Description
RADAY2WKTOT reports the total number of days during the past 2 weeks that illness or injury caused a person to cut down on usual activities for as much as a day.
RADAY2WKTOT is a recoded variable created by the National Center for Health Statistics (NCHS) and included in the original NHIS public use data.
Definitions
The 1969-1996 Field Representative Manuals characterize usual activities as follows:
The things a person usually does are the person's "Usual activities." For school children and most adults, "usual activities" would be going to school, working, keeping house, etc. For children under school age, "usual activities" depend upon whatever the usual pattern is for the child which will, in turn, be affected by the age of the child, weather conditions, etc. For retired or elderly persons, "usual activities" might consist of almost no activity, but cutting down on even a small amount would mean that a person should answer "Yes" to the question.
"Usual activities" on Sundays or holidays are the things the person usually does on such days, such as going to church, playing golf, visiting friends or relatives, staying at home and listening to the radio, reading, looking at television, etc.
In those cases where the "usual activity" was difficult to determine, interviewers were instructed to "accept the respondent's view of what he himself considers to be his 'usual activities.'" For example, interviewers were instructed to accept "working" as a usual activity even if reported by a person having a heart condition that prevented any work for a year or more.
As noted above, RADAY2WKTOT reports specifically on usual activities "cut down" by "as much as a day." These are referred to as "cut down days." The 1969-1996 Field Representative's Manuals characterize cut down as follows:
Restricted activity does not imply complete inactivity but it does imply the minimum of the things a person usually does. A special nap for an hour after lunch does not constitute cutting down on usual activities for as much as a day, nor does the elimination of a heavy chore, such as cleaning ashes out of the furnace or hanging out the wash. All or most of a person's usual activities for the day must have been restricted for the person to have a cut-down day.
The 1969-1981 Field Representative's Manuals state that the meaning of the expression "for as much as a day" is "the whole of that day." Thus, for 1969-1981, the Field Representative's Manuals characterize a cut down day as:
A day of restricted activity (cut down) is a day when a person cuts down on his usual activities for the whole of that day [for that entire day] on account of [because of] an illness or injury.
Although the NCHS intended "cut down day" to mean, in 1969-1981, cutting down on activities for the whole day [the entire day] on account of an illness or injury, the 1969-1981 survey questions asked about activities cut down for as much as a day on account of an illness or injury. This possible tension between the intention of the NCHS and the wording of the 1969-1981 survey questions was resolved, beginning in 1982, with a rewording of the survey questions.
Thus, as noted in The National Health Interview Survey Design, 1973-84, and Procedures, 1975-83, starting in 1982, the concept of a cut down day meaning more than half a day was directly communicated to the respondent in the survey questions asked. Reflecting this change in the survey questions, the 1982-1996 Field Representative's Manuals define "cut down day" as:
Cut-down day--A day of restricted activity during which a person cuts down on usual activities for MORE than half of that day because of illness or injury.
Data Collection Process: Questions and Editing
There is no single survey question associated with RADAY2WKTOT. Instead, RADAY2WKTOT is a recoded variable that sums responses to a series of sequentially asked questions. The questions in 1975-1981 are slightly different than in 1982-1996 since, as noted above, the meaning of "cut down day" was different in these two periods.
1975-1981
Sequentially Asked Questions
Bed disability days in the past 2 weeks (
BDDAY2WK): During the previous two weeks, "how many days did [person] stay in bed all or most of the day?"
School loss days in the past 2 weeks (
SLDAY2WK): During the previous two weeks, "how many days did illness or injury keep [person] from school?"
Work loss days in the past 2 weeks (
WLDAY2WK): During the previous two weeks, "how many days did illness or injury keep [person] from work? (For females): not counting work around the house?" The survey dropped the qualification about females in 1982-1996.
Other restricted activity days in the past two weeks: "Not counting the day(s) [in bed, lost from work, lost from school])" during the previous two weeks, "how many (other) days did he cut down for as much as a day?" In 1975-1981, there is no publicly available data for other restricted activity days in the past two weeks.
