Page 1 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.001_00.000 Instrument Variable Name: PLBORN QuestionnaireFileName: Family
QuestionText: [fill: Were you/Was ALIAS] born in the United States?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: All persons
SkipInstructions: <1> [store "1" in CITIZEN and goto PLBORN1]
<2> [goto PLBORN2]
<R,D> [goto CITIZEN]
Page 2 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.002_00.000 Instrument Variable Name: PLBORN1 QuestionnaireFileName: Family
QuestionText: In what state [fill: were you/was ALIAS] born?
01 Alabama
02 Alaska
03 Arizona
04 Arkansas
05 California
06 Colorado
07 Connecticut
08 Delaware
09 District of Columbia
10 Florida
11 Georgia
12 Hawaii
13 Idaho
14 Illinois
15 Indiana
16 Iowa
17 Kansas
18 Kentucky
19 Louisiana
20 Maine
21 Maryland
22 Massachusetts
23 Michigan
24 Minnesota
25 Mississippi
26 Missouri
27 Montana
28 Nebraska
29 Nevada
30 New Hampshire
31 New Jersey
32 New Mexico
33 New York
34 North Carolina
35 North Dakota
36 Ohio
37 Oklahoma
38 Oregon
39 Pennsylvania
40 Rhode Island
41 South Carolina
42 South Dakota
43 Tennessee
44 Texas
45 Utah
46 Vermont
47 Virginia
48 Washington
Page 3 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
49 West Virginia
50 Wisconsin
51 Wyoming
57 United States (state unknown)
UniverseText: All persons born in the United States
SkipInstructions: <1-51,R,D> [goto HEADST]
Page 4 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.003_00.000 Instrument Variable Name: PLBORN2 QuestionnaireFileName: Family
QuestionText: In what country [fill: were you/was ALIAS] born?
* Please record country of birth. If country not found, type "ZZ"
060 AMERICAN SAMOA
061 AM SAMOA
062 BAKER ISLAND
063 GUAM
064 HOWLAND ISLAND
065 JARVIS ISLAND
066 JOHNSTON ATOLL
067 KINGMAN REEF
068 MANUA ISLANDS
069 MIDWAY ISLANDS
070 NAVASSA ISLAND
071 NORTHERN MARIANAS
072 PALMYRA ATOLL
073 PUERTO RICO
074 ROTA
075 SAIPAN
076 SAND ISLAND
077 ST CROIX
078 ST JOHN
079 ST THOMAS
080 TINIAN
081 US OUTLYING AREA
082 US VIRGIN ISLANDS
083 USVI
084 VIRGIN ISLANDS
085 WAKE ISLAND
100 ABROAD
101 ABU DHABI
102 ADEN
103 AFGHANISTAN
104 AFRICA
105 ALBANIA
106 ALBERTA
107 ALGERIA
108 ALGIERS
109 ALSACE-LORRAINE
110 AMSTERDAM
111 ANEGADA
112 ANGOLA
113 ANGUILLA
114 ANGUILLA BWI
115 ANOJOUAN
116 ANTARCTICA
117 ANTIGUA
118 ANTIGUA & BARBUDA
119 ANTIGUA WI
120 ANTILLES
Page 5 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
121 ARAB PALESTINE
122 ARABIA
123 ARGENTINA
124 ARMENIA
125 ARUBA
126 ARUBA DWI
