([total number of employers reported] >= 1)

COMMENT: Is there at least one employer listed?

{*employer.curflag(1)*}==1

COMMENT: STATUS (Merged,%datevar%,1 WAS R WORKING IN WEEK BEFORE INTERVIEW WEEK?

(INTERVIEWER: ENTERING HEALTH SECTION)

Would your health keep you from working on a job for pay now?

(Are you/Would you be) limited in the kind of work you (could) do on a job for pay because of your health?

(Are you/Would you be) limited in the amount of work you (could) do because of your health?

(([Would your health keep you from working now?]==1) || ([Limited in kind of work due to accident or injury?]==1) || ([Limited in amount of work due to accident or injury?]==1))

COMMENT: Check if R has reported a health limitation which affects work.

([RESPONDENT GENDER]==1)

COMMENT: Is respondent male?

([time unit for time next child planned]==1) && ([number of months r plans to have next child]<=9)

COMMENT: Is R currently pregnant?

Is your limitation entirely due to your current pregnancy?

Since what month and year have you had this limitation [" "/Other than your pregnancy]?

INTERVIEWER: ENTER DATE FROM WHICH R HAS HAD THIS LIMITATION.

{r_asthma}==1

COMMENT: Does R have asthma?

VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])

COMMENT: Was R employed since last interview?

DATE2DAY([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)]) >= DATE2DAY([12 months before reference date])

COMMENT: Has R been employed in the past 12 months?

When we talked to you on [lintdate~X], you reported that you had asthma.

During the past 12 months, how many days of work did you miss due to your asthma?

VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])

COMMENT: Was R employed since last interview?

DATE2DAY([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)]) >= DATE2DAY([12 months before reference date]) && [RESPONDENT GENDER] == 2 && [total bio children reported] > 0 && [asthma reptd for any kids in previous int] > 0

COMMENT: Is R a mother who has been employed in the past 12 months?

When talked to you on [lintdate~X], you reported that (one of) your child(ren) had asthma.

During the past 12 months, how many days of work did you miss due to ([name of biochild(1)]'s/any of your children's) asthma?

How much do you weigh?

(ENTER POUNDS)

How tall are you?

(INTERVIEWER: IF R ANSWERS ONLY IN FEET OR ONLY IN INCHES, LEAVE OTHER FIELD BLANK.)

How often do you do vigorous activities for at least 10 minutes that cause heavy sweating or large increases in breathing or heart rate?

(INTERVIEWER: IF R NEVER DOES THIS TYPE OF ACTIVITY, ENTER "0" IN "FREQUENCY".)

CHOOSE TIME UNIT:

([frequency of vigorous exercise]==0 || [frequency of vigorous exercise]==996)

COMMENT: If R is unable or never does physical activities then skip question about how long

About how long do you do these vigorous activities each time?

SELECT TIME UNIT:

How often do you do light or moderate activities for at least 10 minutes that cause only light sweating or slight to moderate increase in breathing or heart rate?

(INTERVIEWER: IF R NEVER DOES THIS TYPE OF ACTIVITY, ENTER "0" IN "FREQUENCY".)

SELECT TIME UNIT:

([frequency of moderate exercise]==0 || [frequency of moderate exercise]==996)

COMMENT: If R is unable or never does physical activities then skip question about how long

About how long do you do these light or moderate activities each time?

SELECT TIME UNIT:

How often do you do physical activities specifically designed to strengthen your muscles such as lifting weights or doing calisthenics? (Include all such activities even if you have mentioned them before.)

(INTERVIEWER: IF R NEVER DOES THIS TYPE OF ACTIVITY, ENTER "0" IN "FREQUENCY".)

SELECT TIME UNIT:

About how long has it been since your last general physical exam or routine checkup by a medical doctor or other health professional? Do not include a visit about a specific problem.

Has it been...(READ CATEGORIES AS NECESSARY)?

During this last check-up, were you asked about....

