User Note - Adult Functioning and Disability & Quality of Life Supplements

Disability Supplements

Beginning in 2010, the Quality of Life/Functioning and Disability supplement was fielded as part of the NHIS Sample Adult Module. The supplement was developed in partnership with the Washington Group on Disability Statistics (WB) and the Budapest Initiative on the Measurement of Health State (BI) with the goal of developing and testing measures of functioning. A set of questions on functioning and disability was included in the 2010 Quality of Life (QOL) supplement. After additional modifications, the set of questions was included in the Adult Functioning and Disability (AFD) supplement beginning in 2011.

The Adult Disability (ADB) and Child Disability (CDB) questions are asked of sample adults or sample children in households NOT randomly selected to for participation in the Family Disability and Adult Functioning and Disability supplement questions. ADB/CDB supplement questions are asked specifically of the sample person; sample adults respond for themselves, while a knowledgeable adult serves as a proxy respondent for sample children. Persons from families that answered the ADB/CDB questions did not participate in other disability supplements.

The Family Disability (FDB) Questions were asked not about the specific sample person, but instead about anyone in the household. These family-style questions are asked of the family respondent about all persons 1 year of age or older. As with other family-respondent questions, all persons over 18 who are present may answer for themselves, but the appointed respondent will answer for persons under 18 or those who are not responding for themselves. NHIS used this split ballot approach to determine which version, the person-style associated with the ADB/CDB supplement or the family-style associated with the FDB supplement, would be used. In 2013, only the FDB family-style format of these questions is used.

The Adult Functioning and Disability supplement questions are asked of sample adults. Prior to 2013, these sample adults are drawn from families randomly selected to receive the FDB supplement questions. With the decision to use the FDB questions in 2013, sample adults who respond to the AFD supplement are those from families NOT randomly selected to recieve the FDB questions.

In 2010, approximately one quarter of sample adults were randomly selected to receive the QOL supplement. There were 101 questions and two verbatim fields in the supplement. These two fields contain edited narrative text descriptions of the type of equipment or help the respondent received for getting around and reasons for tiredness. In 2011, approximately one half of sample adults (from families who were randomly selected to recieve the family disability supplement) were selected to receive the AFD supplement. In 2012, a random number generator was used to determine who, from families who were randomly selected to receive the family disability questions, would be asked to answer the AFD questions. In the event that this random number generator did not select the sample adult from these families, these selected non-sample adults did not answer the AFD questions and are classified as NIU. As a result of the selection process, different weights were generated for these respondents (SUPP1WT). Beginning in 2013, the AFD respondents are no longer selected from the families flagged to respond to the FDB supplement; instead these two groups are mutually exclusive. Beginning in 2013, families are randomly selected to either answer family disability questions about all members of the family over one year of age, or have the sample adult respond to the AFD questions.

The public use files available from the National Center for Health Statistics contain information about a respondent's functioning in various basic and complex activity domains: vision (difficulty seeing), hearing (difficulty hearing), mobility (difficulty walking, climbing steps, or moving around), upper body (difficulty with self-care), learning (difficulty learning), cognition (difficulty remembering or concentrating), affect (feelings of being worried, nervous, or anxious; feelings of being depressed), pain, fatigue (feelings of being very tired or exhausted), and communication (difficulty communicating). The files also contain a set of questions designed to capture an individual's ability to participate in society - a measure of quality of life. Follow-up questions on the degree of difficulty, use of assistive devices, and functioning with assistance were included for most domains. However, beginning in 2011, the AFD file does not contain as many follow-up questions as the 2010 QOL file, nor does it contain the two verbatim fields that were available in the 2010 QOL file.

Users interested in combining years of data should be aware that the 2012 AFD instrument is not identical to the 2011 and 2010 instruments. For the 2012 instrument, a new question has been added to the vision sequence, and the order of questions in the hearing sequence has been changed. As a result, the vision and some of the hearing questions that were retained in 2012 have different contexts or universes relative to earlier years. In addition, the wording for several of the questions in the mobility sequence has been changed. Some of the changes in question wording are minor (e.g., "any" was removed from LAWALKCLIMDIF). Lastly, the universes for WORFEELEVL and DEPFEELEVL were modified in 2012. Users wishing to combine years of data should read each of the variable descriptions in order to more completely understand the changes in the file.

The variables available in the supplements are described in the table below.

