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.

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

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

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.

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

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

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.

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

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

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.

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

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

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.

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

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

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.

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

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

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.

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

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

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.

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

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

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

Instrument Variable Name: LAHCA
QuestionText:

(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(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: All persons 18 years of age or older who have at least one reported limitation
SkipInstructions:

(1-12,14-35) [goto appropriate follow-up questions: LHAL01N - LHAL12N, LHAL14N - LHAL35N]
(13) [fill "96" in LHAL13N and fill "6" in LHAL13T] (90) [goto LAHCA_S1] (91) [goto 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.

What condition or health problem causes {subject's name} limitations?

FR: SHOW FLASHCARD F2. DO NOT READ. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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 (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
Other impairment/problem

LAHCA1 (1) Vision/ problem seeing
LAHCA2 (2) Hearing problem
LAHCA3 (3) Arthritis / rheumatism
LAHCA4 (4) Back or neck problem
LAHCA5 (5) Fracture, bone / joint injury
LAHCA6 (6) Other injury
LAHCA7 (7) Heart problem
LAHCA8 (8) Stroke problem
LAHCA9 (9) Hypertension / high blood pressure
LAHCA10 (10) Diabetes
LAHCA11 (11) Lung / breathing problem (e.g. asthma and emphysema)
LAHCA12 (12) Cancer
LAHCA13 (13) Birth defect
LAHCA14 (14) Mental retardation
LAHCA15 (15) Other developmental problem (e.g. cerebral palsy)
LAHCA16 (16) Senility
LAHCA17 (17) Depression / anxiety / emotional problem
LAHCA18 (18) Weight problem

(M) More conditions
(97) Refused
(99) Don't know/not sure

(What condition or health problem causes your limitations?)

FR: MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE

(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) (LAHCA@S1)
(37) Other impairment/problem (Specify one) (LAHCA@S2)
(B) Back-up to previous screen

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S1 Condition: __________________________________________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S2 Condition: __________________________________________

What condition or health problem causes {subject's name} limitations?

FR: SHOW FLASHCARD F2. DO NOT READ. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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 (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
Other impairment/problem

LAHCA1 (1) Vision/ problem seeing
LAHCA2 (2) Hearing problem
LAHCA3 (3) Arthritis / rheumatism
LAHCA4 (4) Back or neck problem
LAHCA5 (5) Fracture, bone / joint injury
LAHCA6 (6) Other injury
LAHCA7 (7) Heart problem
LAHCA8 (8) Stroke problem
LAHCA9 (9) Hypertension / high blood pressure
LAHCA10 (10) Diabetes
LAHCA11 (11) Lung / breathing problem (e.g. asthma and emphysema)
LAHCA12 (12) Cancer
LAHCA13 (13) Birth defect
LAHCA14 (14) Mental retardation
LAHCA15 (15) Other developmental problem (e.g. cerebral palsy)
LAHCA16 (16) Senility
LAHCA17 (17) Depression / anxiety / emotional problem
LAHCA18 (18) Weight problem

(M) More conditions
(97) Refused
(99) Don't know/not sure

(What condition or health problem causes your limitations?)

FR: MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE

(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) (LAHCA@S1)
(37) Other impairment/problem (Specify one) (LAHCA@S2)
(B) Back-up to previous screen

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S1 Condition: __________________________________________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S2 Condition: __________________________________________

What condition or health problem causes {subject's name} limitations?

FR: SHOW FLASHCARD F2. DO NOT READ. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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 (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
Other impairment/problem

LAHCA1 (1) Vision/ problem seeing
LAHCA2 (2) Hearing problem
LAHCA3 (3) Arthritis / rheumatism
LAHCA4 (4) Back or neck problem
LAHCA5 (5) Fracture, bone / joint injury
LAHCA6 (6) Other injury
LAHCA7 (7) Heart problem
LAHCA8 (8) Stroke problem
LAHCA9 (9) Hypertension / high blood pressure
LAHCA10 (10) Diabetes
LAHCA11 (11) Lung / breathing problem (e.g. asthma and emphysema)
LAHCA12 (12) Cancer
LAHCA13 (13) Birth defect
LAHCA14 (14) Mental retardation
LAHCA15 (15) Other developmental problem (e.g. cerebral palsy)
LAHCA16 (16) Senility
LAHCA17 (17) Depression / anxiety / emotional problem
LAHCA18 (18) Weight problem

(M) More conditions
(97) Refused
(99) Don't know/not sure

(What condition or health problem causes your limitations?)