127 ARUBA NETHERLANDS
128 ASCENSION ISLAND
129 ASIA
130 ASIA MINOR
131 ASSAM
132 AT SEA
133 AUSTRALIA
134 AUSTRIA
135 AUSTRIA-HUNGARY
136 AZERBAIJAN
137 AZORES ISLANDS
138 BAHAMAS
139 BAHAMAS UK
140 BAHRAIN
141 BAJA CAL
142 BAJA CAL SUR
143 BALBOA
144 BANGLADESH
145 BARBADOS
146 BARBUDA
147 BAVARIA
148 BELARUS
149 BELFAST
150 BELGIAN CONGO
151 BELGIUM
152 BELIZE
153 BENIN
154 BERLIN
155 BERMUDA
156 BESSARABIA
157 BHUTAN
158 BOHEMIA
159 BOLIVIA
160 BONAIRE
161 BORNEO
162 BOSNIA
163 BOSNIA & HERZEGOVINA
164 BOTSWANA
165 BRASIL
166 BRAZIL
167 BRAZZAVILLE
168 BREMEN
169 BRITAIN
170 BRITISH COLUMBIA
171 BRITISH EAST AFRICA
172 BRITISH GUIANA
Page 6 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
173 BRITISH GUYANA
174 BRITISH HONDURAS
175 BRITISH HONG KONG
176 BRITISH ISLES
177 BRITISH VI
178 BRITISH VIRGIN IS
179 BRITISH WEST INDIES
180 BRITISH WI
181 BRUNEI
182 BULGARIA
183 BURKINA FASO
184 BURMA
185 BURUNDI
186 BWI
187 BYELARUS
188 BYELORUSSIA
189 CAICOS ISLANDS
190 CAM PHA
191 CAM RANH
192 CAMBODIA
193 CAMEROON
194 CAN THO
195 CANADA
196 CANAL ZONE
197 CANARY ISLANDS
198 CANTON & ENDERBURY IS
199 CANTON ISLAND
200 CAPE VERDE
201 CARIBBEAN
202 CAYMAN ISLANDS
203 CENTRAL AFRICA
204 CENTRAL AFRICAN REP
205 CENTRAL AMERICA
206 CEYLON
207 CHAD
208 CHANNEL ISLANDS
209 CHIAPAS
210 CHIHUAHUA
211 CHILE
212 CHINA
213 CHINA HONG KONG
214 CHRISTMAS ISLAND
215 CHRISTMAS ISLAND, INDIAN OCEAN
216 COAHUILA
217 COLIMA
218 COLOMBIA
219 COMOROS
220 CONGO
221 COOK ISLANDS
222 CORAL SEA ISLANDS
223 CORK
224 CORSICA
Page 7 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
225 COSTA RICA
226 COTE D'IVORIE
227 CRETE
228 CRIMEA
229 CRISTOBAL
230 CROATIA
231 CUBA
232 CURACAO
233 CYPRUS
234 CZ
235 CZECH REPUBLIC
236 CZECHOSLOVAKIA
237 DA LAT
238 DA NANG
239 DAKAR
240 DANZIG
241 DELHI
242 DEMO PEOPLE'S REP OF KOREA
243 DEMO REP OF CONGO
244 DENMARK
245 DISTRITO FEDERAL
246 DJIBOUTI
247 DOM REP
248 DOMINICA
249 DOMINICA BWI
250 DOMINICA WI
251 DOMINICAN REPUBLIC
252 DUBAI
253 DUBLIN
254 DURANGO
255 DUTCH EAST INDIES
256 DUTCH GUIANA
257 DUTCH INDONESIA
258 DUTCH NEW GUINEA
259 EAST PAKISTAN
260 EAST PRUSSIA
261 EASTER ISLAND
262 EASTERN AFRICA
263 ECUADOR
264 EGYPT
265 EIRE
266 EL SALVADOR
267 ENGLAND
268 EQUATORIAL GUINEA
269 ERITREA
270 ESPANA
271 ESTONIA
272 ETHIOPIA
273 EUROPA ISLAND
274 EUROPE
275 FALKLAND ISLANDS
276 FAROE ISLANDS
Page 8 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
277 FEDERAL DISTRICT
278 FEDERAL REPUBLIC OF YUGOSLAVIA
279 FEDERATED STATES OF MICRONESIA
