AGE and goto HHC.170. If current month is the same as birth month and current day is less than birth day - subtract 1 from AGE and goto HHC.170. If the birth month is missing; then AGE1= (AGE - 1) and AGE2 = (AGE) and goto HHC.160.

HHC.160

Would you say {FULLNAME} is:
AGEPIC
(1) {AGE1} years of age? (Check item HHC09)
(2) {AGE2} years of age? (Check item HHC09)
(7) Refused (HHC.180)
(9) DK (HHC.180)
(N) Neither is correct (HHC.180)

HHC.170

That would make {FULLNAME} {AGE} years old. Is that correct?
AGEVER_A
(1) Yes (Check item HHC09)
(2) No (AGEVER_B)
(7) Refused (HHC.180)
(9) DK (HHC.180)

[If answer equals 2, ask:]
Would you like to correct {his/her} date of birth?
AGEVER_B
(1) Yes (HHC.150)
(2) No, not remember for sure. (HHC.180)

HHC.180

What is {FULLNAME}'s age?

FR: ASK IF APPROPRIATE; OTHERWISE, ENTER YOUR BEST ESTIMATE OF THE PERSON'S AGE. ENTER "0" IF UNDER 1. ENTER (C) FOR COMPUTE IF THE REPONSE IS A RANGE OF AGE.
AGEGES
__________ (0-120) years old (Check item HHC09)
(C) Compute from range

HHC.190

FR: ENTER FIRST AND LAST NUMBERS OF THE RANGE.
AGEGES_1 First/lower:____________________
AGEGES_2 Last/higher:____________________
[Store (AGEGES_1 + AGEGES_2)/2 in AGEGES]
Check item HHC09:
If HHC.160 equals 1 and AGE is not equal to zero, store AGE1 in AGE; Else
If HHC.160 equals 2 and AGE is not equal to zero, store AGE2 in AGE; Else
If HHC.170 equals 1, set AGE equal to AGE; Else set AGE equal AGEGES in HHC.180.

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1996
Survey form view entire document:  text  image
3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1995
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1994
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1993
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1992
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1991
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1990
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1989
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1988
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1987
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1986
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3. What is -- date of birth? (Enter date and age and mark sex.)
Date of birth

Month ___
Date ___
Year ___

Age ____

Sex

1[] M
2[] F

top
1985
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3. What is -- date of birth? (Enter date and age and mark sex.)

Month ____
Date ____
Year ____

top
1984
Survey form view entire document:  text  image
3. What is -- date of birth? (Enter date and age and mark sex.)

Month ____
Date ____
Year ____

top
1983
Survey form view entire document:  text  image
3. What is -- date of birth? (Enter date and age and mark sex.)

Month ____
Date ____
Year ____

top
1982
Survey form view entire document:  text  image
3. What is -- date of birth? (Enter date and age and mark sex.)

Month ____
Date ____
Year ____

top
1981
Survey form view entire document:  text  image
3. What is -- date of birth? (Enter date and Age and circle Race and Sex.)

____ Month
____ Date
____ Year
Race
1[] W
2[] B
3[] OT
Sex
1[] M
2[] F

top
1980
Survey form view entire document:  text  image
3. What is -- date of birth? (Enter date and Age and circle Race and Sex.)

____ Month
____ Date
____ Year
Race
1[] W
2[] B
3[] OT
Sex
1[] M
2[] F

top
1979
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3. What is -- 's date of birth? (Enter date and Age, and circle Race and Sex)

Age ____

Race
1 [] W
2 [] B
3 [] OT
Sex
1 [] M
2 [] F
Month ____
Date ____
Year ____

top
1978
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3. What is -- 's date of birth? (Enter date and Age, and circle Race and Sex)

Age ____

Race
1 [] W
2 [] B
3 [] OT
Sex
1 [] M
2 [] F
Month ____
Date ____
Year ____

top
1977
Survey form view entire document:  text  image
3. What is -- 's date of birth? (Enter date and Age, and circle Race and Sex)

Age ____

Race
1 [] W
2 [] B
3 [] OT
Sex
1 [] M
2 [] F
Month ____
Date ____
Year ____

top
1976
Survey form view entire document:  text  image
3. What is -- 's date of birth? (Enter date and Age, and circle Race and Sex)

Age ____

Race
1 [] W
2 [] B
3 [] OT
Sex
1 [] M
2 [] F
Month ____
Date ____
Year ____

top
1975
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3. What is -- 's date of birth? (Enter date and Age, and circle Race and Sex)

Age ____

Race
1 [] W
2 [] B
3 [] OT
Sex
1 [] M
2 [] F
Month ____
Date ____
Year ____

top
1974
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3. What is -- 's date of birth? (Enter date and Age, and circle Race and Sex)

Age ____

Race
1 [] W
2 [] B
3 [] OT
Sex
1 [] M
2 [] F
Month ____
Date ____
Year ____

top
1973
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3. How old was -- on his last birthday? (Enter Age and circle Race and Sex)

AGE ____
RACE
1 [] W
2 [] N
3 [] OT
SEX
1 [] M
2 [] F
C

top
1972
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3. How old was -- on his last birthday? (Enter Age and circle Race and Sex)

AGE ____
RACE
1 [] W
2 [] N
3 [] OT
SEX
1 [] M
2 [] F
C

top
1971
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3. How old was -- on his last birthday? (Enter Age and circle Race and Sex)

AGE ____
RACE
1 [] W
2 [] N
3 [] OT
SEX
1 [] M
2 [] F
C

top
1970
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3. How old was -- on his last birthday? (Enter Age and circle Race and Sex)

AGE ____
RACE
1 [] W
2 [] N
3 [] OT
SEX
1 [] M
2 [] F
C

top
1969
Survey form view entire document:  text  image
3. How old was -- on his last birthday? (Enter Age and circle Race and Sex)

AGE ____
RACE
1 [] W
2 [] N
3 [] OT
SEX
1 [] M
2 [] F
C

top
1968
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3. How old was --on his last birthday?
Also mark Race and sex

Age ____
Race
0[] W
1[] N
2[] OT
Sex
0[] M
1[] F

top
1967
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3. How old was --on his last birthday?
Also mark Race and sex

Age ____
Race
0[] W
1[] N
2[] OT
Sex
0[] M
1[] F

top
1966

No questionnaire text is available for this sample.


top
1965

No questionnaire text is available for this sample.


top
1964

No questionnaire text is available for this sample.


top
1963

No questionnaire text is available for this sample.