The National Health 

Interview Survey 

Design, 1973-84, 

and Procedures, 

1975-83 

A description of the National Health 

Interview Survey, a national probability 

sample survey of the civilian 

noninstitutiona lized population of the 

United States 

Programs and Collection Procedures 

Series 1, No. 18 

DHHS Publication No. (PHS) 85–1 320 

U.S. Department of Health and Human . 

Services 

Public Health Service 

National Center for Health Statistics 

Hyattsville, Md. 

August 1985 
Copyright Information 

All material appearing in this report is in the public domain and may 

be reproduced or copied without permission; citatton as to source, 

however, is appreciated 

Suggested Citation 

National Center for Health Statistics, M. G. Kovarand G. S, Poe: The 

National Health interview Suwey Design, 1973–84, and Procedures, 

1975-83. Vita/ and Hea/th Statistics, Series 1, No. 18. DHHS Pub. 

No, (PHS) 85-1320. Public Health Service. Washington, U.S. 

Government Printing Office, August 1985, 

Library of Congress Cataloging in Publication Data 

National Center for Health Statistics (U. S.) 

The National Health Interview Survey. 

(9HHS publication ; no. (PHS) 85–1320) (Programs and 

collection procedures. Series 1 ; no. 18) 

Prepared by: Mary Grace Kovar and Gail Scott Poe. 

Includes btbliographles. 

1, Health surveys-United States, 1. Kovar, Mary Grace, 

Il. Poe, Gail S. Ill, Series, IV. Sertes: Vital and 

health statistics, Series 1, Programs and collection 

procedures; no. 18 

RA407.3. N28 1985 362.1 ‘072073 85–3089 

IS8N 0–8406–031 3–4 
National Center for Health Statistics 

Manning Feinleib, M. D., Dr. P. H., Director 

Robert A. Israel, Deputy Director 

Jacob J. Feldman, Ph.D., Associate Director for Analysis 

and Epidemiology 

Garrie J. Losee, Associate Director forData Processing 

and Services 

Alvan O. Zarate, Ph.D., Assistant Director for International 

Statistics 

E. Earl Bryant, Associate Director for Interview and 

Examination Statistics 

Stephen E. Nieberding, Associate Director for Management 

Gail F. Fisher, Ph.D., Associate Director for Program 

Planning, Evaluation, and Coordination 

Monroe G. Sirken, Ph.D., Associate Director for Research 

and Methodology 

Peter L. Hurley, Associate Director for Vital and Health 

Care Statistics 

Alice I-Iaywood, Information Oj?cer 

Interview and Examination Statistics Program 

E. Earl Bryant, Associate Director 

Mary Grace Kovar, Dr. P. H., Special Assistant for Data 

Policy and Analysis 

Paul D. Williams, ChieA Data Applications and Research 

Stafl 

Division of Health Interview Statistics 

Robert R. Fuchsberg, Director


Owen T. Thomberry, Jr., Ph. D., Deputy Director

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 

Section I: Sample Design and Estimation, 1973–84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 

Chapter l: %mpledesign.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 

Selectingthe primary samplingunits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 

Grouping PSU’s into strata . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 

SubsamplingwithinPSU’s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

The 1985 sample design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

Chapter2: Estimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 

Point estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............... 10 

Variances ,, . . . . . . . . . . 0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . .. -. . .. .. . . .. -. . . . . . --- . . . . . . . 11 

Weights onthepublic-use datatapes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 

Figures 

1, Adjustmentfornoninterviews.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . - -- -. . . . . . 10 

2, The 60 age-sex-colorcells intheNational HealthInterview Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

Tables 

A, Number andpopulation ofstratafor 376-primary-sampltig-titdesii%n byregion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

B.	 Number, proportion of children who have received care within an adequate interval, estimates of standard errors, and 

design effects by selected characteristics ofchildren and youths under 18 years of age National Healti Intemiew 

Survey, 1975-76 armual average . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 

Section H: Questionnaires and Survey Operations, 1975-83 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . , . . . . . 15 

Chapter 3: NHIS questionnaire and interview design anddevelopment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 

Major questiomtire chmges. 1969.74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 

1976-81 evaluationperiodobjectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 

1976-81 evaluation periodactivities , . , . , . . ,. , ,. . . .0 . . . . . . . . . . . . . . . . . , !. . . . . . . ,. . . . . . . . . . . . . . . . . . . . . . . . . . . 18 

Topic-by-topic changes in questionnaire format, 1975-83 . . ,. . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . . . . . . . . . . 19 

Supplementstothe basic coreNHIS questionnaire . . . . . . . . . . ...4.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 

Chapter4: Survey operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., . . . . 55 

Introduction ,. . . . . . . ,. . . . . . ,, . , . . , ,. , , . . . , . . . ,, . . . . . , ,, , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 

Interview procedures, 1975-83 , ,, . ,. , , . . . . ,, , ,. . , ., . . . . . , . , . . . . . . . , . . . , . . . . . . . . . , , . . . . . , ,. . . . . . . . . . . . . . . . 55 

Flow ofNHIS field activities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 57 

Figures 

3. Householdcomposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 

4. Date ofbirth, age, andsex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o . . ..o. . . . . . . . . . . 21 

5. Armed Forces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .“.......-... 21 

6. Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 

7. Race and origin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 

8. Employment status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...”..... . . . . . . . . . . 25 

9. Occupation andindusm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..." 26 

10.	 Marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 

11, Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .-.........”..... 27 

. 

Ill 
12. Hospitalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

13. Limitation ofactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

14. Restricted activity (disability days) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

15. Relationships amongthetypes ofdisability days as defiiedbytheNational Healt.h Interview Survey . . . . . . . . . . . . . . 

16. 12-monthbeddays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

17. Doctorcontacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

18. 12-month doctorcontacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

19. General health status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

20. Heightand weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

21. Conditionlists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

22. Detailed condition questions . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

23. National Health Interview Survey, page . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

24. Interviewercalendarcard showing 2-weekreferenceperiod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

25.	 Organization chart of National Health Interview Survey (NHIS) activities at a typical regional office of the U.S. 

Bureau ofthe Census . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tables 

C. Major supplemental topics covered National Health Interview Survey, 1959–83 . . . . . . , . . . . . . . . . . . . . , ,.. . . . . . , , 

D. Response rates andnoninterviewrates by type: NationalHealthInterview Survey, 1975-83 . . . . . . . . . . . . . . . . . . . . . 

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Appendixes 

I. Census regions, census divisions, and States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

II. Tabulation areas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

III. Control and experimental questionnaire data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Iv. Selected supplements, 1975-83 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

v. Subsample selection interview aids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

VI. Preinterview letter to sample households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

VII. Postintemiewletterto sample households. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

VIII. Observation Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

IX. HIS reinterviewforms . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

x. Forms for recording interviewer errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

XI. HIS Production Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

XII. SummaryofHIS InterviewerPerformance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

XIII. NotificationofInterviewerPerformance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

XIV. Transcription sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Symbols 

..- Data not available 

. . . Category nonapplicable 

Quantity zero 

0.0 Quantity more than zero butiess than 

0.05 

z Quantity more than zero but less than 

500where numbers are roundedto 

thousands 

* Figure doesnot meet standardof 

reliability or precision 

# Figure suppressed to comply with 

confidentiality requirements 

30 

32 

38 

40 

40 

41 

44 

44 

44 

45 

48 

56 

58 

59 

53 

57 

65 

68 

69 

70 

73 

92 

93 

95 

96 

97 

120 

124 

125 

126 

127 

iv 
The National Health 

Interview Survey 

Design, 1973-84, 

and Procedures, 

1975-83 

Introduction 

The National Health Interview Survey is the oldest of a 

program of surveys designed to collect data on the health and 

use of health services of the population of the United States. 

On July 3, 1956, President Eisenhower signed the National 

Health Survey Act of the 84th Congress authorizing a continuing 

suwey to secure information about health conditions in the 

population of the United States. Implementation was very rapid. 

A pretest of 1,200 households was conducted in Charlotte, 

N, C., in February 1957. During May and June of that year the 

nationwide operation was given a dry run, interviewing and 

editing proceeded as if the survey were in operation.l Official 

data collection began in July of 1957, and the National Health 

Interview Survey has been continuously in the field ever since. 

From the beginning, the U.S. Bureau of the Census has 

been responsible for the sample design and for the data collection of the National Health Interview Survey (NHIS). Historically, therefore, NHIS has been linked with the Current 

Population Survey (CPS), which is conducted primarily to 

produce data on labor force characteristics of the U, S. population. The sampling frames developed for the CPS have been 

used to select the sample for the NHIS although the latter is 

conducted independently. The CPS, which had been based on 

a probability sample since 1943,2 and the principles and procedures used for it were adopted when the NHIS was designed 

in 1956,1 Understanding the origin and the linkage makes it 

easier to understand NHIS sample design, questionnaire design, 

data collection, and estimation procedures. 

It is possible to use data from the NHIS to look at change 

over the entire period from 1957 to the present. However, 

changes in the sample design, the questionnaire, the field procedures, and the methods of measurement do cause discontinuities. The purpose of this report is to document such changes 

during the 1970’s and early 1980’s so that users of the publications and public-use data tapes will have the information in one 

reference. The actual time period covered varies among the 

chapters because there is more existing documentation for some 

areas than for others and because questionnaire changes and 

sample changes are deliberately not implemented at the same 

time. Changes in the questionnaire are well documented through 

1974,3’4but there is little documentation in National Center for 

Health Statistics publications of the 1973 sample redesign or 

methods used to estimate variances. 

Many people have contributed to this report both directly 

and indirectly. They have contributed indirectly by writing 

documents, especially U.S. Bureau of the Census documents, 

that were the basis for some sections of this report. While great 

thanks are due them, they are not acknowledged here because 

they are cited in the reference list. Others have contributed 

directly by providing unpublished memoranda and old files, 

and through review and discussion. Some who have been 

especially helpful are E. Earl Bryant, Clinton E. Burnham, 

Robert Casady, Karen Frey, Jimmie D. Givens, Patricia B. King, 

Dennis M. Klein, Mitchell P. La Plante, Paul W. Newacheck, 

Gerald C. Sanders, Gary Shapiro, Andrew A. White, Ronald W. 

Wilson, and Theodore D. Woolsey. 
Section 1:Sample Design and Estimation, 1973-84 

by Mary Grace Kovar, Dr. P. H., Special Assistant for Data Policy and Analysis, Interview and Examination Statistics Program 
Chapter 1: Sample design 

Introduction 

The National Health Interview Survey (NHIS) sample 

design has been based on the design for the national sample of 

the Current Population Suwey (CPS) from its inception through 

the 1984 data collection. The two samples have been selected 

simultaneously, and most of the literature on the CPS also 

applies to NHIS.2’5 The theoretical basis for the samples can 

be found in Hansen, Hurwitz, and Madow.6 Details about the 

sample design have been abstracted from these two U.S. Bureau 

of the Census publications and, along with information ffom 

National Center for Health Statistics (NCHS) staff and publications, are given in this chapter. 

Before going into detail, there are aspects of the design 

that are necessary for understanding and using data from the 

NHIS, No one should try using data from this or any other 

survey with a complex sample design without some understanding of how the sample was drawn. 

The sample was designed to produce national estimates 

for the civilian noninstitutionalized population residing in the 

United States. The approach to doing so is first to divide the 

United States into geographically defined areas called primary 

sampling units (PSU’S), which collectively cover the 50 States 

and the District of Columbia. The PSU’S are classfled into 

strata (combinations of PSU’S with similar characteristics), 

and one PSU is then selected from each stratum. Within the 

selected PSU’S, small, compact clusters of housing units are 

then selected. In area sampling, this stage of selection is accomplished by listing small areas of the PSU, called segments, 

and then selecting four adjacent housing units from within each 

segment. In list sampling such listing is not needed. 

Because each family member in the selected housing units 

is in the sample, there is clustering within the household, within 

the segment, and within the PSU. This clustering causes the 

procedures for analysis, especially variance estimation, to differ 

from those in simple random sampling. 

Another important aspect of the NHIS design is that it is a 

multistage probability design that permits a continuous sampling 

of the civilian noninstitutionalized population of the United 

States. It is designed in such a way that the sample scheduled 

for each week is an independent sample of the populatio~ the 

weekly samples are additive over time. Thus, the design permits 

estimates for high-frequency measures or for large population 

groups to be produced from a short period of data collection 

and estimates for low-frequency measures or for smaller population subgroups to be obtained from a longer period of data 

collection. Because interviewing is done throughout the year, 

with about 800 households in the sample each week, there is no 

seasonal bias. 

Because of population shifts over time, the NHIS sample 

design is updated or redesigned after each decennial census. 

The redesign implemented in 1973 was an update and rnodiflcation of earlier sample designs rather than an entirely”new 

design. Details about the original design have been published.l 

Much of what follows is a review of the original design and of 

the modifications for the update instituted in 1973 using data 

from the 1970 census. 

In contrast, the 1985 redesign is entirely new. It will be the 

subject of other reports, and only the important changes are 

highlighted at the end of this chapter. The sample design discussed here applies only to data collected from 1973 through 

1984. 

Selecting the primary sampling units 

The first stage consisted of drawing a sample of primary 

sampling units (PSU’S) from the 1,924 geographically defined 

PSU’S into which the United States was divided by the U.S. 

Bureau of the Census. A PSU consists of a county, a small 

group of contiguous counties, or a standard metropolitan statistical area (SMSA). The PSU’S collectively cover the 50 States 

and the District of Columbia. 

Formation of such PSU’S is more an art than a science 

although several principles and n.des used in the original sample 

design are still relevant. Prominent among them werel 

� PSU’S should be units for which a wide variety of descriptive 

statistics is available, permitting the PSU’S to be stratified 

or classified in an efilcient manner. 

� When the PSU is used by a large survey organization, 

there are distinct economies in using the same set of PSU’s 

for more than one survey. Consequently, there are advantages in having the PSU conform to administrative 

structure in the field, and in having the unit adaptable to 

many social and economic objectives. 

� For technical sampling reasons, the greater the internal 

heterogeneity of the PSU, the more efilcient it is. This 

principle tends to produce geographically large units. 

� In contrast, costs per ultimate sample unit (that is, cluster 

of sample households) tend to increase with travel distances 

between ultimate units within a PSU, and thus to increase 

with the size of the PSU. This factor has limited the size of 

a PSU to not more than a few neighboring counties. 

5 
The rules used by the U.S. Bureau of the Census to define the 

PSU’S for the redesign that was implemented in 19735 were 

1.	 Each SMSA is defined as a separate PSU7 except for the 

two standard consolidated areas (SCA’S), which are each 

defined as one PSU, even though each SCA consists of 

more than one SMSA. 

2.	 Each PSU consists of one county or two or more contiguous 

counties. This rule does not apply for certain States in 

New England where minor civil divisions (towns or townships) are used to define the PSU’S. County equivalents 

are used in some States: (a) cities, independent of any 

county organizations, exist in Maryland, Missouri, Nevada, 

and Virginia, (b) in Louisiana, the county equivalents are 

known as parishes, and (c) in Alaska, where there are no 

counties, divisions defined by the U.S. Bureau of the 

Census are used. 

3. The PSU’S are defined within the boundaries of the four 

U.S. Bureau of the Census regions: Northeast, North 

Central, South, and West. The States in the four census 

regions are listed in appendix I. Exceptions to this rule 

have been made for SMSA’S that cross regional boundaries. 

Those SMSA’S that lie in more than one State are counted 

as single PSU’S for sampling purposes, but the parts within 

the individual States are separately identified for convenience in tabulation and control. There are 30 SMSA’S that 

are in more than one State, 7 of which lie in more than 1 

U.S. Bureau of the Census region. 

4. The area of a PSU does not exceed 2,000 square miles in 

the West and 1,500 square miles in the other regions except 

in cases where a single county exceeds the maximum 

area. 

5.	 The population enumerated in the 1970 census of population of each PSU is at least 7,500 in the West and 10,000 

in the other regions except where this would have required 

exceeding the maximum area specified in rule 4. 

6. In addition to meeting the limitations on total area, PSU’S 

are formed to avoid extreme length in any direction. 

The PSU’S used in the redesign based on the population 

enumerated in the 1970 census were closely related to those 

defined after the 1950 census.2 Steps employed in combining 

counties to form the new PSU’s5 were: 

The counties included in SMSA’S that were new or rede­


fined since the previous revision were incorporated into


the PSU definitions. Parts of PSU’S remaining after such


an operation were reviewed according to the criteria de-


scribed above to determine whether further combination of


counties into PSU’s was necessary.


Any single county that was not in an SMSA that exceeded


the maximum area limitations given previously in number


4 was classified automatically as a separate PSU, regardless


of population.


The characteristics of all other counties within the same


State then were examined to determine whether they might


advantageously be combined with contiguous counties,


keeping in mind the objective of heterogeneity and the


limitations on population and area. Combinations were 

made for: 

— Counties with less than theminimum population were 

combined with other counties, if this did not conflict 

with other requirements. 

— Counties with more than the minimum population 

were combined with other counties only if the maximum 

area was not exceeded and if the combination substantially increased the heterogeneity within the PSU. 

For example, a combination involving counties in different economic areas was generally considered desirable 

even if both counties exceeded the minimum population. 

However, the maximum area limitation was adhered to as 

closely as possible because excessively large PSU’S add 

to operating costs through increased interviewer travel 

expense. 

.	 The characteristics of counties in contiguous States within 

regions were then compared to determine whether better 

combinations could be obtained by combining counties 

horn neighboring States. 

.	 The proposed combinations were reviewed to make the 

final determinations of PSU’S. The reviews of this operation (and of the operation grouping PSU’S into strata) 

represented an effort to apply the competent judgments of 

several persons in these processes. Personal preferences 

can have no place in the actual selection of sample units, 

as known probabilities of selection for all units in the population can be achieved only by the application of random 

processes of selection. However, there are many ways a 

given population can be structured and arranged prior to 

the application of the random selection process, and personal judgment legitimately can play an important role in 

devising an optimum arrangement that is, one that will 

minimize the variances of the sample estimates. 

The above principles and rules led to combining the 3,141 

counties, county equivalents, and independent cities existing at 

the time of the 1970 census into 1,924 PSU’S that were used 

for the NHIS and for other surveys conducted by the U.S. 

Bureau of the Census. 

Grouping PSU’S into strata 

Sampling theory makes it clear that if units to be sampled 

can be classified into strata whose members tend to be relatively 

alike within strata and different between strata, then sampling 

variances are reduced from those of samples of equivalent size 

drawn from an unstratified universe. The PSU’S in the sample 

design that was based on the population enumerated in the 

1950 census were stratified with the principal modes of stratification being geographic location, population density, rate of 

population growth (originally between 1940 and 1950), proportion of the population not of the white race, and type of 

industry in predominantly urban areas. The details of the stratification are given in appendix IV of the NCHS publication on 

the statistical design of the survey, 1 

The sample design for the CPS and the NHIS in 1973 
---

called for the combination of PSU’S into strata with the selection of one PSU from each stratum. It is desirable to form 

strata with approximately equal populations for such samples.G 

The optimal design for estimating characteristics for the total 

population calls for (approximately) equal probability of selection of persons. The maximum stratification effect is gained by 

having as many strata as sample PSU’S. With a self-weighting 

sample, equal stratum sizes also have the advantage of equalizing the interviewer workloads. The objective, therefore, was to 

group PSU’S with similar characteristics into homogeneous 

strata with approximately the same 1970 population in each 

stratum, Because the final counts from the 1970 census were 

not available when the sample was being designed, the preliminary counts were used for stratification in the redesign, 

Theory also requires that the PSU’S with the largest pop 

ulations should be in the sample; that is, they should have a 

high probability of selection. PSU’S with the largest populations 

are designated as self-representing (SR), and each of the 

SR PSU’S was treated as a separate stratum and was included 

in the sample with certainty. The SR PSU’S are listed in ap 

pendix II. 

If the redesign of the sample could have been considered 

independently of the design already in use, it would have been 

relatively simple to form the strata, However, the number of 

strata is determined by considerations of cost as well as by 

considerations of variances, and it was also important to minimize costs when selecting tie new set of PSU’S. The rules for 

reviewing and modifying existing strata for use in the redesign 

reflected concern for both factors. 

The review of the stratification of PSU’S was done primarily by searching for “misfit” PSU’S in the existing strata 

rather than undertakhg an entirely new strat~lcation for the 

redesign that was implemented in 1973. The most important of 

the characteristics that were the basis of the original stratMcation and that were considered for the restrattilcation were: 

� Sh4SA (an SMSA or not an SMSA).


. Rate of population change.


� Percent of population living in urban areas.


. Percent of population employed in manufacturing.


� Principal industries.


. Average per capita value of retail trade.


� Proportion of population not of the white race.


Limits were established for each of the characteristics. When a


stratum contained a PSU with characteristics outside those


limits, the PSU was considered for removal. However, the total


number of revisions was small because a change in several


characteristics beyond the established limits was usually re­


quired before a PSU was removed.


In general, the stratification derived for the earlier desi~ 

was maintained, exceptions for PSU’S and strata were governed 

by the following rules:5 

. The largest of the 1,924 PSU’S in the United States as of 

the 1970 census were designated SR PSU’S. Except in 

special cases, all PSU’s with a population greater than 

about 250,000 were made SR. The remaining PSU’S were 

combined with other PST-J’Swith similar characteristics to 

form the non-self-representing (NSR) strata. The strata 

were defined so that they did not cross regional boundaries 

(table A). 

�	 Strata with NSR PSU’S were made to have approximately 

equal populations. 

�	 NSR SMSA PSU’S were grouped into strata that had only 

SMSA PSU’S so that all strata were either SMSA or nonSMSA strata. 

�	 The restratification of the PSU’S into NSR strata was 

done strictly on the basis of the characteristics of the 

PSU’S within the stratum, without regard to the sample 

PSU’S of the previous design. Each SR PSU was in the 

sample by definition. As shown in table A, there were 156 

SR PSU’S. 

�	 In each of the remaining strata, one PSU was selected for 

the sample with a probability equal to its proportion of the 

total U.S. population enumerated in the 1970 census. The 

actual selection was made in two stages. In the fust, a 

computer was used to designate controlled selection patterns of PSU’S, and a probability was assigned to each of 

the admissible patterns generated by the computer. In the 

second, one of the computer-generated patterns was randomly selected to represent the new sample. 

�	 Separate estimates were also desired for each of the sub 

universes, called “tabulation areas” (appendix II). 

These specitlcations resulted in classification of the PSU’S into 

376 strata. 

Subsampling within PSU’S 

The object of the subsampling procedure within the sample 

PSU’S was to obtain a self-weighting probability sample in 

which every sample unit (person or household) had the same 

probability of selection. Unbiased estimates of population totals 

could then have been made by applying a single multiplier to 

the sample numbers. 

Sampling considerations led to the conclusion that the 

variance would be as close to the minimum possible for a fixed 

cost if the sample was selected in compact clusters comprising 

Table A. Number and population of atrate for 376-primarysampling-unit dasign by region 

Number of 7970 Stratum 

Region strata population size 

Self-representing strata Minimum 

Total . . . . . . . . . . . . . . . . . . 156 130,495,743 

Northeast . . . . . . . . . . . . . . 50 41,854,236 259,754 

North Central . . . . . . . . . . . 32 32,824,092 256,843 

South . . . . . . . . . . . . . . . . . 48 30,049,022 227,222 

West . . . . . . . . . . . . . . . . . . 26 25,768,393 213,358 

Non-self-representing strata Awrage 

Total . . . . . . . . . . . . . . . . . . 220 72,681,943 -.. 

Northeast . . . . . . . . . . . . . . 20 7,143,875 357,194 

North Central . . . . . . . . . . . 72 23,752,566 329,897 

South . . . . . . . . . . . . . . . . 102 32,745,594 321,035 

Weat . . . . . . . . . . . . . . . . . . 26 9,039,908 347,689 

7 
about four adjacent housing units (or the equivalent) on the 

average. Therefore, ultimate sampling units (USU’s) were defined in such a way that each contained an expected four housing units. These housing units represented the 70,6 million living 

quarters presumed to exist as of the 1970 census. The 70.6 

million is the sum of the 1970 census count of 68.6 million 

plus one additional unit for every three persons not residing in 

housing units. 

The overall probability of selection had to be the same for 

all USU’S in order to achieve a self-weighting sample. The 

sampling fractions at each stage of selection had to be determined to meet this requirement. Thus, the probability of selection of the PSU multiplied by the probability of selection of the 

USU within the PSU must equal this overall probability of 

selection. 

In practice, a segment is selected at an intermediate sampling 

stage prior to designating the USU. The character of a segment 

depends on the source from which it was selected. For example, 

it maybe a small area, a place, or an enumeration district (ED). 

Segments do not have a common size, but they may always be 

expressed as an integral number of USU’S. Each USU belongs 

to a specific segment and, for the purpose of administrative 

control, the segments are numbered and the USU’S are identified by their segment numbers. It should be noted that in some 

of the NCHS publications in Series 10 based on data collected 

during 1973 through 1984, segments are called the ultimate 

stage, and six units is given as the expected number of households in a segment because the change from six to four in the 

1973 redesign was not always reflected in the publications. 

The selection of the actual sample within each PSU depends on the resources available within that PSU. As part of 

the 1970 census, the country was divided into 229,000 ED’s. 

About 121,000 of the EDs were in the mail census that covered 

most of the larger urban centers; the remainder were in the 

conventional interview census. Each ED was identitled with a 

State-county code and an ED number, and, for each, an address 

register was produced as part of the census enumeration. The 

completeness of the address information determined the way 

the census information was used in sampling. 

Address registers were used where possible to form “list” 

EDs with address sampling. If the information was not sufficient 

for a “list” ED, the ED was classified as an “area” ED with 

area sampling. In general, ED’s were classified into “list” and 

“area” *samplesby the responses to the following two questions 

1.	 Does the ED have at least 90 percent of the units recorded 

at addresses in the register with complete street name and 

house number? 

2.	 Is the ED within the jurisdiction of an authority issuing 

building permits? 

Question 1 

Question 2 Yes No 

Yes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . List Areaa 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Area Area 

In general, the list frame included the urban areas from which 

about two-thirds of the NHIS sample was selected. 

aAn area sample using building permits to update. 

8 

The CPS A-design5 had a selection probability of 1 in 

1,968 in the desigu implemented in 1973. The initial NHIS 

design had a selection probability of 1 in 1,509.7446, or 1.3035 

times the selection probability for the CPS. This meant that the 

NHIS selections were not evenly spaced selections, which resulted in a slightly increased sampling error. 

At the same time the sample was selected, a block of 12 

adjacent USU’S was set aside for each NHIS selection to 

maintain the sample over the life of the sample desi~, that is, 

until the sample redesign following the 1980 census. Thus, the 

sample design implemented in 1973 could be maintained through 

1984 before the sample would be exhausted. 

However, for some of the smaller PSU’S, the number of 

USU’S needed for all surveys planned for the life of the sample 

design could turn out to be more than the number in the PSU. 

This was not a problem in the SR PSU’S, where the basic 

sampling interval of 1 in 1,312 meant that there are 1,312 

different systematic samples of USU’S within the PSU. It was 

a problem in some of the smaller NSR PSU’S, however, where 

the USU’S would be exhausted before the end of the decade 

because the initial selections were separated by less than 80 

USU’s-the number needed for all the surveys planned at the 

time. 

It would have been possible to return to the original USU’S 

later in the decade and reuse them. Instead, an unbiased system 

of gradual replacement of sample PSU’S over the life of the 

sample design was adopted. However, a system that moved to 

a different PSU only when the sample PSU was exhausted 

would eventually exclude the smaller PSU’S. To avoid this 

bias, clusters of PSU’S were established within each NSR 

stratum that contained a PSU unable to last out the decade. 

Such clusters, called rotation clusters, were determined before 

the sample PSU was designated. Each PSU in the rotation 

cluster that contained a small sample PSU was assigned the 

portion of the decade that it was to be in the sample so that 

each PSU would have its proper expected sampling rate. The 

sample was shifted from one PSU to another within the cluster 

according to these assigned portions. Thus, a stratum containing 

only PSU’S with suf%cient USU’S had only one PSU in the 

stratum (that PSU is considered a rotation cluster all by itself). 

A stratum containing both sut%cient and instilcient PSU’S 

could have one, or more than one PSU in the sample depending 

upon whether a suftlcient or insut%cient PSU was selected, (A 

stratum with only insufficient PSU’S would have had more than 

one PSU (all from the same rotation cluster) in the sample if 

there had been any in the sample.) 

The number of PSU’S replaced was actually quite small. 

There were 14 NSR PSU’S in the design designated for replacement during the decade. For the purpose of calculating variances, these replacement PSU’S were given the same number 

as the original PSU, the replacements are not a problem to the 

user of the public-use data tapes. 

The 1985 sample design 

The design described here, which was used from 1973 

through 1984, was based on the information from the 1970 
census but was not a complete redesign of the sample. It was 

an update of the original. 

The sample design instituted with the 1985 data collection 

year was a complete redesign. Very little of the information in 

this chapter is applicable to data collected in 1985 or later. 

Over the years there was much discussion of changes that 

would be desirable when the opportunity to completely redesign 

the sample arose. A summary of some of the considerations 

and recommendations is in the report of the Technical Consultant Panel on the Health Interview Survey, a report of the 

National Committee on Vital and Health Statistics.s The 1985 

sample redesign did not incorporate all of the recommendations 

of the Technical Consultant Panel or all of the ideas of the many 

people who thought seriously about the features of the sample 

that would be desirable. Nevertheless, it is a major change that 

incorporates some of the recommended features. 

Major features of the 1985 design that differ from the pre1985 design are: 

. The number of PSU’S was reduced from 376 to 201. 

. The entire sample, instead of approximately one-third, 

became an “area” sample. 

. The black population was over-sampled instead of using 

equal probabilities of selection. 

. There are two PSU’S per stratum instead of one. 

These changes permit NCHS to have more flexibility in using 

the respondents to the NHIS as a sampling fi-ame for other 

surveys. They also make the estimates for the black population 

more precise. The changes should also make it possible for 

users of the public-use data tapes to calculate variances and 

standard errors with less computer time and less concern about 

adequate numbers of respondents in the PSU’S. 

9 
Chapter 2: Estimation 

Point estimates 

The National Health Interview Survey (NHIS) is designed 

to make inferences about the civilian noninstitutiondized pop 

ulation of the United States. To do so it is necessary to inflate 

the sample counts to national estimates. 

Four basic operations were involved for the data for each 

elementruy unit (household, person, condition, hospitalization, 

and doctor visit) collected from 1973 through 1984 

� Probability of selection inflation, The data for each elementary unit were multiplied by the reciprocals of the 

probabilities of selection at each step in the desi~ prim~ 

sampling unit (PSU), segment, and household. 

� Nonresponse a@ustment, The data for each elementary 

unit were inflated by a multiplication factor to adjust for 

units where an interview was not obtained. 

� First-stage ratio adjustment. The data for each elementary 

unit were ratio adjusted to the 1970 population within 12 

color-residence classes within each geographic region. 

� Poststratl~cation by age-sex-color. The data for each 

elementary unit were ra~o adjusted within each of 60 agesex-color cells to an independent estimate of the population 

of each cell by a multiplication factor applied to the weight 

of each elementary unit (household, person, condition, 

hospitalization, and doctor visit). These independent estimates are prepared by the U.S. Bureau of the Census. 

The probability of selection inflation is carried out each 

week. After the incoming reports are passed through controls 

to insure that the data input to the computers is consistent with 

sample design, properly coded, and capable of being tabulated, 

a series of mechanical edits is carried out on the computers. 

These edits make the questionnaire internally consistent, and 

adjust or account for item nonresponse. 

Into each record of an elementary unit (person, household, 

condition, and hospitalization) basic sampling inflation factors 

are inserted. This step takes account of all stages of sampling. 