([RESPONDENT GENDER])

COMMENT: Gender of R

During the past 12 months, that is since [refdate_12mo~X], have you seen or talked to a doctor who specializes in women's health (an obstetrician/gynecologist) about your own health?

Are you now trying to lose weight, gain weight, stay about the same, or are you not trying to do anything about your weight?

When you buy a food item for the first time, how often would you say you read the nutritional information about calories, fat and cholesterol sometimes listed on the label - would you say always, often, sometimes, rarely or never?

When you buy a food item for the first time, how often would you say you read the ingredient list on the package - (would you say always, often, sometimes, rarely or never)?

Are you currently taking any cholestrol lowering medications known as "statins"?

([RESPONDENT GENDER])

COMMENT: Gender of R

Are you currently taking any hormone replacement therapy or "HRT" medications?

Now I'm going to read a list of opinions people have about themselves. After I read each statement, please tell me how much you strongly agree, agree, disagree or strongly disagree with these opinions.

ORIGINAL QUESTION NAME: *CREATED

Self-esteem score

Now we have a few questions about health care and hospitalization plans.

Are you covered by any kind of private or governmental health or hospitalization plans or health maintenance organization (HMO) plans?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, [Medicaid or a Medicaid alternative plan such as [name of state Medicaid Program]].

(INTERVIEWER: GENERALLY, IF R OR EMPLOYER DO NOT HAVE TO PAY, THE INSURANCE IS MEDICAID OR A MEDICAID ALTERNATIVE. PLEASE SEE HELP SCREEN FOR LIST OF MEDICAID ALTERNATIVE PROVIDERS AND PLANS FOR [RESPONDENT STATE].)

Do you have one health plan or more than one?

VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])

COMMENT: Was any employer reported?

([total number of employers reported] > 0 && [DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)] == [1998 int (current) date])

COMMENT: Is R currently employed?

([spouse/partner employed in 2001] ==1 || [spouse/partner employed in 2001] ==0 || [spouse/partner employed in 2001] ==2)

COMMENT: Was R's spouse/partner employed in past calendar year?

{r_healthplan_text1}

Does your current employer pay for any part of the cost of this plan?

Does your current employer pay the total cost of the premiums for this health plan, or do you also have to contribute toward the cost?

([spouse/partner employed in 2001] ==1 || [spouse/partner employed in 2001]==0 || [spouse/partner employed in 2001] ==2)

COMMENT: Was R's spouse/partner employed in past calendar year?

{r_healthplan_text1}

Does {spar3}'s current employer pay for any part of the cost of this health plan?

Does [Spouse/partner's name]'s current employer pay the total cost of the premiums for this health plan, or does [Spouse/partner's name] also have to contribute toward the cost?

{r_healthplan_text1}

Do you or other family members pay the total cost of the premiums for this health plan?

Even though you or other family members pay the full cost of this health plan, is it purchased through a former employer of you or another family member?

Is this health plan paid for through a government program, such as Medicaid?

Does a former employer of yours [or] [Spouse/partner's name]'s pay for any part of the cost of this health plan?

Does this former employer pay the total cost of the premiums for this health plan, or do you and your family also have to contribute toward the cost?

Who pays the cost of the premiums for this health plan?

(INTERVIEWER: ENTER VERBATIM)

I want to ask you about your primary insurance plan. That is the plan that pays most of the cost of your doctor and hospital bills.

Is this plan either a Health Maintenance Organization, HMO, network or Point of Service plan?

Is this a Preferred Provider Organization or a PPO? That is, do you get increased benefits or lower co-pay if you use a participating provider?

Does this plan require you to get authorization from a primary care provider before seeing a medical specialist?

Have you (or your employer) set up a medical savings account (msa) to help pay your health care expenses?

Since [LINTDATE~X], was there any time when you were not covered by health insurance?

(((([marital status code]==1) || ([marital status code]==5) || ([marital status code]==4)) && ([spouse in hh?]==1)) || ([partner in hh?]==1))

COMMENT: Is current marital status "married" or "remarried" and there is a spouse listed on the household roster or is a partner listed?

