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CDC OPTIONAL MODULES: Back to topics
STATE ADDED QUESTIONS:
Back to topics
RISK FACTORS AND DERIVED
VARIABLES (Located within the corresponding section)
CDC
CORE SECTIONS:
HEALTH STATUS
Would you say in general that your
health is excellent, very good, good, fair or poor?
RISK FACTORS / CREATED VARIABLES
Risk factor for fair and poor health
HEALTHY DAYS Back to topics
Now thinking about your
physical health, which includes physical illness and injury, for
how many days during the past 30 days was your physical health not
good?
Now thinking about your
mental health, which includes stress, depression, and problems with
emotions, for how many days during the past 30 days was your mental
health not good?
During the past 30 days,
for about how many days did poor physical or mental health keep
you from doing your usual activities, such as self-care, work or
recreation?
HEALTH CARE ACCESS Back to topics
Do you have any kind
of health care coverage, including health insurance, prepaid plans
such as HMOS, or government plans such as Medicare?
Do you have one person
you think of as your personal doctor or health care provider?
Was there a time in the
past 12 months when you needed to see a doctor but could not because
of cost?
About how long has it been since you last
visited a doctor for a routine checkup?
RISK FACTORS / CREATED VARIABLES
Adults aged 18-64 who have health care coverage
EXERCISE
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During the past month,
other than your regular job, did you participate in any physical
activities or exercises such as running, calisthenics, golf, gardening,
or walking for exercise?
RISK FACTORS / CREATED VARIABLES
Adults that report doing physical activity or exercise during the past 30 days other than their regular job.
HYPERTENSION AWARENESS
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Have you ever been told by a doctor, nurse or other health professional that you have high blood pressure?
Are you currently taking medicine for your high blood pressure?
RISK FACTORS / CREATED VARIABLES
Adults who have been told they have high blood pressure by a doctor, nurse or other health professional.
CHOLESTEROL AWARENESS
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Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
About how long has it been since you last had your blood cholesterol checked?
Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high?
RISK FACTORS / CREATED VARIABLES
Cholesterol check within the past five years
Adults who have had their cholesterol checked and have been told by a doctor, nurse or other health professional that it was high.
TOBACCO USE Back to topics
Have you smoked at least
100 cigarettes in your entire life?
Do you now smoke cigarettes
every day, some days or not at all?
During the past 12 months,
have you stopped smoking for one day or longer because you were
trying to quit smoking?
RISK FACTORS / CREATED VARIABLES
Four level computed smoking
status
Risk factor for smoking
ALCOHOL CONSUMPTION Back to topics
During the past 30 days, have you had at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
During the past 30 days,
how many days per week or per month did you have at least one drink
of any alcoholic beverage?
On days when you drank,
about how many drinks did you drink on the average?
Considering all types
of alcoholic beverages, how many times during the past 30 days did
you have 5 or more drinks on an occasion?
During the past 30 days,
what is the largest number of drinks you had on any occasion?
RISK FACTORS / CREATED VARIABLES
At risk for binge drinking.
At risk for heavy alcohol consumption
Heavy Drinking Among Men
Heavy Drinking Among Women
ASTHMA Back to topics
Have you ever been told
by a doctor, nurse or other health professional that you had asthma?
Do you still have asthma?
RISK FACTORS / CREATED VARIABLES
Adults who have ever been told they have asthma (Lifetime Asthma Prevalence)
Asthma status
Adults who have been told they currently have asthma (Current Asthma Prevalence)
DIABETES Back to topics
Have you ever been told
by a doctor that you have diabetes?
FRUITS AND VEGETABLES Back to topics
How often do you drink fruit juices such as orange, grapefruit of tomato?
Not counting juice, how often do you eat fruit?
How often do you eat green salad?
How often do you eat potatoes not including French fries, fried potatoes or potato chips?
How often do you eat carrots?
Not counting carrots, potatoes or salad, how many servings of vegetables do you usually eat?
RISK FACTORS / CREATED VARIABLES
Summary index for fruits and vegetables
Consumed five or more servings of fruits and vegetables per day
IMMUNIZATION Back to topics
During the past 12 months,
have you had a flu shot?
