Question ID:FHS.350_00.000 QuestionnaireFileName:
Instrument Variable Name: LAHCA Family
Question Text:
(book) F2 What conditions or health problems cause [fill: your/ALIAS's] limitations?
* Enter 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
Universe Text All persons 18 years of age or older who have at least one reported limitation
Skip Instructions:
(1-12,14-35) [go to appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T]
(90) [go to LAHCA_S1]
(91) [go to LAHCA_S2]
(R,D) [repeat this question for the next person 18 years of age or older with a reported limitation; if no more persons 18 years of age or older with a reported limitation, goto PHSTAT]
NOTE: This question and all appropriate follow-up questions are asked, in sequence, for each person 18 years of age or older with a reported limitation. The instrument then proceeds to PHSTAT.
Question ID:FHS.351_90.000
Instrument Variable Name: LAHCA_S1
Question Text:
* Read if necessary. What is the other impairment or problem?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All persons less than 18 years of age who have a limitation due to at least one condition not listed at LAHCC
Skip Instructions:
go to LHAL90N
Question ID:FHS.351_91.000
Instrument Variable Name: LAHCA_S2
Question Text:
* Read if necessary. What is the other impairment or problem?
Verbatim Verbatim response
7 Refused
9 Don't know
Universe Text All persons less than 18 years of age who have a limitation due to at least one condition not listed at LAHCC
Skip Instructions:
go to LHAL91N