The factor is the reciprocal of the combined sampling fraction, 

which varies among tabulation areas (appendix II). 

These steps are carried out weekly and provide a tape of 

edited and adjusted sample data for each week of the 13 weeks 

of the quarter. Therefore, the “scale” of data at this point is 

1/1 3th of universe totals, Weekly data are then merged into 

quarterly totals. The nonresponse adjustment, fwst-stage ratio 

adjustment, and postatratification are performed for each quarter 

(13 weeks). 

Despite intensive followup efforts, reports on some households in the sample had not been received at the tabulation 

cutoff. The noninterview rate was usually very low less than 5 

percent of the households did not respond— 1 percent refusal, 

and the rest for all other reasons, such as no one at home after 

repeated callbacks. Nevertheless, any estimating procedure 

must necessarily impute values for statistics for which measurement had been intended for a sample household for which no 

interview is obtained. 

Adjustment for nonintewiews was accomplished by a calculation that assumes that respondenta within a particular 

segment for a quarter represent the nonrespondents in that 

segment. In the rare instance in which less than half a segment 

is interviewed, the noninterview adjustment is modiiled by evidence from reports over the entire tabulation area. An illustration of the process is given for a hypothetical tabulation area in 

figure 1. Data for the five households in segment 2 are multiplied 

by the factor 1.2000 so that the five represent the six households intended for interview in the segment. Segment 4 in the 

example is of the unusual type in which less than half the households in the segment were interviewed, which leads to a fiu-ther 

adjustment at the tabulation area level after a preliminary one 

has been made at the segment level. The tabulation area adjustment factor is the ratio of total households scheduled for 

interview to total households scheduled for interview minus the 

“excess” noninterviews; that is, the factor in the example is 

220/21 8 or 1.0092. Data for all reporting households in the 

hypothetical tabulation area are multiplied by this factor to 

account for the two-household “excess” of noninterviews. 

Statistical theory demonstrates that a ratio estimate for a 

I

Households 

scheduled Households Segment Excess 

Segment for not adjustment nonnumber interview intewie wed factor interviews 

1 6 0 1.0000 0 2 6 1 1.2000 0 

3 8 0 1.0000 0 4 4 3 2.0000 2 . . . . . . . . . . . . . . . . . . . . . .,. .,. ,.. ,,. ... ... ... ...
 Tabulation 

area 

tots I 220 10 .,. 2 I 

I 

Figure 1. Adjustment for noninterviews 

10 
statistic generally is superior to an ordinary inflation estimate if 

there is correlation between the numerator and the denominator 

of the ratio, Also, if Y and X are ordinary inflation estimates 

of two characteristics of a population, Y and X, respectively, 

and if the “true” total X is known independently, then the ratio 

estimate Y“ = ( Y’/X’)X is a better estimate of Y than is Y’,if 

there is correlation between Y’and X’, In this form of estimate, 

the quantity (X7X’)becomes a calibration factor for the survey. 

This principle is utilized at two stages in the NHIS. In the 

first-stage ratio adjustment it was used to reduce sampling 

variance among PSU’S. Estimates of the 1970 population that 

would have been obtained from a complete enumeration of 

only the 376 sample PSU’S were compared with official 1970 

population counts for each of 12 color-residence classes within 

each of the four geographic regions. A multiplication factor 

was applied to the weight of each elementary unit. This brought 

the sample data into closer conformity with population controls 

for the universe; introduced only trivial, if any, bias into the 

estimate; and reduced sampling variance. 

Advantages of the ratio-estimating process were exploited 

further by the introduction of a second calibrating or ratio factor, 

the poststratification, which brought the estimates of the U.S. 

population derived from the NHIS into agreement with independently determined controls for 60 age-sex-color classes of 

the civilian noninstitutionalized population of the United States. 

The last poststratification factor is probably the one most 

important to users because the independent estimates are the 

same as those used for the Current Population Survey (CPS). 

Thus the national population estimates for these characteristics 

from the two surveys are the same, which greatly enhances 

comparability for users of data from both surveys. 

The CPS is conducted the first week of every month, and 

independent national estimates of the civilian noninstitutionalized population are produced for each month. The NHIS is 

conducted weekly and is designed to produce quarterly estimates as well as annual ones. In practice, the estimate for the 

CPS conducted in the middle month of the quarter was used for 

the NHIS quarterly estimate. The NHIS quarters and the dates 

of the estimates ara 

NHIS quarter Population estimates 

January-March . . . . . . . . . . . . . . . . , February 1 

April-June . . . . . . . . . . . . . . . . . . . . . May 1 

July-September . . . . . . . . . . . . . . . . August 1 

October-December. . . . . . . . . , . . . . November 1 

The 60 age-sex-color cells are shown in figure 2. Note that the 

color categories were changed from white and other to black 

and other beginning in 1980. The change was made to improve 

the precision of the estimates for the smaller black population. 

Variances 

One of the advantages of a probability sample is that an 

estimate of the reliability of the results can be made from the 

sample itself. The form of the variance estimator depends on 

the sample design and the estimation procedures. It is desirable 

that the variance estimator be unbiased (and it should be conColor 

1979 and earlier 

White Other 

1980 and later 

Other Black 

Age Male Female Male Female 

Under l year . . . . . . . . . . 

l-4 years . . . . . . . . . . . . . 

5-9 years . . . . . . . . . . . . . 

10-14 years . . . . . . . . . . . 

15-16 years . . . . . . . . . . . 

17-19 years . . . . . . . . . . . 

20–24 years . . . . . . . . . . . 

25–29 years . . . . . . . . . . . 

30-34 years . . . . . . . . . . . 

35-44 years . . . . . . . . . . . 

45-49 years . . . . . . . . . . . 

50-54 years . . . . . . . . . . . 

55-64 years . . . . . . . . . . . 

65-74 years . . . . . . . . . . . 

75 years and over . . . . . . 

Figure 2. The 60 age-sex-color cells in the National Haalth 

Interview Survey 

sistent if not unbiased) and that it have a small sampling error. 

It is also desirable for computation to be simple. 

At the time the National Health Interview Survey was 

initially designed, there had been relatively little work on 

methods of estimating variances for surveys with complex 

sample designs. Computers were slow, awkward, and had little 

memory. Computer software was virtualIy nonexistent. Nevertheless, the decision was made to present sampliig errors in all 

reports based on NHIS data. Calculating and presenting 

sampling errors for the national estimates from the NHIS in all 

reports was a great advance in the presentation and interpretation of data. 

The presentation of sampling errors in statistical reports is 

not a simple matter. There are two major decisions that must 

be made. The fwst is how to calculate the variances. The second 

is how to present them. The method used for estimating the 

variances for the statistics presented in the Series 10 reports 

has changed over time. The method of presenting them, charts 

of relative standard errors for classes of variables, has remained 

relatively constant. 

Initially variances for the NHIS were calculated by a technique called the random group method. 1The method was used 

first for data collected in 1957. The variance charts constructed 

in 1961 based on the random group method of variance estimation were used until the late 1960’s when some of them were 

replaced by charts based on the Keyi%z estimation procedure.g 

For data collected in 1972, the Keytitz estimation procedure 

was used to calculate new variance curves. 

When the redesigned sample for the survey was implemented in 1973, new estimates of variances were needed. 

Balanced half-sample replication had been considered before, 

11

and early work on the method had been supported by the 

National Center for Health Statisitcs (NCHS).10 In the meantime there had been fhrther workl 1 and a computer program 

had been written to apply the technique to the data from the 

National Health Examination Survey {IWIES, now NHANES). 

However, at that time no one knew how to form orthogonal 

patterns when there were as many PSU’S as there were in the 

NHIS. That problem was solved when George Schnack formed 

the orthogonal patterns for more than 100 strata.12 The computer program was extended so that it could be applied to the 

NHIS. 13 Using this program, variances were calculated for 

data collected in 1973.13 Those calculations are the basis for 

the relative standard error charts published in Series 10 reports 

for data from 1973 through 1984. 

The problem of presenting variances for a great number of 

statistics in limited space was solved by publishing charts of 

relative standard errors for classes of statistics. 

A report on the research on the Keylltz procedure also 

gave the argument for presenting curves for classes of estimates: 

Instead of presenting variances for each statistic, the data 

can be grouped and “average variances” given. . . . Grouping 

the statistics is not easy, but two points to consider are that 

the survey characteristics such as prevalence of any diseases 

represented in a group should have similar design effects and 

that the groups should cover the possible range of variation 

in the data. 14 

Instead of presenting the individual estimates for each cell in 

the tables, a set of relative variance curves was drawn using the 

empirical relationship between the size of the estimate and the 

relative variance of the estimate. The formulas and the procedures for estimating the parameters are given in Hansen, 

Hurwitz, and Madow.b The procedures, using a function of the 

form, v~t= a -1-b/x’, are illustrated in the case study on the 

Current Population Survey. 

The curves of relative standard errors (the square root of 

the relative variances) are published in all Series 10 reports 

from the NHIS. There are curves for wide-range, medium-range, 

and narrow-range response variables to allow for the differing 

distributions of the variables and their design effects. The curves 

were calculated for each of the recall periods used on the questionnaire and for each period of data collection from one quarter 

through 2 years. 

A narrow-range statistic is defined for this purpose as (a) 

an estimate of the number of people in the population with a 

characteristic, such as the number of high school graduates or 

the number in excellent health, and (b) an estimate for which 

the response is usually Oor 1 but may take on the value of 2 or 

very rarely 3, such as the number of hospital episodes in a 

year. 

A medium-range statistic is defined for this purpose as an 

estimate that will rarely lie outside the range O–5, such as the 

number of doctor visits in 2 weeks. 

A wide-range statistic is defined for this purpose as an 

estimate that often will lie outside the range O–5, such as the 

number of days of restricted activity in 2 weeks or the number 

of contacts with a physician in a year. 

The total number of persons in the U.S. civilian noninstitutionalized population or in an age-sex-color class or combination of classes used for poststratification is not subject to 

sampling error because these numbers are adjusted to demographically adjusted decennial census figures supplied by the 

U.S. Bureau of the Census. 13Also, when the number of people 

in one of those classes is the denominator for a rate, the denominator has no sampling error. 

The curves of relative standard errors serve a useful purpose by allowing the reader to obtain an estimate of the variability of the statistic of interest quickl~ however, they may not 

be sufilcient for relational analysis for several reasons. One is 

that a number of approximations and assumptions were required 

to derive relative standard errors (a) that would be applicable 

for the large number of data items obtained from the NHIS, 

(b) that could be prepared at reasonable cost, and (c) that could 

be presented in relatively little space. As a result, the charts 

provide estimates of the approximate relative standard errors 

rather than an estimate for each specific estimate. Second, although they take the size of the denominator into account, they 

do not take the differential effects of the clustered design into 

accoun~ that is, two population groups of the same size may 

have different design effects. A limitation in using the curves is 

that the analysts cannot incorporate covariances in the analysis 

where it is appropriate. 

An example of the differences in design effects for populations of similar size is shown in table B for the proportion of 

children with medical care within an interval. There are approximately 22 million children in families with six or more 

me,mbers in the household and there are approximately the 

same number in families in which the head has 13 or more 

years of education. Nevertheless, as can be seen in table B, the 

design effect for children in the first category is 3.41 and for the 

second it is 1.62. The standard error of the proportion of children 

with medical care for the fwst group is twice that for the latter. 

Each time the curves have been recalculated, they have 

been used without modification in succeeding years until the 

sample is redesigned as if there has been no change in the distribution of the population or the dependent variables over an 

extended time period. The effect of the changes over time may 

not be trivial. In evaluating the change from 1973 through 

1979, Givens found that the weighted relative standard errors 

for each of the eight curves he evaluated showed consistent 

increases over time because of the attrition in sample size.15 

Moreover, the values predicted from the curves differed from 

the computed values. In 1980, which was a special case because 

4 weeks were eliminated from the sample, one-third of the 

variance estimates were in error by more than 20 percent. 

Also, it is important to note that the NHIS was designed 

with one sample PSU selected from each stratum (there is more 

than one if the stratum is a non-seli-representing stratum and the 

PSU is a rotation cluster containing more than one PSU, although it is still treated as one and there is only one in any 

given year). The methods usually used for estimating the variances assume two PSU’S in each stratum. Therefore, pseud~ 

strata, each containing two PSU’S, had to be created to calculate the variances. This was done in the self-representing 

strata by dividing each stratum into two PSU’S so that it was a 

stratum with two “PSU’S.” The non-self-representing strata 

12

Table B. Number, proportion of children who have received care within an adequate interval, astimates of standard errors, and design effects 

by selected characteristics of children and youths under 18 years of aga: National Health Interviaw Survey, 1975-76 annual average 

Standard error Design effact 

Proportion 

Number with Simple 

in adequate random 

Characteristic 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Family size 

l-3 persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

4peraona, ., ., . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

5peraona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

6or more persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Education of head of family 

O-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

12 yeara, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

130r more years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Family income 

$0-$4,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$5,000-$ 9,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$10,000-$ 14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$15,0000 r more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age ofchild 

0-5yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

6-n years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

12-17 years .. i, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Standard metropolitan statistical area 

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

NOTE: SE=stsndard error. 

thousands interval sampla Complex SE Varianca 

73,234 0.8566 0.001295 0.002152 1.66 2,76 

12,789 0.9090 0.002543 0.002693 1.06 1.12 

21,063 0.8963 0.002101 0.002687 1,28 1.64 

17,081 0.8598 0.002656 0,003170 1.19 1.42 

22,301 0.7864 0.002744 0,005067 1.85 3.41 

24,771 0.7953 0.002563 0.004240 1.65 2.74 

25,888 0.8678 0.002105 0.002960 1.41 1.98 

21,874 0.9161 0.001875 0.002383 1.27 1.62 

8,418 0.8186 0.004200 0.005437 1.29 1.68 

15,171 0.8231 0.003098 0.004678 1.51 2.28 

17,558 0.8543 0.002663 0.003760 1.41 1.99 

26,697 0.8932 0.001891 0.002822 1.49 2.23 

21,130 0.8789 0.002244 0.002796 1.25 1.55 

24,298 0.8693 0.002157 0,003257 1.51 2,27 

27.806 0.8287 0.002265 0.003284 1.45 2.11 

53,324 0.8701 0.001456 0.002415 1.66 2.75 

19,910 0.8204 0.002720 0,004562 1.68 2.81 

SOURCE: tvl. G. Kovac Amethodologicsl study of factors associated with whether children receive adequate medical care. /nstitute of Statistics Mimeo Series 

No. 1426, Chapel Hill, University of North Carolina, School of Public Health, Department of Biostatistics. Dec. 1982. 

were paired with one another and a pseudo-PSU number was 

assigned to one member of the pair and that number plus one to 

the other,12 

The pseud&PSU’s are on all public-use data tapes for 

data collected in 1980 or later. They enable the interested tape 

user to estimate variances and standard errors for a variety of 

statistics using one of several commercially available computer 

programs. 16-19 They do not enable the user to replicate the 

variance estimation procedure used by NCHS for the Series 

10 reports. The NCHS balanced half-sample replication program takes poststratification into account.13 To do so, the 

balanced half-sample replicates must be used and those replicates, which take up a great deal of space, are not on the 

public-use tapes. 

Tape users should also note that the variance estimation 

methods based on Taylor-series approximationl G’18’19cannot 

be used directly for estimating the variances of medians. The 

balanced half sample methods can be used. 

For data collected prior to 1980, the published curves of 

relative standard errors must be used. These are adequate for 

many analyses, and many users of the data will prefer using 

them regardless of when the data were collected. Instructions 

for using the charts are given in all NCHS Series 10 publications. 

Weights on public-use data tapes 

Core questions 

For estimates of the population of persons with attributes 

(such as persons limited in activity, in poor health, or with one 

or more bed days during the year), the four quarterly weights 

are averaged to produce the annual weight. This is labeled 

“basic weight” on the public-use data tapes. Weights for a 

quarter, 6 months, 1 year, and 2 years of data collection are on 

the public-use data tapes. Weights for longer periods of time 

can be constructed by averaging the annual weights over the 

desired time period. 

For estimates of events with 2-week recall periods (such 

as the number of disability days, doctor visits, or acute conditions), events are added to produce the annual estimate. This is 

labeled “6.5 weight” on the public-use data tapes. The weight 

is 6.5 because 13 weeks in the quarter divided by 2 weeks of 

recall equals 6.5. 

Example—A user wanting to estimate the number of people 

limited in activity should use the basic weight if using data from 

a full year of data collection. 

Example—A user wanting to estimate the number of bed 

days (2-week recall) should use the 6.5 weight. 

13 
Example—A user wanting to estimate the number of bed 

days per person limited in activity should use the 6.5 weight for 

the numerator and the basic weight for the denominator. 

Special core questions 

Because six different lists of chronic conditions were used 

beginning in 1978, with respondents in one-sixth of the households being asked each list, special weights had to be developed 

to provide national estimates of the prevalence of chronic conditions. A factor, which is also on the public-use tapes, is 

multiplied by the basic person weights to produce weights approximately six times as large. 

Similarly, the recall period used for the number of hospital 

discharges and days in short-stay hospitals published in Series 

10 reports is 6 months. Therefore, the weight is double the 

basic person weight (that is, the semiannual weight), if the user 

wants to duplicate the published estimate. That can be done 

from the information on the hospital tape. 

However, the user of the public-use data tapes should be 

careful to note that the published number of hospital episodes 

during the year is based on a 12-month recall question, so the 

appropriate weight for episodes and the associated days is the 

basic person weight. 

Supplements 

The questions on many supplements were asked about all 

household members at the time of the interview. The weights 

for questions on those supplements are the same as the ones for 

equivalent core questions. 

In other cases, there was subsarnpling for the supplement 

or response rates were different (as when supplements were left 

to be mailed in or only a fraction of the people in the household 

were asked the question). The weights for questions on those 

supplements are different from those for core questions. 

For example, questions about smoking were asked of onethird of the adults in the last 6 months of 1980. The weights 

reflect the subsampling. The Child Health Supplement questions were asked about only one child in each family in 1981. 

The weights for that supplement also reflect the subsampling 

and differ from the basic weights by a factor approximately 

equal to the inverse of the number of children under age 18 in 

the household. 

Thus, each supplement is given appropriate weights, and 

the public-use data tapes are released separately from the core 

questionnaire tapes. 

14

Section 11:Questionnaires and Survey Operations, 1975-83 

by Gail Scott Poe, MPH, formerly with the Division of Health Interview Statistics 
Chapter 3: NH IS questionnaire 

and interview design and 

development 

Introduction 

The NHIS questionnaire consists of two basic parts: core 

and supplements. The questions on the core portion of the 

questionnaire are asked each year. The supplements change 

from year to year. 

The basic concepts measured in the core questionnaire 

have remained essentially the same since the inception of the 

survey. These concepts include morbidity, disability, and use 

of medical services and facilities. For a discussion of these 

concepts see references 3 and 20. The questions to address the 

concepts on the core include illnesses and injuries, days of disability including bed days, work-loss days, school-loss days, 

and other cut-down days due to acute or chronic conditions. 

Questions on limitation of activity caused by chronic conditions or impairments, hospitalization, doctor contacts, perceived 

health status, as well as the social, economic, and demographic 

characteristics of the interviewed persons are also included. 

From 1975 through 1981 questions on dental visits were part 

of core, but in 1982 these questions were eliminated fi-omcore. 

Supplements on a wide variety of health topics have been 

included in the NHIS since 1959. The supplements have 

changed from year to year in response to current interest in 

special health topics. Some supplements, such as out-of-pocket 

health expenditures and health insurance, have been repeated 

several times to enable measurement of change over time. 

There have been three major periods in the history of the 

NHIS questionnaire: 1957-68, 1969–81, and 1982–83. These 

periods were demarcated by two large-scale formal evaluations 

that resulted in major changes in the survey questionnaire and 

procedures. Within each of three periods there was some degree 

of continuity in the measurement of survey concepts. Across 

periods, however, there were major differences in the survey 

design. In the first period, 1957–68, there was less continuity 

in the measurement of survey concepts because this period was 

viewed as an experimental one, and major methodological research projects were conducted to refine the survey procedures. 

In the next period, 1969–81, there was more continuity in the 

measurement of concepts. This was not considered a period of 

experimentation, and the philosophy at that time was to attempt 

to restrict changes until the next evaluation period. The philosophy espoused at the beginning of the more recent period 

starting in 1982 was, again, to restrict changes until the next 

major evaluation, 

In data analysis of trends, extreme caution must be exercised 

whenever the questionnaire format for a variable changed. 

Changes in levels of estimates could be due to changes in the 

questions asked or in interviewer procedures, rather than to 

actual changes occurring in the population. 

The history of the NHIS questionnaire format (including 

both core and supplements) from 1957 through 1974 is documented.3’4This chapter presents the major changes in the questionnaire made between 1969 and 1974. It also contains a detailed, topic-by-topic discussion of the changes made in the 

core questionnaire from 1975 through 1983. This period encompasses a major changeover in 1982 in questionnaire format 

resulting from a formal evaluation of the survey. The objectives 

of the formal evaluation and the major projects undertaken 

during the evaluation period are presented first. In addition, 

this chapter presents a discussion of the supplemental topics 

from 1975 to 1983. This discussion on supplements includes a 

description of the procedures used for addi,ng supplemental 

topics, the content of the supplements, and the data collection 

methods, such as respondent rules, that have been used in the 

supplements. 

Major questionnaire changes, 1969-74 

Although there was a fair degree of continuity in the questionnaire design from 1969 to 1981, some important changes 

were made that should be considered when analyzing changes 

in estimates over the period because, as mentioned, changes in 

questionnaire format can have a major effect on the levels of 

estimates. The changes from 1975 to 1983 are described in 

detail later in this chapter. Because the changes from 1969 to 

1974 are documented in detail elsewhere,3 only a summary of 

the most major changes is presented here. Items or batteries of 

items that were included on a one-time basis during 1969–74 

and then removed are not listed. They are described in reference 3. However, inclusion of such items also could have had 

an effect on the estimates produced in the survey. A change 

that is not reflected in the questionniare occurs each time the 

U.S. Bureau of the Census designates new standard metropolitan statistical areas, redraws the boundaries of old ones, or 

makes any other changes in the geographic codes. There were 

many such changes in 1973 as a result of the new information 

obtained from the 1970 census. 

� Starting in 1969 two new areas were added to the 2-week 

recall questions in an attempt to elicit certain kinds of 

conditions: one was related to dental visits for the treatment of oral conditions and the other was related to hos17 
vitalizations during the 2-week period for emergency or 

other types of care. However, neither of these areas produced a sufficient number of reportable conditions to justifi 

including them on a permanent basis. Hence, the hospital 

probe question was deleted in 1970, and the dental probe 

question relating to conditions was dropped from the 

questionnaire in 1971. 

.	 In 1971 the question to ascertain whether the hospital 

episode was the first admission for the designated cause of 

hospitalization was removed because it was confusing to 

respondents and because the information obtained was of 

questionable reliability. 

. In 1971 a probe on accidents and injuries occurring during 

the 2-week recall was added. 

� In 1973 a question on the amount of income for each individual family member was added. 

. In 1973 a question to determine year of birth was added to 

verify the accuracy of the reported age. 

. In 1974, questions relating to education, military service, 

employment, and marital status were asked later in the 

interview. 

1976-81 evaluation period objectives 

Starting in 1976, in accordance with the long-range plan of 

the survey and in light of changes in the medical care system 

and problems that had emerged in the survey since 1969, the 

second major reassessment of the survey occurred. The products 

of the reassessment, a revised questionnaire and accompanying 

interviewer materials, were fielded beginning in January 1982. 

The major focus of the reassessment was on the core component of the NHIS questionnaire. The major objectives of the 

reassessment were to 

�	 Improve the quality of the data by decreasing the nonsampling error component attributed to the interviewer 

collection procedures, lack of understanding by the respondents of the items, and/or the processing of the information. For example, whenever possible interviewer instructions were printed on the questionnaire to reduce the 

number of procedures the interviewer had to remember. 

Question wording specifically appropriate for children, 

which in the past was left up to the interviewer, was put on 

the questionnaire. On the doctor contact probe page, the 

concept of reporting medical contacts (even when it was a 

physician’s assistant (for example, nurse, etc.) who actually 

provided the care), was directly communicated to the respondent. Items on the revised questionnaire were reordered 

to improve the continuity of the interview and minimize 

the amount of backtracking required of the interviewer. 

One of the major improvements in the revised questionnaire 

was the standardization of the conventions used by the 

interviewers in administering the questionnaire. For example, the use of parentheses, brackets, etc., meant the 

same in all questionnaire locations. 

.	 Remove from the questions any unnecessary repetition 

and avoid asking questions not relevant to a particular respondent (that is, in asking subsequent questions, use or 

retrieve information given earlier). For example, in the 

revised questionnaire, only persons who report themselves 

as currently employed are asked about recent work loss or 

whether a particular condition caused work-loss days. 

Review survey concepts and modify them to be consistent 

with current and anticipated data requirements. This objective was expanded to include a review of NHIS sociodemographic items in light of the recommendations made 

by the Oflice of Federal Statistical Policy and Standards 

and the U.S. Bureau of the Census. These recommendations were made to standardize certain items in an effort to 

insure comparability among Federal surveys. 

Structure the core so that these items will remain basically 

fixed for several years and be independent of supplemental 

topics to (a) eliminate the need for costly revisions of interviewer and processing procedures from year to year, 

and (b) minimize the effect of a supplement on the responses 

to the core items. 

Reduce the amount of interview time and other resources 

devoted to the core to devote a higher proportion of resources to tie development of and inclusion of supplemental 

topics in the NHIS. 

These objectives were, for the most part, met by the 1976-81 

evaluation process except for a reduction in the interview time 

devoted to core. Although some core questions were eliminated 

in the revised instrument, other questions were added to more 

clearly communicate concepts to respondents. The objective of 

increasing the quality of survey results while retaining all of the 

topics was not compatible with the reduction of interview time. 

1976–81 evaluation period activities 

NH IS Technical Consultant Panel 

During 1976–77 the National Committee on Vital and 

Health Statistics initiated a series of actions to review the data 

collection procedures and basic data sets being managed by the 

National Center for Health Statistics (NCHS). The overall 

review process adopted was the establishment of subcommittees 

consisting of several members from the National Committee 

on Vhal and Health Statistics and supplemented by nonmembers who were specialists in the subject matter involved. Each 

of these subcommittees was designated a “Technical Consultant 

Panel” with the specific name or mission of the subcommittee 

appended. 

The Technical Consultant Panel on the National Health 

Interview Survey was the subcommittee named to evaluate 

how well the NHIS was meeting its legislative mandate in light 

of its historical role and current data needs. The members of 

the panel were selected from many disciplines so that the technical aspects could be reviewed as well as the applicability of 

the results to users such as Congress, the Department of Health 

and Human Services, other Federal agencies, State health 

departments, health planning units, and health research investigators. The final report of the Technical Panel was released 

in December 1980.8 

18

First pilot study 

The first data collection using a draft revision of the NHIS 

questionnaire was conducted by a private contractor in the 

spring of 1978. The staff of the Division of Health Interview 

Statistics took a major role in the questionnaire design, manual 

preparation, interviewer training, quality control procedures, 

and field observations. The contractor hired and paid the interviewers, selected the households to be interviewed, arranged 

for printing of the questionnaires and duplication of other survey 

forms and manuals, rented training facilities, and provided staff 

to support the survey activities. 

The field test gave the staff of the Division of Health 

Interview Statistics an opportunity to observe a large number 

of interviews and to make a subjective assessment of the overall 

feasibility of the revised questionnaire. As a result of these 

observations, the staff made modifications to specific questions 

that respondents misunderstood as well as to those items that 

hampered the flow of the interview. In summary, the field test 

provided an opportunity to test and modify the revised questionnaire, interviewer’s manual, and training procedures based 

on staff observations. The U.S. Bureau of the Census pilot 

study (described in the next section) used these improved instruments and procedures to collect data that could then be 

compared with data obtained from the ongoing NHIS. 

Second pilot study 

In 1979, a major field pilot study using the revised questionnaire was conducted by the U. S. Bureau of the Census in a 

probability sample of U.S. households. In addition to testing 

field procedures, a major objective of this study was to compare 

national estimates obtained using the revised questionnaire 

with those based on results from the current questionnaire. 

Phase I of the pilot study, a pretest of the procedures, took 

place in Springfield,Ohio, in June 1979 (OMB No. 68-S79031). 

Approximately 225 household interviews were completed, and 

minor modifications were made to the test questionnaire and 

procedures in preparation for the national study. 

Phase II of the pilot study occurred simultaneously with 

the regular 1979 NHIS fourth quarter data collection using a 

separate national sample. This study afforded direct comparisons 

of estimates produced from the experimental questionnaire to 

estimates obtained from the ongoing survey. 

The interviewing in phase II was spread over a full calendar 

quarter (13 weeks) in a national probability sample. Approximately 5,000 household interviews were completed. 

The field operations involved in phase II were identical to 

those used for the regular NHIS (for example, supervisors’ 

training session followed by a 2-day interviewer training session 

in the week immediately preceding the first week of interviewing). 

A comparison of selected estimates based on data from the 

phase H experimental questionnaire and from the ongoing 

NHIS for the fourth quarter of 1979 (called the control questionnaire) is presented in appendix III. Caution should be exercised in drawing inferences from the comparisons of data 

from the experimental and control questionnaire to the data 

from the final instrument introduced in 1982 because for some 

topics major changes were made to the questionnaire after the 

pilot study. Estimates derived from questiomaire sections in 

which major changes were made after the pilot study are indicated with a footnote in appendix III. Mention of the changes 

is made in the topic-by-topic discussion of the questicmnsire 

that follows. 

In summary, the local area study (phase 1) permitted a 

more intensive subjective review of the questionnaire concepts 

and procedures while the national study (phase H) enabled 

analysts to make a quantitative analysis of the survey results. 

Final pretest 

Based on the results of analysis from the previous studies, 

a final pretest questiomaire was developed and tested in approximately 300 households in August 19S 1 in York, Pa. With 

few exceptions, only minor modifications were made in the 

survey instrument and procedures after the York pretest. Regular 

data collection using the revised questionnaire began in January 

1982. 

Topic-by-topic changes in questionnaire 

format, 1975–83 

One of the things that remained constant over the period 

1975–83 was the use of different recall periods for different 

questiomaire topics. Generally, shorter recall periods were 

used for events that occur with higher frequency and are harder 

to recall, and longer recall periods were used for events that 

occur with lower frequency and are easier to recall. Sometimes 

both short and long recall periods were used when a variable 

was used for different purposes. 

There are five different reference periods used in the core 

NHIS: a 2-week period, a 12-month period, a 13-month period, 

“now,” and “ever.” Sometimes other reference periods are 

used for supplemental questions. 

The 2-week reference period is used for reporting doctor 

contacts, disability days, and employment status. These are 

the 2-weeks (14 days) just prior to the week in which the interview is conducted. The 2-week period starts on a Monday and 

ends with and includes the Sunday just prior to interview week, 

which starts on Monday. It does not contain any days of the 

interview week. 

The 12-month reference date is used for the 12-mcmth bed 

days item and the 12-month doctor visits item. The 12-month 

date is “last Sunday’s” date a year ago; therefore, the 12-

month reference period begins on that date and ends on the 

Sunday night before interview. 

The 13-month hospital date begins on the first day of the 

month preceding the month in which Monday of interview week 

falls, 1 year ago. Estimates of hospital episodes are based cm 

those hospitalizations that occurred during the 12 months prior 

to interview. A 13-month recall period is used for hospital episodes to obtain reports of hospitalizations that started over 12 

months ago but ended within the 12-month period. 

