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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