Is [Spouse/partner's name] covered by any kind of private or governmental health or hospitalization plans or health maintenance organization (HMO) plans?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, [Medicaid or a Medicaid alternative plan such as [name of state Medicaid Program]].

(INTERVIEWER: GENERALLY, IF R OR EMPLOYER DO NOT HAVE TO PAY, THE INSURANCE IS MEDICAID OR A MEDICAID ALTERNATIVE. PLEASE SEE HELP SCREEN FOR LIST OF MEDICAID ALTERNATIVE PROVIDERS AND PLANS FOR [RESPONDENT STATE].)

Does [Spouse/partner's name] have one health plan or more than one?

([spouse/partner employed in 2001] ==1 || [spouse/partner employed in 2001] ==0 || [spouse/partner employed in 2001] ==2)

COMMENT: Was R's spouse/partner employed in past calendar year?

VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])

COMMENT: Were any employers reported?

([total number of employers reported] > 0 && [DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)] == [1998 int (current) date])

COMMENT: Is R currently employed?

{sp_healthplan_text1}

Does {spar3}'s current employer pay for any part of the cost of this plan?

Does [Spouse/partner's name]'s current employer pay the total cost of the premiums for this health plan, or does [S/HE] also have to contribute toward the cost?

VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])

COMMENT: Was any employer reported?

([total number of employers reported] > 0 && [DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)] == [1998 int (current) date])

COMMENT: Is R currently employed?

{sp_healthplan_text1}

Does your current employer pay for any part of the cost of {spar3}'s health plan?

Does your current employer pay the total cost of the premiums for this health plan, or do you also have to contribute toward the cost?

{sp_healthplan_text1}

Do you {sp_or} {spar3} or other family members pay the total cost of the premiums for this health plan?

Even though you [or] [Spouse/partner's name] or other family members pay the full cost of this health plan, is it purchased through a former employer of you [or] [Spouse/partner's name] or another family member?

Is this health plan paid for through a government program, such as Medicaid?

Does a former employer of yours [or] [Spouse/partner's name]'s pay for any part of the cost of this health plan?

Does this former employer pay the total cost of the premiums for this health plan, or do you [or] [Spouse/partner's name] and your family also have to contribute toward the cost?

Who pays the cost of the premiums for this health plan?

(INTERVIEWER: ENTER VERBATIM)

([total bio children reported] > 0)

COMMENT: ANY BIOLOGICAL CHILDREN REPORTED?

{childins_intro} covered by any kind of private or governmental health or hospitalization plans or health maintenance organization (HMO) plans?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include {CHIP_NAME}, Blue Cross, Blue Shield, Medicaid/Welfare/Public Medical Insurance.

(Does/Do) your child(ren) have one health plan or more than one?

VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])

COMMENT: Was any employer reported?

([total number of employers reported] > 0 && [DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)] == [1998 int (current) date])

COMMENT: Is R currently employed?

([spouse/partner employed in 2001] ==1 || [spouse/partner employed in 2001] ==0 || [spouse/partner employed in 2001] ==2)

COMMENT: Was R's spouse/partner employed in past calendar year?

{ch_healthplan_text1}

Does your current employer pay for any part of the cost of your (child's/childrens') health plan?

Does your current employer pay the total cost of the premiums for this health plan, or do you also have to contribute toward the cost?

([spouse/partner employed in 2001] ==1 || [spouse/partner employed in 2001]==0 || [spouse/partner employed in 2001] ==2)

COMMENT: Was R's spouse/partner employed in past calendar year?

{ch_healthplan_text1}

Does {spar3}'s current employer pay for any part of the cost of your (child's/childrens') health plan?

Does [Spouse/partner's name]'s current employer pay the total cost of the premiums for this health plan, or does [Spouse/partner's name] also have to contribute toward the cost?

{ch_healthplan_text1}

Do you or other family members pay the total cost of the premiums for your (child's/childrens') health plan?