The “now” and “ever” reference periods are used in akMimI 

to the past 12 months for chronic conditions. “Now” is defined 

as during the past 2 weeks including last Sunday night and 

“ever” means at any time prior to interview week 
---------------

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--

--

-------------------------------------------------------------------------- --------

------ -------------------------------------------------- ------

-------------------- ----------------------- ------ ----

--

Changes in questionnaire items and organization from on the basis of the reference person. The reference person 

1975–83 are presented on a topical basis in the remainder of concept is consistent with standard U.S. Bureau of the Census 

this chapter. practice on other demographic surveys such as the Current 

Population Survey. 

Household composition 

Household composition questions (figure 3) are used to Date of birth, age, and sex 

construct the variables: number of families in the household, Both date of birth and age are asked to reduce reporting 

number of unrelated individuals, number of persons in the error in age of persons. Items on date of birth, age, and sex 

household, size of family, and family structure. Between 1975 remained the same from 1975 through 1983 (figure 4). 

and 1981 the household composition questions remained unchanged. in 1982 the questions were expanded slightly to im- Armed Forces 

prove the coverage of the survey (that is, to decrease the likeli- The Armed Forces questions are used to classi~ persons 

hood of missing persons). In addition, in 1982 the “head of as to whether they served on active duty in the Armed Forces 

household” concept was replaced by the “reference person” by period of service (figure 5). In 1976 post-Vietnarn (“May 

(that is, one of the household members who owns or rents the 1975 to present”) service was added to the response categories. 

residence). Family relationships are assigned by the interviewer Also starting in 1976 the questions were asked of both males 

1975-81 Sc SCHOOL 

n [7 

la. What is the name of the head of this household? - Enter name In fwst column 10. Forst name 

b. What are the names of all other persons who live hers? - List all persons who l!ve here. Yes* No 1 

c. I have Iixted (Read names). Is there anyone �lse staying here now, such as friends, relatives, or roomers? u u o d. Have I missed anyone who USUALLY lives her- but is now away from home?. . . . . . . . . . . . . . . . . . . . . D D RACE 

�.Doony.af the people inthishouseho ldhaveo hwneanywhereolse?. . . . . . . . . . . . . . . . . . . . . . ~ n Last name lW 

* APPly household membe,sh, p rules. 2B 

f. Are O“Y of the persons in this household now on full-time 3 07 active duty with the Armed Forces of the United States?. . . . . . . . . I Y CoI(s) .— (Delete) 2 N 

2. HOW is related to (Head of household)? 2. Relatlonshbp SEX 

lM 

HEAD 2F 

A. HOUSEHOLD COMPOSITION PAGE 

la, What arc the names of all persons living or staying h-m? Start with the name of the person or onc of 

th. p.rsons who owns or rents this hem*. Enter name In REFERENCE PERSON column. 1 I 

Last name Sex 

li~M 

b.	 What are the names of 011 other persons living or staying here? Enter names in columns. f “’Yes.., enter z~F lames tn colunms 2. Relaclc.mhip 

c. 1 have listed (read names). Have I missed: Yea No REPERENCE PERSON 

3. Oale ot btrth 

-any b.abi*sor small children?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c D Mcmh Oate Y.mr 

- any lodgers, boardws, or persona you �mploy who live here? . . . . . . . . . . . . . . . . . e z anyone who USUALLY Iivcs here but is maw away from hem. traveling .x in o hotpitol? . . . . CG 

-anyone* Ise staying her- ?.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .TI c1 :7


d. Do all of thm persons you havs named usually live hr.? m Yes (2) 

~ No (APPLY HOUSEHOLD MEMBERSHIP 

Probe If necessary: RULES. Delete nonhousehold members 

by an “X’” from I-C2 and enter reason.) Does usually live som.where �lse? 

Ask for all Dersons beg!nn:?g w,th column 2: 

L What is r.lation~ hip to (re erence .Derson)? 

.,. C*B


A3 ~ All w,s..a”s 6S and . . . . (5)

/43 Refer m ages of all re!ated HH members. ~ Other (4) 

4a. Arm any of the persons in this famil now en full-time active 

duty with the Armed Forces of tht IK”nlted States? 

~ Yes ~ No (5) _____ . . . . . ._-----_-

b. Who is this? 

Delete column number(s) by an “X’. fmm I - C2. .- . I . . . . ..- ,-------------- .._- . ... ___ ..-----_-_-

C. Anyone else? 

~J	 Yes (Reask 4b and c) V No _---------- ____ - _ -v------- _______________ 

Ask for each Paso” an Armed Forces: 4d. ~ L,vng ac home 

d. Where does usually live and sleep, her. .x somewhere else? .= NW I,v,”z a! home 

Mark box !n Derson. s column. 

1[ related Ders,ms 17 a“d over ore Ilsted ,n addit, o” m the respondent and are not present. say: 

5.	 We would like to have Qll odult family members who are at home take part in the interview. 

Are [names of Dersons 17 cnd over) at home now? If “Yes,” ask: Could they ioin us? (Allow time) 

Figure 3. Household composition 

20 
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--

------ --------- ----------------------------------------------------------- --

---

--

------- ------ ---------------------

--

--------

--------------------------

I


1975-83 

I 3. Whet is date of birth? (Eruer date and age and mark sex.) 

Figure 4. Date of birth, age, and sex 

and females whereas before they had been asked of males only. 

In 1980 several changes were made to the Armed Forces questions because there was concern that the previous set of questions produced an overestimate of veterans due to the inclusion 

of reservists and/or National Guardsmen. In addition, there 

was the desire to establish a uniform definition of the term 

“veteran” to increase comparability of data provided in NHIS, 

the 1980 Decennial Census, and administrative records of the 

Veterans Administration. The phrase “serve in the Armed 

Forces” was changed to “serve on active duty in the Armed 

Forces.” In addition, questions were added to determine whether 

the person was ever an active member of a National Guard or 

military reserve unit and, if so, whether all of the person’s active 

duty service was related to the Guard or reserve unit. 

Education 

Questions on education (figure 6) are used to construct the 

variables education of individual and, before 1982, education 

of head of household. In 1982 “school” was changed to “regular 

school” to make it clearer to the respondent to exclude schools 

such as technical schools, and “has attended” was changed to 

“has ever attended,” The lower age limit for asking the education 

1975-791 

~. old .v.r S. IV. In th. Am~ Fore.. d tho united stat.,? 

b. h%- did ho sow-? VimIWII 

First name 

Last name	 Sex 

lCIM 

2CIF 

Relationship 

Date of birth 

Month I Date I year 

I 

question was lowered from 6 to 5. From 1971–81 education 

was asked for all persons 17 years of age and oveq starting in 

1982 education was asked for all persons 5 years and over. 

Race and origin 

Respondents are classified according to race and, starting 

in 1976, whether they are of Hispanic ongin (figure 7). Comparing estimates for racial groups in some cases may be inappropriate because the questions to determine race and national 

origin changed considerably over the period 1975–83. These 

changes resulted from tests and analysis of race and origin 

data.21’22In addition, directives from the OffIce of Federal 

Statistical Policy and Standards23’24contained new policy on 

race and origin data collection and presentation. 

Prior to 1976, the only survey item on race was interviewerobserved race; there was no national origin question. If a household member was not seen, the interviewer marked a box based 

on the race of those household members present. The interviewer 

did not ask, but rather marked one of the categories white (W), 

black (B), or other (OT) for each household member. This 

observed-race item stayed unchanged until 1982. 

In 1976, in addition to interviewer-observed race, a ques3,. :Y 2 N (NPJ . 

Era (AIJS. ’64 co April- 75) . . . . . Vt4 b. I VN 5 PVN 

Circle code in descendant order of priority. Thus if 

person served in Vietnam and in Korea, circle VN. 

Kwean War (Juna “YJ-Jan. ’55). . . . . . . . KW 

World War II (~pt. ‘40-JuIY “47) . . . . . . . WWII z KW * 0s 

World War I (April “17-Nw. ’18) . . . . . . . wWI 3 Wwll s OK 

Post Vietnam (My ,75 m wasant) . . . . . . PVt4 

other 5ervlc* (s11 ether plod.) . . . . ...05 4 WI 

l-post Vietnam (May 1 g75 to present)” was added to the 1976 NHIS questionnaire. 

1980-83 

la, Did EVER serve on active duty in the Armed Forces of the United States? 10. t ~Yes I 

I 2CNO(2) 

b.	 When did serve? (Vietnam Era (Aug. ’64 to April ’75) . . . . . . . . VN b. l~vt’4 5 ~ PVN 

Korean War (Jun{’50 to Jan. ’55) . . . . KW zUKw e~~s 

A!ark box In descending order of priority. 

Thus, if person served In V;ecnam ,]nd !n Korea, World War II (Sept. ’40 to July ’47) . . . . . . . . WWII 3~wwll 9 ~, OK 

mark VN. World War 1 (April ’17 to Nov. ‘IS) . . . . W’WI 4 @ Wvil 

{ Post Vietnam (May ’75 to Dresent) . . . . PVN 

—----- ________________________________________________________________ ~~ther Service (all’other periods) “. . . . . OS 

---, 1__________________ c, Was EVER on active member of a National Guard or military reserve unit? l—.— c. ~Yes 2: No (2) 7 G OK (2) 

_________________________________________ 

d. Was ALL of nctive duty service related to National Guard or military reserve training? 1 

Figure 5. Armed Forces 

21 
--

-- -- --

--------------------

---------------------- --

---------------

-- -------------------------------------------------------------------- --- ----- ---------------

--

1975-81 

Mark box or ask: � Under 17 (NP) 

a. What is tho highest grads or year attondcd in school? 2a. OOj_J None (3) 

Elem: 12345678 

Hl;h: 9 10 II 12 

._____________________

Colle;e: I 2 3 4 5 6+

b. Did I b. finish the -grade (yww)? 

1lY 2N 

1982-83 

2a. What is thehighest grade oryeorof regular school --has ever attended? 20. 00 ? Never attended or 

—	 kmdergarten(NP) I 

b. Did finish the (number In 20) [grade/year]? 

Figure 6. Education 

tion was added onnational origin orancestry for persons 17 

years of age and older. Although the question asked for origin, 

the response categories provided to the respondent on a flashcard included racial categories. The observed-race and the 

origin questions were continued in 1977 although the flashcard 

changed somewhat. In 1978 respondents aged 17 years and 

older were asked separately their race and origin, and the origin 

question was changed to Hispanic origins only. In 1979 the 

race category “Alaskan Native or American Indian” was 

changed to “Aleut, Eskimo. or American Indian.” 

In 1982 the following changes were made: In the Spanishorigin question the response categories of Mexican and Mexicano 

were combined; questions on race and Spanish origin were 

asked for all family members and not just for persons 17 years 

of age and oven the box for recording the interviewer-observed 

1975-81, obsenfed race 

race item was moved to after the race question, and the observed 

race of only the household respondent was marked. 

In NHIS analyses, for purposes of classifying persons 

according to race, from 1975–79 interviewer-observed race 

was used however, reported race and origin were on the computer files for methodological purposes. For NCHS publications, starting in 1980 respondent-reported race was used and 

interviewer-observed race was used to impute race only if 

the respondent-reported race was unknown. Although from 

1976–79 respondent-reported race is on the computer files, 

caution must be exercised in its use because of the many changes 

made in the question during that time period. For children, in 

1980–8 1 race was imputed based on the reported race of 

parent(s). Starting in 1982 race for children was based on 

respondent-reported race for the children. 

SCHOOL 

E m 

1m Ft,st mine AGE o 1

— 

RACE Last name Iw 

20 

3 01 

2. Relatnonshw SEX 

IM 

H EAO 2F 

3. Month Date Year 

I 3. what is --’s dot. of birth? (Enter date and Age, a“d circle Race a“d %x) 

1976-77, national origin 

Hand Card O 60. � Under 17 (NP) 

If 17+. ask. 

do. Which of fhos* groups BEST detcribes ‘s national origin or Onc*stry? 

4 ---------

(Enter P,8CWJ8) 

If multlple entr!es. ask. 

b.	 Which of those groups, that is, (entries [n 6a) would you say b. 

BEST describes ‘s national origin or ancestry? (Spolry) 

Figure 7. Race and origin 

22 
01

02

03

04

05

06

07

08

01

02

03

04

05

06

07

08

--- --

1976, flashcard for national origin 

CARD O 

National Origin or Ancestry 

Countries of Central or South America 09 

Chicano 

Cuban 10 

Mexican 

Mexicano II 

Mexican-American 

12 

Puerto Rican 

Other Spanish 

OR 

Other European, such as German, 

Irish, English, French 

Black, Negro, or Afro-American 

American Indian or Alaskan Native 

Asian or Pacific Islander, such 

as Chinese, Japanese, Korean, 

Philippine, Samoan 

Another group not Ii steal - Specify 

1977, flashcard for national origin 

0;
1 

: 

I -----..-----------—- -— 

CARD () 

Nati6ttal Origin ctt Arwe$try 

Countries of Central or South America 09 European, except Spanish (such as 

Chicano


Cuban


Mexican


Mexicano


Mexican-Americtm


Puerto Rican


Other Spanish


German, Irish, English, French and 

all other European countries) 

10 Black, Negro, or Afro-American 

I I American Indian or Alaskan Native 

12 Asian or Pacific Islander, such 

as Chinese, Japanese, Korean, 

Filipino, Samoan 

OR 

Another group not listed - specify 

Figure 7, Race and origin—Con. 

Employment status 17 years of age and over (figure 8). The employment status 

questions refer to the 2 weeks prior to Sunday night before the 

The employment status questions, used to classify persons interview. In 1982 the questionnaire was reorganized to elimiaccording to employed, unemployed, and not in the labor force, nate repetition through the questions so that the au-rent emremained unchanged from 1975–8 1 and were asked for persons ployment status was ascertained for persons age 18 (instead of 

23 
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1978 

Hand Card R 

Mark box or ask: 

11.. ~ Und.r 17 tNPl 

a.	 Please give mc the nwnb~r of thm group w groups which 

describes ‘~ racial backgrwnd. 

13.345 C,rcle all that apply. 7 

1- Alaskan Nat[ve or American Indian 

2- Asian or Pacrftc Islander 

3- Black 

4- White (Specllyl 

5- Another group not listed - Please spac!fy. 

If multiple entr,es ask: 12345F 

b. b.	 Which of thost groups; that is, (entries m I I a) would you say BEST describes --’s mcial background? 

(sDec, ry, 

Hand Card O ~ Under 17 lNPI 

Mark box Gr ask: 

10. Arc any of those groups --’ s national origin or ancestry? 12c- ,y 2 N (NP1 

(Where did --’* anctstorz coma from?) 

b. b. Please give me the numb-r of the group. 

C!rcle all that apply. 1234 S678 

I - Puerto Rican 5- Mew can-Amen can 

2- Cuban 6- Chicano 

3 - ?-lex,can 7 - Other Lattn American 

4 - Kex, cano 8- Other Spanish 

Hand Card R - Mark box or ask: � Under 17 (NP) 

a. Plcas~divo m. the number of the group or groups which dcacribes --’s racial background. 4a. 1 2 3 4 5.-spadfyF 

Circle all that apply. 

I - Aleut. Eskimo or Amarican Indian 

2- Asian or Pacific Islander 

3- Black 

4- White 

5- Another group noc I Is ted - Please apec//y 

—-----

If multiple entries ask: 12345 - spacltYF 

b. Which of those groups, that is, (entries in 4a) would you soy BEST doscribos --’s racial background? b. 

Hand Card O - Mark box or ask � Under 17 (NP) 

u.	 Are arty of thoa* greups--’s national ofigin or ancestry? 5a. ,.f z N (NP) 

(~~:r:~jd_==--_-_---_‘s ancestors come from?) ___ ___________ 

b. Pleas* giv~ mc tho numbar of the group. b. 

Circle all that apply. 

I - Puerto Rican 4- Mexicano 7- Other Latin American 1234 S678 

2- Cuban 5- f4sxlcan-Amarican 8- Other Spanish 

>. 3 - Mexican 6- Chicano 

Figure 7. Race and origin—Con. 

17) and over before the questions on 2-week disability days 1983 the 1980 Census of Population: Alphabetical Index of


were asked. In addition, several wording changes were made; Industries and Occupation was used.


for example, the phrase “at a job or business” was added to


“did — work at any time.” The concepts measured by the Marital status


employment status series over the entire period 1975–83 were 

similar to the concepts measured by the standard U.S. Bureau The marital status question remained unchanged from 

of the Census Current Population Survey items. 1975 through 1981 (figure 10). Starting in 1982a slight wording change was made and the interviewer instructions were Occupation and industry changed to ask the item of all persons aged 14 years and over 

The questions relating to occupation and industry for cur- (rather than aged 17 years and over) to conform with standard 

rently employed persons remained basically unchanged from U.S. Bureau bf the Census practice and to facilitate comparisons 

1975–83 (figure 9). For the purposes of coding occupation and with data from other surveys. In addition, the response boxes 

industry in 1!?73–82, the 1970 Census of Population ClasslYed were changed from “married-spouse present” to “married— 

Index of Industries and 0ccupation$5 was used. Starting in spouse in HH” and from “married-spa.sse absent” to “married— 

24 

1979-81 
--

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-- --

--

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Hand Card R. Ask first alternative for first person: ask second alternative for other persons. 

3a. 

K hat is race? 1 30. 1234 

‘J C,rcle all that apply 

I - Aleut, Eskimo, or American Indian 4- White 

2- As Ian or Pacific Islander 5- Another group not I isted - S~ecify 

hot is the number of the group or groups which represents race? 

3 - Black 

___ Specify _______ _______________ 

Ask If multtple entries: b. !234 

b. Which of those groups; that is, (entries in 3a) would you say BEST represents race? ‘J 

$pecily 

c. t’dark abserved race of respondent(s) only. 

c. fnw 2cr3 s@o 

Hand Cord O, 

4a. Arc any of those groups national origin or ancestry? (Where did ancestors come from?) 4a. 1 ~Yes 2~N0 (IvP) 

h,€ Pleosa give m~ the number of fhe group, 

Circle all that apply 

I - Puerto Rican 5- Chicano b. 1234567 2- Cuban 6 - Other Latin American 

3- Mexican/Mexicano 7- Other Spanish 

4 - Mexican Amer[can 

10.3.82) D.. - .4, 

Figure 7. Rata and origin—Con. 

1975-81 

Mark bax or ask 

te, Did .- work at any time last week or the week baforc - not counting work around the house? 

b, Even though did not work during those 2 we~ks, doos have o iob or business? 

c. Was looking for work or on layoff from a lob? 

d, Which - looking for work or on layoff from a iob? 

1982-83 

D. RESTRICTED ACTIVITY PAGE PERSON 1 

Hand calendar. 

f_’J Under 17 (NP) 

6a. 1 Y (7) 2N

b.t 

1Y 2N 1 . 

c. lY 2 N (7) 

d.	 I U LookIn; 3 cl Both 

t 2 f-l Layoff 

{The next questions refer to the 2 weeks outlined in ,ed on that calendar, 

beginning Monday, (c&e) and ending this past Sunday f-e).} 

Refer to age. 

Di ~ IJnder 5 (4) ~ 5_17 (3J ~ 18 and over (1)

la.	 DURING THOSE 2 WEEKS, did work at any time at a iob or business, 

not counting work around the house ? (Include unpaid work in the fomily 

[form/bus iness].) 

I ~ Yes (Mark ““WO” box, THEN 2) z~-: No 

________________________ _________________________. 

b.	 Even though did not work during those 2 weeks, did 

have a iob or business? 

1: Yes (Mark “Wb” bax, THEN 2) 2 C No (4) 

L2 O ~ Under 18 (NPJ 

I ~ Wa box marked (&.)

L2 Refer co “Age” and “Wa/Wb” boxes in Cl. Zr Wb box marked (5aJ 

3 G Neither box marked (5bJ 

59.	 ~a~iar you said that has o iob or business but did not work last we-k or the week before. 5a. t C Yes /5c) z,~ No f6b) 

looking for work or on layoff from a iob during those 2 weeks? —--------- —- —-----------

b. Earlier you said that didn’t have a iob or business last week or the week before. 

was looking for work or on layoff from a iob during those 2 weeks? b. I ~ Yes z~ No (NPl~ 

—-- ——------------------ J 

c.€ Which, looking for work or on layoff from a iob? e. ! ~ Looking (6c) 3 ~ Both(6B 

2 ~ Layoff (6bJ 

Figure 8. Employment status 

25 
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--

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-- --

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IC17F,-R1l


,skforall 7a. Fccwhc+mdfd --w~k? Name ofcompany, business. or:anizatiOn. ~0theremPl0Yer ,e, Employer 

ersons 

“’Yes” 

with -
 n 6a, b; or c. b. What kirid of businaat or industry is th]a? For example, TV and radio manufacturing, b. Industry 

f “Ye$”’ in 6C retail shoe stwe, State Labw Dept., farm 

~-------- .-1

nly, questions Occupao.wl c. What kind of work waa doing? Far example, electrical engineer. steck clerk. CYPIStOfarm=f ~. a through 7e 1 

pply to this .- . ~ Duths erson’s LAST d. What wara --’a most important activities w dutiaa? Fc+ example. CYPCS. keeps accOunt b00k3 I
 ull-tirns civilian files, sells cars, operaees printing press, finishes concrete .-t ob . ------------------­
 .
 Complete from entries in 7a-d: if not clear, ask: 1Class of wc+ar 

t. Was an �mployaa”of PRIVATE company, busirnas, or individual �� 

lUP sol forwagea, salary, orcommisaion? . . . . . . . . . . . . . . . . . . ..P 

--o F150ERAL govemmant amployas?. . . . . . . . . . . . . . . . . ..F 

--a STATE govammant employee? . . . . . . . . . . . . . . . . . . . ..S zUF cCSE 

--o LOCAL govommontemploye? . . . . . . . . . . . . . . . . . . . ..L 

salf.amployad in OWN kusinass, professional pcocticc, - fe~? 30s 7nwp 

if not � farm, ask IS tha Lwainass incerpofated? 

Yes . . . . . . . . . . . . . . . . . . . . . . . . . 1 

No (or farm) . . . . . . . . . . . . . . . . . . ..$E 

working WITHOUT PAY in family businass w farm? . . . . . . . . 

NEVER WORKEO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..KV 

f. How many hours a weak (does/did) usually work at that iob? f. t 

—+XNS 

If ‘“N” in 6b, go to 8: otherwise ask 1 g. Ourfin; ths past 2 weeks, did have any othor iob or busin*sa? ~. lY z N(8) 

. 

h. How ~On Y hW,, a week da., IJSISdl Y work fm p~y d ALL iebs? h. 

t — HOIXS 

1 In 1980 and 1981 the “’never worked” categow was removed from 7e. 

6a. Earlier you said that -worked last week or tht w*ek bc{ore. Ask 6b. 

I I — b, For “hom did -.. work? Enter name of company, business. organization, or other employer. 6b. 

Employer 

. nd 

c. 

c. For whom did work at last full.tim~ civilian iob or business Ioating 2 consecutive weeks or more? 

Enter name of compony, business, organtzotion, or ot4er employer. 

d. What kind of business or industry is this? For example, TV and radio manufacturing, retail shoe store, d. Industry 

Store Labor Department, farm. 

�. What kind of work was doing? For example, electrical engineer, stock clerk, typist, farner. ~. Occu!xiclon 

.-

f.	 What wore most important activities or duties at that iob? For �x~mple, types, keeps account books, f. Dut#es 

files, sells cars, operates printing press, finishes concrete. 

,1 

Complete from entries in 6b-f. if not clear, ask: H Classof worker 

g, was 9. 

An amployca of a PRIVATE company, buainass or Self.amployad in OWN husinass, pr.fcssional 

individual for wages, salary, or commission? . . . . . . . P pracllca, or farm? 

A FEDERAL govmrnmo.t ..mnloy..? . . . . . . . . . . . . . F // not /arm, ask: Isthe business incOrp.rated? 

A STATE govammanrompioyao? . . . . . . . . . . . . . . . S Yes, ,,, , . . . . . . . . . ...1 4~L 

A LOCAL government amployca? . . . . . . . . . . . . . . . L No(orfarm) . . . . . . . . . . . ..SE I I Working WITHOUT PAY i. f.mily b., iness 

or form? . . . . . . . . . . . . . . . . . . . . . . . . . . . 

- NEVER WORKED or never worked of a full.!im. 

civilian lob lasting 2 weeks or more. . . . . . . . . 

‘;V ~ 

Figure 9, Occupation and industry 

spouse not in HH’; however, the interviewer instructions for household member (even if the spouse was an Armed Forces 

filling these boxes remained the same over the entire period member). The interviewers marked the “reamed—spouse not in 

1975–83. (HH is the abbreviation for household.) The inter- HH’ (or absent) if the couple was not legally separated and the 

viewers were instructed to mark the “married-spouse in HH” spouse was not listed on the questionnaire as a household 

(or present) if the spouse was listed on the questiomaire as a member. 

26 

1982-83 
--

-- --

--

1975-81 

If 17+, ask: o � under 17 

4.	 IS now ~orried, widowed, divorced, separated, or never married? 4. 

1 Cl ‘arrled — sPOu= present 

6 � Marrl=d – sPOu= absent 

2 � W,d.wed 

4 � Divorced 

5 � Separated 

3 � Never married 

1982-83 

Mark box if under f 4. If “’Morried” refer to household composition and mark accordingly. 7. 0 @ Under 14 

7. Is now married, widowed, divorced, separated, or has never been married? I � Married - spouse In HH 

Figure 10. Marital status 

Income 

From 1975–8 1 the income questions were unchanged 

(figure 11). First a family income for the past 12 months 

was ascertained according to 10 income groups shown to 

the respondent on a flashcard. Next a 12-month individual 

income question was asked with the same 10 income categories. In 1982–83 the income questions were restmctured 

to obtain more detail on family income and to reduce the 

level of refusals and “don’t know” responses. Only family 

income was determined. In the new questions, respondents 

were first asked whether the family income was more or 

less than $20,000. Different flashcards were for families 

above and below $20,000. Additional sources of income 

were listed in the questions and the interviewer explained 

why income data were needed if the respondent was reluctant 

to answer the question. The increased number of categories 

on the flashcards also made it possible to determine poverty 

level. 

1975-81 

Hand Card I. 

2 = Married - spOus= IWX in HM’ 

3 � Widowed 

40 Divorced 

s ~ Separated 

6 � Never married 

I I 

Hospitalization 

The questions on hospitalization (figure 12) are divided 

into two parts: probes to determine number of times an overnight 

hospitalization occurred duzing the past 12 moritis and detailed 

questions on each hospitalization. The NHIS final data set 

does not contain hospital stays for normal newborns; nor does 

it include hospitalizations for patients who do not stay overnight. 

NHIS estimates relating to number of short-stay hospital discharges and average number of hospital days are based on discharges occurring during the 6 months prior to interview, 

whereas estimates of short-stay hospital episodes and 12-month 

hospital days are based on the 12 months prior to interview. 

The shorter reference period for discharge-related estimates is 

used because it produces less response error and less total error 

despite higher sampling error for this type of statistic. Because 

the survey is restricted to persons who were reported living in 

the household at the time of interview, the estimates do not 

include the hospital experience of persons who were hospital10.	 Which of thoso incomo groups roprcscnts your total combhmd fomily Income for tht post”12 months - 10. 

that Is, yours, your --’s, ttc,? Includo Income fram all sources such as wages, salaries, social 

security or rotiromcnt bonoflts, hslp from rolativos, rent from property, and so forth. 

ha,	 Which (othor) family membars rocoiwd sores Incenw during tho past 12 months? 1la. 

Mark “Income” box in pereon’s calumn. _____________________________________________________________________________ � Income 

b.	 Did any othw family mombors rocoivo any incemo during the post 12 months? Y (Reask I la and b) 

N 

If only one person with “Income” box marked, go to 13. 

If 2 ar more persons with ‘“Income” tmx marked, ask 12 for each. 

12, Which of thoso incemo groups raprosonts ‘s income for the past 12 months? 12. 

Figure 11. Income 

27 

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1975-81, flashcard income groups 

CARD I 

Under $1,000 (including loss) . . . . . . . . . . . . . . . . . . . . . . .. Group A 

$ 1,000 -$ 1,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group B 

$2,000 – $ 2,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group C 

$3,000 –$ 3,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group D 

$4,000 – $ 4,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group E 

$5,000 –$ 5,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group F 

$ 6,000 -$ 6,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Group G 

$7,000 –$ 9,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group H 

$10,000 -$14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group I 

$15,000 -$24,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Group J 

$25,000 and over . . . . . . . . . . . . . . . . . . . . . . . . . ... . .. Group K 

1982-83 

Ea. Was tho total combinod FAMILY irrcomc during tho past 12 months - that is, yours, (read names. includin~ 8a, 1 D $~:tiO~ 04 mm (Hand 

Armed Forces members living at home) more or Ies% than $20,000? Include money from iobs, social security, 

retirem~nt incemr, unemployment paymmrts, public assistance, and so forth. Also include income from 20 & ~jn $zo,~ (Hzmd 

interest, dividends, net income from business, farm, or rent, and any other money income received. 

Read if necessary: Income is important in attalyzing the health information W* collect. For exampla, this 

information helps us to learn whether persons in one income group use certain types of medical care services 

or have certain conditions more or lass often than those in another group. 

Read parenthetical phrase if Armed Forces member Iivlng at home or if necessary. b. 000A 10 ~J K Zonu 

b. Of those income roups, which letter best represents the totol combined FAMILY income 01(-JB !lUL Zlnv 

during the past 13 months (that is, yours, (read names, including Armed Forces members Oznc 12~M 22UW 

living at home))? Include wages, solari~s, and the other items we iust talked about. 0300 13~N 23=X 

Read if necessary: Income is important in analyzing the health information we collect. For example, this 040E t4~o 24DY 

information helps us to learn whether persons in one income group use certain types of medical care services OSOF !s~P 25UZ 

or hove certain conditions more or less often than those in onother group. 

Figure 11. Income—Con. 

ized during the 12-month reference period but who died prior 

to the interview or who were discharged to institutions or longterm-care facilities. These considerations should be taken into 

account in using NHIS hospital discharge data, especially for 

the elderly. 

A method was developed for obtaining data and estimating 

the specific portion of decedent experience that should be added 

to the data on the living population so as to produce estimates 

of total hospital utilization over any specified reference period.27 

From 1975 through 1981 the hospital probe questions re06i3G 16@Q 26 � 22 

07UH ,,,~R 

0801 lens 

09~J 190T 

mained unchanged. In 1982 several changes in the probe questions were made. The probes were moved to the beginning of 

the questionnaire for two reasons. First, the interviewer is provided with an opening question that focuses immediately on a 

health variable that is easily understood and reported by the 

respondent. Second, this information is useful to the interviewer 

in asking about physician contacts later in tke interview. Another 

change starting in 1982 was that the concept of an “overnight” 

stay was stated in the question to the respondent to avoid having 

this decision made by the interviewer and perhaps missing a 

28 
I 

I 

I 

i 

1 

1982-83, flashcard income groupa 

CARD I CARD J 

u ....... 20,000 – 24,999 

v ....... 25,000 – 29,999 

w ......30.000 – 34,999 

x ....... 35,000 – 39,999 

Y .......40.000 – 44,999 

z ....... 45,000- 49,999 

Zz ...... 50,000 and over 

Figure 11. Income—Con. 

physician contact. Still another change was the elimination of 

the probes to determine stays in nursing homes, convalescent 

homes, and similar places. These probes were never intended 

for the purpose of making estimates of the use of nursing homes 

and sinilar places but rather were included to pick up additional 

short-stay hospitalizations. Because the probes were not contributing significantly to the reporting of shofi-stay hospitalizations, they were dropped in 1982. 