280 FIJI
281 FILIPINES
282 FINLAND
283 FOREIGN COUNTRY
284 FORMOSA
285 FRANCE
286 FRANKFURT
287 FRENCH GUIANA
288 FRENCH MOROCCO
289 FRENCH POLYNESIA
290 GABON
291 GALAPAGOS ISLANDS
292 GALWAY
293 GAMBIA
294 GAZA STRIP
295 GEORGIA
296 GERMANY
297 GHANA
298 GIA DINH
299 GIBRALTER
300 GLORIOSO ISLANDS
301 GOA
302 GRAND BAHAMA
303 GRAND CAYMAN
304 GRAND TURK
305 GREAT BRITAIN
306 GREAT COMORE
307 GREECE
308 GREENLAND
309 GRENADA
310 GUADALAJARA
311 GUADELOUPE
312 GUANAJUATO
313 GUATEMALA
314 GUERNSEY
315 GUERRERO
316 GUIANA
317 GUINEA
318 GUINEA-BISSAU
319 GUYANA
320 HA DONG
321 HAI PHONG
322 HAITI
323 HAMBURG
324 HANOI
325 HANOVER
326 HAVANA
327 HEARD & MCDONALD ISLANDS
328 HERZEGOVINA
Page 9 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
329 HESSE
330 HIDALGO
331 HIGH SEAS
332 HOLLAND
333 HONDURAS
334 HONG KONG
335 HUNGARY
336 HYDERABAD
337 ICELAND
338 INDIA
339 INDONESIA
340 INTERNATIONAL WATERS
341 IRAN
342 IRAQ
343 IRELAND
344 IRIAN JAYA
345 IRISH REPUBLIC
346 ISLE OF MAN
347 ISRAEL
348 ITALY
349 IVORY COAST
350 JALISCO
351 JAMAICA
352 JAN MEYAN
353 JAPAN
354 JAVA
355 JERSEY
356 JIBUTI
357 JORDAN
358 JUAN DE NOVA ISLAND
359 JUGOSLAVIA
360 KALININGRAD
361 KAMPUCHEA
362 KASHMIR
363 KAZAKHSTAN
364 KENYA
365 KHANH HUNG
366 KINSHASA
367 KIRIBATI
368 KOREA
369 KORO ISLAND
370 KUWAIT
371 KWAJALEIN
372 KWANTUNG
373 KYRGYZSTAN
374 LABRADOR
375 LABUAN
376 LAOS
377 LATAKIA
378 LATIN AMERICA
379 LATVIA
380 LEBANON
Page 10 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
381 LEEWARD ISLANDS
382 LESOTHO
383 LIBERIA
384 LIBYA
385 LIECHTENSTEIN
386 LITHUANIA
387 LOAS
388 LONDONDERRY
389 LONG XUYEN
390 LORRAINE
391 LUBECK
392 LUXEMBOURG
393 MACAO
394 MACAU
395 MACEDONIA
396 MADAGASCAR
397 MADEIRA ISLANDS
398 MAINLAND CHINA
399 MAJORCA
400 MALAGASY REPUBLIC
401 MALAWI
402 MALAYSIA
403 MALDIVES
404 MALI
405 MALLORCA
406 MALTA
407 MACHURIA
408 MANICA
409 MANILA
410 MANITOBA
411 MARSHALL ISLANDS
412 MARTINIQUE
413 MAURITANIA
414 MAURITIUS
415 MAYOTTE ISLAND
416 MELANESIA
417 MEXICO
418 MICHOACAN
419 MICRONESIA
420 MIDDLE EAST
421 MOLDAVIA
422 MOLDOVA
423 MONACO
424 MONAGAS
425 MONGOLIA
426 MONTENEGRO
427 MONTSERRAT
428 MORELOS
429 MOROCCO
430 MOZAMBIQUE
431 MY THO
432 N. IRELAND
Page 11 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
433 NAM DINH
434 NAMIBIA
435 NAURU
436 NAYARIT
437 NEPAL
438 NETHERLANDS
439 NETH. ANTILLES
440 NETH. EAST INDIES
441 NEVIS ISLAND
442 NEW BRUNSWICK
443 NEW CALEDONIA
444 NEW GUINEA
445 NEW HEBRIDES
446 NEW SOUTH WALES
447 NEW ZEALAND
