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2022

No questionnaire text is available for this sample.


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2021

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2020

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2019
Survey form view entire document:  text  image
Question ID: HCC.0290.00.1
Variable: NATORG
Interview Module: Roster
Content Type: Annual Core

Question Text:

^NATORGAGE
Fills:
^NATORGAGE
Description: Is ^ALIASNAME Hispanic or Latino?/^DoyouDoesALIAS consider
^yourhimherself to be Hispanic or Latino?
Instruction: If person is 17 or younger: "Is ^ALIASNAME Hispanic or Latino?"
If person is 18 or older: "^DoyouDoesALIAS consider
^yourhimherself to be Hispanic or Latino?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
^DoyouDoesALIAS
Description: you/Does ^ALIASNAME
Instruction: For person being spoken to (PX=LNO_RESP)fill: "Do you" For all other adults in family fill: "Does ^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF
Response:
1 - Yes
2 - No
7 - refused
9 - do not know
Universe:
All nondeleted persons
Skip Instructions:
If last non-deleted person on roster [goto RACE]
else [goto NATORG for next non-deleted person on roster]
Question ID: HCC.0300.00.1
Variable: RACE
Interview Module: Roster
Content Type: Annual Core

Question Text:

^RACEAGE

^RACEFILL
Enter all that apply, separate with commas.
Fills:
^RACEAGE
Description: What race or races is ^ALIASNAME/What race or races
^dodoes ^youALIAS} consider ^yourhimherself to be?
Instruction: If person is 17 or younger: "What race or races is
^ALIASNAME?"
If person is 18 or older: "What race or races ^dodoes
^youALIAS consider ^yourhimherself to be?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
^dodoes
Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF
^RACEFILL
Description: Race list full
Instruction: For first or only non-deleted person:
Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, Asian, or some other race?

Else fill:
*Read if necessary: Please select 1 or more of these categories:
White, Black, African American, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, Asian, or some other race?F
Response:
01 - White
02 - Black/African American
03 - American Indian
04 - Alaska Native
06 - Other Pacific Islander
07 - Asian
97 - Refused
99 - Do not Know
Universe:
All nondeleted persons
Skip Instructions:
8 = IN RACE [goto RACE_SP]
1-7,RF,DK = If last non-deleted person on roster AND at least one person with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC] else [goto RACE for next non-deleted person on roster]
Question ID: HCC.0310.00.1
Variable: RACE_SP
Interview Module: Roster
Content Type: Annual Core

Question Text:

^RACESPAGE

Start typing and then select from list. If race is not on the list, type "ZZ" and enter verbatim.

If any of the following are mentioned, back up to previous screen and correct the entry.

White Black
African American American Indian Alaska Native Native Hawaiian Pacific Islander Asian

If respondent provides more than one other race, select 'ZZ' from the lookup table. At the next question, enter ALL the other races in the verbatim field.
Fills:
^RACESPAGE
Description: What other race or races is ^ALIASNAME?/What other race or races ^dodoes ^youALIAS consider ^yourhimherself to be?
Instruction: If person is 17 or younger: "What other race or races is
^ALIASNAME?"
If person is 18 or older: "What other race or races
^dodoes ^youALIAS consider ^yourhimherself to be?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
^dodoes
Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF
Response:
ZZ - Other
97 - Refused
99 - Do not know
Universe:
Person identifies as some other race
Skip Instructions:
selection from picklist,DK,RF = If last non-deleted person on roster AND at least one person with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC] else [goto RACE for next non-deleted person on roster]
ZZ = [goto RACE_VRBAT]
Question ID: HCC.0320.00.1
Variable: RACE_VRBAT
Interview Module: Roster
Content Type: Annual Core

Question Text:

Read if necessary.

^RACESPAGE
Fills:
^RACESPAGE
Description: What other race or races is ^ALIASNAME?/What other race or races ^dodoes ^youALIAS consider ^yourhimherself to be?
Instruction: If person is 17 or younger: "What other race or races is
^ALIASNAME?"
If person is 18 or older: "What other race or races
^dodoes ^youALIAS consider ^yourhimherself to be?"
^ALIASNAME
Description: {Value of ALIAS}
Instruction: Fill value from ALIAS
^dodoes
Description: Do/Does
Instruction: If subject=respondent, fill "Do", else if subject NE respondent, fill "Does"
^youALIAS
Description: you/^ALIASNAME
Instruction: If subject=respondent, fill "you";
else if subject ne respondent, fill "^ALIASNAME"
^yourhimherself
Description: yourself/himself/herself/themself
Instruction: if subject=respondent fill "yourself";
else fill "himself" if SEX=1 or "herself" if SEX=2 or "themself" if SEX=DK or RF

Response:
97 - Refused
99 - Do not know
Universe:
Person identifies as some other race and Interviewer does not use pick-list to select this race
Skip Instructions:
allow 8 => If last non-deleted person on roster AND at least one person with AGE18=2 or AGEGUESS=2 or AGE[PX] = 17-64 [goto AFNOW]
elseif last non-deleted person on roster [goto EDUC] else [goto RACE for next non-deleted person on roster]