From 1975 through 1981 the detailed questions on each 

A ......... Less than 1,000 (including loss) 

B ......... 1,000 – 1,999 

c ......... 2,000 – 2,999 

D ......... 3,000 – 3,999 

E ......... 4,000 – 4,999 

F ......... 5,000 – 5,999 

G ......... 6,000 – 6,999 

H ......... 7,000 – 7,999 

I .......... 8,000 – 8,999 

J ......... 9,000 – 9,999 

K .........10.000 – 10,999 

L .........11.000 – 11,999 

M ........12.000 – 12,999 

N ..........13.000 – 13,999 

0 .........14.000 – 14,999 

P .........15.000 – 15,999 

Q .........16.000 – 16,999 

R .........17.000 – 17,999 

s .........18.000 – 18,999 

T .........19.000 – 19,999 

hospitalization were unchanged. They were placed after the 

detailed questions on conditions. In 1982–83 the detailed hospital questions were placed before the detailed condition pages 

so that the interviewer could enter conditions for which there 

was a hospital night during the 2-week reference period and 

complete detailed condition pages without backtracking. Another 

change starting in 1982 was that the detailed questions on the 

condition causing hospitalization needed for coding to the fourdigit International Classification of Diseases (ICD) were no 

29 
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1975-81, probe questions


2%. was -- 0 patient in a hospital at any timo since (date) a year ago? 290. N (Item Cl


b. How many times was in a hospitol since (date) a y*Or ago? T,mes (Item C) 

100. Was anyone in tha family in o nursing home, eonvalcscmtt home, or 

similar ploce since (date) 0 year ago? Y N (31) 1 -

b. Who was this? - Circle “Y” in person’s column. 30b. Y 

______________________________________________________ --b y ______________________ 

If Y,” ask: c. _ Times (Item C) c. During thot period, how many times was in a nursing home or similar place? 

Ask for each child I year old or under if date of birth is on or after reference date. 

310. was -- born in a“hospitol? 310. 

If ‘“Yes,” and no hospitalizations entered in his and/or mother’s column, enter “ l“ in 29b and item C. Y N (NP) 

If “Yes,” and a hospitalization is entered for the mother and/or baby, ask 3 I b for each. .------------------­

b.lsthis hospitalizotiotr included inthanumbar yougavcmc for--? b. 

Y N If “No,’” Correct entries in29 and item Cformother and/or baby. 

1975-81, detailed questions 

HOSPITAL PAGE 1. Person number 

YOU said that was in the hospital (nursing homo) during the post year. Month Oate Yew 

USE YOUR CALENDAR !, won did �ntor tiw hospital (nursing homo) (the lost time)? Make SW. tha YEAR IS corrcc L 19 — 

Nsms 

Street 

]. %otistho nomcand addrtss ofthishospi*l (nursin~hom*)? L 

City (or county) stat, 

, 

1, Haw mony nights was in ths haspital (nursing hamo)? 1. . Nizhts 

Complete 5 from entries in 2 and 4: if not clear, ask the questions, 

in. HOW many of these nights wore during tho ~st 12 manths? im,I Ni;hts -. 

b. How many of these nights wero during the post 2 wooks? b. — Nights .- I c. was still in the hospittti (nursing hemc) last Sunday night for this hospitalization (stay)? 

i. For what condition did �nter tho haspitol (nursing home) - do you knew the medical name? 

If medical name unknown, enter an adequate description. 

For delivery ask: Show CAUSE, KIND, and 

Was this a normal ddivory? If ‘“NO,’” ask: 

!

1PART OF 800Y in same 

1 

For newborn, ask: What was the mattar? 1 detail as required for the Kind 

I Was tfw k+by narmol at birth? 1 1 

1

I Condition page. 

t

t 

P-a;t-Oi L;d; -----------------------’ 

‘a. Wero any opwtttions pdarm.d on during this stay at the hospital (nursing homa)? b. Y 0 N (NextHOSP) 

b. what was ths tsamt of tfw operation? t. If name of operation is not known, describe what was done. ,-------------------------------- Y (Describe) 7N 

i c. Any oth-r opomtiens during this stoy? c. I 

‘OOTNOTES 

A Condition page is required if there is an entry of “I” o~ more nights in 5b, If there is no Condition page, enter P2 I condition in item C and fill a page for it after completing columns for all required hospitalizations. 

Figure 12. Hospitalization 

30 
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1982-83, probe questions 

HOSPITAL PROBE 

6a. Sincc(13-month hcspltal dote) a year ago, was a p.ati.nt in a hospital OVERNIGHT? 2~t4;~~jkp;HOSP.” box, 

.;; ‘ ‘yes 

b.	 Howmnnydiff*rwM times did-- stoyinanyhospitol overnight erlengetsinc. (Make enfry m (13-month hosptral date) a ye.r.go? b. .eHCSP..8 h,, 

Numb,, of tome% } THEN NP) 

Ask for each child under one: 7.3. I ~ Yes 

70, Was born in o hotpitol? 2 ~ No (NPJ 

J. 'A;~];r-;o~{e;>~ ~~[#id~---------------------------------------------------------- -<. D Yes /NP) 

b. Hav* YOU included this hospitalization in the number you govt m~ for --? I-J g:xjcorrecl 6 and -HasP.-

1982-83, detailed questions 

J. HOSPITAL PAGE HOSPITAL STAY 1 — 

1. Refer to C 1, “’HOSP.”’ box. 1. Person number 

— 2.	 YOU said sarlier that was a patient in the hospital since ( 13-month hospital date) a year .lomh Date Year 

qo, On what date did �nter the hospital ([the lost tim~the time before thot )? 

Record each entry date in a separate Hospital Stay calumn.	 2. 19_ 

— 3. How many nights was in the hospital? 3. ma ~ None (Next US) 

—Nleh= — 4. For what condition did enter th. hospital? 4. 1 � Normal delwery 

� For delivery osk: � For newborn ask: � For initial “No condition” ask:. ZU Ncxmal at birth (5) 

Was 

If “t40,” osk: If ““No, ” ask: * For tests, ask: � Condicio. 

What was the matter? What was the matter? What wore the results of the te5ts? 2 

If no results, ask: 

Why were the tests performed? 

this a normal dclivary? Wos the baby narmal at birth? Why did errtw the hospital? 3 � No condmaon } 

J1 �	 At least one nisht m 2-week 

reference pericd (Enter condition 

in C2, THEN 5) JI Refer to questions 2, 3, and 2-week reference period. ~ No .#ghts in 2-week reference period (5)

I — 

5a. Did have any kind of surgery ar operation during this stay in the hospital, 50. 1 � Yes 2 n No (6) 

including bone settings and stitches? 

b.	 What was the name of the surgery or operation? 

If name of aperation not known, describe what was dane. 

c. Wax there any othor surgery or operation during this stay? 

6. What is the nama and address of this hospital? 

Figure 12. Hospitalization—Con. 

longer collected on the detailed hospital page. Hence, starting 

in 1982, except for hospitalizations occurring during the 2-

week reference period, conditions were not coded according to 

the ICD. Rather, the items asked in 1982–83 permitted classification of each hospitalization into the following categories: 

(a) normal birth, (b) birth with complications, (c) normal delivery, 

(d) delivery with complications, (e) other than birth or delivery 

and condition reported, and (~ other than birth or delivery and 

no condition reported. From 1975 through 1983, although 

conditions were coded to four-digit ICD detail, the data were 

b. (1) 

(2) 

(3) 

_________ 

c. � Yes (Reask 5b and c) o No 

lam 

lumber and sweet 

:Ity orCounty state 

processed in such a way that for many hospitalizations it was 

not possible to determine whether a birth or delivery was involved. Other changes made in 1982 through 1983 included 

deleting probe questions to clarify whether any nights were 

during the past 12 months or 2 weeks, because these probes 

were deemed no longer necessary; and adding the phrase “including bone settings and stitches” to the question on operations. 

to make explicit to the respondent that these should be included, 

The results of the 1979 phase II nationwide field test indicated that there were no differences between the NHIS control 

31 
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and experimental questionnaire in statistics produced on number Between 1975 and 1981 there were no changes in the core 

of discharges, average length of stay, and number of nights.zs questions asked on limitation of activity (figure 13). These 

(See appendix III.) questions first asked for a person’s major activity during the 

past 12 months (that is, working, keeping house, going to school, Limitation of activity due to chronic conditions or something else). Persons ages 45 years and over reporting 

All persons are classified into one of four groups: their major activity as something other than “working,” “keeping 

� Unable to perform major activity due to chronic condition house,” or “going to school” were asked whether they were 

or impairment. retired. If the person was reported as “retired,” the next ques-

� Limited in kind or amount of major activity due to chronic tion was whether he or she retired because of health. These 

condition or impairment. cursory questions were not adequate, however, to permit class-

� Limited in other activities due to chronic condition or im- ification of the person as retired because the word “retired” 

pairment. means different things to different people. For children under 6 

� No limitation in activity due to chronic condition or im- years, it was assumed that the child’s major activity was taking 

pairment. part in ordinary play. Next, questions were asked about limita1975-81 

19a.	 What was doing MOST OF THE PAST 12 MONTHS - (For males): working or doing wxnathing �lsQ? 19. 1 I_J Working (24a) 

If “something else,” ask: (For females): keeping house, workin~ or doing # . 2 � Keepm; house (24b) 

Ages b. What WaS doing? something else? 

3 � Retired, health (23) 17+ If 45+ years and was not “working,” “keeping house, ” or “going to school, ” ask: 

c. IS retired? 4 I_J Retired, orher (23) 

d. If “retired,” ask: Did he retire because of his health? S � Going to school (26) 

_________ ____________________________________ 

20a. What WOS doing MOST OF THE PAST 12 MONTHS - going to school or doing something else? 6 � 17+ something �lse (23) 

Ages 

6-16 If “something else,” ask: 7 I_J 6-16 sonwthlng �lse (25) 

b. What WOS doing? ____________________ . 

Ages 0 � I -5 years (27) 

under 6 o � U rider I (22) 

?lIJ.	 Is able to take port at all in ordinary Ploy with other children? _-------___ _-------------------------:------------------------------------- & __-L-____.J-!&Lb. Is he limited in the kind of Pfay he con do because of his heolth? b. z Y (28) N 

c. Is he limited in the amount of pfay because of his health? c. 2 Y (28) N (27) 

22a.	 Is limited in any way bacsruse of his heelth? 22.. IY s N (NP) ______________________________________________ ., ____________________ ___________________ . 

b.	 In what way is he limited? Record limitation, not condition. b. (28) ——--

230.	 Does heolth now keep him from working? 230. ! Y (28) N ______________________________________________ ., ___ _____________________________ ___________________ . 

b.	 Is he limited in the kind of work he could do bscouse of his health? b. 2 Y (28) N _______________________________________________ ____________________ _____ - —_________________ . 

c. Is he limited in the amount of work he could do because of his health? _____________________	 -,__ c, 2 Y (28) N ________________ 

d. Is he limited in the kind or omount of other activities because of his health? d. 3 Y [28) N (27) 

24a. Does NOW have a iob? 24.. Y (24c) N . ______ ________________________ . 

b. In terms of health, is NOW able to (work – keep house) ot all? b. Y 1 N (28) _____________________________________________________ __ _____________ -

c. Is he limited in the k!nd of (work - housework) he can do because of his health? c. 2 Y (28) N _____	 ___________ _________ ___________________ . 

d. Is he limited in the amount of (work - housework) he can do because of his health? d. 2 Y (28) __ y_--_­ ________________________________________________________ _______________________ 

e. Is he limited in the kind or amount of other activities because of his health? �. 3 Y (28) N (27) 

25, In terms of health would be able to go to school? 25. Y 1 N (28) 

26o. Does (would) have to go to o certain type of school because of his health? 260. 2 Y (28) N ___________________ . . . 

b. Is he (would he be) limited in school attendance because of his health? b. 2 Y (28) N _________________________ __ ____________________ 

c.	 Is he limited in the kind or amount of other activities becouse of his health? c. 3 Y (28) N -— 

27a.	 Is limited in ANY WAY because of a disability or health? 27.. 4Y 5 N (NP) ___________________________________________ _____ ____ __________________________ 

b.	 In what way is he limited? Retard Iimitatian, nat canditlon. —— b. _______ 

been limited in 000 � Less than I month 

2Sa, About how long hos he been unable to 2aa. 

{ had to go to a certain type of school? } __ --~_7 Mos. -__Z_=-Y:: — . . .. —_______ ___________________ 

b.	 What (other) condition couses this limitation? b. Enter condition In {tam C 

Ask 28c 

[f “old age” only, ask: Is this limitation caused by any specific ccmditicm? u Old age only (##P) 

___________________________________________ .. ___ _____ _-

Y (Reask N C. is this Iimitatian caused by any other condition? c. 28b and c) __ _________ . . . .. . . __________________ . � Only 1 condition Mark box or ask: 

d.	 Which of these conditions would you say is the MAIN cause of his limitation’? d. Enter main condition —- —-. . . . . .. 

Figure 13. Limitation of activity 

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I 

I 1982 

B. LIMITATION OF ACTIVITIES PAGE II 

B1 Refer to age. B1 1 � IG-70 (1) 

1.whatWos -doing MOST OF THE PAST 12 MONTHS; working at a lob or bu.sincss, 1. I � Workinz (2) 

kwping house, going to school, or something �ISC? 2 � Keeping house (3) 

Priority if 2 or more octlvities reported: (J) Spent the most tjme doing; (2) Considers the most important. 3 � Golnc to school (5) 

2 u Other (NP) 

4 � %rnsthinz else (5) 

la. Does any Impoirmont or haalth problom NOW keep -from working at a ieb or business? 2a. t � Yes (7) � No - -

b. IS Iimitcd in the kind OR amount of work con do bocausc of any Impoirmcnt or health problom? b. 2 � Yes (7) an No (6) 

3a. DOQS any Impairment or haelth probltm NOW kaep from doing any housework at all? 30. 4 � Yes (4) � No 

b. Is Iimitad in tho kind OR amount of heusawrsrk -_ eon de b.causo of any impolrmcnt or health pro blom? b. 5 rJ Yes (4) 6 m No (5) 

b.	 What (othor) condition eauscs this? 

Ask if injury or operotion: When did [tho (in”ur ) eccur?/--h0v* th* Op.rotlon?] 4a. (Enter condition In C2, THEN 4b) 

Ask If operotlon over 3 months ego: For w? at condition did have tho operation? 1 � Old �;e (Mark “O/d w#’ bOX, If pregnmcy/delivery or O-3 months injury w operation - THEN 40) f&sask question 3 where Ilmitotion reported, soykrg: Exc_pt for (gondkion), . ..? 

OR reosk 4b/c. 

b.	 Besides (condNion) is thorc any othor condition thot couses this Iimitetlon? b. � Yes (Reask 4e and b) 

� No (4d) 

c. IS this limitation cous*d by my (Cthor) •p*clf~c condit~on? c. a Yes (Reask 4+sand b) 

� No 

Mork box 1/ only one condition. d. D only I Corrdltlon 

d. Which of thoso conditions would you say is the MAIN COUS* of this limitation? 

Main cause 

So. D-s ony Impairmcrrt or health pmblam koap from working at a 10b or business? 30. 1 � Yes (7) � No 

b, h Iimitad in the kind OR omount of work could do bocouso of any impoirmmt or hrnlth problrm? b. 2 � Yes (7) 3UN0 

B2 ! @ ““Yes”In 3a or 3b (fVP) B2, Refer to questions 30 and 3b. 2 n Other @) 

!0. 19-- limited in ANY WAY in any activities btcausa of an impoiramnt or haalth pmblom? be. 1 (g Yes 2 � No (NP) 

b. In what way is Iimitod? Record limitation, not condition. b. 

Llmitstion 

!a. What (oth) condition couscs this? 

Ask lf ln@y or operation: Whmr did ~h~ (irr’ur ) occur?/--hava the opwatiorr?] 78. (Err!er condition In C2, THEN ?b) 

Ask If operation over 3 nrenths ago: For wP at condition did have tht opomtion? 

If pregnoncy/dellvery or O-3 months injury or ofwdon - 1 � Old �Se (Mark “OM we” 60s, 

Reask question 2. S, or 6 where fimitotion reported. soying: Except for (gonditiorj, . . .? THEN 7c) 

OR reosk ?b/c. 

-

b.	 Bcsidos (condition) isthoro any othor condition that causas this Iimitetlon? b. a Yes (k?eask 7a end b) 

aNo(7d) 

c.	 Is this Iimitotion caused by any (other) specific condition? e. � Yes (Reask 7a and b) 

� No 

-----------------------Mark box if only one condition. d. l-g only i Cendklorr 

d. Which of those conditions would you say is tho MAIN COUS* of this Iimitotlen? 

MsIn 2SUSC. 

. ... . . . . . . . . . . . . . . e... . .“” “,. -, ,, ..., ..-. -.., . -*” . 

Figure 13. Limitation of activity—Con. 

tions in major activity. For persons 17 years and over, including 

retired persons, whose reported major activity was something 

other than work, keeping house, or going to school, questions 

were asked about limitation in working. All children 6– 17 years 

of age were asked about school attendance and school activity 

limitations, If no limitations were reported in major activity, 

the person was asked about limitations in other activities. Finally 

the person was asked if he or she was limited in any way because of a disability or health. For any reported limitation, the 

main condition causing the limitation was ascertained. In 

processingthe data, limitations caused by other-than-chronic 

conditions are eliminated. The limitation of activity variable 

does not include limitations caused by acute conditions. 

Many mocMcations were made to the limitation of activities 

questions in the revised 1982 questionnaire. Many more interviewer instructions were printed on the questionnaire to reduce 

errors. The phrase “because of any impairment or health problem” was substituted for the phrase “because of a disability or 

health.” For babies under 1 year, additional questions were 

asked concerning limitation in play activities. Attending special 

classes because of a health problem was added to the school 

limitation concept and the school age was lowered to include 

children 5 years of age. All persons ages 18–69 years (ages 

18–70 years in 1982), not just those whose usual activity was 

working, were asked about their limitations in working at a job 

or business. Persons whose major activity was housework were 

33 
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1982—Con. 

R 1 lUITATltlM 11= AFrlVITISX 9ACE r,..,: . ....t II “. -,nl, ,- , ,“,. “o n-o s. , , .k.z . -“-, %“.., !,, ”s” 

B3 o � Under 5 (10) 3 u 6a-71 (f4) 

1 � 5-17(71) 4 � 71 �nd B3 Refer to ate. 2 D 18-59 (B4) over (B] 

8.	 Wfrot Wos doing MOST OF THE PAST 12 MONTHS; working at o ~ob or business, keeping heuw, 8. t � Workln~ 

going to school, or wmdring .1s0? z � KeepIn; house 

Priority if 2 or more activities reported: (1) Spent the most time doing; (2) Considers the most important.	 3 � Going to school 

4 n %methlng elw 

90. BQCOUS. of any impoirmont or health probltm, dots no-d tho halp of othor persons with personal 90. I � Yes (73) D No 

care	 noods, such as catln~, bethinl, dressing, or getting around this home? —---—--- -—- —- —----------- — 

b.	 Bwwrw of wry impairmmrt or hcaith problom, doos -wed the help of othor pwsons in handling routine b. 2 � Yes (13) J fJ No (12) 

moods, such os �veryday houwhold choros, doing rrc.sessary business, shopping, or g-tting around for 

othor purpews? 

Oa. Is able to iako partAT ALL in tho usual kinds of play activities done by most children age? 100. � :.s o c: No (13) 

b. rs------------------------------------------------------------------------ Iimitad in the kind OR amount of ploy wtivitias can do bacauw of �y impoirmmtt or hwlth probltm? ‘-- b. ‘-~~-y~li~----~ri~~;fii-­

la. Dow any impairment or health problam NOW kotp from attending school? 11-. 1 � Yes (13) � No 

—-------------------- b. fi:c-,---: zit:n-d-a-:p-.: i-a~~:h-ezrx,-,-p::l~ ~:lzis-.i -bi:a-v~: zF:n-y-i:~~i~~.-n~ :~ke-aitk -p~o-b~e-m-?--------- --K 

___ __::-:-’-(;3) ‘::-----

c. Daw --nwdtaattwda spwiol whwlar spacioi classw bwauw ofanyimpairment orhwitbproblom? c. 3n Yes (f3) D No 

d.ia limited In school attondanco bocatrw of hoolth? ‘-- d. ‘-i~-Y&-(7J----i’filY---­

2a. Is Iimitod in ANY WAY In any activities bccausc of an impoirmart or hcaith problom? 12@. 1 n Yes 2DNO(NP) 

b.T{;K&%Z;l;--------------=-7-=--------.-"----------------------------------­ --limited? Record ftmnatlon, not condttlon. ‘--

b. 

Llmimtlon 

3a.	 What (otfwr) eanditias causes this? 

Askifhtjury araperation: Whondid [ths(i~) occur?/--hovc theoperation~ 120. (Enter cmdlthm In C2, THEN 13b) 

AskifoPeroticm 

If pregnancy/delivery or O-3 months injury ar operation - THErJ13c) 

Reask question where Iimitation reported. saying: Except for-- (gonditi~), . . .? 

ORrewk 13b/c. 

Bwidos (canditian) isthcrc anyothcr 

aver3montftsogo: Forwhaf condition did-- hav~~coPoration? lDOlda e(kfark’’Oldage’’box, 

b.	 '------------------------------------------------------------------------- condition that causes this limitation? --c ‘--~-y.s?j%a~~ 7~a-a-ti-x)-----­

� No(13d) 

c.ls this limitatiwt catsaad byany(atfwr) apacific condition? e.	 U Yes (Reask 13a and b) 

a No 

EZS-&iifinifiCe-C0i2EGi d. ‘--~-&i~i&-ni~<~ 

d. Which of these conditions woufd you say is the MAIN cousc of this Iimltotion? 

Mcin c8use 

04 n ~--~ ..d’”Old w.”” box marked 

B4 Referto”’Age, “*”’Old age,’* and””LA’’ boxes.. Mark first oppropriatelrox. � 5-59 and entry in ““LA”* box (14) 

n Other (NP) 

40.	 Bocousc ofwyimpoirmento rhoalthproblom, doos need tho help of othw parsons with paraanai 140, 1 (-J Yol (W) U No 

caronaods, auchas catin~ bathing, drwaing, argottingarwndthia hamo? 

Askifo#e 18 and over. b. 2 n Y-s JUNO 

b.	 Bscww of �y I irmant arhcolth problom, daas mad tho h*lp of otbor persons in bandlin~ --rautine need,, 

wchaacvaryday ‘T ouaahaldcharw, daingnaccaaary buaiwss, shopping, orgafting arwndfor athcrpurpasw? 

IRM!+11.:(1901)14.E.S21 8. , -*. “ 

Figure 13, Limitation ofactivity-Con, 

also asked about limitations in housework, Persons ages 

18-69 years whose major activity was going to school or 

something else were asked only about limitations at a job or 

business. Allpersons 5years andoverreporting alimitationof 

activity as well as all persons 60 years of age and over were 

asked about their need for the assistance ofanother personin 

performing necessary activities for daily living. Note that all 

persons 60–70 years ofage(60–69 years in 1982) were asked 

about limitations in working and about need for assistance in 

activities for daily living, 

The revised experimental questionnaire used in the 1979 

phase II nationwide field test resulted in a higher proportion of 

children being limited (because of the added special class question) than the control questionnaire, (See appendix III.) Lower 

proportions of persons 65 years and over had limitation of 

activity on the experimental questionnaivq that is a consequence 

of not asking about work limitation for persons 65 years and over. 

The upper age limit for asking questions on work limitation 

was raised from 65 to 70 years before the final 1982 questionnaire went into use. These changes should be taken into consideration inmaking inferences from the experimental version 

to the final 1982 instrument. Nevertheless, a considerable 

effect was observed onlimitation in major activity for the experimental questionnaire when all persons 17–64 years were 

asked about work limitation. Although no increases were ob 

served in the overall proportion of persons ages 17–64 reporting 

34 
LIMITATION 

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1983 

—-

B. —........ .. .. OF . . .ACTIVITIES .. . . . . .. . .PAGF ... . II 

J 

BI Refer to age. B1	 1n 18-69(1) 

2 a Other (NP) 

1. What was doing MOST OF THE PAST 12 MONTHS; working at a iob or business, 1. 1 � Working (2) 

kocping house, going to school, or something else? 2 � Keeping house (3) 

Priority if 2 or more octivlt!es reported: (1) Spent the most time doing; (2) Constders the most Important. 3 � Going to school (5) 

4m Something else(5) 

20. Deasany impairmmt orhoalth problem NOWkceP from werking ata iob or business? ___________________ __________ _2:: 1 � Yes(7) D No _______________________ 

b. Is limit~d inthekind OR amount of work can do because of any impairment or health problem? b. 2 � Yes (7) 3@ No (6) 

3a. Doe. any impairment or health problem NOW keep from doing any housework at all? _3: ._ 4nYes(4] __ ______ ____ __ __ ~ NO -------— _______________ 

b. Is Iimitcd intho kind ORomount of housework con do because of any impairment or health problem? b. s � Yes (4) 6 ~ No (5) 

4a. What (oth~r) condition causes this? 

Askifinju~ oroperotion: Whcndid [the(w) occur?/--have theoPecation?] 40. (Enter cOtiltionin C2, THEN #b) 

Ask ifoperation over 3monthsogo: 

lfpregnancy/deli very or O-3 months 

Reoskquestion3 where Iimitation 

Forwhot condition did 

injury or operation -

reported. saying: Except 

have the operation? 

for (condition), . ..? 

1 � Old aee@6wk 

THEN 4c) 

‘“O/d age”” box, 

OR reosk 4b/c. 

b. Besides (condition) is there anyother condition that causes this limitation? b. � Yes (Reesk 4a and b) 

� No(4d) 

-——.. 

c. Is this Iimitotion caused by any (other) specific condition? c. n Yes (Reask 4a and b) 

� No —- —.. _______________________ 

Mark box if only one condition. d. a Only I condition 

d. Which ofthrsr corrditions would yousayis the MAIN cause of this limitation? 

Main cause 

Sa. Doasony impairment orhealth problem keep-- from working ata iob or business? ~: I � Yes (7) n N. _____________________ __________________ _ _______________________ 

b. Is Iimitcd inthekind ORamountofwork could do becouse of ony impairment or health problem? b. 2D Yes (7) 3 Cj No 

B2 1 @“”Yes”. in 3a.x3b(NP) B2 Refer to questions 3a and 3b. 2 � other (6) 

6a. Iz -.. limited in ANy WAY inanyactivities because ofanimpairment or health problem? _ _______ _ 60: _ In Yes zCt40(~~~_-­

b. In what way is Iimitad? Record limitation, not condition. b. 

Limscacto. 

7a.	 What (other) condition COUS.SS this? 

Aski(inju~ oroperotion: When did fihe(in”ur )occur?/--have the operation?] 7’s. (EnfercotiN@nin C2, THEN7b) Ask ifoperotion over 3 months ago: Forw F atcondition did-- have the operation? 

lf pregnancy/delivery or O-3 months injury oroperotion - I @ Old age fMark “0/da ge”’ box. 

Reask question2. 5, or6 where Iimitation reported, saying: Except for-- (condition), . . .? THEN 7c) 

OR reosk 7b/c. 

,- . 

b. B*sidet (condition) isthere anyother condition that causes this Iimitotion? b. n Yes (Reask 7a and b) 

n No ( 7d) 

--------------------------------------------— 

c.	 Is thi~ Iimitotion caused by any (other) specific condition? e. � Yes (Reask 7a ard b) 

� No 

Mork box if only one condi[ion. d, monlyl condition 

d. Which of these conditions would yousayis tha MAINcause of this Iimitotion? 

t-fain cause 

>RW HtS.1 {10,11 {0.,.02) P... 4 

Figure 13. Limitation of activity-Con. 

limitation of activity, a considerable shift occurred in the types 

of limitations reported. The proportion of persons, whose major 

activity was keeping house, reporting “unable to work” was 

more than twice the percent of the same group that reported 

being unable to perform housework. For a more complete description of the experimental questionnaire results compared 

with the control questionnaire, see references 28 and 29. 

In 1983 the upper age limit for asking questions on limitations in work was lowered from 70 to 69. In addition, all persons 

responding that they needed help with personal needs were 

asked for the condition causing the limitation. In this way, 

limitations caused by nonchronic conditions could be deleted. 

Disability days 

Estimates of total disability days (also called restricted 

activity days) and disability days by type (bed days, work-loss 

days, school-loss days, and other disability days) are made 

using the disability day questions (figure 14). Figure 15 shows 

the relationships among tie types of disability days. The number 

within the large circle represents the total number of disability 

days. The small circles represent bed-disability days and workIoss or school-loss days. Note that work- or school-loss days 

and bed days are includedin disabilitydays. 

The disability day set of questions is also used along with 

35 
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1983—Con. 

B. LIMITATION OF ACTIVITIES PAGE, Continued 

03 0 n Under 5 (10) 2 ~ I B-69 (NJ 

!33 Refer to age. 

3 � 5-17 [71) 3r70m.i — over i8J 

8.€ What was doing MOST OF THE PAST 12 MONTHS; working at a iob or business, keaping hous~, 8. I � Worktng 

going to school, or something �lse? Z � Keeping house 

Priority if 2 or more activities repxted: (1) Spent the most time daing: (2) Cansiders the most important.	 3 � Going to school 

4 � %methmg else 1 1 

9a. B.cmJs. of eny impairment or h.alth problem, does n.ed the help of other persons with personal 90. 1 � Yes (13) D No 

.- care ncods, wch os �ating, bathing, dressing, oor getting around this home? — b. Bacouw of any impairment or health problem, does -need the help of othor persons in handling routine b. 2 Q Yes (13) 3C No (12) I needs, such as �vorydoy housohold chor.s, doing nacessary busincs~, shopping, or getting around for Ii othor€ PwPOSOS? I I 

lea. IS ablt to take part AT ALL in the uxual kinds of play activities dono by most children age? 100. ~ Y.. o~No(13) 

I b.€Is limit-d in the kind OR amount of ploy activities can do bccousc of any impairment or health problem? b. 1 C Yes (13) 2 ~ No (12) 11 

I I 

I b, 1 la. Doo$ any impairmwzt or haalth probl~m NOW k~ep from att*nding school? 11.a. 1 � Yes (13) D No 

~:a;-::---------------------------------------------------------------------- attend a special school or spcctal classes because of any tmpatrmwtt or health problem? --K -ban;____ 11 

c. Do-s rmcd to attend a special school or special classas bccausa of any impairment or health problem? ii . . 3 I-J Yes (13) � NO I 

I d.	 Is limit-d in school .attondonc* bccmssa of health? d. 4~ Yes (13) SONO 11 

I I 

120. Is Iimitod in ANY WAY in any activities bacause af an impairmmtt or health problom? 120. 1 � Yes 2 � No (AfP)

:----~-,------------ I -~------, . 

b. In what way IS Itmttcd? Retard /lmltatian, nat cofldluon. Ii 

b. 

Llmltatlon 

130. What (other) condition causas this? 

b. 

Ask if injury or operation: When did [tho (i~) occur?/--have tho oporatien~ I 30. fEnter ctmdlthx In C2, THEN 13b) 

Ask if aperatian aver 3 months ago: For what conditien did lmv~ the op.ration? 

If pregnancyldelivery ar O-3 months injury or ooeratian -

1 � old ~ 9 (uark’”Old ago”’~, THEfi 13c) 

Reisk questian where limitation reported, saying: Except for (gonditio~), . . .? 

---+OR reask 13b/c. : ~ --- ; : : ~ -------------------- Bcsldcs (condltlan) IS thoro any othor candttmn that cautos this Iimitatian? b, - ‘~-Y&ii&ii iii-a-$ii-- ‘-. 1 � NO :- $--~ : ~ ----.-, 

(73d) 

c. Is thts Ilmitatlon causad by any (othor) spcclftc condttlon? c, ~ Yes (Reask 13a and b) 

i � No -.-: Mark box if only one condltton. d. Q Only I condition 

d. Which of these conditions would you say is the MAIN caus- af this limitation? 