448 NEWFOUNDLAND
449 NHA TRANG
450 NICARAGUA
451 NIGER
452 NIGERIA
453 NIUE ISLAND
454 NORFOLK ISLAND
455 NORTH AFRICA
456 NORTH AMERICA
457 NORTH KOREA
458 NORTH VIETNAM
459 NORTHERN IRELAND
460 NORTHERN TERRITORY
461 NORWAY
462 NOVA SCOTIA
463 NUEVO LEON
464 OAXACA
465 OCEANIA
466 OKINAWA
467 OMAN
468 ONTARIO
469 OVERSEAS
470 PAKISTAN
471 PALAU
472 PALESTINE
473 PANAMA
474 PANAMA CANAL ZONE
475 PAPUA NEW GUINEA
476 PARACEL ISLANDS
477 PARAGUAY
478 PELAGOSA
479 PEOPLE'S REP. OF CHINA
480 PEOPLE'S REP. OF CONGO
481 PERSIA
482 PERU
483 PHAN THIET
484 PHILIPPINES
Page 12 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
485 PITCAIRN ISLAND
486 POLAND
487 POLYNESIA
488 PONAPE
489 PORTUGAL
490 PORTUGUESE INDIA
491 PRINCE EDWARD ISLAND
492 PRINCIPE ISLAND
494 PRUSSIA
495 PUEBLA
496 PUNJAB
497 PUNJAB, INDIA
498 PUNJAB, PAKISTAN
499 QATAR
500 QUANG LONG
501 QUEBEC
502 QUEENSLAND
503 QUERETARO
504 QUI NHON
505 RACH GIA
506 RAJASTHAN
507 RED CHINA
508 REPUBLIC OF CHINA
509 REPUBLIC OF CYPRUS
510 REPUBLIC OF IRELAND
511 REPUBLIC OF KOREA
512 REPUBLIC OF PANAMA
513 REP. OF PHILIPPINES
514 REP. OF SOUTH AFRICA
515 REPUBLICA DOMINICANA
516 REUNION ISLAND
517 RHODESIA
518 ROC
519 ROK
520 ROMANIA
521 ROTTERDAM
522 RUMANIA
523 RUSSIA
524 RUSSIAN FEDERATION
525 RWANDA
526 SAIGON
527 SALVADOR
528 SAMOA
529 SAN ANDRES
530 SAN LUIS POTOSI
531 SAN MARINO
532 SAN SALVADOR
533 SAO TOME ISLAND
534 SAO TOME & PRINCIPE
535 SARAWAK
536 SASKATCHEWAN
537 SAUDI ARABIA
Page 13 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
538 SAXONY
539 SCOTLAND
540 SENEGAL
541 SEOUL
542 SERBIA
543 SEYCHELLES
544 SHANGHAI
545 SHARJAH
546 SIBERIA
547 SICILY
548 SIERRA LEONE
549 SIKKIM
550 SINALOA
551 SINGAPORE
552 SLAVONIA
553 SLOVAK REPUBLIC
554 SLOVAKIA
555 SLOVENIA
556 SOLOMAN ISLANDS
557 SOMALIA
558 SONORA
559 SOUTH AFRICA
560 SOUTH AMERICA
561 SOUTH AUSTRALIA
562 SOUTH KOREA
563 SOUTH VIETNAM
564 SOUTH WALES
565 SOUTH YEMEN
566 SOUTHEAST ASIA
567 SOUTHERN AFRICA
568 SOUTHERN RHODESIA
569 SOVIET UNION
570 SPAIN
571 SPRATLEY ISLANDS
572 SRI LANKA
573 ST BARTHELEMY
574 ST BARTS
575 ST CHRISTOPHER
576 ST CHRISTOPHER-NEVIS
577 ST EUSTATIUS
578 ST HELENA
579 ST KITTS
580 ST KITTS-NEVIS
581 ST LUCIA
582 ST MAARTEN
583 ST MARTIN
584 ST PIERRE & MIQUELON
585 ST VINCENT
586 ST VINCENT & THE GRENADINES
587 SUDAN
588 SUMATRA
589 SURINAM
Page 14 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
590 SURINAME
591 SVALBARD
592 SWAZILAND
593 SWEDEN
594 SWITZERLAND
595 SYRIA
596 SYRIAN ARAB REP
597 TABASCO