Variable Name Variable Description
Vision
GLASSES Wears glasses
VDIFAMOUNT Amount of difficulty seeing
GLASSEEFAR Wears glasses to see far away
VDIFACEROOM Amount of difficulty clearly seeing someone's face across a room
GLASSEECLOS Wear glasses for reading/seeing up close
VDIFPICCOIN Amount of difficulty seeing picture on a coin
Hearing
HRPROBAMT Amount of difficulty hearing
HRAUSESQOL Use a hearing aid
HRAFREQ How often use a hearing aid
HRDIFCONV1QR Amount of difficulty hearing conversation with one person in quiet room
HRDIFCONV1NR Amount of difficulty hearing conversation with one person in noisier room even when wearing hearing aid
Mobility
LAWALKCLIMDIF Amount of difficulty walking or climbing steps
LAHOMEDIFAMT Amount of difficulty moving around inside home
LAWALKCLIMPERQ Use equipment to help walk, climb stairs, or move around?
CANE Use a cane or walking stick
WALKER Use a walker
CRUTCHES Use crutches
CHAIR Use a wheelchair or scooter
ARTIFLIMB Use prosthesis
LAWALKCLIMPER Use someone's assistance
LAWALKCLIMOTH Use other type of equipment or help
WALKDIF1BL1 Amount of difficulty walking 100 yards on level ground without the use of aid or equipment
WALKDIF5BL1 Amount of difficulty walking a third of a mile on level ground without the use of aid or equipment
WALKDIF12ST1 Amount of difficulty walking up or down 12 steps without the use of aid or equipment
WALKDIF1BL2 Amount of difficulty walking 100 yards on level ground when using aid or equipment
WALKDIF5BL2 Amount of difficulty walking a third of a mile on level ground when using aid or equipment
WALKDIF12ST2 Degree of difficulty walking up or down 12 steps using aid
Communication
LACOMDIFEGO Amount of difficulty communicating using usual language
LACOMDIFOTHS Amount of difficulty people have understanding you when you speak
LACOMDIFASHY Talk to fast/feel shy/have trouble expressing yourself
LACOMDIFPHYS Physical problem with mouth/tongue
LACOMDIFLANG Need to understand other languages/different ways of speaking
LACOMDIFHEAR Have trouble hearing
USESIGNLANG Use sign language
Memory
LAMEMCONDIF Amount of difficulty remembering or concentrating
LAMEMORCON Difficulty remembering, concentrating, or both
LAMEMDIFOFT How often have difficulty remembering
LAMEMDIFAMT Amount of things you have difficulty remembering
LAMEMYBUSY Forget things because too busy/too much to remember
LAMEMWORSE Difficulty is getting worse
LAMEMDANGER Difficulty has put me/my family in danger
LAMEMINOR Only forget little/inconsequential things
LAMEMWRITE Must write down important things so I don't forget
LAMEMWORRY Family members/friends are worried about my difficulty remembering
LAMEMNORMAL Difficulty is normal for my age
LACONDIF10M Amount of difficulty concentrating for 10 minutes
LACONDIFCLAR When difficulty concentrating for 10 minutes is between a little and a lot, is it closer to a little, closer to a lot, or exactly in the middle
Self-care & manual dexterity
LAWASHDRESDIF Degree of difficulty with self-care
LARA2LITRDIF Degree of difficulty raising 2 liter bottle of water or soda from waist to eye level
LAHANDDIF Degree of difficulty using hands and fingers
Cognition
LACOGDIFGAME Amount of difficulty learning rules for new game
LACOGDIFINST Amount of difficulty understanding/following instructions
Anxiety & Depression
WORFREQ How often feel worried, nervous, or anxious
WORRX Take medication for worried, nervous, or anxious feelings
WORFEELEVL Level of feelings when you last felt worried, nervous, or anxious
WORFEELCLAR Last worried, nervous, or anxious feelings were closer to a little, closer to a lot, or exactly in the middle
WORPOSITIV Worried, nervous, or anxious feelings help me to accomplish goals and be productive
WORINTFER Worried, nervous, or anxious feelings sometimes interfere with life and wish did not have these feelings
WORJOBSTOP If had more money or a better job, would not have these feelings
WORNORMAL Everybody has these feelings/are part of life/normal
WORHPSAYANX Been told by a medical professional has anxiety
DEPFREQ How often feel depressed
DEPRX Take medication for depression
DEPFEELEVL How depressed you felt last time you were depressed
DEPFEELCLAR Was the level of most recent depression closer to a little, closer to a lot, or exactly in the middle
DEPYMOURN Feelings caused by death of a loved one
DEPINTENSE Sometimes feelings so intense cannot get out of bed
DEPINTFER Feelings of depression sometimes interfere with life and wish did not have these feelings
DEPJOBSTOP If had more money or a better job, would not have these feelings
DEPNORMAL Everybody has these feelings/they are part of life/normal
DEPHPSAYDEP Told by a medical professional have depression
Pain
PAINFREQ Have frequent pain
PAINFREQ3MO Frequency of pain in past 3 months
PAINDURALAST How long pain lasted last time had it
PAINFEELEVL How much pain you had last time you had pain
PAINFEELCLAR Was level of most recent pain closer to a little, closer to a lot, or exactly in the middle
PAINCONSTANT Pain is constantly present
PAINAMTVARY Sometimes in a lot of pain and sometimes it is not so bad
PAININTENSE Sometimes pain is unbearable/excruciating
PAINDISTRAC When mind on other things, not aware of pain
PAINRXCURE Medication can take pain away
PAINYWORK Pain is because of work
PAINYEXER Pain is because of exercise
Fatigue
TIREFREQ3MO How often felt very tired or exhausted in past 3 months
TIREDURALAST How long most recent tired or exhausted feelings lasted
TIREFEELEVL Level of tiredness last time felt very tired or exhausted
TIREFEELCLAR Level of tiredness closer to a little, closer to a lot, or exactly in the middle
TIREYWORKEX Tired because too much work or exercise
TIREYNOTSLEP Tired because not getting enough sleep
TIREYHEALTH Tired because of physical or health-related problem
TIREYOTHER Tired because of something else
Daily Tasks
LADLDIFAMT How limited in carrying out daily activities
CANDOWORK Working outside the home to earn an income
CANDOEDUC Going to school or achieving your education goals
CANDOSOCIAL Participating in leisure or social activities
CANDOGETOUT Getting out with friends or family
CANDOHWORK Doing household chores such as cooking and cleaning
CANDOTRANS Using transportation to get to places you want to go
CANDORELIG Participating in religious activities
CANDOCOMUN Participating in community gatherings

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