During the past 12 months,
have you had a flu vaccine that was sprayed into your nose?
Have you ever had a pneumonia
shot? This shot is usually given only once or twice in a person’s
lifetime and is different from the flu shot. It is also called the
pneumocoocal vaccine.
Have you ever received
the hepatitis B vaccine?
Are any of these statements true for you?
You have hemophilia and have received clotting factor concentrate:
You have had sex with a man who has had sex with other men, even just one time:
You have taken street drugs by needle, even just one time:
You traded sex for money or drugs, even just one time.
RISK FACTORS / CREATED VARIABLES
Risk factor for respondents
aged 65 or older that did not have a flu shot within the past 12
months.
Risk factor for respondents
aged 65 or older that have never had a pneumonia shot.
GASTROINTESTINAL DISEASE Back to topics
In the past 30 days, did you have
diarrhea that began within the 30 day period?
Did you visit a doctor, nurse or
other health professional for this diarrheal illness?
When you visited your health care
professional, did you provide a stool sample for testing?
ARTHRITIS BURDEN Back to topics
The next questions refer to your joints. Please do not include the back or neck. During the past 30 days, have you had any symptoms of pain, aching or stiffness in or around a joint?
Did your joint symptoms first begin more than 3 months ago?
Have you ever seen a doctor or other health professional for these joint symptoms?
Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia?
Are you limited in any way in any of your usual activities because of arthritis or joint symptoms?
CARDIOVASCULAR DISEASE PREVALENCE Back to topics
Has a doctor, nurse or other health professional ever told you that you have had a heart attack, also called a myocardial infarction?
Has a doctor, nurse or other health professional ever told you that you have angina or coronary heart disease?
Has a doctor, nurse or other health professional ever told you that you have had a stroke?
PHYSICAL ACTIVITY Back to topics
When you are at work, which of the following best describes what you do?
Now thinking about moderate physical activities you do in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes some increase in breathing or heart rate?
How many days of the week do you do these moderate activities for at least 10 minutes at a time?
On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Now, thinking about the vigorous physical activities you do in a usual week, do you do vigorous activities for at least 10 minutes at a times, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
How many days per week do you do these vigorous activities for at least 10 minutes at a time?
On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
RISK FACTORS / CREATED VARIABLES
3 level moderate physical activity category
Moderate Physical Activity Risk Factor
3 level vigorous physical activity category
Vigorous Physical Activity Risk Factor
5 level physical activity category
Physical Activity Recommendation
Status
Adults that have reported participating in physical activity or exercise
EMOTIONAL SUPPORT AND LIFE SATISFACTION Back to topics
How often do you get the soical and emotional support you need? Would you say....
In general, how satisfied are you with your life? Would you say...
DISABILITY Back to topics
Are you limited in any
way in any activities because of physical, mental, or emotional
problems?
Do you now have any health
problem that requires you to use special equipment, such as a cane,
a wheelchair, a special bed or a special telephone? Include occasional
use or use in certain circumstances
HIV/AIDS
Back to topics
Have you ever been tested
for HIV? Do not count tests you may have had as part of a blood
donation.
Not including blood donations,
in what month and year was your last HIV test? Include saliva tests.
Where did you have your
last HIV test- at a private doctor or HMO office, at a counseling
and testing site, at a hospital, at a clinic, in a jail or prison,
at home or somewhere else?
Was it a rapid test where you
could get your results within a couple of hours?
RISK FACTORS / CREATED VARIABLES
Adults aged 18-64 that have ever been tested for HIV
OBESITY VARIABLES Back to topics
Four categories of Body Mass
Index
Risk factor for overweight
or obese
VETERAN STATUS
Back to topics
Have you ever served on active duty
in the United States Armed Forces, either in the regular military or in
a National Guard or Military Reserve Unit?
CDC OPTIONAL MODULES
Back to topics
DIABETES
How old were you when
you were told you have diabetes?
Are you now taking insulin?
Are you now taking diabetes
pills?