598 TADZHIK
599 TAHITI
600 TAIWAN
601 TAIWAN ROC
602 TAJIKISTAN
603 TAMAULIPAS
604 TANGANYIKA
605 TANGIER
606 TANZANIA
607 TASMANIA
608 THAILAND
609 THANH HOA
610 THE GRENADINES
611 TIBET
612 TIJUANA
613 TLAXCALA
614 TOBAGO
615 TOGO
616 TOGOLAND
617 TOKELAU
618 TONGA
619 TORTOISE ISLANDS
620 TORTOLA
621 TRANSVAAL
622 TRANSYLVANIA
623 TRIESTE
624 TRINIDAD
625 TRINIDAD & TOBAGO
626 TRIPOLI
627 TROMELIN ISLAND
628 TRUK
629 TUNIS
630 TUNISIA
631 TURKEY
632 TURKMENISTAN
633 TURKS & CAICOS IS
634 TURK ISLANDS
635 TUVALU
636 TUY HOA
637 UGANDA
638 UK
639 UKRAINE
640 UKRAINIA
641 UNION ISLANDS
Page 15 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
642 UNION OF SOUTH AFRICA
643 UNION OF SOVIET SOCIALIST REPUBLICS
644 UNITED ARAB EMIRATES
645 UNITED KINGDOM
646 UPPER VOLTA
647 URUGUAY
648 USSR
649 USBEKISTAN
650 VANCOUVER
651 VANUATU
652 VATICAN CITY
653 VENEZUELA
654 VERACRUZ
655 VICTORIA
656 VIETNAM
657 VINH LONG
658 VUNG TAU
659 WALES
660 WALLIS & FUTUNA ISLANDS
661 WEST AFRICA
662 WEST BANK
663 WEST BENGAL
664 WEST INDIES
665 WEST PAKISTAN
666 WESTERN AUSTRALIA
667 WESTERN SAHARA
668 WESTERN SAMOA
669 WHITE RUSSIA
670 WINDWARD ISLANDS
671 WINNIPEG
672 WURZBERG
673 YAP
674 YAR
675 YEMEN
676 YEMEN ARAB REPUBLIC
677 YEREVAN
678 YUCATAN
679 YUGOSLAVIA
680 YUKON TERRITORY
681 ZACATECAS
682 ZADAR
683 ZAIRE
684 ZAMBIA
685 ZANZIBAR
686 ZIMBABWE
687 ZURICH
688 ANDORRA
689 BRITISH INDIAN OCEAN TERRITORY
690 DEUTSCHLAND
691 FRENCH SOUTHERN AND ANTARCTIC LANDS
692 GRENADINES, THE
693 KOSOVO
Page 16 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
694 MYANMAR
695 NORTHWEST TERRITORY
696 NUNAVUT TERRITORY
996 Country not listed
997 Refused
999 Don't know
UniverseText: All persons not born in the United States
SkipInstructions: <60-85> [store "2" in CITIZEN and goto USYR]
<100-696,996,R,D> [goto USYR]
Question ID: FSD.004_00.000 Instrument Variable Name: USYR QuestionnaireFileName: Family
QuestionText: * Read if necessary.
Earlier I recorded [fill1: your/ALIAS's] date of birth as [fill2: AGEDOB@3(text version) AGEDOB@4, AGEDOB@5].
In what year did [fill3: you/ALIAS] come to the United States to stay?
1880-Current Year 1880-Current Year
9997 Refused
9999 Don't know
UniverseText: All persons not born in the United States
SkipInstructions: <1880-Current Year> [if USYR lt AGEDOB@5, goto ERR2_USYR; else, goto CITIZEN]
<R,D> [goto USLONG]
NOTE: The "*Read if necessary…Earlier I recorded…" portion of this question is included for persons with complete
date of birth information.