FOOTNOTES 

Figure 13. Limitation of activity-Con. 

the doctor contact questions (figure 17) to elicit the reporting of 

illness and injuries for constructing estimates of acute conditions. Respondents are asked to report any conditions causing 

the disability days. 

From 1975 through 1981 the questions to determine the 

number of disability days remained the same. Questions were 

asked for a 2-week recall period about bed days (days in which 

the person stayed “in bed all or most of the day”), work-loss 

days for persons 17 years of age and over, school-loss days for 

persons 6– 16 years of age, and other days the person “cut 

down on the things” he or she “usually does because of illness 

or injury.” Where appropriate, the interviewer probed to clarify 

1 

I Maincause 

how many of the work-or school-loss days the person stayed in 

bed. For persons with one or more disability days during the 

past 2 weeks, the conditions causing the restricted activity 

were ascertained. 

To reduce underreporting of disability days from accidents 

or injuries and the underreporting of accidents or injuries that 

caused either disability days or a doctor contact, a probe was 

included about any accidents or injuries occurring during the 

past 2 weeks. 

Some work- or school-loss days may also be bed-disability 

days. From 1975 to 1981 NHIS defined work-loss days only 

for persons 17 years of age and over and school-loss days only 

36 
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1983—Con. 

B. LIMITATION OF ACTIVITIES PAGE, Continued 

B5 Refer to “Oldage,” and “LA” boxes. Mark (irst appropriate box. 

I 

14a.	 BecausG of any irnpainnent or health problem, does --need theheip of other persons with--personal 

care needs, such as eating, bathing, dressing, or getting around this home? 

If under 18, skip to next person, otherwise ask: 

b, Becauss of any impairment or health problem, does need the help of other persons in handling rmztine 

naeds, such as everydoy hsusehold chores, doing necessary business, shopping, or getting around for other purposes? 

150,	 What (other) condition causes this? 

Ask If injury or operation: When did [the (-) occur?/ have the operation?] 

Ask I f apcratian over 3 months ago: For what condition did have the operation? 

If pregnancy/delivery or O-3 months ;njury or operation -

Reosk questian 14 where iimitatton reported, soying: Except for (condition), . . .? 

OR reosk 15b/c. —-- . —---------- _________________________________ 

b, Besides (condition) is there any other condition that causes this limitation? 

=--------- _------- —___________________ c. Is this limitation caused by any (other) specific condition? 

___________________________________________________ 

Mark bax if only one candition. 

d, Which of these conditions would you say is the MAIN cause of this limitation? 

-&i 

B5 

— 

14a. 

b. 

15a. 

b. 

c. 

d. 

0 ~ tJnd=, 5 (NP) ~ !: 60-69(14) 

1 ~ 5-59 (B5) 3 ~	 70 and 

ova (NPI 

7 4oOld age” box marked (14)


=
 L Entry ,n “LA”’ box /14)


~ Ocher (NP)


1 ~Yes (75) ~ No 

2 Lq Yes 3 In No (NP) 

(Enter cmdition in C2, THEN 15b) 

1 D	 Old age (Mark “O/d age. ” bax, THEN 15cJ 

_______________________ ‘~ Yes (Reask 15a and b) 

~ No (15d) 

—- —----—---- G Yes (Reask 75a and b) 

~ No 

—— 

~ Only’ I co”dtttan 

Main cause 

:OOTNOTES 

Figure 13. Limitation of activity-Con. 

for children ages 6-16. Starting in 1982 NHIS defined work10SSdays only for persons 18 years of age and over and schoolIoss days for children ages 5–17. 

From 1975-81, employment status was obtained after 

work-loss days and the analyst reconciled any inconsistencies 

between the two variables. Starting in 1982, the interviewer 

determined current work status prior to asking the work-loss 

series. This change was made to assist the interviewer. Another 

change was that the concept of a disability as being “more than 

half of a day” was communicated to the respondent in the 

questions asked. Still another change in questionnaire format 

was that an entire page was devoted to each family member for 

recording disability days. The probe questions on accidents 

and injuries were moved to the Health Indicator Page. 

The results of the 1979 phase II evaluation test indicated 

that for all persons the revised experimental questionnaire elicited about the same level of total restricted activity days per 

person.2B*Z9However, for persons 65 years and over the number 

of restricted activity days was higher for the control group (9.7) 

than for the experimental group (6.8). Again, caution must be 

exercised in drawing inferences between the experimental 

questionnaire results and the final results from the 1982 questionnaire because major changes were made to the experimental 

questionnaire battery of questions on restricted activity before 

37 
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1975-81 ,, 

If related persons 17 years old or over are listed In addition to the respondent, say: O[_] Under 17 

H Ike to have all adults who are at home toke part in the interview. H 1, ,Atllmlw 

Is your --, your --, etc., at home now? If “Yes, ” ask: Please azk them to ioin US. 

2 [.7 NOI ax home 

This survey is baing conducted to collect information on the Nation’s health. I will ask about visits to 

doctors and dentists, il Iness in the fomil y, and other health related items. (Hand calendar) 

The next fcw questions refer to the past 2 weeks, the 2 weeks outlined in red on that calendar, 

beginning Monday, (date) , and �riding this past Sunday, (date) . Y (5b) 

We would 1“ 

50, During those 2 weeks, did stay in bad b-cause of any illness m injury? 50. 00 N If a;e: 

- . . . . . . . . . . . . . . . ..-------.-------- 17+ (8) 

6-16 (7) 

b. During that 2-week period, how many days did stay in bed all or most of the day? b. . Days 1Under 6 (9) 

6. During those 2 woaks, how many days did illness or iniury keep from work? 6. WL days (8)

(For	 females): not counting work around the housr? 00 m None (9) 

7. During those 2 weekt, how many days did illness or iniury keep from school? 7. SL days 

00 m None (9) 

If one or more days In 5b, ask 8; otherwise go to 9 

— Days 8. On how many of these days lost from stay in bed all or most of the day? 8. 00 n None 

{ ‘:;5”’ } ‘id 

in bed 

90. (NOT COUNTING the day(s) lost from work ) ?.. lY 

{ lost from school } 

Were there any (othe,) days during the past 2 weeks that cut down on the things 2 N (10) 

he usually does brcause of illness or iniury? 

.----- . . . .. — . ..----- .---- . . . . . - —--.--—--- . . . . . . . . . . . . . .. -.--— 

in bed 

b.	 (Again, not counting the cloy(s) lost from work ) b. — Days 

{ lost from school } 00 a None 

During that period, how many (other) days did he cut down for as much os a day? 

If one or more days In 5-9, ask 10; otherwise go to next person. 

Enter conU!tjon m item C 

100. What condition caus~d to during the past 2 weeks? 10,I. Ask 10b 

{%!:} . -. . .. -_--— 

Y 

b.	 Did any other condition cause him to b. 

N INP) 

{3!::1 )d”ringthatpe’iod’ - —,. - . ___________ _______________ ________________________________________ -_ ______________ 

c, What condition? c. Enter condtf)on #n I fern C (fob) 

[ 

b FIII [tern C, (BED DAYS), from 5b for all perscas. 

11o. During the past 2 weeks, did anyone in the family, that is you, 

your - -,. etc., hove any (other) accidents or injuries? Y N (12) 

. .1 ------

.-— b. Who was this? - Mark “Accident or Injury” box in person’s column. 1b. � Acc#dent w ,njury’ 

Injury 

c.	 What was the iniury? c. 

.- —.- — -------------------

d.	 Did anyone hove any other accidents or iniuries during that period? Y (Reask I lb and c) N 

--—-—- _________ ______________ 

If “Accldent or injury:’ ask Y (Enter lnlury In Item C) 

e. As a result of the occident, did - - see a doctor or did he cut down on the things he usually does? -1 e. N

Figure 14. Restricted activity (disability days) 

the final 1982 questionnaire went into use. NHIS makes estimates of disability days caused by spechic types of conditions 

(for instance, annual number of disability days caused by acute 

respiratory illnesses). For the purposes of making these estimates, from 1975 through 1981, for each condition reported on 

the detailed condition pages, the number of each type of disability day during the past 2 weeks was asked. On tie restricted 

activity page, the experimental questionnaire ascertained the 

number of each type of disability day for each condition reported as causing disability, This procedure led to a reduction 

in condition-specific disability days and hence the final 1982 

questiomaire reverted to the previous approach of eliciting 

condition-specific disability days on the detailed condition 

pages. 

The experimental questionnaire resulted in more work-loss 

days for females-probably because of placing the employment 

status question prior to the work-loss question. It is likely that 

when people are asked about whether they have a job or business before the work-loss question, they may remember about 

days lost from work more often than when these questions are 

not asked in sequence. Because this approach was retained for 

the 1982 questionnaire, it is possible that the estimated workIoss days in 1982 will be higher than in 1981 even if there were 

no real change in the population. 

38 
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1982-83 

D2 Refer to 2b and 3b. D. RESTRICTED ACTIVITY PAGE PERSON 2 z No days ,n 2b or 3b (6) 

Hand calendar. z I or more days ,n 2b ar 3b (5) 

{The next questions refrr to the 2 weeks outlined in red on that calendar, 

bmgin.ing Monday, (-e) and ending this post Sunday fdge). } 

Refer to age. ~. 7 Nane — DI :: Under S (4) r 5-17 (3) ~; 18 a“d ~ver (/) 

No.ofdays 

I Refer to 2b, 3b. and 4b. 

la. DURING THOSE 2 WEEKS, did work at any time at a iob or business, missed from work 

not counting work around the house? (Include unpaid work in the family m. (Not counting the day(s) missed from school 

[farm/business].) [ (and) in bed 1), 1.- Yes (Mark “WO” box, THEN 2) 27N0	 Was there any (OTHER) time during those 2 weeks that cut down 

on the thing5 usually does because of illness or iniury? 

b.	 Evwr though did not work during those 2 weeks, did ~ Yes 00 v No (03) 

-hove a job or business? 

mi sscd from work I i-” Yes (Mark 4’Wb” box, THEN 2) 2 ~ No (4) b. (Again, not counting the day(s) missed from school 1), [ (and) in bed 

2a.	 During thoze 2 weeks, did miss any time from a iob During that period, how many (OTHER) days did cut down fOr or business because of illness or iniury? more than half of the day because of illness or inirrry? 

:’ Yes 00 :: No (4) No. of cur-down days 1 

00 ~ None L---__l. b, During that 2.week period, how many days did miss more Refer to 2-6. than half of the day from iob or business because of


illn*ss or iniury? D3 CZNO days in 2-6 (Mark “No” in RD. THEN NH


~ I w more days in 2-6 (Mark “yes” in RD, THEN 7) 

Refer to 2b, 3b, 4b, and 6b. rmiss work 1 

miss school 7a. What (other) condition caused to (or) stay in bed during those 1 

3a. During those 2 weeks, did miss any time from school because 1 (ar) cut down 1 

weeks? 

of illness or iniury? 

(Enter condition in C2, THEN 7b) 

_ No (4) ~ __-- _-_-- ___ —______________ -_ —_________ Yes 00 7 

________________________________________________ 

b.	 During that 2.week period, how many days did miss more b. Did any other condition couse to 

than half of the day from school because of illness or inlury? 

~:-Yes (f?eask 70 and b) 

[li:s:: 2:N0 

FOOTNOTE5 

4a. During those 2 weeks, did stay in bed because of illness or iniury? 

: Yes oa ~ No (6) 

- . - —____________________________________________ 

b.	 During that 2.week period, how mony days did stay in bed mare 

than half of the doy because of illness or iniury? 

00 ~Nom(6) n(Mark4BDob0xTHE ND2) 

la. During the 2.wc.k period outlined in red on that calendar, has anyone in the family had an iniury 

from an accident ar otha cause that you have not yet told me about? 

� Yes ~ Na (2) ___. b. Who was this? Mark “Injury’” box in person’s column. 

- __ - ___ 

1b. I G Injury 

_ _ _-_--, 

C. what waz iniury? 

Enter Injury (les) in person’s calumn. c. 

hjury 

d. Did unyrrrw have any other iniuries during that period? 

o	 Yes (Reask lb, c. and d) H Na t 

--+---------------------- Ask for each injury in fc: e. ~ Yes (Enter ;njury m C2. THEN 

c,	 As o r~sult of the (in ur in Ic) did [--/anyone] see or talk to a medical doctor or assistant Ie for next Injury) 

(abaut --) or did -*n an “$ual activities for more than half of a day? a No (le for twxt injury) 

[ I I 

Figure 14. Restricted activity (disability days) —Con. 

39 
--

--

Bed 

daya mSchool-loss days Work-loss days

1975-81:17 years 1975-81: 

Other disability days 

\ / 

Total disability days 

Figure 15. Relationships among the types of disability days as 

defined by the National Health interview Survey 

Another issue of importance relates to the probe question 

on accidents and injuries. In the 1979 phase II experimental 

questionnaire, this probe was separated from the disability day 

questions and was asked later in the interview, with the idea of 

eliminating the probe if it had no apparent effect on the estimates. It was decided, however, that without the probe there 

would have been a reduction in reports of accidents and injuries 

that caused either disability days or doctor contactq hence the 

probe was reinstated for the final 1982 questiomaire. 

12-month bed days 

The question on number of 12-month bed days was not on 

the questionnaire in 1975 but it has been on every year since 

then (figure 16). This variable is used to classify persons according to number of bed days within broad ranges. In this way 

estimates can be made of the percent distribution of persons 

1975-81 

Mark box(es) from item C, 

BD 

according to the number of bed days in the 12 months prior to 

interview. The question on 12-month bed days is not used to 

produce estimates of the number of bed days because the level 

of accuracy for this purpose is inadequate. Instead, the 2-week 

recall question for bed days is used to produce such estimates. 

In the 1982 revised questionnaire, the 12-month bed day question remained essentially the same but the response category 

boxes were replaced with an open-ended response entry, thus 

permitting more flexibility in analysis (different groupings of 

number of days can be used). Based on the evaluation experiment, the level of estimates was not tiected by the slight changes 

in the question and relocation of the item within the questionnaire. 

2-week doctor contacts 

NHIS estimates of annual doctor contacts according to 

place of visit, type of specialist seen, reason for visit, and conditions are based on the respondent reporting events for the 2 

weeks ending Sunday night before interview (figure 17). The 

doctor contact questions are also a major avenue, along with 

the disability day questions, for the reporting of acute illness. 

The questions on doctor contacts using a 2-week recall 

period remained essentially the same from 1975 through 1981. 

A minor change occurred starting in 1976 when the interviewer 

instructions were printed directly below the question to remind 

the interviewer not to count doctors seen while a patient was in 

a hospital (question 14 in figure 17 for 1975–81 ). Similarly, 

the details asked for each contact (such as place) remained 

essentially unchanged from 1975–8 1 except that in 1977 the 

reason for the visit was not asked (question 6 in figure 17 for 

1975-81). 

The revised questionnaire for 1982 incorporated major 

changes in the probes and detailed questions on doctor contacts 

occurring during the past 2 weeks. The probes were expanded 

to explicitly convey to the respondent the concept of including 

all medical care contacts in which the care was provided by a 

physician, nurse, or anyone else working under the supervision 

of a medical doctor. The respondent was reminded to include 

telephone calls for prescriptions or test results and house calls 

as contacts. These new procedures are consistent with the im1 � i+ Bad Days 

BD 2 � 1+ Hospltml Stays 

3 � No Bad tr~y~ 

34.	 During t!w pott 12 months (that is sine. (date) a yoor ago), ABOUT how many days did 34. 0 � Non. 

Illness or inlury koop in bod all or most of tho day? 1 � 1~7 

(Includo tho cloys In tho past2 woekt.) (Includo tho days whil* a Vtiont in o hospital.) 2 � 8-30 

(WSISit moro then 7 days or lass tkan 7 days?) ! I_J 31-180 (1-6 month:) 

(Wos it moro then 30 doyt or loss then 30 cloys?) 4 n IW+ (6 months+) (Was it moro than half the yaar or less than half the yaar?) 

1982-83 

2.	 During the past 12 months, {that is, since (/2-month date) a year ago} ABOUT how many days did illness 2. 000 a Non= 

or iniury keep in bed mare than half of the day? (Include days while an overnight patient in a hospital.) 

No. of days 

Figure 16. 12-month bed days 

40 
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1975-81, probe questions 

14.€ During th. post 2 w..ks (th. 2 w.eks outlingd in r.d on that cal.nd.r) how many times did s.* a medical doctor? 14. 00 � k., NP _ Numb., of v,,, t, } 

(B.s,d., fh.i. vtsits) 

150, During that 2.w..k period d,d .nyon. in fh. Iomily go to a doctor’s of fic. or Y 

clinic 10, shots, X.roy., t.sts, ., �x.mi. ati.. %? N (16) . . . . . . . . . .--. —-— —.. . . . . . 

b.€Wh. was thts? - Mark .. Doctor VI SII,. box tn persons COI. CIUI. . 

c. Anyone •l,e~ 

I If .. Doctw v,s, t.”” ask 

d. How many timrs did visit thr doctor during that period? IId. _ Number of VISIIS (Np) I 160. During that p.riod, did .nycm. in th. family get any m.dical ad.ic. from Y 

o€doctor over th~ ielcphonc? N (17) 

.— . . . . ..-. . . . . . . . . . . . . 

b. Who VI.m the phone colt .abeu*? - Mark .. Phone call.. box ,. person,. column. 

c.€Any cafl! about anyone else? Y (t7eosk 16b and c) 

N 

If .’Phone call,’” ask II 

d, How many telephon. ..11s were mod. t. get medical advice about ? I d. —N.mb.r .f ..IIs (NP) 

1 r 

P FIII Item C, (DV), from 14-16 for all persons. ~ Crndltlon (Item C 

THEN 17d) 

Ask 17A for each person w,th v!s Its ,n DV box. � Precnancy (17.) 

10. For what condition did se. or talk to o &ctor during the past 2 we.ks? ~~: __p_y-::::iy ________ 

b. Did see ot talk to o doctor obo.t any specific condition? b. Y N (NP) 

Enter condltlon In Ncm C c. What condition? . . Ask l?d 

=lL==: 

d.€During that period, did see or talk *O a doctor ab.aut any eth.r condition? . . . . 1::1---:::::-::::)----

� , During the post 2 weeks was sick because of her pragnancy? . . Y N (17d) 

. . 11 

f. What was the motttt? I f.l Entarcw[tlmlnltem C(17fi 

1975-81, detailed queationsz 

2-WEEKS DOCTOR VISITS PAGE 1. Parson numkmr 

Earli.r, youhldm. Aat--had s..nortilk.d tead.ctor during ~.~st2wcoks. 20. 7777f3 Laltwmk 

OR 

2a. On what (othot) dates during that 2.w.ck pcriad did visitor iolk to a doctor? T?Gir axir 

{ 8*81 � weak befwe 

.------ --.__--

Y (Rc#ak 2a md b) N (Ask 3-d W b, W-m th.r. any ofhct doctor visits fer him during that period? b. �wh V/#/t) 

3. whor~did httocthc doctor onthc 3. 0 � wh,l* ,nPaI$*nt ,n hosp, mr (Next DV) 

clinle, hetpiml, doctor’ solfic*, orsomcot orplaco? 1 Q bctor’s OIIIC* (:IOUD p,,et,c, w 

doctw-s elm, c) 

If Hosp!tal: Was itthoeutpdkntc linic 2 Q T.1.phm. 

or th~ �msr~ncy room? 3mHoImd Outmt,.nt Clime 

b � Hem. lfClln!c: Was ita hospital outpatitot 

clinic, a company clinic, or san. oth., 513 lfosPItd EmwscncY RorIm 

ktnd of clinic? smComQanyor lnd.stry Clm,. 

7 � Other (S~Ny) ~ 

L Waakodoctor agrncral practltionw orasp*ciolist? 4 O!m Gan.calpra.tmon.r fg2P*.l*lIst -

Whaf bind .f speclmllst IS h.? 

7 

5. Ou,In O ,hi$ “ISIt (call) did scrumlly ,.. (talk to) the dotter? 5. lY 2N 

6a, Why did hc visit (cull) the doctor on (date) ? b.. 

Write inre*~On 

I n Dla:. ortraatmant(Oo) 

Mmk �ppropri ate box(es) *nGcncral chuk.p(8b) 

20 P,*W P,,t”aM c8r. 

a � Eyc .X*6L (;1.ss8s) (pvj 

5i_J Imm.niz.c,en 

& � Oth.r } 

b, Was this for cny sp.cific conditien? b. Y€ (EntwcmdN[c. ?ln6a N (Next Dv) m?dcha~fo “O/#g. or Imatnmnt’.) 

Mark box or ask: � Condition r.port.d i. 6. 

~. For ~~t ~mditien &d visit (cgll) t!+. doctor an (dars) ? c. 

PI \ ACondition pa;eisrequired forthecondition inquestion6. If [here isno Condition pa;e, enter condition initem Csnd 

f,ll a page for itafier completin; columns for �ll required doctor visits. 

lln 1975 the interviewer instruction in question 14 was noton questionnaire. 

Zln 1977 question 6 was not asked. 

Figure 17. Doctor contacts 

41 
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1982-83, probe questions 

E. 2.WEEK DOCTOR VISITS PROBE PAGE 

Read to respondent(s), 

Th.s. n.xtqu.stions or. eb.uth.alth c.r. t.c. iv.dduring th.2w.*ks outlined inred.n that colmdar. 

I I 

El ~ Under [4 [lb)

El Refer to age. C 14 a“d .“.? (Iaj 

la.€ During thos. 2 w.eks, how many tire. s did s.* o,ta[k toa m.dical doctor? {Includ. .11 typ., of doctors, 1.. m- None 

such as dwmotologists, psychiatrists, and ophtholmologi~ts, os WCII as general practitioners and osteopaths,) and~. 

(Do not count times whil. . . overnight patient in a hospital.) 

n ‘“p’ b.€During thos. 2 w..ks, how many tim.s did onyon. see or talk to q medical doctor about --? (Do not count Number .aI wne. } 

tire.> while an .v.rnight patient in a hospital. ) 

20. (B.sides the tire+) you iust told m- about) D.rin~ thos. 2 w..ks, did .ny.ne in th. fqmily ,.c.iv. h..lth 

core at home or go to o doctor’s office, clinic, hospital or sorn. other place? Include cam from a nurs. or 

anyone working with or for a medical doctor. Do not count tire. s while an ov.might poti.nt in o hospital. 

m Yes ~ No (3.] 

-------_-_--------.----

b. Who received this car.? Mark “DR Vis, c.’ box m person’s column. Zb. ~ OR V,slc 

c. Anyone �lse? ~ Yes (R60sk 2b and c) m No 

Ask for each person wtth O’DR Vts#t’” in 2b: 

d.€How many tim.s did receive this cam during that period? d m 

Number of l,mes 

3a.€ (B.sid.s the tire. (,) y.. alr.ady told m. ~b..t) During those 2 w..ks, did my... in th. f.mily g.t my 

medical odvicc, prescriptions or test r.svlt~ ova th. PHONE from a doctor, nurs*, or anyon. working with 

or for a medical doctor? 

� Yes C NO (E2) 

b.€Who was the phone call obout? Mark “Phone call” box in person’s column. :? - ~ Phcme call -

c.€W.r. there any cells about any... .1s.? � Yes (Re.sk 3b and c) ~ No 

Ask for each person w,th “phone call” in 3b: 

d. How many t.1.phww .di, W.,. mad. about --? 

Figure 17. Doctor contacts—Con. 

plied concept used before 1982 but the concept had not been 

fully communicated to the respondent. Another change in 1982 

was that specialists (for example, psychiatrists) to whom visits 

were underreported in the past were mentioned in the probes. 

Prior to 1982 interviewers were required to remember to reword 

questions about children to convey the concept that someone 

other than the child could have seen or talked to a doctor about 

the child. 

Starting in 1982 the alternate question wording for children 

was printed on the questionnaire. More detail was obtained 

starting in 1982 on the doctor contacts concerning the type of 

person providing the care and the place of the visit. Another 

major change in the detailed questions was that a question on 

surgezy or operations was added in 1982 because of the increasing rate of “in and out” surgery. 

Based on the findings from the 1979 evaluation test, 

modifications in the doctor contact questions resulted in improved reporting of doctor contacts.28’29More contacts were 

reported, and a higher proportion of contacts were reported for 

nonmedical providers. Telephone and home contacts accounted 

for a larger proportion of the total contacts as a result of better 

classification of type of contact. (See appendix III.) 

12-month doctor contacts and interval since 

Iaat doctor contact 

The questions on 12-month doctor contacts and interval 

since last doctor contact remained unchanged from 1975 through 

1981 (figure 18). In the revised 1982 questiomaire, the wording 

d m 

. .... . . . . . . . . .. 

was altered to make it clear to the respondent that contacts to 

doctor’s assistants should be included. These questions are 

used to classify persons according to ranges of doctor visits 

during the past 12 months and time since last doctor contact. 

The 12-month doctor contact question is not used to make 

estimates of the volume of doctor contacts because the 2-week 

recall question on doctor contacts produces more accurate 

estimates.30 

Based on the evaluation experiment, the level of estimates 

was not affected by the slight rewording and relocation of the 

items within the questionnaire. 28(See also appendix 111,)The 

minor changes made in the questions after the experiment are 

not expected to change the level of estimates. 

General health status 

The general health status question was asked in the same 

way from 1975 through 1981 (figure 19). This variable is used 

to classi~ people according to their own or the respondent’s 

perception of their health status. In 1982 major changes in the 

question were made. In the experimental questionnaire the 

wording of the question remained the same except that the response option of “very good” was added to be consistent with 

other NCHS surveys and to improve the ability to differentiate 

among people. The addition of this response category caused 

the distribution of responses to change.2s (See also reference 

31 and appendix III.) After the evaluation test, another major 

conceptual change was made in the question. This was to remove 

the phrase “compared to other persons —’s age.” Because 

42 
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1982-83, detailed questions 

r. z.wcch UULIUK VIM 12 rauc UR VISIT 1 

Refer to Cl, ““2-WK. DV” box. Person number 

F1 I Refer m we. F1 � Under 14 (lb) 

� 14 and over (1.9) 

Ia, On w+at (otfwr) dom(s)duri.j those 2 weeks did see or falk to a medical doctor, nurse, or &ctor’s assistant? _________________________________________________ 1..

b. On whet (.th.r) dote(.) durin9 those 2 w.cks did onyone see o, talk to o medicol doctor, nurse, .:: M.mth 0’ {xg~k;::re or	 doctor’s assistant about --? —----------------------------

Ask after last OR visit column for this Person: . . I @ Y=s (Reask la u b and @ 

e, W.re th.,. my oth.r visits or calls fOr -- during that period?tike necessaV cwrcct,on to 2-Wk. DV tax !. Cl. z � NO (Ask 2-5 for each .IsIt) 

‘, Wh.m did receive h.olth cam on (-], at a doctor’s office, clinic, hospitel, some c.th.r 2. 01 C Telephone 

place, or was this a telephone call? 

lf doctor’s office: Was this office in o hospital? 

N.* In h.a,pile!: 

02 � Home 

03 D b.td. .ffm.e 

HOSPI,QI: 

080 O.P. .1, ”,. 

09 � Emergency room 

If clinic: Was it a hospital outpoti.nt clinic, o company clinic, . public health clinic, or some 0s � Ocher .18.,. ltD Lab 

other kind of clinic? 06 � Lab 12 ~ Ove,n, zht w!,,”, 

lf lab: Was this lab in a hospital? 07 � Other (Sp?c//y) (Next DR VMN) 

What was don. du,ing fhi~ visit? (Footnote] ~ 88 � Oth.r f$oeclty) 

ti 

If hosfxtal: was it th. outpotimt clinic or the rmer9ency room? 040 Co. or Ind. cI,”,c 10 � O..,., <sof,.. 

Ask 3b if under 14. 30. 1 � Yes (3f) E El DK If M.D. 13c) 

a. ~~d-==.o~~.~lJ~ tnlk to a m.dical doctor~ “:: 2 � No (3c) 9 ~ DK who was _________________________________________________________ 

b, Oid any... .ctuolly talk to . medical doctor about --? *... (3f) 

c, What typr of mtdical perton or assistant was talked to? 

c.	 99 � OK 

_______ Type ____ 

d. Oc..s the (entrv I. 3c) work with or for ONE doctor or MORE than . . . doctor? d. I ~ one (3/) 3 C No”,(4) 

______________________________________________________ .__’_Q-EO:=___ --___ --l959__________

� . For this ~isit/..alDwhct kind of doctor w.. the (entry ic 3c) workin9 with or for -. gen.ral 

proctitionar or a specialist? e. I a GP (4J z � Spec,alisr (3g) 9 � DK (4J and 

f. Is thot doctor o g.rmrol pmctition.r or a specialist? f. 

g. What kind of specialist? 

9. K,nd of w,oe,.l,st 

Ask 4b if under 14. 40. I C c..d,~,on (Item C2. TffEN 49) 0. For what condition did see or tilk to the [doctir/(e”w i“ 3c~ on (d-l)? h+mk fm! awm$riate t-ax. o;d Z � ‘r=: . ...? (4e) ___________________________________________________________________ . 3 � T.*t(s) or .xamtnatmn (4c) 

b.	 Far what condition did anyone see or talk to the @tor/(entry in 3c] about on (d~)? 8 C other f3.@c~fY)

Murk L first appropriate box. (4g) 

c. was o . ..ditio” found as a result .( the ~est(s)/exmni”otio$ ? . . @ Yes (4h) � No 

& ki~ ihl~~+;;t~~x~~~.~fi~j &~<u~&j~~ ~~~cjfi<~~nj~t~.~_~~~~d~~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ _<. _ _______ � Ye, (4h) __________Q~~@g)_______

� . D~;;9-;h;-p;~t-2-;;.-ki ‘was sick because of p,e9...cx ________________________ ___ -___Q_Y::___-_--____Q_j: &g)_______ ___ 

f. What wos thr mottcr? 

f.	 (Nan C2, Co”d,t,on THEN 4,2) 

---__ 94 -

b;;;; his- IX;;rc:lu:a-s-txi ___- TL; 

_____ ;0;7(;”; -__y --’--­ ____________________________________ !n 3cfl tolked to about OIIY (other) co”diticm? _9___ ___+_y_e= ___- _-____ -G_ F- f2L _______ 

h. What WLIS the condition? h. � Pregnancy (4e) 

(/tml C2, 

C.and,u.an THEN 49) 

Mmk box if “’Telephone” in 2. 50. 0 � Tel=ph... m 1 (Next DR VISit) 

m. Did hove any kind of surgery or operation during this visit, including bone settings I � Yes 

and	 stitch.s? z � No (Next OR VW!) ________________________________ 

b, What was the n.rm of th. surgery or ovration? If name of operation not known, b. (11 

describe what was done. (2) I c, Was ther. any oth. r surgery or opemtion during this vi$it? ,. � Yes (Reask 5b and .) 

@No 

.	 .

.. ...=.. -...., . .,,. .... ... . ,. ... .. ... . P... ..=. 1.-R 

Figure 17. Doctor contacts—Con, 

of this critical conceptual change, analysis of trends in selfperceived health status crossing the period 1981 through 1982 

is inappropriate without major qualifications. 

Height and weight 

Height and weight questions were not included in the 1975 

NHIS. In 1976 questions on height and weight were asked of 

all persons 17 years of age and over and, in 1977, questions 

were asked of only a one-third subsample of persons 19 years 

of age and over (figure 20). In 1978–83 the questions were 

asked with a modification to the weight question “Without 

clothes” was removed from the question wording. No changes 

in the height-weight questions were made for 1982 and 1983 as 

part of the evaluation test (except the questiomaire location). 

Chronic conditions 

For purposes of making prevalence estimates of chronic 

conditions, a list of conditions is read to the respondent (figure 

21). For each condition reported, detailed questions are asked. 

