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FLCLIMB
How difficult to walk steps w/o special equipment

Codes and Frequencies



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Description

FLCLIMB reports how much difficulty the person has climbing steps without equipment. Before 2019, the person was asked about how much difficulty they had, by themselves and without special equipment, walking up 10 steps without resting. Beginning in 2019, separate questions were asked of sample adults who reported that they did not need equipment or help to get around and those who reported that they did need need equipment or help to get around. Both groups were asked about how much difficulty they had walking up or down 12 steps, but those who reported needing equipment or help to get around were asked how much difficulty they experienced without the use of their aid. IPUMS NHIS staff combined variables with responses to these two questions into FLCLIMB to maximize comparability with previous years. Please see Comparability and Universe tabs for changes in universe and question wording between samples.

The Washington Group on Disability Statistics 

In 2019, functioning and disability measures included on the NHIS questionnaire were modified to align with validated, internationally-comparable disability measures developed by the Washington Group on Disability Statistics (WG). For more information about the WG initiative, other WG functioning and disability measures included on the NHIS questionnaire, and guidance for researchers about how to use the WG measures in analyses, please see our user note on the Washington Group Disability Measures.

The 1994 and 1995 NHIS-D Supplement 

In 1994 and 1995, this variable is part of the Disability Supplement (NHIS-D) that collects information on disability. NHIS-D included two household interviews: in Phase I all members of sample families were screened for any indication of disability; in Phase II persons with any indication of disability were followed-up for additional information. Phase I includes sensory, communication, and mobility problems; health conditions; activities of daily living and independent activities of daily living; functional limitations; mental health; services and benefits; special health needs of children; early child development; education; relationship to respondent; and perceived disability. Phase II includes four Disability Followback Survey (DFS) questionnaires: one for children, one for adults, one for elderly persons (69 years of age and over) without any indication of disability (also called the Supplement on Aging or SOA; only in 1994), and one for persons with a history of polio.

Definitions 

The term "difficult" was respondent-defined. A brief definition of "special equipment" based on examples (i.e., "such as a cane, a wheelchair, a special bed, or a special telephone") was part of the preceding question. The Field Representative's Manual for 1997 forward defined "special equipment" as "any device, tool, utensil, instrument, implement, etc., used as an aid in performing an activity because of a physical, mental, or emotional problem." The Manual for 1997-2000 continued, "This includes the use of adult 'diapers' for incontinence. However, ordinary eyeglasses and hearing aids should not be considered 'special equipment.' For example: a spoon is not normally considered as 'special equipment'; however, a uniquely designed or functioning one used for eating by a person because of physical, mental, or emotional problems is considered 'special equipment.'"

Beginning in 2001, the Field Representative's Manual formally defined the words "by yourself." Specifically, "By yourself is considered to be without the help from another person or without hands-on assistance with performing an activity. Another person may be a friend, relative, paid helper, volunteer from an agency or organization or anyone else who helps the family member in doing the activities mentioned. He or she may be a household member or a non-household member."

A formal definition of "health problem" was also included in the Field Representative's Manual, with only slight changes in wording over time. The Manual for 1997 stated:

'Problem' is the Sample Adult's perception of a departure from physical, mental, or emotional well-being. This includes specific health problems, such as a disease or condition, a missing extremity or organ, or any type of impairment. It also includes more vague disorders not always thought of as health related problems or illnesses, such as alcoholism, drug dependency or reaction, senility, depression, retardation, etc.

No definition of terms except the aforementioned definition of "health problem" as "any physical, mental, or emotional problem or illness (not including pregnancy) was routinely supplied to respondents during the interview.

Related Variables 

Other questions in the series collected information about how difficult the sample adult found the following activities, if performed "by yourself and without using any special equipment":

  • Stooping, bending, or kneeling (FLSTOOP)
  • Reaching above the head (FLREACH)
  • Participating in social activities (FLSOCIAL)
  • Doing things to relax at home (FLRELAX)

Comparability

Changes in universe and question wording limit comparability between samples.

In 1984, the universe includes sample persons ages 55 and older.

In 1994 and 1995, this question was asked of all persons ages 18 and older in the National Health Interview Survey-Disability Survey (NHIS-D) Phase I sample who reported any difficulty walking up 10 steps without resting. Unlike other years, a family respondent answered as a proxy for all persons ages 18 and older in 1994 and 1995.

Beginning in 1997, respondents selected the appropriate response from choices listed on a card. For 1997-1999, the card listed 5 choices: Not at all difficult (0); Only a little difficult (1); Somewhat difficult (2); Very Difficult (3); and Can't do at all (4). Beginning in 2000, a sixth choice was added: Do not do this activity (6).

Beginning in 2019, the question wording changed from asking about difficulty walking up or down 10 steps to 12 steps and those who reported needing an aid or assistance in getting around were asked about how much difficulty they experienced climbing steps without their aid, whereas those who did not report needing an aid or assistance in getting around were asked about how much difficulty they experienced climbing steps without reference to an aid or assistance.

 

For years prior to 2000, a small number of cases were coded as "Do not do this activity" in the NHIS public use data files. The Field Representative's Manual for 2000 explained,

Beginning in 2000, for all activities (not just shopping, participating in social activities, and relaxing at home as in previous years), respondents had the opportunity to respond in the interview that they 'do not do this activity.' This response was added to certain functional activities (related to walking, climbing, standing, sitting, stooping, reaching, grasping, carrying, and pushing) in the 2000 NHIS. In prior years, respondents were not permitted to use this response during the course of the interview, but might have been reassigned to 'do not do this activity' in the course of data editing based on information obtained from other condition questions.

Although, technically, "Do not do this activity" was a category for FLCLIMB for 1997 forward in the NHIS public use files, this category is not actually comparable across the two periods 1997-1999 and 2000 forward. Very few cases (only 1 in 1997) were coded as "Do not do this activity" via data editing, compared to the number of respondents who self-selected this category for 2000 forward (349 in 2000). To increase comparability across years, researchers are advised to combine the categories "Can't do at all" and "Do not do this activity" when analyzing data collected both before and after 2000.

Questionnaire design changes introduced in 2019 limit comparability with earlier years. The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.

Universe

  • 1984: Sample persons age 55+.
  • 1994-1995: Persons aged 18 years and older in the NHIS-D Phase I sample who reported difficulty walking up 10 steps without resting.
  • 1997-2018: Sample adults age 18+.
  • 2019: Sample adults age 18+.

Availability

  • 1984, 1994-1995, 1997-2019

Weights