Question ID: FSD.005_00.000 Instrument Variable Name: USLONG QuestionnaireFileName: Family
QuestionText: About how long [fill1: have you/has ALIAS] been in the United States?
* Read if necessary: Earlier I recorded that [fill2: you are/ALIAS is] [fill3: AGE] years old.
*Enter '95' for 95 or more years.
*If less than 1 year given as a response, code the answer as '0'.
00-94 00-94 years
95 95+ years
97 Refused
99 Don't know
UniverseText: All persons not born in the United States and refused or don't know was reported for USYR
SkipInstructions: <0-95> [if USLONG gt AGE, goto ERR_USLONG; else, goto CITIZEN]
<R,D> [goto CITIZEN]
Page 17 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.006_00.000 Instrument Variable Name: CITIZEN QuestionnaireFileName: Family
QuestionText: (book) F20 ?[F1]
[fill: Are you/Is ALIAS] a CITIZEN of the United States?
1 Yes, born in one of the 50 United States or the District of Columbia
2 Yes, born in Puerto Rico, Guam, American Virgin Islands, or other U.S. territory
3 Yes, born abroad to American parent(s)
4 Yes, U.S. citizen by naturalization
5 No, not a citizen of the United States
7 Refused
9 Don't know
UniverseText: All persons not born in the United States or a United States territory
SkipInstructions: <1> [if PLBORN eq 2, goto ERR1_CITIZEN; else, if PLBORN eq R, goto ERR3_CITIZEN; else, goto HEADST]
<2> [if (PLBORN eq 2 or PLBORN eq R), goto ERR2_CITIZEN; else, goto HEADST]
Question ID: FSD.007_00.000 Instrument Variable Name: HEADST QuestionnaireFileName: Family
QuestionText: ?[F1]
Is [fill: ALIAS] now attending Head Start?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: All persons less than 7 years of age
SkipInstructions: <1> [if no more persons less than 7 years of age, goto EDUC; else, repeat this question for the next eligible person]
<2,R,D> [ goto HEADSTEV]
Page 18 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.010_00.000 Instrument Variable Name: EDUC QuestionnaireFileName: Family
QuestionText: (book) F21 ?[F1]
What is the HIGHEST level of school [fill: you have/ALIAS has] completed or the highest degree [fill: you have/ALIAS
has] received? Please tell me the number from the card.
* Enter highest level of school completed.
00 Never attended/kindergarten only
01 1st grade
02 2nd grade
03 3rd grade
04 4th grade
05 5th grade
06 6th grade
07 7th grade
08 8th grade
09 9th grade
10 10th grade
11 11th grade
12 12th grade, no diploma
13 GED or equivalent
14 High School Graduate
15 Some college, no degree
16 Associate degree: occupational, technical, or vocational program
17 Associate degree: academic program
18 Bachelor's degree (Example: BA, AB, BS, BBA)
19 Master's degree (Example: MA, MS, MEng, MEd, MBA)
20 Professional School degree (Example: MD, DDS, DVM, JD)
21 Doctoral degree (Example: PhD, EdD)
96 Child under 5 years old
97 Refused
99 Don't know
UniverseText: All persons 5 years of age or older
SkipInstructions: repeat for all eligible persons, then goto FMILTRY
Page 19 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.041_00.000 Instrument Variable Name: FMILTRY QuestionnaireFileName: Family
QuestionText: [fill: Have you/Has any family member, that is
*Read names
(fill roster of people ge 18 years of age)]
ever been honorably discharged from active duty in the U.S. Army, Navy, Air Force, Marine Corps, or Coast Guard?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: All families with persons 18 years of age or older
SkipInstructions: <1> [if only one person 18 years of age or older, store the person number in PMILTRY and goto DOINGLW; else,
goto PMILTRY]
<2,R,D> [goto DOINGLW]
Question ID: FSD.042_00.000 Instrument Variable Name: PMILTRY QuestionnaireFileName: Family
QuestionText: * Ask or verify. Enter all that apply, separate with commas.
Who was this?