(S~e next section.) From-1968-77 the following six lists of 

conditions were used (one per year except in 1974 when no list 

was used): 

� Conditions of the musculoskeletal system and skim 1969, 

1976. 

. Conditions of the respiratory system 1970. 

. Impairments: 1971, 1977. 

� Conditions of the cardiovascular system 1972. 

. Conditions affecting the nervous system, glandular disorders, and conditions of the genitourinary system 1973. 

� Conditions of the digestive system 1968,1975. 

Starting in 1978 and continuing through 1983 a major change 

in interview procedures was made in which all six of the lists of 

conditions were included on the questionnaire. However, any 

specflc household was asked only one list. The assignment of 

lists was made prior to the interviews by the U.S. Bureau of the 

43 
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1975-81 

80.	 During the past 12 months, (that is since (date) 0 y*f2r a90), about how marry tim*s did see or 180. ooo � only when in hospital 

tolk to o medical doctor? (Do not count doctors seen while a patient in a hospital.) 000 � None 

(Include the visits you olready told me about.) _ Number of visits 

b. ~~~ti~;;;-l;n-g-ha~-i~ b[e”n-s;;c;-:- LAST saw or talked to a medical doctor? b. 1 � 2-week DV 

Include doctors seen while a patient In a hospital. 

2 �	 Past 2 weeks 

not reported 

(14 and 17) 

3 02 wks.4 mos. 

4 � Over 6-12 mos. 

5 a I year 

6 � 2-4 years 

7 � 5+ years 

8 � Never 

3a.	 During the past 12 months, ABOUT how many times did L-- /anyoneJ see or talk to a medical doctor 30. ooo � None (3b) 

or assistant (about --)? (Do not count doctors seen while an overnight patient in a hospital.) 000 @ Only when overnight 

(include the (number in 2-W~ DV box) visit(s) you already told m* about.) patient in hospital 

(NP 

No. of visits ___ 

b.	 $~o:; hew long has it been since [-- /anyone] last saw or talked to a medical doctor or assistant b. t ~ lnterv, ew week (Heask 3b) 

--)? Include doctors seen while a patient in a hospital, Z ~ LeSS than I yr, (Fleas~ 3a) 

3 � I yr., less than 2 yrs. 

4 � 1 Yrs., less than 5 y’r=. 

5 � S yrs. or more 

o ~ Never 

. 

Figure 18. 12-month doctor contacts 

1975-81 

33. Comporod to othor persons --’s ogc, would you soy that his health is cxcollont, good, foir, or poor? 33. IE2G3F4P 

1982-83 

4. Would YOU SOY health in generai is �xcell*nt, very good, 4. t ~ Excellent 4 C Fslr 

good, fair, or poor? 2 � Very goal s ~ Poor 

3 � Gocd 

Figure 19. General health status 

1976-77 

r 

12G. Abeut how toll ore you without shoss? I 2.. — Feet — Inches .- .------------------. 

b. About how much do you weigh without clothts. or shoes? b. Pcu”d% 

1978-83 

Mark box If wrder 18. 5m. � Under IS (NP) 

5a. About how toll is without shoes? 

Feet —Inches 

_______ ______________________ 

b.	 About how much does weigh without shoes? 

1 b. — Pounds 

Figure 20. Height and weight 

44 

1982-83 
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197s-831 

H. CONDITION LISTS 1 AND 2 

Reed to resDondent(s J and ask list speclf!ed ,n A2: 

No I am going to r-ad a list of medical conditions. Tell me if anyonr 

yot Iavc mentioned them before. 

la, Does anyone in the family {read names) NOW havo -

If “’Yes, ” ask lb and c. 

b. Who is this? 

c. Does anyone �lse NOW hava -

Enter condltlon and letter ,n omrotsr,ate ixrson’s column. 

1 A. PERMANENT stiffness or any deformity of the foot, leg, 

fingers, arm, or back? (Permanent suffness - ioints will 

not mov. at all.) .----------------------- ._--------- _— __ 

B. Paralysis of any kind? 

Id. DURING THE PAST 12 MONTHS, did anyone in the family 

have - If “Yes,’” ask Ie and f. 

c, Who was this? 

f. DURING THE PAST 12 MONTHS, did anyone else have -

Enter condition and letter In appropriate person”s column. 

Condlcions C-N and V are conditions affecting the bone 

and muscle. 

Condiuons O-U and W-Z are conditions affecting the skin. 

C. Arthritis of any kind or Reask Id 

Rheumatism? P. Eczema or Psoriasis? -----.--.--­ (ek’so-mo) or 

D. Gout? .------------------

(so.rye-uh.sis) 

_-

Q. TROUBLE with dry or 

E. Lumbago? itching skin? - —_________________ __, . ---

F. Osteomyelitis? 

(es.tee-ah-my-uh-ly e’tis) R. TROUBLE with acne? 

___ .------------------

S. A bone cyst or bone 

spur? S. A skin ulcer? 

. ___ 

+. Any other disease of the 

bone or cartilage?	 T. Any kind of skin allergy? 

. -- —--------------- ___ 

U. Dermatitis or any other 1.	 A trick knee? skin trouble? —---- —----— . 

J. A&pped or ruptured 

_ . ---: V, TROUBLE with fallen 

arches, flatfeet, or 

K. Curvature of the spine? clubfoot? —------- —-----— —-

L.	 REPEATEL)trouble with W. TROUBLE with ingrown 

neck, buck, or spine? toenails or fingernails? 

% Bursitis or $ynovitis? X. TROUBLE with bunions, 

(sin-0. vy*’ti.) corns, or calluses? —--

N, Any di seas. of the ‘f. Any disease of the hair 

muscles or tendons? or scalp? 

-----------------— -1 Z, AriY disease of the lymph 

1 

I 0.	 A tumor, cyst, or growth 

of the skin? or sweat glands? 

mM HIS. ! Saa, ,9.,.,2, 

lVerslon shown, used in 1982-83, contains some modifications of versions used 

Figure 21, Condition lists 

Census staff in such a way that each list was asked for a random 

one-sixth of the households. The results of asking each list for a 

one-sixth subsample of households is that for estimating prevalence of conditions for population subgroups and for estimating 

prevalence of less common conditions data must be cumulative 

over 2 or more years to provide enough cases for the survey 

estimates to be reliable. For the most common conditions, and 

for groupings of conditions, a one-sixth sample for 1 year of 

data collection is adequate for the production of reliable prevalence estimates. 

in the family has any of these conditions, even if 

20. Does anyone in the fomily {read names} NOW hove -

If “Yes, ” ask 2b and c. 

b. Who is this? 

c. Ooes onyone �lse NOW have -

2 Enter cond! tlon ond letter rn opproprlote person’s column. 

fiear, ng 

A-L are co”dct!ons affectin~ V,st On 

s~eech {} 

Cond!tdons O-W are ,rnpatrments. 

Cond!clons Y and Z affect t nervous system. — I Reask 20 

A. Dsafness in o“e or both 0. Palsy or Cerebral palsy? 

ears? (ser’a-bml) _---------------_— 

B. Any other trouble hsaring P. Paralysis of any kind? 

with one or both ears? 

Q. Curvature of the spine? -. C.	 Tinnit. s or ringing in 

the ears? R. REP EATEO trouble wit] —- back or spine? 

D. Blindness in one or both 

eyes ? S. Any TROUBLE with 

fallen arches or fl.atieet? 

E. Cotaracts? 

T. A clubfoot? 

F. Glaucoma? 

- —-----------------

U. PERM.414ENT stiffness 

G. Color blindness? or any deformity of the 

foot, leg, or back? 

H. A detached retina or any (Permanent st, ffness -

other condition of the joints will not move 

retino? at all.) ----------—_------- —- -. 

1. Any other tible seeing V. PERMANENT stiffness with one or both �yes EVEN 

den wearing glosses? or any deformity of the 

.------------—----- fingers, hand, or arm? 

-. 1. A cleft palate or Hareiip? 

------------—------	 -— W. Mentol retardation?

----------------A- -. K. Stammering or Stuttering? X. Any condition caused by .— —--------------- 1 an accident or iniury 

which happened more thal L. Any other speech defect? 3 TOnths,,ag::: what is .---- ——----------- I ‘Yes 

IL A missing finger, bond, t (1e con~ition? -. or arm; toe, foot, 

or leg? Y. Epilepsy? 

.-

{.	 A missing (breast), Z. REP EATEOconvulsions, 

kidney, or lung? 1seizures, or blockouts? 

:e 22 

1975–81. 

The changes in the six lists made as a result of the NHIS 

evaluation were mainly the provision of more interviewer instructions. One change worth noting made the interviewer’s job 

much easier The introduction, read to the respondent before 

asking the list, states that the respondent should report conditions even if he or she reported them earlier in response to 

previous questions. Before 1982 the interviewer was responsible 

for notisig if a condition had been previously mentioned. Although most other changes in 1982 were minor, some worth 

noting are that cancer of any kind was added to the list referred 

45 
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------------------- --- -- -------------------- ---

------------------- ---- --- -----

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--- ---

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1975-83—Con. 

,,. k“,,”, , ,“,, LI.J l.1 J MIYIJq


Read to respondent(s) and ask list specif;ed in A2:


Now I am going to read a list of modicai conditions. Tell me if anyone in the family has had any of these conditions, even if


you have mentiond them before. 

3a.	 DURING THE PAST 12 MONTHS, did anyone in the 

family {read names} havo -

If ““Yes, ” ask 3b and c. 

b. Who was this? 

3 c. DURING THE PAST 12 MONTHS, did anyone �lse have -

Enter candi tian and /e tter In appraprl ate person’s cal umn. 

Make no entry in Item C2 far cald; flu; red, sare, ar strep 

throat; or “virus’” even if reported !n this list. 

Conditions affecting the digesdve system. 

Reask 3a 

N. Any othar stomach 

A. Gallstones? trouble? 

____________________ 

B. Any other gallbladder 

trouble? O. Enteritis? 

-------------------— 

P. Diverticulitis? 

C.	 Cirrhosis of the liver? (Dye. ver.tic.yoo.lye’tis) 

- —-----------------

D. Fatty liver? Q. Colitis? 

—--------------- ____________________ 

E. Hepatitis? R. A spastic colon? 

/ 4a. OURING THE PAST 12 MONTHS, did anyone in tho family 

{read names}have -

If “Yes,’” ask 4b and C. 

b. Who was this? 

4 c. DURING THE PAST 12 MONTHS, did anyone �lse h.ww -

Enter condiuan and letter In apprapr!ate person’s column. 

A. A goiter or other thyroid 

[ trouble? 

— 

6.	 Diabetes? Glandular disorders 

—--- —------ --— 

__ C. Cystic fibrosis? 

- 1 

D. Anemia? Bload disorder 

E. Epilepsy? 

—------------- —--

F. Multiple sclerosis? 

__ 

Condition affecttng the G. Migraine? nervous system —---- —--------

H. Neuralgia or Neuritis? 

__ L sciatica? (si..at i.kuh) 

, / 

J. Nephritis? _ —----------- —----

K. Kidney stones? _ —-----------

L. Any other kidney 

trouble? 

—---------------. —- ___ 

F. Yellow iaundice? 

___________________ ____ 

G. Any other liver trouble? —__ —______ ____ 

H. Any disease of the 

pancreas? ——---------

1.	 An ulcer? —-------- ____ 

J. A hernia or rupture? 

—-- —-

K. Any disease of the 

esophagus? 

L. Gastritis?


--------. - .------- —---


M. FREQUENT indigestion? 

>R$.4 WIS.1 C1083) 10-3-82) 

Figure 21. Condition lists—Con. 

S. FREQUENT constipation? __________________ 

T. Any other bowel trouble? ________ 

U. Any other intestinal 

trouble? ___________________ 

V, Cancer of the stomach, 

colon, or rectum? ___________ _ 

W. Duting the past 12 

months, did anyone (else) 

in the family have any 

other condition of the 

digestive system? 

If ‘“Yes,’” ask: Who 

was this? - What was 

the condition? Enter 

in item C2. THEN 

reask W. 

M. Bladder trouble? > Genito-urinary conditions 

N. Prostate trouble?


____ ---_ —___________ _-


O. Any disease of the


uterus or ovary? 

—-----------

P. Any other female troublo? ) -

Q. Cancer of any kind? 

. .-

rage u 

to as the “catch-all” list containing conditions of the nervous 

system, glandular disorders, and conditions of the genitourinary 

system (list 4 on the 1982 and 1983 questionnaires), and diabetes was removed from the conditions of the digestive system 

list and was asked only on list 4. 

The reference periods used for the chronic conditions lists 

vary from list to list and condition to condition. The reference 

periods used include within the past 12 months, ever, and now. 

The additional questions asked on the detailed condition pages 

relating to onset and current status are needed to classify and 

code the conditions. 

For tie purposes of making prevakmce estimates for chronic 

conditions, a chronic condition is counted for a household only 

if that condition specifically was asked for in that household. 

For example, if a condition is recorded as a cause of limitation 

of activity but the condition is not a part of the condition list 

asked for that person, that condition and household are not 

included in making prevalence estimates for that condition. 

(The condition would be included, however, in the estimates of 

conditions causing limitation of activity,) These procedures are 

used because NHIS experience has indicated that, unless a 

condition is spectilcally asked for, generally there is likely to be 

underreporting of the condition. According to the evaluation 

test results2s (see also appendix III), the modifications to the 

six condition lists did not have an effect on the number of conditions of selected types that were reported. 

46 
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1975-83—Con. 

H. CONDITION LISTS 5 AND 6 

Read ta res~andenc(s) and ask Itst specified {n A2. 

Now I am aoinateraad a Iistof medical conditions. Tell me if anyone in the family has had any of these conditions, � ven if you Iav* ment;erwd them before. 

5a. Hasanyonc inthcfamily {read names }EVER had - ha. OURING THE PAST 12 MONTHS, did anyone in thr fomily 

{read nomes} have - If ‘“Yes, ” ask 5bandc. 

If “Yes,”’ ask 6b and c. b. Who was this? b. Who wos this? 

5 c. Has anyone �lse EVER had - c. DURING THE PAST 12 MONTHS, did anyone else hove -

Enter canditian andlecter ;nappraprlate person’s column. Enter condirlon and letter in oppropnote persan”s column. 

Conditions affecting theheart ondctrculotary system.	 Make no entry In item C2 for cold; flu; red, sore, or sCreP 

thraat; or ““virus” even if reported In this Ilst. 

Conditions affecting the respwotory system. A. Rheumatic fever?


B. Rhmsma}ic heart disease?


C.	 Hardening of the arteries 

or Arteriosclerosis? 

D, Congenital heart disease? 

E. Coronory heart disease? 

F,	 Hypertension, sometimes 

called High blood 

pressurr? 

~.	 DURING THE PAST 12 

fami [y have -

If “Yes, ” ask Se and f. 

c. Who was this? 

f. DURING THE PAST 12 

,--

11 

<) 

G.A stroke or a 

Cerebrovascular accident? 

(ser’a.bro vas ku.lor) 

H, ~r}l~orrhage of the 

1.	 Angina pectoris? 

(pek’to.ris) 

J.	 A myocardial 

-infarction? 

K. Any othrr heart 

A. Bronchitis? 

‘ 

:. B. Bronchiectasis? 

(brong kc-ok tah.sis) 

. IIC. Asthma?

D. Hoy fever? 11’1 

R eosk 60. 

K. Emphysema?

+_-,--- l-- L.	 Pleurisy? -

II M. Tuberculosis? I 

i-­ ! N. An obscess of the lung?. I 

-------------------l--

1 -. 

O. A tumor, cyst, or growth 

of the throat, larynx, or 

1 trachea? -. 

I 

--, 

t 1“ 

II 

E. A nasal pOiyp? 

, 

F. Sinus trouble? 

G. A deflacted or deviated 

nasal septum? _ —----------------

H.	 *Tonsillitis or enlargement of the tonsils or 

odenoids? —- —- ———---—--

1.	 *Laryngitis? __ —____ —---— 

t attack? I 1 

MONTHS, did anyone in the 1 

1 

I 

I 

P. Any work. reloted respira 

tory condition such as 

dust onthelungs, silicosis 

or pneu.mo-co-ni-o- sis? 

--_----- ——--------- / -. 

Q.	 Ouring the past 12 months 

did anyone (else) in the 

fami Iy have any other 

respiratory, lung, or pulmo 

nary condition? If ’’Yes,’ 

ask: Who was this? 

What was the condition? 

Enter in Item C2, THEN 

reosk Q. 

MONTHS, did anyone else have - II 

Enter condition and letter in oPproDrface Persafl’s column. II 

Conditions ottecting the heart and circulatory system. 

II 

L. Damaged heart valves? R. Gangrene? ,_--_-_	 -___ -—------ JJ- Ill 

M. ~~;$cardia or Rapid S. Varicose veins? 

T. Hemorrhoids or 

N. A hrart murmur? II Pil*s? ill 

J.	 A tumor, cyst, or growth 

of the bronchial tube 

or Iuna? . I

I J 

‘If reported in this list only, ask: 

1.	 How many times did have (conditian) in the past 12 months? 

If 2 or more times. enter condition in item C2. 

------------------i--+ ------------------t--+ ‘1 If only I time, ask: 

O. Any other hwsrt trouble? U. Phlebitis or 

II Thrombophlebitis? 1[1 2. How long did it last? If J month or longer, enter In item C2. 

P. (an An aneurysm? If less than I month, do not recOrd. 

yoo.rizm) , V. Any other condition If tonsils or adenoids were removed dur;ng pasc 12 months, 

affecting blood enter the conditfon causing removal !n I [em C2. 

Q. Any blood clots? 1/

, circulation? 111 

3RM His. !903) (9.3.021 Page 24

Figure 21. Condition lists—Con. 

Detailed condition questions 

NHIS produces estimates of the incidence of acute conditions, prevalence of chronic conditions, and disability caused 

by conditions. As described earlier, the disability or restricted 

activity day questions, in addition to the doctor contact questions, are used to elicit reporting of acute conditions; the lists of 

chronic conditions are used to elicit reporting of chronic conditions, 

To produce data on the conditions reported throughout the 

interview, a series of questions related specifically to each one 

is asked on the condition page (figure 22). These items identify 

(a) medical attention received, (b) the condition with a detailed 

description to facilitate medic~ coding, (c) condition onset to 

determine incidence and acute/chronic status, (d) 2-week disabiMy due to specitlc condition, (e) a series of additional impact 

measures for chronic conditions having as their reporting source 

the chronic condition checklists, and (f) for injuries and impairments from injuries, information about the nature and cause 

of accidental injuries. 

It should be noted that although NHIS attributes disability 

days to specitic conditions, there is a reporting problem for 

many persons who have more than one condition in the 2-week 

recall period. For example, if a person had both chronic bron47 

I 
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1975–81 

CONDITION 1 Except for eyes, ears, or internal organs, ask if there are any of 

the following entries in 3a-d: . Person rwrmbor Name of condition 

In f.ctlon sore Sorcn-ss 

1 f. What part of the (part of body in 3e) is affcctcd by tho (infection\ 

!. When did last s.. or talk to a doctor about his , . .? sOr*\sor*nOss) - tho skin, muscle, bono, or -ma Ofhcr Prf? SPecifY~ 

1 � ~e~kcervlew	 I � f%SC 2 wks. (If em C) 5D 2-4 yrs. 

2U 2 wks, -6 mos. 6(35* YCS. 

(Reosk 2) 30 Over 6-12 mos. 7 D Never Ask if there are any of the following entries in 3a-d: 

4CI I yr. an DK [f Dr. seen Tumor cyst Growth 

SD DK when Dr. seen g. Is this (tumor/cyst/growth) malignant or ksign? 

Examine “Name of condition” entry and mark t a Malignant 2 a Benign sDDK 

I_J Color blindness (NC) I_J (2o Card C (A2) Al � Accident or injury (A2) ~ Neither (30) 

If “Doctor not talked to,” transcribe entry from !tem 1. — If “Ooctor talked to, ” ask: 2i_JQ.3a 4i3Q.3c sOQ.3a la. What did the doctor my it was? - Did he givo it a medical name? 

4. Durina the Bast 2 weeks. did his . . . cause him I 

to-cut-dow~ on the thing; he USUCIIY dets? IY 2 N (9) 

Do not ask for Cancer U On Card C (A2) 5. During that period, hew mony days did ho cut 

b. What WaS the couso of . . .? down for as much as a day? _ Oays 

u Acctdent or injury (A2) 00 m None (9) 

If the entry in 3a or 3b includes the words: 6. ~~ing that 2-wa_k period, how many do s did _Oays 

Ailment Cmrdit[on Disorder Ruptura . . . koap him in bcd all or most of t i � day? 

I 00 � None Anemia cyst Growth Trouble


Asthma Defec? Mwaslas Tumor Ask c: Ask if 17+ years:


Attack Diswoso Problcm Ulc*r } 7. How many days did his . . . keep him from work _Days (9)


c.	 What kind of . . . is it? during that 2.wack period? (For females): not 

counting work around tha houst? 000 None (9) 

_________________________________________________ Ask if 6-16 years: 

For allergy or stroke, ask: 8. How many days did his . . . keep him from —Qays 

d. How doss the allergy (stroke) affccf him? school during that 2.week period? OZD None 

9. When did first notico his . . .? 

-----------------------------------------—------ . ~ o Last week to 2 weeks-3 months 

If in 3a-d there is an impairment or any of the following entries: z a Week before 5CI Over 3-12 months 

Absc*ss D.meg. Paralysis *O Past 2 weeks-DK whtch a � More than 12 months azo 

Achs (wteept head e, �od Growth RUPW8 (Was it during tho past 12 months or befor~ that time?) 

Bleeding kfmmorfhage Soro(ness) (Was it during the post 3 months or bcforo that time?) 

Blood clot Inf*ction Stlff(n-ss) (Was it during the past 2 waaks or before that time?) 

soil I. flommotian Tumor Ask e 

COnc*r NmI+io Ulcar I � Not an aye cond. (AA) 3 a First aye cond. (6+ yrs.) 

cramps (*xc*pt Nmu.itis VQricos9 vains ‘A3 2 a First eye cond. (lo) 

menstrual) Pal” Wcak(twss) (under 6) (AA) 411 Not first eye cond. (AA) cyst POISY \ 

�. What part of tha k-ady is affacttd? 10. Con sas WOII �reugh to read ordinary rmwspapor print 

Specify WITH GLASSES with his Icfi �ye?. ..l Y ZN 

Head . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..sk.ll. scalp. fats right �y*?. ..1Y 2N 

Back/splno/v*rtmbm* . . . . . . . . . . . . . . . . . . . . . . . . .upp*r, middle, lower {} 

Sibs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Ioft or right FOOTNOTES 

Ear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . inner or outer; left, right, or both 

Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..loft. right. or both 

Arm . . . . . . . . . . . . should-r, uppw, �lbow, Iow.r or w,ist; I.ft, right, or both 

Hand . . . . . . . . . . . . . . . . . . . �ntirc hand or flnwrs only; Iaft, right, or borh 

Leg . . . . . . . . . . . . . . . .hip, uppsr, knee, Iowar, oranklm; Ioft, right, or both 

Foot . . . . . . . . . . . . . . . . . . �ntira foot, arch, m t-s only; Icft, right, or bath 

Figure 22. Detailad condition questions 

Show the following detail: 

chitis and a sprained ankle, it is frequently diftlcult forthere- . Eithec 

spondent to report how many of the disability days were for the — A doctor (or assistant) contact about the conditon 

chronic bronchitis and how many were for the ankle. In fact, in during the past 2 weeks 

the absence of chronic-bronchitis-relateddisability days, the — One or more disability days (work loss, school loss, 

respondent might not have reported any disability days for the bed day, or other cut-down day) due to the condition 

ankle. during the past 2 weeks. 

It is very important to note that in the processing of the However, when making estimates of disability days due to 

NHIS data, acute conditions (by NHIS definition, conditions 

acute conditions, the only criterion is that the disability occurred 

with onset within the past 3 months, resulting in no obvious in the past 2 weeks regardless of when the condition began within 

permanent disability, and not on a list of conditions always the last 3 months. The detailed condition questions, for the 

considered chronic regardless of onset) are not counted unless most part, stayed the same from 1975-81. One exception was the following criteria are mec that in 1980 questions 3f and 3g shown in figure 22 were added 

� Onset during the 2-week recall period. because they were needed for medical coding with the new 

48 
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1975-81—Con. 

1 � Missing extremity (A4) 

4A an Condition In C2 does nottrave � letter as source (A4) 

s � Condition in C2 has a letter �s source, Doctor seen (I 1) 

4 m Condition in C2 has a letter as source, Doctor not seen (15) 

la.
Deet--- NOW tako any modichto or traatmont lY 

for his . . .? 2 N(/2) . 

b.	 Was any of this modiclrw or treotmont rocommsndad 1 Y 

by a doctor? 2N 

2. Nas ho �vor had surgery for this condition? tY 

2N 

L Was ho �vor hospitalixad for this condition? lY 

2N 

L Durhr~ tha past 12 months, about how many times has 

s-an or ~lked to a dactar about his . . .? _ Times 

(Da not count visits whilo a patient in o hospital.) 000 u None 

Se. Akrt how many days during tho past 12 months has 

this condition kept him in bed 011 or most of thm day? _ Days 

000 � None . 

Ask if 17+ years: 

b.	 Abwt how many days during tho past 12 months has _ Days 

this condition kept him from work? 

For femalea: Not counting work around tha house? 000 � None 

k.	 How often does his . . . bethtr him - all of tira time, often, 

once in a whila, or never? 

I � All the time 2 � Often 3 � Once in a while 

o � Never {/6c) a � Other - Specify 

b. Whmr N does bother him, ia ha bothered a great deal, somo, or very Iittlo? 

I � Great deal 2 � Some s � Very little 

4 � Othar - Specify 

n All the time in 16a OR condition list 4 asked (A4) 

c. Deaa still hovo this condition? 

I Y (A4) N 

. 

d. la this condition camplatdy cured or is it undar control? 

z u Cured 3 � Under control (A4) 

a � Other - Specify (A4< 

�. About how long did hava tfris condition boforo it waa cured? 

o m Less than one month — Months — Years 

‘igure 22. Detailed condition questions—Con. 

medical coding system based on the International ClasslYcation of Diseases, 9th Revision. Another minor change was 

made in 1978 because of the conversion to the use of all six 

condition lists each year: an interviewer instruction was added 

before the question on whether the person still had the condition 

to skip that question if the condition list of impairments was 

asked for that household. Questions 16c–e for 1975–8 1 shown 

in figure 22 were deleted for 1977 only because in that year all 

households were asked the impairments condition list. 

As a result of the evaluation, major changes were made in 

the detailed condition questions on the 1982 questionnaire. No 

additional changes were made in 1983. One siwlcant deletion 

was the questions on medications and surgery or treatment for 

1 

~Al � Accident or ini.ry � Other (NC) 

7a, Did tho accident happen during tho peat 2 years or before that time? 

n During the past 2 years � Before 2 years (ISO) 

b. When did tho occidmt happ~n? 

� Last week I_J Over 3-12 months 

� Weak before ~ i -2 years 

I_J 2 weeks-3 months 

&. At the time of th~ accidant what part of tho body was hurt? 

What kind of in@y was it? Anything �lse? 

Part(s) of body Kind of iniwy 

— — 

t t 

If accident happened more than 3 months ago, ask: 

b. Whet part of tha body is affoctad new? 

How	 is his affoctod? is he affoctod in any ether way? — 

Part(s) of body Present effects 

— —---——


t 1 

9. Whtre did tho accident happen? 

1 � At home (inside hcuse)


z � At home (adjacent premises)


s � Street and highway (includes roadway and public sidewalk)


4 � Farm


s •l Industrial place (includes premises)


G Cl school (includes premises)


7 � place of recreation and sports, except at school


a I_J Other - Specifyg


O. Was at work at his iob or busirmss when tho accident happwrod? 

tY 9 � WhlIe in Armed Services 

2N 4 n under 17 at time of accident 

la.	 Was a car, truck, bus, or othor motor vahicla 

involved in th~ occidont in any way? lY 2 N (NC) 

b. Was moro than on. vthiclc involvod? Y N 

c. Was it (oithor ens) moving at the tima? lY 2N 

the conditions. (See questions 11 and 12 of figure 22 for 

1975–8 1.) These questions were removed to reduce the length 

of the interview with the view that these items were more ap 

propriate for supplements. A question was added for conditions 

reported as being cured to determine whether the condition was 

present at any time during the past 12 months (question 12d in 

figure 22 for the 1982–83 questionnaire). 

Many of tie changes starting in 1982 were made to simplify 

the interview procedure to make the interviewer’s job easier. 

For example, in the previous questionnaire interviewers were 

instmcted not to ask the cause of the condition if it was listed 

on card c, a flashcard listing a set of conditions for which medical 

coding did not require ascertaining the cause. So that inter49 
--

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� 

� 

� 

1982-83 

n6 . ..- ,,. - “––, 4-.-.-: ““... h9 P-.. -..,., ,u”.b C-.. .-_, _–.

ASK CONDITION LIST— . US- eoro _ .-,“ “.1.,, r,,,,. <,.... ”1-”.- . -, .”,,,.,. J.\”, m .. 4, “Wa, gs, . 

, 

CONDITION 1 Person No. _ Ask 3g if there is cm impairment (refer to Cord CP2) or ony of the 

1. Name 01 condition following �ntries in 3b-f: 

Abscess Oanmg* Palsy 

Mark ““2-wk. ref. pd. ” box without asking if ‘“DV” or “HS”’ Ache (OXG@ head or car) Growth Paralysis 

in C2 as source. Bleeding (txcept menstrual) Hamorrhagc Rvptvre 

sled clot lnf*ctlOn SOr*(nasa) 2.	 When did [--/anyonoJ last $*o or talk to a doctor or assistant Boil In flmnrnatio. Stiff (n.ss) about (condition)? canc*r N.urelgia Twnm 

o G Interview week (Reask 2) s � 2 yrs., less than 5 yrs. Ctarnps (*xcept menstrual) Neuritis Ulc*r 

I � 2-wk. ref. pd. 6 � S yrs. or more cyst POin Varicos. veins 

Woak(rmss) 

2 a Over 2 weeks, less than 6 mos. 7 � Dr. seen, OK when 

3 � 6 mos., less than I yr. 8 � OK if Dr. seen g. What part of the body is affected?


4 � I yr., less than 2 Yrs. 9 � Dr. nwer seen } 

(3b) Specify


3a. (Earlier you told m- about (~)) Did the dOctOr er a=istant Show the following detoil: 

call the (~ndition) by o mor* technical or spacific name? H-ad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . skull, sCal I?, faCe 

Back/spine/vertobrac . . . . . . . . , . . . . . . . . . . . .upp*r, middle, lewm 

Side, . . . . . . . . . . . . . . . . . . . . . . . . . ..t. ..l . . . ..l.ftor right 

Ask 3b If ‘<Yes” in 30, otherwise transcribe condition nome from Ear . . . . . . . . . . . . . . . . . . . . . . . . in.ar or outer; Iaft, right, or both item I without asking: Eye . . . . . . . . . . . . . . . . . . . . ,, . . . . . . . . . . .. loft. right. or both 

b. What did ho or shc call it? Arm . . . . . . . . shoulder, upper, �lbow, Iowar or wrist; left, right, or both 

Specify Hand . . . . . . . . . . . , . . .*nNr* hand or fingers only: lmft, right, or both 

I � Color Blindness (NC) Z � Cancer (3e) Lg . . . . . . . . . . . . hip, upp.r, k.a., low-r, or.ankle; left, right, or both 

3 I_J Normal Pretnancy, 4 I_J Old age (NC) Foot . . . . . . . . . . . . �.ti,. foor, arch, or toes only; left, right, or both normal delivery, f5) a � Other (3c) vasectomy } 

c, What was thecausaof (condition in3b)? (Specify) Except for eyes, eors, or internal orgons, osk 3h if there ore any of the 

J I following entries in 3b-f: 

\ I. f.ction Sor* sQr*”*ss 

h. What part of the (pm-t of body in 3b- ) IS affoctcd by tha finfoction/ 

Mark boxifaccident orinjwy. on Accident/iniury (5) sore/soreness] - the skin, muscle, one, or some oth~r part? 

d, Didthe (condition in3b) r~sultfrom onoccidant oriniury? 