About how often do you check your
blood for glucose or sugar? Include times when checked by a family
member or friend, but do not include times when checked by a health
professional.
About how often do you
check your feet for any sores or irritations? Include times when
checked by a family member or friend, but do not include times when
checked by a health professional.
Have you ever had any
sores or irritations on your feet that took more than four weeks
to heal?
About how many times
in the past 12 months have you seen a doctor, nurse, or other health
professional for your diabetes?
A test for "A one
C" measures the average level of blood sugar over the past
three months. About how many times in the past 12 months has a doctor,
nurse, or other health professional checked you for hemoglobin "A
one C"?
About how many times in
the past 12 months has a health professional checked your feet for
any sores or irritations?
When was the last time
you had an eye exam in which the pupils were dilated? This would
have made you temporarily sensitive to bright light.
Has a doctor ever told
you that diabetes has affected your eyes or that you had retinopathy?
Have you ever taken a
course or class in how to manage your diabetes yourself
ARTHRITIS MANAGEMENT Back to topics
Thinking about your arthritis
or joint symptoms, which of the following best describes you today?
Has a doctor or other
health professional ever suggested losing weight to help with your
arthritis or joint symptoms?
Has a doctor or other
health professional ever suggested physical activity or exercise
to help your arthritis or joint symptoms?
Have you ever taken an
educational course or class to teach you how to manage problems
related to your arthritis or joint symptoms?
CARDIOVASCULAR HEALTH Back to topics
After you left the hospital
following your heart attack did you go to any kind of
outpatient rehabilitation? This is sometimes called "Rehab".
After you left the hospital following
your stroke did you go to any kind of outpatient rehabilitation? This is
sometimes called "Rehab".
Do you take aspirin daily or every
other day?
Do you have a health problem or
condition that makes taking aspirin unsafe for you?
MENTAL ILLNESS AND STIGMA Back to topics
About how often during the
past 30 days did you feel nervous?
During the past 30 days,
about how often did you feel hopeless?
During the past 30 days,
about how often did you feel restless or fidgety?
During the past 30 days,
about how often did you feel so depressed that nothing could cheer you up?
During the past 30 days,
about how often did you feel that everything was an effort?
During the past 30 days,
about how often did you feel worthless?
During the past 30 days,
for about how many days did a mental health condition or emotional problem
keep you from doing your work or other usual activities?
Are you now taking medicine or
receiving treatment from a doctor or other health professional for
any type of mental health condition or emotional problem?
Treatment can help people with
mental illness lead normal lives. Do you agree slightly or strongly,
or disagree slightly or strongly?
People are generally caring and
sympathetic to people with mental illness. Do you agree slightly or
strongly, or disagree slightly or strongly?
ACTIONS TO CONTROL HIGH BLOOD PRESSURE
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Are you changing your eating habits
to help lower or control your high blood pressure?
Are you cutting down on salt to help
lower or control your high blood pressure?
Are you reducing alcohol use to help
lower or control your high blood pressure?
Are you exercising to help lower or
control your high blood pressure?
Has a doctor or other health professional
ever advised you to change your eating habits to help lower or control your
high blood pressure?
Has a doctor or other health professional
ever advised you to cut down on salt to help lower or control your
high blood pressure?
Has a doctor or other health professional
ever advised you to reduce alcohol use to help lower or control your
high blood pressure?
Has a doctor or other health professional
ever advised you to exercise to help lower or control your high blood pressure?
Has a doctor or other health professional
ever advised you to take medication to help lower or control your
high blood pressure?
Were you told on two or more different
visits to a doctor or other health professional that you had high blood pressure?
STATE ADDED QUESTIONS Back to topics
PROSTATE CANCER SCREENING Back to topics
Has a nurse, doctor or other health
care professional ever talked with you about any kind of screening test
or exam to check for prostate cancer?
Did you receive the prostate cancer screening test?
OBESITY INDICATOR Back to topics
Excluding diet drinks, 100% fruit juice
or carbonated water, how often do you drink regular soft drinks, sweet tea,
fruit drinks or fruit punch, Kool-aid, or sports drinks?
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