FR: MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE

(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) (LAHCA@S1)
(37) Other impairment/problem (Specify one) (LAHCA@S2)
(B) Back-up to previous screen

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S1 Condition: __________________________________________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S2 Condition: __________________________________________

What condition or health problem causes {subject's name} limitations?

FR: SHOW FLASHCARD F2. DO NOT READ. MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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 (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
Other impairment/problem

LAHCA1 (1) Vision/ problem seeing
LAHCA2 (2) Hearing problem
LAHCA3 (3) Arthritis / rheumatism
LAHCA4 (4) Back or neck problem
LAHCA5 (5) Fracture, bone / joint injury
LAHCA6 (6) Other injury
LAHCA7 (7) Heart problem
LAHCA8 (8) Stroke problem
LAHCA9 (9) Hypertension / high blood pressure
LAHCA10 (10) Diabetes
LAHCA11 (11) Lung / breathing problem (e.g. asthma and emphysema)
LAHCA12 (12) Cancer
LAHCA13 (13) Birth defect
LAHCA14 (14) Mental retardation
LAHCA15 (15) Other developmental problem (e.g. cerebral palsy)
LAHCA16 (16) Senility
LAHCA17 (17) Depression / anxiety / emotional problem
LAHCA18 (18) Weight problem

(M) More conditions
(97) Refused
(99) Don't know/not sure

(What condition or health problem causes your limitations?)

FR: MARK ALL THAT APPLY, BUT DO NOT PROBE. ENTER (N) FOR NO MORE

(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) (LAHCA@S1)
(37) Other impairment/problem (Specify one) (LAHCA@S2)
(B) Back-up to previous screen

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S1 Condition: __________________________________________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LAHCA@S2 Condition: __________________________________________

What conditions or health problems cause {subject's name} limitations?

FR: SHOW CARD F2. DO NOT READ. CODE ALL THAT APPLY, UP TO 5, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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
19. Other impairment/problem

(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 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
(19) Other impairment/problem (specify one)(FHS.291)
(20) Other impairment/problem (specify one)(FHS.292)
(97) Refused
(99) Don't know/not sure

[ ]
[ ]
[ ]
[ ]
[ ]

(Go to FHS.300)

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LACASPEC CONDITION: _______________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LACASPEC_1 CONDITION: _______________

What conditions or health problems cause {subject's name} limitations?

FR: SHOW CARD F2. DO NOT READ. CODE ALL THAT APPLY, UP TO 5, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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
19. Other impairment/problem

(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 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
(19) Other impairment/problem (specify one)(FHS.291)
(20) Other impairment/problem (specify one)(FHS.292)
(97) Refused
(99) Don't know/not sure

[ ]
[ ]
[ ]
[ ]
[ ]

(Go to FHS.300)

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LACASPEC CONDITION: _______________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LACASPEC_1 CONDITION: _______________

What conditions or health problems cause {subject's name} limitations?

FR: SHOW CARD F2. DO NOT READ. CODE ALL THAT APPLY, UP TO 5, BUT DO NOT PROBE. ENTER (N) FOR NO MORE.

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
19. Other impairment/problem

(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 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
(19) Other impairment/problem (specify one)(FHS.291)
(20) Other impairment/problem (specify one)(FHS.292)
(97) Refused
(99) Don't know/not sure

[ ]
[ ]
[ ]
[ ]
[ ]

(Go to FHS.300)

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LACASPEC CONDITION: _______________

FR: SPECIFY CONDITION CAUSING LIMITATION. THIS SHOULD BE THE NAME OF A SPECIFIC CONDITION THAT IS NOT ON THE CONDITION LIST.

LACASPEC_1 CONDITION: _______________