Even though you or other family members pay the full cost of this health plan, is it purchased through a former employer of you or another family member?

Is (child's/childrens') health plan paid for through a government program, such as Medicaid?

Does a former employer of yours [or] [Spouse/partner's name]'s pay for any part of the cost of this health plan?

Does this former employer pay the total cost of the premiums for this health plan, or do you and your family also have to contribute toward the cost?

Who pays the cost of the premiums for (child's/childrens') health plan?

(INTERVIEWER: ENTER VERBATIM)

{birthdate~Y} <= 1958

COMMENT: Check age of resp

Part of this study is concerned with people's memory, and ability to think about things. First, how would you rate your memory at the present time? Would you say it is excellent, very good, good, fair or poor?

Compared to (two years ago/2004), would you say your memory is better now, about the same, or worse now than it was then?

I'll read a set of 10 words and ask you to recall as many as you can. We have purposely made the list long so that it will be difficult for anyone to recall all the words. Most people recall just a few. Please listen carefully as I read the set of words because I cannot repeat them. When I finish, I will ask you to recall aloud as many of the words as you can, in any order. Is this clear?

(INTERVIEWER: PROBE AS NEEDED FOR UNDERSTANDING OF TASK. READ ITEMS BELOW AT A SLOW, STEADY RATE - APPROXIMATELY ONE WORD EVERY TWO SECONDS.

IF R REFUSES DURING OR AFTER THE INTRODUCTION AND BEFORE ANY WORDS ARE READ, SELECT "REFUSED WORD LIST" AND SELECT <SUBMIT AND CONTINUE> TO PROCEED.)

WORD LIST TO READ - ONE WORD EVERY TWO SECONDS
[word_list_read]

{cog_word_list_flag}

COMMENT: Check word list flag

Now please tell me the words you can recall

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

Now please tell me the words you can recall

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

Now please tell me the words you can recall


(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

Now please tell me the words you can recall


(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: PLEASE INDICATE WHETHER ANY OF THE FOLLOWING PROBLEMS OCCURRED IN RELATION TO WORD RECALL.)

(SELECT ALL THAT APPLY.)

For this next question, please try to count backward as quickly as you can from the number I will give you. I will tell you when to stop.

Please start with: 20

(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)

INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.

R CAN CORRECTLY COUNT DOWN FROM 19 TO 10 OR FROM 20 TO 11.

You may stop now. Thank you.

(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)

Let's try again.

The number to count backward from is : 20

(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)

INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.

You may stop now. Thank you.

(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)

Now please try counting backward from a different number. Remember to count as quickly as you can from the number I mention.

Please start with: 86

(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)

INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.

R CAN CORRECTLY COUNT DOWN FROM 86 TO 77 OR FROM 85 TO 76.

You may stop now. Thank you.

(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 85 TO 76 OR FROM 86 TO 77 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. ALLOW R TO START OVER IF S/HE WISHES TO DO SO.)

Let's try again.

The number to count backward from is : 86

(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)

INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.

You may stop now. Thank you.

(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 85 TO 76 OR FROM 86 TO 77 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)

Now let's try some subtraction of numbers. One hundred minus 7 equals what?

(INTERVIEWER: IF R ADDS 7 INSTEAD, YOU MAY REPEAT THE QUESTION. IF DON'T KNOW OR REFUSED ANY NUMBER, SELECT <SUBMIT AND CONTINUE> TO PROCEED.)

And 7 from that?

And 7 from that?

And 7 from that?

And 7 from that?

{word_list_refused1} == 2 || {correct_words_cnt1} > 0

COMMENT: Did R refuse to answer word recall?

{cog_word_list_flag}

COMMENT: Check flag

A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.


(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.


(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

([R's age] >= 40)

COMMENT: Is R age GE to 40?

([r complete 40+ health module?]==1)

COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out

Now I am going to read a list of the ways that you might have felt or behaved recently. After each statement, please tell me how often you felt this way during the past week.

During the past week.....

CESD - SCORE

I would like to know about your most recent visit(s) to a health care professional.