1 ~Yes (5) ZONO Specify 

Ask 3e if the condition name in 3b includes ony of the following words: 

Ailment Cn”e. r Dis.aso Problmn Ask if there are any of the foflowing entries in 3b-f: 

Anemia Condition Disorder Ruptvro Tumm Cysi Growth 

Asthma cyst Growth Trouble 

Att.a=k D.fecr M.osl.s Tumor 4. Is this Ctumor/cyst/growtKJ malignant or benign? 

Bad Ulcu t n Malignant z @ Benign 91-JDK 

0. When was (condition In 3b/3f) 1 ~ 2-wk. ref. pd, 

�.What kind of (condition in 3b) is it? first noticed? 2 u Over 2 weeks to 3 months 

Specify -_-------- _------ _----- __ - —--------------------— - 5 [ 13 ~ Over 3 months m I year

Ask 3f onfy if ollergy or stroke in 3b-e: b. When did [name of in)urf in d G Over I year to 5 years 

f. How does ths Collergy/strekc] NOW affect --? (Specify) 1311J? J- s � Over S years 

J 

Ask probes as necessary: 

(Was it on or since (first date of 2.week ref. period) 

or was it before that date?) 

(Was it less than 3 months or more than 3 months ago?) 

For Stroke, fill remainder of this condition page for the first present (Was it less than 1 year or more than 1 year ago?)
 effect. Enter in item C2 ond complete o se~arate condition page (or


each additional present effect. (Was it less then 5 years or more than 5 years ago?)


-.. .,,. . ..”.., ,... ..., e--- 50 

Figure 22. Detailad condition questions—Con. 

viewers would not have to remember the condhions on card c 

or have to interrupt the interview to look them up, this instruction was eliminated. A couple of the conditions for which it 

would have been awkward for the interviewer to ask the cause 

were listed on the questionnaire with the instruction to skip the 

cause question. 

Other modifications made to the detailed condition questions for 1982 include: 

.	 Questions referring to a doctor were amended to include a 

doctor’s assistant. . 

The interviewer was required to ask (unless already re-


ported) for each condition whether it was a result of an


accident or injury.


“Bad” and “cancer” were added to the list of words used


by respondents requiring the interviewer to ask kind of


condition.


In the question on disability occurring during the 2-week


recall period the concept of “more than half of the day”


was introduced to be consistent with the disability day


questions.


To reduce redundancy in the questionnaire, the 2-week


50 
-- --

-----------------------------------------------

--

--

--

--

--

--

-- ---

--

------------------------------------------------

--------------------------

--

--

--

-- --

-----------------------------------------------

----------------------

--

--

1982-83—Con. 

FWer to R13 ati C2. 

,1Y4s”” in ““RD’’box AND more than I condition in C2 (6) KI H Other (K2) 

~ 

6a. Durinqth* 2weoksoutlined inredon that coltndar, did-- (condition) 

cause to cut down on tho things usually does? 

D Yas U No (K2) 

b.	 During that period, how many days did cut down for mere than half 

of tha-day? 

00 � None (f(2) —DaYs 

7.	 During thos. 2 wooks, how many days did stay in bed for more than 

half of tha day bccauso of this condition? 

00 I_J None Oays 

Ask if “Wa/Wb” box marked in Cl: 

8.	 During thos* 2 we-k., how many days did miss more than half of 

th~ day from iob or busines~ b~causo of this condition? 

00 L None _DaYs 

Ask if age 5-17: 

9,	 During those 2 weeks, how many days did miss ~ore than half of the 

day from school because of this condition? 

00 � None _ Days 

~ Cond!tlo” has “CL LTRO’ in C2 as source (10) K2 I ~ Condltio” does .othave ‘*CI. LTR. in.C2 as source (F(4) 

O.	 About how many days since ( 12-month dote) a year ago, has this 

condition kept in bed more than half of the day? (Include days 

while an overnight patient in a hospital.) 

000 D None Days 

1. was � ver hospitalized for (condition in 33)? 

1 � Yes ZDNO 

CIMiss,ng extremity or organ (K4) K3 n Other (72) 

20. DO*S still have this condition? 

I � Yes (K4) ~ No 

b. Is this condition completely cured or is it under control? 

2 � Cured 8 n Other (Specify)i 

3 � Under control (K4) 

(K4) ~:-------_-_-------__--

c. About how long did have thts condlt!on before it was cured? 

n Less than I month OR � Months 

Number { � Years 

o � Not an acc!denti,nlury (NC) 

I(4 I � Frost accide”r/in@,y for this person (14) 

8 a Other (13) 

Iu HIS-1 (19831 !s-s.,2) Pai 

Figure 22. Deteiled condition questions—Con. 

disability day questions were not asked if the respondent 

had not already reported any 2-week disability or if the 

respondent had only reported one condition causing 

2-week disability. (See check item K1 in figure 22 for 

1982-83.) 

.	 To the 12-month bed day question (see item 10 in figure 22 for 1982–83) the statement “include days while an 

overnight patient in a hospital” was added to reduce interviewer and respondent confimion. 

.	 The questions on when the accident happened for accidental injuries, questions 17a and 17b shown in figure 22 

for 1975-81, were incoqzorated into the onset question 

(question 5 of figure 22 for the 1982-83 questionnaire). 

13.	 Is this (condition In 3b) the result of the same accident you already 

told mc about? 

~ Yes (Record condition page numbe, where 

accident questions first comDIeted.) ~ _ [NC) 

Page No, 

14. Where did the accidtnt haotxn? ,. ! � AC home (inside house) 

20 At hOme (adiacent prem!ses)


: ~ ~::t ~d hl?.hway ( includes roadway and publ!c s,dewalk)


d 

s ~ Ind”strtial place (includes pmrmses) 

60 School (Includes prern, ses) 

~ G place of recreauon md sports. except =C school 

a � Other (Specify) 

d 

Mark box if under 18. ~ Under 18 (16) 

l!fa. Was under 18 when the accident happened? 

I ~, Yes (16) � No _______________________________________________ 

b. Was in the Armed Forces when the accident happened? 

2 C Yes (16) ~ NO 

_______________________________________________ 

,. 3 C Yes 4@N0 

16.3. Was a car, truck, bus, or other motor vehicle involved in the accident 

in any way? 

~.Wa$ at wo,k at iob or bu~i”e~~ ~he” the ~ccident hanoened? 

I ~ Yes z G No (77) _______________________________________________ 

b.	 Was more than one vehicle involved? 

I � Yes 2GN0 

c. Was fit/either one] moving at the time? 

I m Yes 20N0 

170. At the time of the accident what part of the body was hurt? 

What kind of iniury was it? 

Anything else? 

Part(s) of body * Kind of iniu.y 

l---_____l__--------l 

Ask if box 3, 4, or 5 marked in Q.5: 

b. What part of the body is affected now? 

How is (port of body) affected? 

Is affected in any other way? 

Part(s) of bcdy * Present effects ** 

I 

I I 

* Enter part of body in same detai I as for 3g. 

** if multi D[e ~re~enc effects, enter in C2 each one thar is not the 

ssme as 3b’or C2 and complete a separate condition page for it. 

,9 

Before, the onset questions asked when the condition was 

first notice@ in the revised questiomaire for injuries the 

question is “When did — (name of injury)?” (For 

example, when did Mr. Doe break his arm?) In other 

words, in the pre-1982 version the onset question asked 

when the injury was fiist noticed, which could have been 

later than when the accident occurred and in the 1982–83 

questiomaire the interviewer asked when the accident 

happened. For a condition that was the present effect of an 

accident occurring 3 months ago or longer, for the entire 

period 1975–83, the interviewer asked when the condition 

first was noticed. 

� A question was added to determine whether the accident 

51 
happened while the individual was in the Armed Forces 

(question 15b in figure 22 for 1982–83). In the previous 

questionnaire the information had to be volunteered by the 

respondent to be reported. 

Supplements to the basic core 

NH IS questionnaire 

Starting in 1959, supplementary topics have been included 

in the NHIS. These supplements have changed from year to 

year in response to current interest in special health topics. 

Suggestions and requests for special supplements are solicited 

and received from many sources, including other parts of the 

Department of Health and Human Services, university-based 

researchers, and administrators of national organizations and 

programs in the private and public health sectors. As always, 

the final decisions on which topics to include rested with the 

Director of NCHS. Following is a discussion of the procedures 

used for adding supplemental topics, the content of the supplements for 1959–83, and the methods, such as subsampling, 

that have been used for the supplements. 

Procedures for addition of supplemental topics 

In the early years of the NHIS a large panel of advisors 

was formed to review the activities of the survey and to make 

recommendations in many areas. One of these areas was sup 

plemental topic selection. TheNHIS continued to solicit input 

on topics from these advisors until the mid 1970’s. In addition 

to soliciting input from those advisors, content advice was 

requested from other organizations within the Public Health 

Service and other components within NCHS. 

One of the charges to the Technical Consultant Panel 

(created in 1977 by the National Committee on Vital and Health 

Statistics) was to make recommendations on supplemental 

topics. NHIS relied on this panel for priority ranking of potential topics that were included in the survey from 1978 through 

1983. In its fiial reports the panel made recommendations on 

procedures for adding items to the NHIS in the future. 

These recommendations of the panel led to somewhat 

more formalized procedures for selecting supplemental topics. 

In 1981 advertisements for soliciting topic suggestions were 

published in professional journals and newsletters. In addition, 

letters were mailed to individuals and organizations asking for 

topic suggestions. Information packets containing a brief description of the survey and guidelines for submitting suggestions 

were distributed to persons who indicated an interest in making 

topic suggestions. 

It was hoped that after an initial screening of proposals by 

an NCHS panel the major review of submissions would be 

conducted by outside consultants. Because of budget constraints, however, this was not possible, The major review was 

performed by the NCHS panel and the American Public Health 

Association (APHA) Committee on Federal Statistics for 

Public Health. 

Based on recommendations of the NCHS panel and the 

APHA committee, final decisions were made by the Director 

of NCHS on the NHIS topics for 1984 and 1985.32 

Supplement content and location of copies 

Table C shows the major supplemental topics covered in 

NHIS from 1959 through 1983. Some topics included only a 

few questions whereas other topics included batteries of questions lasting up to 20–25 minutes. Some topics included several 

subsets of questions. For example, although the table shows 

only one topic in 1981 on child health, that supplement was 

very comprehensive and covered many major areas including 

medicine use, family structure, behavior problems, child care, 

chronic conditions, birth and prenatal events, breastfeeding, 

and motor and social development. Another example of a large 

subset of questions included in a major topic was the set of 

questions on number of siblings, how many were still living, 

and whether parents were still living included in the 1976 

Diabetes Supplement. 

Several supplements, such as personal health expenses 

and special aids, have been repeated several times; other supplements have been used only one time. The repetition of 

supplemental topics has permitted the analysis of trends in 

various health-related areas. Sometimes the identical set of 

questionnaire items and survey procedures was used when topics 

were repeated. Other times questions and/or survey procedures 

were changed. Whenever any changes in questions andlor procedures were made, extreme care must be exercised in the 

interpretation of trends. For example, if a definition of a questionnaire term was changed from one year to another, there 

could have been a resulting change in the level of the estimates 

produced. 

Over the years there have been many additional important 

supplemental questiomaire items that are not included in 

table C. Some of these have been repeated several times. For 

example, receipt of medlcaid was asked in each calendar year 

from 1977 through 1982. 

Copies of specitic questionnaire items may be located in 

the following manne~ 

� Core questionnaire: Vital and Health Statistics Series 10 

report on “Current Estimates” for the particular year of 

interest. 

� Supplements 1957–74: Vital and Health Statistics Series 

1, No. 11, “Health Interview Survey Procedure 1957-74:’ 

appendixes I and II. 

. Supplements 1975–83 

— If not in bold in table C of this report, appendix IV. 

—	 If in bold in table C of this report, in “Current Estimates” for the particular year of interest. 

Some of the supplemental items not listed in table C as 

major supplements are contained in the “Current Estimates”; 

others are contained within the major supplements and may be 

found in either reference 3 or in appendix IV of this report, 

Supplement procedures 

As described earlier, the core portion of the NHIS questionnaire is asked about all members of the sampled households of a household respondent and interviews are conducted 

each week of ‘the year. However, the procedures used for supplements differ sometimes from the procedures used for the 

52 
Table C. Major supplemental topics covered: National Health Interview Survey, 1959-83 

Fiscal yeer 19— Calendar year 19— 

Supplemental topic 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 

Health insurance . . . . . . . . . . . . . . . . . . . . x x x x x x xx x x xx 

Hearing impairments. . . . . . . . . . . . . . . . . x x x 

Loss of income . . . . . . . . . . . . . . . . . . . . . x x 

Home care and/or nursing care . . . . . . . . x xx x x 

Special aids . . . . . . . . . . . . . . . . . . . . . . . . x x x x x 

Personal health expenses. . . . . . . . . . . . . x x x xx x 

Medicines . . . . . . . . . . . . . . . . . . . . . . . . . x x 

Smoking habits . . . . . . . . . . . . . . . . . . . . . xx x x x xx x 

Corrective lenaes . . . . . . . . . . . . . . . . . . . . x x x x x x 

Vision impairment . . . . . . . . . . . . . . . . . . . x x x 

X-ray visits . . . . . . . . . . . . . . . . . . . . . . . . . x x x 

Acute conditions..,........,.. . . . . . . x 

Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . x 

Blood donorship . . . . . . . . . . . . . . . . . . . . x x 

Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . x x 

Hypertension . . . . . . . . . . . . . . . . . . . . . . . x 

.Medical care availability/barriers to 

care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x x 

Motor vehicle accidents. . . . . . . . . . . . . . x 

Dental care . . . . . . . . . . . . . . . . . . . . . . . . x x x 

Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . x 

Preventive care . . . . . . . . . . . . . . . . . . . . . x x 

Specialist’a services and routine 

checkups, . . . . . . . . . . . . . . . . . . . . . . . . x 

Disability/functional limitation. . . . . . . . . xxx xx x x x 

Usual source of care, ,., ..,.,. . . . . . . . x x x 

Accidents . . . . . . . . . . . . . . . . . . . . . . . . . . xx x 

Haalth maintenance organizations. . . . . . x 

Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . x 

Health habits . . . . . . . . . . . . . . . . . . . . . . . xx x 

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . xx 

Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . x 

Medicaid/AFDC. . . ,., ,, .,,. . . . . . . . . . x xx x x x ‘x 

Armed Forces disability . . . . . . . . . . . . . . x 

Immunization for children. . . . . . . . . . . . . xx 

Eye care visits . . . . . . . . . . . . . . . . . . . . . . x 

Residential mobility . . . . . . . . . . . . . . . . . x x 

Retirement income . . . . . . . . . . . . . . . . . . x x 

Longest job . . . . . . . . . . . . . . . . . . . . . . . . x 

Child health. . . . . . . . . . . . . . . . . . . . . . . . x 

Alcohol/health practices. . . . . . . . . . . . . . x 

1 Became part of the core questionnaire. 

NOTE Foraupplemants 1975-83 a bold Xindicates that acopyof the supplement may be found in the Vita/ arrrf Hea/t/r Statistics, Series 10publication ”’Current estimates’’ forthe year thesupplement was fielded. For 

supplements 1970-83 astandard X indicates thata copy of thesupplement containing the topic may be found in appendix lVofthia publication. 

07 

cd 
core. Described in this section are the timing of supplements, 

subsampling procedures, respondent rules, mode of interview, 

and placement of supplement items in the interview. 

The NHIS sample is designed so that each week’s sample 

is an independent national probability sample. This design 

feature permits using only a part of a year for making estimates. 

The survey takes advantage of this design feature in that supplements “are not always included for the entire fiscal year or 

calendar year but rather are included for only part of the year. 

For example, the Influenza Supplement was included in the 

last quarter of calendar year 1976 and the first quarter of calendar year 1977. This timing was intended to allow tracking of 

influenza immunizations and influenza cases during the expected “swine flu” epidemic. Another example of a supplement 

not being included for an entire calendar year is the Personal 

Expense Supplement. The last few times the expense supplement was included (1971, 1975, 1976, and 1978) it was administered during only the first quarter of the calendar year. 

Respondents were asked to report their health expenditures for 

the previous calendar year. 

Supplements are not always asked for the entire NHIS 

sample. Rather for some supplements a subsample of the main 

sample is selected, For some supplements, such as Smoking 

and Eye Care Visits, a one-third subsample was selected. For 

the 1981 Child Health Supplement questions were asked about 

only one child per family. A major reason for asking questions 

for only a subsample is the respondent rules for the supplement 

and their commensurate survey costs. Where more stringent 

respondent rules requiring additional interviewer followup were 

used, fewer sample cases have been selected to keep survey 

costs down. For several supplements, including the 1976–1 980 

Smoking and 1983 Alcohol/Health Practices, a self-respondent 

rule was used because it was determined that only a selfrespondent could give sufficiently accurate answers. For some 

other supplements a “prefemed” respondent rule was employed. 

For example, in the 1981 Child Health Supplement a biological 

parent was interviewed. In cases in which neither of those 

parents was available during the interviewing period, the interviewer was allowed to interview a person identified by the 

household responding as being most knowledgeable about the 

child. 

For supplements using a one-in-three subsample scheme, 

interviewers are provided three random selection tables. (See 

appendix V for subsampling tables.) Each table shows which 

household members to select according to the number of persons 

in the household. During the preparation of interviewer assignments each questionnaire is stamped to indicate which of the 

three tables the interviewer is to use. The assignment of tables 

is made so that each of the three tables is used a random third 

of the time. Each table is designed so that each person in the 

target population has a one-in-three chance of selection. 

For the 1981 Child Health Supplement, computer-generated 

labels were atlixed to the questionnaires (also shown in appendix V) to show the interviewer which one child in each 

family to select according to how many children there were in 

the family. The labels were created in such a way that in a 

family of n children (n= 1 through 10) each child had an equal 

chance of selection@ = l/n). Whenever a subsampling scheme 

for a supplement is used, appropriate weights are created for 

use with that supplement. 

The core NHIS interview is always conducted in person in 

the household. For supplements, the telephone is frequently 

used where callbacks are required. That is, at the time of the 

initial interview the interviewer administers tie supplement to 

all eligible respondents who are at home, and makes most of 

the callbacks by telephone to persons not originally available. 

In the case of the Family Medical Expense Supplement, a selfadrninistered form was left with respondents who were requested to mail the form back the telephone was used to follow 

up on nonresponses. 

Starting in 1981, all supplement questions were put after 

the entire core set of questions. This decision was made after 

an increasing amount of evidence and analysis indicated that 

supplemental questions had a potential biasing effect on core 

items. For instance, in 1974 there was a supplement on acute 

conditions that may have caused a dramatic drop in the NHIS 

estimates of acute conditions based on core items.33 Interviewers were required to complete a supplement for each condition having an onset during the 2 weeks prior to interview. 

The first year the supplement was added there was a drop in 

the estimate of the incidence per 100 persons per year of about 

10 percent. The second year the supplement was included the 

rate was the lowest ever reported in the history of the survey 

(about 22 percent lower than the year before the supplement 

was included). Afler the supplement was dropped, the rate reverted to the approximate level it was before the supplement. 

Other supplemental effects have been noted in other NHIS 

years as well as on other surveys. Several have been discussed.34,35Not integrating supplemental questions with core 

items sometimes creates awkward questions. For example, in 

the 1981 Child Health Supplement condition section, respondents are told, “Some of the following conditions were 

asked about earlier, but tell me whether or not — EVER 

had any of the conditions even if they have been mentioned 

before.” However, it is believed that an occasional awkward 

question is a lesser evil than increased response error. 

54 
Chapter 4: Survey operations 

Introduction 

Since the beginning of the National Health Interview Survey 

(NHIS) in 1957 the U.S. Bureau of the Census has served as 

the data collection agent for the survey. Each year since 1957 

a new Federal interagency agreement has been signed between 

the U.S. Bureau of the Census and the National Center for 

Health Statistics (NCHS). Once survey supplemental topics 

have been determined and NHIS staff has prepared a first draft 

of the questionnaire, U.S. Bureau of the Census staff joins the 

NHIS staff in developing the survey procedures and refining 

the questionnaire. The U.S. Bureau of the Census is responsible 

for the data collection, including hiring, training, and supervising interviewers and carrying out quality control programs on 

the fieldwork. Starting in 1968, NCHS assumed responsibility 

for data coding and machine editing, but before that time the 

U.S. Bureau of the Census performed these fhnctions also. 

This chapter first presents a number of procedures related to 

tie interview. These include the advance household letter, the 

postinterview “thank you” letter, interviewer’s introduction to 

respondent, use of interviewing tools (flashcards and calendars), 

reference periods, callbacks for noninterviews, and respondent 

rules. The use of a subsampling scheme for selection of persons 

for some NHIS supplements is discussed in the section entitled 

“Supplements to the basic core NHIS questionnaire” in the 

previous chapter. Next the flow of the NHIS field activities is 

described, and a description of these activities is presented. 

Interview procedures, 1975-83 

Respondent letters 

Approximately 1 week before interview week each sample 

household is mailed a letter from the regional oftlce of the U.S. 

Bureau of the Census. A copy of the letter is shown in appendix 

VI. In accordance with the Privacy Act of 1974 (5 U.S.C. 

552a) the letter informs the household of the purpose of the 

survey, the sponsorship of the survey, the authorization of the 

survey, the fact that the data will be treated conildentially, that 

participation in the survey is voluntary, and that there is no 

penalty for not responding. (For a description of procedures to 

insure coruldentislity of interview responses including the 

Privacy Act requirements, see the last subsection of this chapter 

entitled “Confidentiality provisions.”) Starting in 1983 a telephone number was provided for the respondents to call the 

regional office of the U.S. Bureau of the Census to ask questions 

about the survey. 

For sample households for which there is no address accurate enough to send the advance letter and for households 

that deny receiving the letter, interviewers are required to provide a copy of the letter at the beginning of the interview. 

At the close of the interview, the interviewer gives the 

respondents a “thank you” letter from the Director of NCHS. 

(See appendix VII for a copy of the “thank you” letter.) 

Interviewer identification 

After locating the sample household, interviewers identifi 

themselves to the respondent by showing their U.S. Bureau of 

the Census picture (ID) card. They must ask whether the respondent received the advance letter and, if not, they must give 

the respondent a copy. The time the interview started is entered 

on the front of the questionnaire (see item 15 of figure 23, a 

copy of the front page of the questionnaire) when a person in 

the household opens the door or is fust greeted by the interviewer. After the introduction, the interviewers veti the exact 

address of the dwelling unit to insure that the correct sample 

unit has been identified (item 6 in figure 23). Other items are 

asked (items 7–10) to ascertain the type of dwelling unit and to 

determine whether dwelling units may have merged with other 

units or divided into more than one household since the sample 

listing was prepared. 

Respondent rules 

After obtaining a listing of household members, the interviewer determines who is eligible to respond to the questions. 

The basic respondent rule for the core questionnaire is that any 

adult household member (person 19 years or over or any age if 

ever married) may respond for himself or herself and for any 

other related household member not present. All persons 17 

years old or over in the household are asked to take part in the 

interview if they are at home. (See item 5 in figure 3 for 

1982–83.) Never married persons 17 or 18 years old may 

respond for themselves but are not permitted to answer questions about other family members. Answers for children must 

be obtained from a related family member who is at least 19 

years of age or who has been married. Unrelated household 

members (for example, a roomer) or unrelated families must be 

interviewed separately on a separate questionnaire. 

Different respondent rules are sometimes used. For example, for some supplemental questions a self-respondent rule 

is used, These procedures are explained in the section entitled 

“Supplements to tie basic core NHIS questionnaire.” 

55 
-----------------------------------------------------------

------------------------------------------------------------------

-----

-------------------------------------------------------------------

---------------------------------------------

---------------------------------------------

--------------- ------------------------------------------------

-------------------------------

-------------------------------

--------------------------------

..-—-.. .-. --. — +S.1613 O.M. B. No. 0937 -WJ21 : A99tov~l =X PlfCS JU.9 x), I m, 

UTtCZ - lnfomtion contmnd 0. ttm fwm *I* Wuld wmat tdu0tflcti8m of w Miwdud or 1. 2. P.O. number 3. Sample 

stilldtmznt has b9m CollQCtCd With � 2ux=tN tht 11 Will b I!*Id in alflct cm ftdmcq mll b USNI Book —of nty W P&!im~ Sflt8d tOf this SIUdY, ati Will mt be di=lowd Of r81aamd W 0fh9fs WtttOUt U!4 C@lS~t 

f d12 itiWitid W th2 8$t*li$hTIWlt in XC0ti21Ct *WI =OOn W(d) of W P“bl,c Heslth S9w,c. 

St (42 USC z42n). —bOOks 

O.W H13.1 (1983) 1.s.,2) 

4. Se;ment type 

� A,,. 

5. Control 

Psu 

number 

1 

, Seonenc : %r!.1 

Us. OC*ARTMENT 

,“. OF COMMERCE � P,rrn,c , 1 .“”.. ” 0. . ..s”s 1 ..,,.. ., C. LL. C,, NG . . . . . .0” r-z � Address 1 U.S. PU6LIC WEALTH SERVICE r @ cm-sup , 1

NATIONAL HEALTH INTERVIEW SURVEY � SP.c,al place 

I 

I I 

, 6*. What ia vow �xact addr.ss? (Include House No., APL No., or other tdentrf, catton. \ ;l;:&NTG 14. Noninterw ew reason 

county and ZIP cede) 

1 TYPE A 

+ of I-J Refusal - DOscfI& In f00h70t*$ FIN Items 

l-a, 7, l— oz @ N. on. at home - repeated calls 98s t Sheet No. 

: 01 � Temuwarily .bsent - Fc.afnom %Dfl#: , 

Z;~--------------------~ St;;e---------~ C;;nl~--------[-Zl P-cX;e--- , _ 04 � Other (S&NYJ } ,-

t 1 : Lme N.. J I 1 / 

b. Is this yaw tnoiling addr.ss? (Mork box or specI fy Lf different. Include D Same as 6. 

county and ZIP code.) TYPE B 

05 Ig vacant - “0”,,. $0”.1 

os � V=anc - seasonal 

07 � Occuu,ed enc,relr by 

p.r.o.s WI* URE City '--------------------------~~;a;e----------~?;;n-v-----------~Z-l-P-c-ode

t I 1 on � tic.pi.d entlmly by Armed 

Fo,ce, member, Fill Items 

1-CW. ?, 8, 

e. Spectal place name I Sample unit number / Type code os � Unf,t or m be d.msl ished 9 4s 

I t 0 n Uncle, CO”,lIUCtd CM, .OC ready awl,cable. 

I 11 ~ Con.eKed to cemprnaw bust..%% 10, 12-15 

or SCo, aze AREA SEGMENTS ONLY ! z C :fl=c.. wed rent mte w tral I.r 

7. YEAR WILT 

� Ask ! 3 C Perm, t tranced, c... cructmn 

“., ,tart.d � 00 not ask I 4 � Ofher (Spaclfy) 1 When was this struetur. .;iginolly built? J 

c B.fw. 41-70 [Cmttnta int.mew) 

� Aft.r 4!-70 (Complete It.m & Mm. requl,ed; end l“tervlov) 

TYPE C 

8.	 COVERAGE QUESTIONS !s � unused 1I.. of 1,.tmg sheet 

� Ask Ik.ms that .,. marked ! 6~ Oem.lt shed 

� D. not �sk ~-----__-------------_ 17 C House or L?.,IU mo.ed 

F,!! ,Irms 

a. � Arc tbre any occupied or vacant living quartws b~sidts : � Yes (Fill Table X) I a~] O.tsnde setment 1-5*, W 

your own Converted ,! mmhsd, in this building? ; � N. t 9 � Or .Zor.ze 

to pemm..nt bum.. . . 

12-15. S*.O 

4--------------------- z o� Mnrced /“t*,-C.amm, 

b. c Are *her. any occupied or vacant living qwrt.rs b.sid.s I � Yes (FIN Table X) 21 � Condemned yeut own on this floor? ; � N. Ian B.Ilt after AWII 1. 1970 

------_ ------_ -------------------------_-----+--------------------- 23 a Other (SPocNyJ 1 

c. C Is there any othsr building on this prop+ for psopl@ I � Yes (Fill Table x) J 

to Iiw in cith:r occupi*d or vacant? j � N. 

— 15. Record of calls

90. LAND USE , Bez,nmnt Endtnz ComD1.t* I ~ URBAN (10) MCmth ; Date ~,m* r,me Mark (X) 

z U RURAL 

- Ret. WKS �nd SP. PL. .mts ceded 85-S4 m 6C - Ask Item 9b 1 ; a.m. �.m. 

-SP. PL. umts not coded 8S-2a m 6.- Msrk .,No,, 1“ !fem 9b W/tnouf asking mm. o.m. 

--: ~ , 

b. Dur,.g th. peat 12 months d,d sales of crept, Iiv.st.ack, and oth.r 2 ! a.m. a.m. 

farm products from this place omount to $1,000 w more? p.m. o.m. 

1 � Y=s (?0) I a.m. �.m. 3 : 

20N0	 } p.m. p.m. , 

I 

10.	 CIX.SIFICATION OF LIVING QUARTERS - A%rk by observation a.m. a.m. 4 ‘ 

a. LOCATION of untt ~ d. HOUSING unat (Mwk one. THEN page 21 p.m. mm. 

Un,t I*: 1 0! ~ Hcase, apartment, flat 1 a.m. a.m. � t. 8 Special Place - Refer to Table o in 02@ HU ,n nonu..sient hotel. motel. em. 5 : v.m. P.m. Part C ot manual; tfmn cc,nplere lC.j or e / 

� NOT m a Soe.a81 Place (fOb) ! 03 ~ HU-p+mmne”t m W..swnt hotel, motel. etc. ( 

04~ HU In ,omninc house 6 

1 �.m. a.m. 

b. Access 0s � Mcbl14 home .x tr. tl.r with no Demmn..t D.m. mm. 

G ot,ect (lW) r-m added 16. List column numbers of persons requsnn; 

� Thro.zh another ..,, (lWJ 06 � Mobile ho~ or tm,ler .v,th one u callbacks. met. permanentrooms�dded � None ; 07 � HU nor specified abov. - Descrlb 

e. Complete k,tchen facilities 1 /“ tcotnotes Cl. N- Oe”tal Rcq.,,ed Alcohol Re.qui,ed 

� F.< th,s u“i, only (fti) ~ . . OTHER untt (Mark one) � Ye, � No � Yes � No 

� Also used ! 08 a Qumrmrs noc HU In r.xmint w boarding house � Y.* C No � Y.* � MO 

bv . ..fher h.a”, eh.ald Not a sepsrate HU: ccmbhw ; 09 n U.IC not Pernm.e.t in tr..sient hotel. � Yes � N. � Yes � No 

w Ith u“lt mrm.gh whicn frmtel, etc. 

� Nw, access is gamed. (APPly I to C U“occuP,ed tent s ,Ke M trs,ler SK. 17. Record of additional contacts 

} meqsd WI! pwxdwes t{ ~ 

! 1 � OTHER un,t not s~c,f ied above - DeScrlb8 1 Cmnplec, zdowcnel riving warters Bezmni”z Endin~ cd. No< space was listed sernrately.) ! /n twmotes Month / Date ,im. ~,m= 

I D A , 1 P �.m. a.m. 1 1 T P.m. p.m. GO 10 HOUSEHOLO COMPOSITION PAGE 

1 P a.m. �.m. 2 ; 

11. What is the fslephone numbw here? / Area code:number 12. Was th!s Interview observed? T p.m. p.m. 

1 # P n None 1 “3 ! a.m. �.m. 