NCHS Editing (1975-1981)
The NCHS edited the data collected in answer to the sequentially asked questions identified above to provide consistency with other data collected during the interview--specifically, the number of restricted activity days associated with specific health conditions during the past two weeks. As noted in the Current Estimates from the Health Interview Survey: United States, 1982:
Before 1982 ... [I]f any condition had a greater number of restricted-activity days than was calculated for that person's total number of restricted-activity days, the person's restricted-activity days were replaced with the number of days from the condition record listing the largest number of restricted activity days. (p. 193)
Thus, whenever a person had, in the condition record, a condition whose number of restricted-activity days was greater than the person's total number of restricted-activity days in the person record, those days replaced the person's restricted activity days in the person record. For example, suppose that in the condition record, a person had 12 bed disability days in the past 2 weeks, but in the person record, had only 8 total restricted-activity days in the past 2 weeks and 2 bed disability days in the past 2 weeks. In this case, the NCHS changed the 2 bed disability days in the past 2 weeks to 12 bed disability days, and recalculated the total number of disability days reported on the person record, based on that substitution. This editing stopped in 1982.
A second set of NCHS edits corrected reported values greater than fourteen (which were inconsistent with the two-week, or fourteen day, reference period). As mentioned in the Current Estimates from the Health Interview Survey: United States, 1982:
A final change to the disability day edits involved the specifications for editing "out-of-range" numbers of days (days in excess of 2 weeks), Codes of 15 days or more were ... edited to 14 days. (p. 194)
Thus, in 1975-1981, reports of 14 days mean 14 or more days. As noted below, this changes beginning in 1982. In 1982-1996, 14 days means only 14 days.
1982-1996
Sequentially Asked Questions
As in 1975-1981, RADAY2WKTOT reported the sum of responses to a series of questions about disability days in the past 2 weeks. The wording of these questions during 1982-1996 was, however, slightly different from the wording of such questions in 1975-1981. Specifically (italics used to indicate important changes from 1975-1981 in the question wording):
Bed disability days in the past 2 weeks (
BDDAY2WK): During the previous two weeks, "how many days did {person} stay in bed
more than half of the day because of illness or injury?"
School loss days in the past 2 weeks (
SLDAY2WK): During the previous two weeks, "how many days did {person} miss
more than half of the day from school because of illness or injury?"
Work loss days in the past 2 weeks (
WLDAY2WK): During the previous two weeks, "how many days did {person} miss
more than half of the day from {person's} job or business because of illness or injury?"
Other restricted activity days in the past two weeks (
RADAY2WKRSID): "Not counting the day(s) [missed from work, missed from school, (and) in bed]), During that period, how many (OTHER) days did [person] cut down for
more than half of the day because of illness or injury?"
NCHS Editing (1982-1996)
According to the Current Estimates from the Health Interview Survey: United States, 1982, beginning in 1982, codes of 15 or more days were edited to 0 days. As noted above, this differs from 1975-1981, where codes of 15 or more days were edited to 14 days. According to NCHS, the number of codes of 15 days or more was very small.
1975-1996 NCHS Data Editing
During the entire 1975-1996 period, the NCHS used the condition record to edit data in the person records. This sometimes, though infrequently, caused a problem. Suppose that a person had 14 restricted-activity days in the past 2 weeks (e.g., 14 bed disability days in the past 2 weeks). Further, suppose that when asked what conditions caused these disability days, the person indicated 2 or more conditions. When recording responses for the condition record of an individual, the interviewer first asked, "How many days did you cut down on things you usually do?" Because the person was bedridden for the entire 14 days (if, for example, they had a longstanding disabling illness), it was possible (and occasionally happened) that the person answered this question with "none." When this happened, the other condition questions were not asked, and were assigned a value of 0. Finally, because the NCHS used the condition record edits as the master edits, with no condition registering any kind of restricted activity days, the person days were also edited to have no restricted activity days. In contrast, when the person reported only 1 condition, the NCHS did not back edit the person record and kept the 14 days.