When was the last time you visited a health care professional for any reason?

(ENTER MONTH AND YEAR)

When did you last visit a health care professional for a general physical exam?

(ENTER MONTH AND YEAR)

This next series of questions asks about your biological parent's health.

Is your biological father still alive?

What caused your biological father's death?

How old was he when he died?

(ENTER AGE)

{Did_doesswitch} your father have any major health problems?

What [are/were] these problems?

Is your biological mother still alive?

What caused your biological mother's death?

How old was she when she died?

(ENTER AGE)

{did_doesswitch} your mother have any major health problems?

What [are/were] these problems?

Next I will be asking you more specific questions about your health. This information will help keep track of how you feel and how well you are able to do your usual activities.

If you are unsure about how to answer, please give the best answer you can.

In general, would you say your health is ....

The following items are activities you might do during a typical day. Does your health limit you in these activities?

......Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf?

..... Climbing several flights of stairs?

During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?

..... Accomplished less than you would like?

.... Were limited in the kind of work or other activities?

During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?

.... Accomplished less than you would like?

.... Didn't do work or other activities as carefully as usual?

During the past 4 weeks, how much did pain interfere with your normal work (including both work outside of the home and housework)?

Thinking only of the past 4 weeks, please give the one answer that comes closest to the way you have been feeling. How often during the past 4 weeks....

.... have you felt calm and peaceful?

.... Did you have a lot of energy?

.... Have you felt down-hearted and blue?

During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?

Has a doctor ever told you that you have high blood pressure or hypertension?

In what month and year was that first diagnosed?

(ENTER MONTH AND YEAR)

Do you have high blood pressure or hypertension at the present time?

Has a doctor ever told you that you have diabetes or high blood sugar?

In what month and year was that first diagnosed?

(ENTER MONTH AND YEAR)

Has a doctor ever told you that you have cancer or malignant tumor of any kind except skin cancer?

How many such cancers have you had?

(ENTER AMOUNT)

REPEAT

COMMENT: Start loop

In what month and year was [most recent/next most recent] cancer diagnosed?

(ENTER MONTH AND YEAR)

In which organ or part of your body did this cancer occur?

Do you currently have any such cancer?

UNTIL ([Q11-loop3 counter]==[Number of cancers R reported] || [Number of cancers R reported]==0)

COMMENT: Repeat until no more cancers to be reported

Not including asthma, has a doctor ever told you that you have chronic lung disease such as chronic bronchitis or emphysema?

Has a doctor ever told you that you had a heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems?

Did you have a heart attack or myocardial infarction?

In what month and year did you have your (last) heart attack or myocardial infarction?

(ENTER MONTH AND YEAR)

Do you currently have any angina or chest pains due to your heart?

Has a doctor ever told you that you have congestive heart failure?

In what month and year was your congestive heart failure?

(ENTER MONTH AND YEAR)

Do you currently have congestive heart failure?

Has a doctor ever told you that you had a stroke?

In what month and year did you last have a stroke?


(ENTER MONTH AND YEAR)

Has a doctor ever told you that you had emotional, nervous, or psychiatric problems?

In what month and year were your emotional, nervous or psychiatric problems diagnosed?

(ENTER MONTH AND YEAR)

During the last 12 months, have you had any emotional, nervous, or psychiatric problems?

Have you ever had, or has a doctor ever told you that you have, arthritis or rheumatism?

In what month and year was your arthritis or rheumatism diagnosed?

(In what month and year was your arthritis or rheumatism diagnosed?)

(ENTER MONTH AND YEAR)

Do you sometimes have pain, stiffness, or swelling in your joints?

Do you have any of the following health problems? (other than problems discussed earlier)

([RESPONDENT GENDER]==2)

COMMENT: Is R female?

(Do you have any of the following health problems? (other than problems discussed earlier))

Have you ever had a change in menstrual patterns?

Have you had a fracture or broken bone in the last 10 years?

In what year did you last break a bone?

(SELECT YEAR)