* Indicate each family member with honorable discharge.
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: All families with two or more persons 18 years of age or older and at least one was honorably discharged from active
duty in the U.S. Army, Navy, Air Force, Marine Corps, or Coast Guard
SkipInstructions: goto DOINGLW
NOTE: In the instrument, interviewers enter the line numbers associated with the persons reported by the respondent.
As shown above, each eligible person receives an edited response code in subsequent data processing.
Page 20 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.070_00.000 Instrument Variable Name: WRKHRS QuestionnaireFileName: Family
QuestionText: ?[F1]
How many hours [fill: did you work LAST WEEK at ALL jobs or businesses/did ALIAS work LAST WEEK at ALL jobs
or businesses/do you USUALLY work at ALL jobs or businesses/does ALIAS USUALLY work at ALL jobs or
businesses]?
001-168 1-168 hours
997 Refused
999 Don't know
UniverseText: All persons 18 years of age or older who were working for pay at a job or business, or working, but not for pay, at a
job or business last week, or on a planned vacation from work, or on family or maternity leave, or temporarily unable
to work for health reasons, or have a job/contract and off-season
SkipInstructions: <1-34,R,D> [goto WRKFTALL]
<35-94> [goto WRKLYR]
<95-168> [goto ERR1_WRKHRS]
Question ID: FSD.080_00.000 Instrument Variable Name: WRKFTALL QuestionnaireFileName: Family
QuestionText: ?[F1]
[fill: Do you/Does ALIAS] USUALLY work 35 hours or more per week in total at ALL jobs or businesses?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: All persons 18 years of age or older who worked less than 35 hours last week or did not know/refused to answer how
many hours they worked last week
SkipInstructions: [goto WRKLYR]
NOTE ON QUESTIONNAIRE FLOW: The instrument cycles through the appropriate questions from DOINGLW
to WRKFTALL for each eligible person, then proceeds to WRKLYR.
Question ID: FSD.110_00.000 Instrument Variable Name: WRKMYR QuestionnaireFileName: Family
QuestionText: How many months in [fill1: last calendar year in 4-digit format] did [fill2: you/ALIAS] have at least one job or business?
* If less than one month, enter '1'.
01 1 month or less
02-12 2-12 months
97 Refused
99 Don't know
UniverseText: All persons 18 years of age or older who worked last year
SkipInstructions: goto ERNYR
Page 21 of 21
2007 NHIS Questionnaire - Family
Family Socio-Demographic
Document Version Date: 12-Jul-06
Question ID: FSD.120_00.000 Instrument Variable Name: ERNYR QuestionnaireFileName: Family
QuestionText: ?[F1]
What is your best estimate of [fill1: your/ALIAS's] earnings before taxes and deductions from ALL jobs and businesses in
[fill2: last calendar year in 4-digit format]?
Include hourly wages, salaries, tips and commissions.
* Enter '999,995' if the reported income is greater than $999,995.
000001-999994 $1-$999,994
999995 $999,995+
999997 Refused
999999 Don't know
UniverseText: All persons 18 years of age or older who worked last year
SkipInstructions: goto HIEMPOF
Question ID: FSD.130_00.000 Instrument Variable Name: HIEMPOF QuestionnaireFileName: Family
QuestionText: Regarding [fill1: your/ALIAS's] job or work last week, was health insurance offered to [fill2: you/ALIAS] through [fill1:
your/ALIAS's] workplace?
1 Yes
2 No
7 Refused
9 Don't know
UniverseText: All persons 18 years of age or older who were working for pay at a job or business, or with a job or business, but not
at work, or working, but not for pay, at a family-owned job or business
SkipInstructions: goto INTROINC
NOTE ON QUESTIONNAIRE FLOW: The instrument cycles through the appropriate questions from WRKLYR to
HIEMPOF for each eligible person, then proceeds to INTROINC.
| File Type | application/msword |
| Author | Howard Riddick |
| Last Modified By | Howard Riddick |
| File Modified | 2006-09-29 |
| File Created | 2006-09-29 |