T p.m. p.m. 

130 Interviewer’s name ~ Code 

I P 1 4 / a.m. ..m. 

I T p.m. mm. 

Figure 23. National Health Interview Suwey, page 1 

56 
I


Volunteered conditions 

From 1975–8 1 interviewers were instructed to record any 

condition reported, regardless of where in the interview the 

condition was reported. Then for each condition, the detailed 

condition questions were asked. Starting in 1982, interviewers 

were not required to record a condition reported when asking 

about disability days or doctor contacts unless there was some 

disability or a doctor contact associated with the condition. 

However, the interviewers still were required to record any 

condition reported while asking the condition lists. 

Callbacks 

If no one is at home, callbacks in person are made. The 

exact number of interviewer callbacks is not speciiled because 

factors such as travel costs are considered by the interviewer’s 

supemisor in determining how many times a household should 

be revisited. Because the interviewer is not restricted in the 

number of callbacks she makes, in some cases there are many 

(5-10). The times of callbacks are entered in item 15 of 

figure 23. 

Late interviews 

In some cases a household may be interviewed the week 

after the week for which the household was assigned to be interviewed. In such cases the household is counted in the week 

for which it was originally assigned. In administering the interview, however, the interviewer changes the reference periods to 

correspond to the week in which she is interviewing. This 

procedure aids in recall by not allowing a full out-of-scope 

week between the end of the reference period and the interview 

week. 

Noninterviews 

If attempts to obtain an interview are ended, the reason for 

the noninterview is entered in item 14 of figure 23. Noninterviews are divided into three types labeled A, B, and C. Type A 

noninterviews are those not conducted in eligible, occupied 

sample households. Types B and C are sample units not eligible 

for the survey. (Table D shows the NHIS noninterview rates 

for 1975-83.) 

Flashcards and calendar 

The interviewer’s flashcard booklet consists of cards used 

for reference during the interview. Some cards are shown to the 

respondents as an aid in answering certain questions (for example, see figure 7) while others are an aid to the interviewer 

only and are not shown to the respondents (for example, an 

age-verification chart to complete the person’s age from the 

date of birth). For each card shown to the respondent there is 

an English and a Spanish version. 

Table D. Response rates and noninterview rates by type: National Health 

The calendar card is furnished to the respondent with the 

appropriate 2-week reference period (for 2-week disability and 

doctor contacts questions) marked in red (figure 24). The dates 

for the 2-week reference periods as well as the dates for the 

other reference periods are stamped on each questiomaire and 

change with each week’s new assignment, 

Additional callbacks 

For some supplemental items requiring a self-response, 

additional contacts must be made when the person is not at 

home at the time of the initial interview. A record of these 

additional contacts is made in item 17 of figure 23. In item 16 

of figure 23 the interviewer indicates the column numbers and 

sections requiring additional contacts. (For 1983, these topics 

were “Dental care” and “Alcohol/health practices. ” These 

topics change each year.) Usually callbacks may be done either 

in person or over the telephone. 

End of interview 

At the end of the interview the interviewer thanks the respondent, provides him or her with a copy of the “thank you” 

letter (appendix VII) and asks the respondent for the household 

telephone number in case additional contact is required (item 

11 of figure 23). The interviewer marks whether the interview 

was observed (for instance, by a supervisor) in item 12 and 

puts his or her name and interviewer code in item 13. 

Flow of NH IS field activities 

All interviewers are thoroughly trained after interviewer 

training, assignments prepared by staff of the regional ofiice of 

the U.S. Bureau of the Census are given to the interviewers. 

Approximately 1 month prior to the assignment of a group of 

households, interviewers go into the field to list the addresses 

of households requiring such listing. (See chapter 1.) After completing a week’s assignment, including manually editing his 

or her own work, the interviewer mails the assignment to the 

regional office of the U.S. Bureau of the Census. The NHIS 

office clerk in the regional ofiice then checks in the assignment 

and performs a manual edit to insure that all required information is recorded. Approximately 2 weeks after the questionnaires 

are received in the regjonal ofiice they are mailed to the NCHS 

data processing center in Research Triangle Park, N.C. (RTP). 

After they are checked against a master sample listing they are 

edited for completeness, coded, keypunched, and the information is put on tape. The resulting computer data files are retained 

at RTP. The questionnaires generally are kept at RTP until the 

computer fdes are processed, which includes computer editing. 

After computer editing of the files, the paper questionnaires are 

Interview Survey, 1975-83 

item 1975 1976 1977 1978 1979 1980 1981 1982 1983 

Percent of eligible households responding. ., ., , , ., , . . . . ., ., , , , ., 96.9 96.2 96.7 96.2 96.6 97.2 97.1 97.1 96.8 

Percent of noninterviews, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 3.8 3.3 3.8 3.4 2,8 2.9 2,9 3.2 

f??rCGfIt of refusals of net eligible households . . . . . . . . . . . . . . . . . . 1.6 2.1 1.9 2.o 1.9 1.7 1.6 1.8 2.0 

57 
NATIONAL 

MAY 

JUNE 

Red line (the past 

2 weeks) 

Week 12, Ssmple 832 

(interview week) 

UNITED STATES 

HEALTH INTERVIEW SURVEY 

1983 

Sun Mon Tue Wed Thu Fti Sat 

1 2 3 4 5 6 7 

8 9 10 11 12 13 14 

15 16 17 18 19 20 21 

22 23 24 25 26 27 28 

29 @ 31 

1 2 3 4 

s’ 6 7 8 9 10 11 

—— .— . 

u.S. DEPARTMENT OF COMMERC 

MmEAu W WE CH4SU 

Figure 24. Interviewer calendar card showing 2-week rafarance period 

sent to a storage facility in Atlanta, Ga. After 5 years the questiomaires are destroyed and only the computer files are retained. 

Figure 25 is an organizational chart of a typical regional 

ofilce of the U.S. Bureau of the Census with respect to the 

NHIS activities. The Director of that regional oftice has responsibility for all demographic and economic census and 

survey field activities in his or her regional area. These activities 

include the Decennial Census, the Current Population Survey, 

and the Annual Retail Trade Survey. The Demographic Coordinator has responsibility for coordinating demographic 

surveys in the regional office. 

The interviewer training program and the field quality 

control procedures, including a manual edit of questionnaires, 

interviewer observation, and a reinterview program, have been 

thoroughly described.36 The most upt~date field quality control procedures are described in detail in the U.S. Bureau of the 

Census National Health Interview Survey Oflce Manual, 

which is continuously updated,37In this chapter only an overview 

of the field procedures and noteworthy changes in these field 

procedures and quality control programs occurring during 

1975–83 are described. Also covered in this chapter are the 

NHIS data processing procedures, including coding, keying, 

and computer editing. 

Interviewer training 

The interviewers’ initial training consists of five stages: 

preclassroom training, classroom training, postclassroom training, on-the-job training, and editing of questionnaires by the 

interviewer supervisor. The preclassroom training is self-study 

at home. The classroom training consists of 4-5 days of instruction and covers the interviewer’s manual, the questionnaire 

and related forms, and interviewing techniques. This training is 

58 
Director T

Assistant 

Director 

v 

Demographic 

Coordinator 

1


Superviso~ Supervisory 

Field - NHIS Supervisor w Field 

Representatives Representatives 

1 

NHIS NH[S Office Clerk NHIS 

Interviewers 

Figure 25. Organization chart of National Health Interview Survey (NH IS) 

the Census 

conducted in one of the 12 regional offices of the U.S. Bureau 

of the Census. The training consists of formal lectures by the 

trainer, reading portions of the interviewer’s manual, answering 

questions, participating in group discussions, completing written 

exercises, and practice interviews. After the classroom training 

there are self-study programs that review classroom topics and 

that also help the interviewer understand sample unit coverage 

in area segments, the use and background of the address lists 

taken from the decennial census, and the procedures to be followed at special dwelling places such as motels or boarding 

houses. The interviewer receives on-the-job training during the 

first two assignments and her first listing assignment. This type 

of training is also referred to as initial observation. The work of 

all new interviewers for their first four assignments is also edited 

by their supervisor. 

There is a relatively low turnover rate among NHIS interviewers. Many have worked continually on the survey for several 

years. Several types of continued training are used. Group 

classroom training usually occurs twice each year in each of 

the regional offices of the U.S. Bureau of the Census, In the 

first session, which is usually held in January prior to fielding 

the new year’s questionnaire, the interviewers are refreshed on 

the core questionnaire procedures and are trained on new supplement procedures. In the second session, which is usually 

held about midyear, the interviewers are refreshed on both core 

and supplement procedures, In addition to the classroom study, 

occasionally a home study is sent to the interviewers to insure 

that the interviewers have mastered the materials that were 

covered in class, Another part of the continued training process 

Interviewers 

activities at a typical regional ofFica of the U.S. Bureau of 

is the feedback of errors by the interviewer’s supervisor based 

on the manual regional ofilce edit of questionnaires, the supervisory observations made, and the reinterview program. 

Interviewer listing of housing units 

The design of the NHIS sample is based on housing unit 

address information obtained during the most recent Decennial 

Census. Because new construction, conversion of structures to 

dwelling units, and so forth, can occur between the time of the 

Decennial Census and the conduct of an NHIS interview, interviewers make a record or “list” housing units in sample 

segments wherever required before conducting interviews. The 

purpose of listing is to insure that all eligible household units 

have a chance for selection in the survey. In addition, if in 

conducting an intemiew an interviewer discovers another housing unit in the dwelling, she is required to record the housing 

unit and to conduct an interview in it. 

Observation of intewiewers 

The in-the-field observation program for all interviewers is 

considered one of the most important quality control programs 

for the survey because the majority of interviewer problems 

can be detected only through direct observation. 

There are three types of field observations conducted by 

the interviewer’s superviso~ initial, systematic, and special 

needs. Initial observations are conducted for each new interviewer for 2 days on her first interviewing assignment, for 1 

day on her second assignment, for part of a day on the first 

listing assignment, for 1 day on the third assignment, and for 1 

5’3 
day between the fifth and eighth assignments. In addhion, systematic observation assignments are made by the regional 

oi%ces. One-half of the experienced interviewers are observed 

each quarter. Special needs observations are scheduled if an 

interviewer’s work is rejected in reinterview or if an interviewer’s 

work falls below certain minimum performance standards in 

the areas of production, noninterview rate, number of recording 

errors and omissions on the questiomaires, or performance on 

recent observation, 

In conducting the observation the supervisor fills in an 

observation form to record various aspects of the interviewer’s 

performance. A revised observation form was introduced in 

1980. Appendix VIII contains a copy of the new form. It is 

basically the same as the previous form with a few modiilcations, 

such as the addition of the item “Follow Privacy Act Pr@ 

cedures.” 

Reinterview program 

In the NHIS reinterview program, the initial interview 

responses are compared with responses obtained from a subset 

of the same questions asked a short time later by the interviewer 

supervisor for a small subsample of households. This comparison provides a check on interviewer problems. In addition, the 

measurement obtained of reliability of response, also referred 

to as the simple response variance, is useful in gauging the 

quality of the survey data. 

The reinterview assignments are made on the basis of interviewer workload. There have been changes in the methods 

of assignments over the period from 1975 through 1983 that 

will be described later in this section, Overall, the level of 

NHIS households reintetiewed decreased from 10 to 5 percent 

between 1975 and 1983. The reinterview is scheduled for the 

week following the original interview and must be completed 

no later than 2 weeks after the data of the original interview. 

Because the questions on the NHIS refer to specific time 

periods, such as “last week or the week before,” the reinterviewedmust be certain to get the information for the same time 

period used in the original interview. (See appendix IX.) One 

part of the reinterview is a coverage check to see if all households and household members have been properly included in 

the survey. Another part of the reinterview reports personal and 

health characteristics. The reinterview fieldwork also includes 

verifying the original interviewer’s work in the listing of 

segments. 

The reinterview sample is divided into two parts: an 80-

percent subsample and a 20-percent subsample. In the 80-

percent subsarnple, the supervisor carries out a reconciliation 

of reinterview results with the results of the original interview. 

If the reinterviewer finds that differences exist, he/she attempts 

to determine from the respondent the proper response and any 

possible reasons for differences. The reconciliation form pre 

vides space for recording reasons for differences. (See appendix 

IX,) The data from the 80-percent sample are used to estimate 

response bias and to assess interviewers. No reconciliation is 

carried out for persons in the 20-percent subsample. The data 

from the 20-percent group are used to estimate gross reporting 

differences that should be untiected by the accessibility of 

original responses to the reinterviewer. 

The reinterviewer is instructed not to look at the original 

interview results before the reinterview. In the 80-percent subsample, the NHIS reconciliation record containing the transcribed information from the original interview is given to him/ 

her in a sealed envelope. The reinterviewer does not open this 

envelope until the reinterview is completed. 

After a reinterview assignment has been completed, the 

reinterviewer compiles a summary report of the NHIS reinterview showing the number of differences for five categories of 

the interviewer’s work listing, household composition, personal 

characteristics, characteristics of conditions and hospitalizations, and the number of conditions, hospitalizations, and injuries. An interviewer’s work is evaluated by the number of 

differences in any classification compared with the number 

given in a table of acceptability. Supervisors initiate retraining, 

observations, and so forth for interviewers whose work is unacceptable. 

Several changes were made from 1975 through 1983 in 

the NHIS reinterview program described in reference 36. These 

changes occurred in the interviewer sample selection, mode of 

reintemiew, listing checks, and the method of interviewer 

evaluation. 

Interviewer sample selectio:t for reinterview-Between 

1975 and 1980 interviewers with eight or more assignments 

per quarter were selected three times for reinterview for the 1 

calendar year. Interviewers with fewer than eight assignments 

per quarter were selected two times for reinterview. In 1981, 

interviewers were selected two times for the calendar year 

regardless of assignment size. In 1982, the method of selecting I 

interviewers was changed to a more randomized approach, and 

interviewers were selected an average of 1.5 times for the calendar year. In 1983, the more randomized selection approach 

was retained but interviewers were selected an average of two 

times during the calendar year. 

Mode of reinterview-In the beginning years of the reinterview program all reinterviews were done face to face in the 

respondent’s household. From 1969–72 the primary mode of 

reinterview was face to face but the use of the telephone was 

permitted for followup of those not at home. From January 

1973 through June 1973 all reinterviews were conducted by 

telephone; if a household had no telephone it was eliminated 

fi-omthe reinterview sample. From July 1973 through December 

1974 the initial attempt at reintemiew was made face to face, 

but the telephone mode was permitted for followup of nonresponses. From January 1975 through 1983 the telephone 

mode was acceptable for initial contact and the face to face 

mode was used only if the household had no telephone. 

Listing checks for reinterview-From 1975 through 1981 

listing checks were made each time an interviewer was selected 

for reinterview in sample addresses or segments that were last 

listed or updated by that interviewer. In 1982–83 listing checks 

were made once per calendar year in sample addresses or segments that were listed or updated by that interviewer. 

Method of interviewer evaluation in the reinterview program—From 1975 through 1978 interviewers either passed or 

failed in the various content areas according to a “tolerance” 

table of acceptable number of errors. Also from 1975 through 

1978, 90 percent of the reinterview sample was used to evaluate 

60

interviewer performance. (Reconciliation between the original 

responses and the reinterview responses was carried out for 90 

percent of the reinterview sample.) From 1979 through 1983, 

the original interviewer’s performance was evaluated based on 

the reinterview using a “levels of concern” table of acceptable 

number of errors as a guideline. The “pass/fail” concept was 

eliminated. Also from 1979 through 1983, 80 percent of the reinterview sample was used to evaluate interviewer performance. 

Manual editing of questionnaires 

All interviewers are instructed to edit their own completed 

work before submitting it to the regional ot%ce. When the 

questionnaires are received in the regional oftlce, one of three 

types of additional editing is performed 

� Initial—A complete (100 percent) edit of all questionnaires in a new interviewer’s first four assignments and a 

complete edit of the first assignment in a new calendar 

year for experienced intewiewers. 

. Systematic—A complete edit of a sample of questiomaires 

in each interviewer’s assignment, 

. Special needs—A complete edit of all (or some) of the 

questionnaires in an assignment of an interviewer not performing at least satisfactorily. 

From 1975 through 1981, the determination of whether to 

perform the systematic or special needs edit was left to the 

regional oflice NHIS editor’s judgment, The guidelines for 

making this determination were to conduct the special needs 

edit if “an interviewer’s work appears less than satisfactory,” 

in which case a “suftlcient number of questionnaires” were to 

be fully edited until the editor was “satisfied with the interviewer’s performance.” 

Beginning with the 1982 data year, a qualiied edit (QE) 

procedure was initiated to standardize the qualifications and 

activities involved with the systematic versus the special needs 

edhs. To attain QE status initially, an interviewer must maintain a “satisfactory” or better (7 percent or less) error rating 

for four consecutive assignments. A complete edit is conducted 

on all questionnaires in the assignments until this qualification 

is met. Once QE status is achieved, the systematic edit is performed as long as the error rate does not fall into the “needs 

improvement” (7$01–9.00 percent) range for three consecutive 

assignments or does not fall into the “unsatisfactory” range for 

any one assignment. If either of these occurs, a complete (special 

needs) edit is performed on each assignment until the error rate 

is “satisfactory” or better for two consecutive assignments. 

In selecting the sample for the systematic edit, enough 

questiomaires must be edited to provide a reasonable base for 

rating the interviewer. For some interviewers this means editing 

their entire assignments. For most interviewers only a sample 

of each assignment is edited. The sample is a systematic one 

and is based on the number of assignments made to the interviewer in the calendar quarter and the number of units in each 

assignment, 

Throughout the period 1975–83, the regional office edit 

could be conducted by the NHIS supervisor, NHIS alternate 

supervisor, NHIS clerks, or, if necessary, superviso~ field 

representatives, or regular NHIS interviewers. However, at the 

begiming of the period most, if not all, of the editing was performed by the clerical staff. Because the edit program is an 

important part of the supervisor’s responsibilities and it is essential to the survey that each supervisor be actively involved 

in and lmowledgeable about all facets of the project, beginning 

with the third quarter of 1976 each NHIS supervisor was required to edit at least one assignment in 6 of the 13 weeks each 

quarter. These six required editing assignments are preselected 

by the staff at the U.S. Bureau of the Census in Suitland, Md., 

at the beginning of each qumter to provide each supervisor with 

a variety of interviewers and/or primary sampling units to edit. 

In an effort to improve the quality of the NHIS data through 

timely feedback of problems to the regional office editors, a 

reedit of a sample of questionnaires from each ofllce is conducted by the Washington staff of the U.S. Bureau of the 

Census. During this reedit, three types of errors are identified 

. Interviewer errors not found in the regional office edit. 

� Errors charged incorrectly to the interviewers by the regional office editor. 

� Regional office editor errors. 

The results of the reedit are routinely reported to the regional offices for use in evaluating editors’ performance and to 

improve the editors’ proficiency. This review of completed 

questionnaires also assists the Washington staff in identifying 

frequent or consistent interviewer errors that need to be covered 

and corrected through group training sessions and/or periodic 

self-study programs. 

The actual editing procedures have remained fairly consistent through this period. The changes that have occurred 

generally resulted either for clarification of procedures or to 

accommodate changes in the NHIS questionnaires. Copies of 

the forms used for recording interviewer errors found during 

the regional ofilce editing are in appendix X. 

Measures of interviewer performance 

In the preceding sections of this chapter the activities for 

controlling the quality of survey results have been presented. 

Results from these quality control activities are combined with 

other data to provide an overall evaluation of interviewer performance. 

The measurement of interviewer performance in the NHIS 

is a combination of subjective ratings by supervisors and quantitative measures based on an examination of an interviewer’s 

completed work. Minimum standards of performance on the 

quantitative measures are established and a cumulative record 

of performance for each interviewer is maintained in the regional 

office of the U.S. Bureau of the Census. If, at any time, this 

record indicates that an interviewer’s work has fallen below the 

minimum standard, corrective action is taken. This corrective 

action may consist of retraining, observation, or, in some cases, 

replacement of the interviewer. In practice the evaluation of 

interviewer performance is based on the pattern of performance 

over time and on diRerent aspects of the interviewing job rather 

than performance on any single aspect. 

In the NHIS, three quantitative measures of performance 

are computed on a continuing basis. They are the edit error 

score, the noninterview rate, and the production ratio. The edit 

61 
error score is computed as follows: (number of errors)/(number 

of questiomaires edited -1-total conditions, doctor visits, and 

hospitalizations reported). The numerator is the number of errors 

identiiled during editing. Errors include omitted entries, missed 

conditions, missed hospitalizations, and diagnostic errors. 

Missed conditions and missed hospitalizations are those identified in the early or probing section of the interview but not 

followed up for additional information in the latter sections of 

the interview. Diagnostic errors occur when the interviewer 

fails to record sufficient information to allow a medical coder 

to assign diagnostic codes. 

The noninterview rate is computed as follows: (number of 

type A noninterview households)/(number of interviewed 

households -1-number of noninterviewed households). The type 

A noninterview households are households eligible to be included in the NHIS, but for which no interview was conducted. 

Included as noninterviews are those the interviewer has reported 

as “refusals,” “no one at home,” “temporarily absent,” and so 

forth. 

The production ratio is calculated as follows: (estimated 

time based on production standards)/(actual payroll time charged 

by the interviewer). The numerator is estimated from an equation that takes into account such factors as the average time per 

household, the number of assigned households, and the distance 

to area of assignment from interviewer’s home. The production 

guide is shown in appendix XI. Appendix XII contains a copy 

of Form 11–39 (NHIS), Summary of HIS Interviewer Performance. 

In addition to quantitative measures used to evaluate interviewer performance, the results of supervisory reinterviews 

and observations are used as much as possible. Also, if specific 

individual interviewer errors are discovered during the editing, 

they are noted and forwarded to the regional supervisor. He or 

she in turn informs the interviewer of these errors and suggests 

means of eliminating them. 

After a probationary period of 6 months, each interviewer 

receives a report on her performance over the past quarter. See 

appendix XIII for a copy of Form 11–40, Notification of Interviewer Performance. The report contains a descriptive rating 

and a numerical score. The descriptive ratings are “Excellen~” 

“Satisfactory,” “Needs improvement,” or “Unsatisfactory.” 

If an interviewer receives a rating of “Needs improvement” or 

“Unsatisfactory,” she will receive a warning notice and face 

possible termination unless, in the judgment of her supervisor, 

there are extenuating circumstances. 

Coding, keying, and computer editing of data 

After checking interviewer assignments and performing 

manual edits on the questionnaires the regional oi%ces of the 

U.S. Bureau of the Census send the forms to NCHS for processing. After a check-in process to determine that all units are 

accounted for, questionnaires are coded onto transcription 

sheets. (See appendix XIV for an example of a transcription 

sheet.) Detailed coding instmctions and coding keys are prepared for the purpose of translating the questionnaire responses 

into numbers. The codes on the transcription sheet are then 

keyed and transferred to computer files. The transcription sheet 

was not used for the 1978–79 Smokmg Supplements and the 

1983 Alcohol Supplement in these cases the questionnaires 

were preceded (that is, numerical codes for response categories 

were printed on the questionnaires beside the responses) and 

the questionnaires were directly keyed. 

There are quality control procedures for coding and keying. 

As for keying, the transcription sheet is keyed by a contractor 

with 100 percent dependent verification performed with the 

keystroke verifier correcting any wrong keystrokes made by the 

entry operator. The supplement books, which are directly keyed 

(bypassing the coding) onto a transcription sheet, are 100 percent dependently ve$led, which provides keystroke verification 

and coding veriilcation on all items. Errors are recorded and 

error rates assigned for both keystroke and coding errors. 

From 1975 through 1981 the quality check on the coding 

process involved having a systematic 10-percent sample of the 

questiomaires recoded independently by two additional coders. 

A “majority concept” was employed in which error rates were 

computed assuming that if one coder’s work was different from 

that of the other two coders, the disagreeing code was in error. 

If the error rate for a batch of questionnaires (about 95) exceeded 5 percent, the entire batch was adjudicated by a fourth 

person (adjudicator). If the error rate for a particular type of 

page exceeded 12 percent, the pages involved were adjudicated. 

Coder error rates by page type and overall item error rates 

were computed and reviewed by the coding supervisor to verifJ 

that no coders needed remedial action, such as retraining. 

Starting in 1982, the coding quality control check was changed 

so that only 5 percent of the work was recoded independently 

by only one other ceder. This meant that discrepancies were 

coded by a third coder, who is a senior coder, to determine 

whether code 1 or 2 was in error. Again, batches with error 

rates in excess of 5 percent and page types in excess of 12 

percent were adjudicated by a fourth person. The cutback to a 

5-percent verification by only one coder was made for budgetary 

reasons. 

As mentioned above, detailed written instructions are provided to coders for assigning codes to questionnaire responses. 

The coding of medical conditions is based on the World Health 

Organization’s International Class@cation of Diseases (ICD). 

From 1969 through 1978 the Eighth Revision International 

Classz3cation of Diseases was used to develop codes for the 

NHIS.3S Beginrdng with the data collected in 1979, the 9th 

Revision39 of the ICD was used. Although the ICD is used as 

the benchmark for coding conditions reported in the NHIS, 

NHIS must provide coders with a great deal of additional instruction because lay responses must be converted into the 

codes reflecting the medical terminology in the ICD. An additional coding manual for medical conditions is also used by 

NHIS coders.40 

After the NHIS data are coded and keyed, a substantial 

amount of processing by computer occurs before the data are 

analyzed. A major portion of this processing falls into the area 

of editing for inconsistencies in data items. For inconsistent 

codes other available data on the data tape are used to make 

corrections. Where there is insufllcient additional information 

on the data tape, the inconsistent code is usually assigned to 

the unknown category. Unless there are major patterns or large 

numbers of inconsistencies, the source documents (the ques62 
I


tionnaires) are not referenced to resolve problems. This procedure is used because, with the large volume of data processed 

in the NHIS, individual record correction at this stage of 

processing is very expensive. This procedure results in all records 

being handled in the same manner so that all problems of the 

same type are resolved in a consistent way. “Decision logic” 

tables are prepared to guide the programming of the editing 

steps. These decision logic tables become a part of the permanent record of the processing of data. 

Another large task in the processing of the data is the 

matching and merging of the data files (for example, the supplement data for an individual with the core data for the same 

individual) and the resolution of “mismatches” or cases in 

which part of the data appears to be missing. Still another major 

task is the assignment of weights and the adjustments for nonresponse. (See chapter 2 in section I for an explanation of the 

weighting and adjustment procedures.) 

Once the data files are considered complete and cleaned, 

individual identifiers are removed and public-use tapes with 

accompanying documentation are prepared. 

Confidentiality provisions 

Since its inception NCHS has worked diligently to maintain 

the contldentiality of its records. This effort has succeeded 

there is no known case of this cofildentiality having been 

breached, While it is a matter of principle for NCHS to maintain the confidentially of records, a set of laws and regulations 

exists that requires and/or permits NCHS to do S0.41 

Section 308(d) of the Public Health Services Act (42 

U.S.C. 242m) provides the basic legal requirements for protecting the Center’s records. It reads in pm 

No information,if an establishmentor personsupplying 

the informationor describedin it is identified,obtained in 

the courseof activitiesundertakenorsupportedundersection 

304, 305, 306, 307, or 309 may be used for any purpose 

other than the purpose for which it was supplied unless such 

establishment or person has consented (as determined under 

regulations of the Secretary) to its use for such other purpose 

and (1) in the case of information obtained in the course of 

health statistical or epidemiological activities under section 

304 or 306, such information may not be published or released in other form If the particular establishment or person 

supplying the information or described in it is identifiable 

unless such establishment or person has consented (as determined under regulations of the Secretary) to its publication 

or release in other form . . . 

Whenever the Center requests information, it apprises 

the person or agency supplying the information as to the 

uses to be made of it. (Normally, the specitled uses are 

limited to statistical research and reporting,) The first clause 

of Section 308(d) guarantees that thereafter the Center will 

be limited to those uses so specified to the supplier. Moreover, the information obtained may be used only by staff of 

NCHS, or its qualified agents, in the pursuit of such stated 

purposes, and by them only in activities directly aimed at 

achieving those specific purposes. 

The second clause states that the Center may never 

release identifiable information without the advance, explicit 

approval of the person or establishment supplying the information or by the person or establishment described in the 

information. 

The Privacy Act of 1974 (5 U.S.C. 552a.) also provides 

for the confidential treatment of records of individuals maintained by a Federal agency according to either the individual’s 

name or some other identi17er.This law also requires that such 

records in NCHS are to be protected from uses other than 

those purposes for which they were collected. It further requires 

agencies to (a) collect only that information necessary to perform 

agency functions, (b) publish descriptions of existing data systems (called “systems of records”) so that the public can learn 

what records are mtitained by the agency, (c) inform individuals at the time of data collection as to the legislative authority under which it is requested, whether the request is mandatory 

or voluntary, the consequences, if any, of nonresponse,. and the 

purposes and uses to be made of the data, (d) maintain no 

records on how an individual exercises his or her rights under 

the first amendment except with special legal authorization, 

(e) with certain exceptions, permit individuals to examine 

records maintained about themselves and to challenge the accuracy of those records, (f) establish rules of conduct governingpersons involved in collecting and maintaining records, 

and (g) establish appropriate administrative, technical, and 

physical safeguards to protect records. Employees of agencies 

and their contractors subject to the act who willfully disclose 

personal information cpntrary to the law, or who fail to give 

notice of a system of records, maybe fined up to $5,000, and 

the agency may be sued for damages. Finally, the act places 

severe restrictions on the use of an individual’s Social Security 

number. 

The Department of Health and Human Services has allowed NCHS to have a “K-4 exemption” for its statistical 

systems, as permitted under the Privacy Act. This means that 

NCHS does not have to allow subjects of its data files to have 

access to the records about themselves in those files. This exception to Privacy Act requirements is permitted because 

NCHS does not have in its data files any records that are used 

in any direct way to affect the persons whose records exist in 

these files; rather, the files are used strictly for statistical and 

related purposes. NCHS, however, must comply with all other 

requirements of the Privacy Act, 

The Federal Law Governing Federal Employees’ Behavior 

(18 U,S.C. 1905) includes the following provision, which is 

also relevant to the maintenance of contidentislity for NCHS 

records: 

Disclosure of Cotildential Information 

Whoever, being an ot%ceror employee of the United States 

or any department or agency thereof, publishes, divulges, 

discloses or makes known in any manner or to any extent 

not authorized by law any information coming to Km in the 

course of his employment or official duties or by reason of 

any examination or investigation made by, or return, report 

or record made to or filed with, such department or agency 

or officer or employee thereof, which information relates to 

trade secrets, processes, operations, style of work, or apparatus, or to the identity, confidential statistical data, 

amount or source of any income, profits, losses, or expenditures of any person, firm, partnership, corporation or asso63 
ciation, or pennits any income return or copy thereof or any 

book containing any abstract or particular thereof to be seen 

or examined by any person except as provided by law, shall 

be fined not more than $1,000 or imprisoned not more than 

one year, or boti, and shall be removed from ot%ce or employment. 

The Freedom of Information Act (5 U.S.C. 552), which 

was first passed in 1967 and amended in 1974, requires Federal agencies to make their records available to persons who 

request them. Some have speculated that this law undoes the 

privacy protection required under the laws just cited. However, 

such a view is mistaken, because several kinds of records are 

specifically exempted from the disclosure requirements of the 

Freedom of Information Act. Two exclusions provided in section 552(b) of the act are of special relevance: Subsection (6) 

exempts “personal and medical files and similar files the disclosure of which would constitute a clearly unwarranted invasion of personal privacy” and subsection (3) provides that 

matters “specifically exempted from disclosure by statute” are 

also excluded from the disclosure requirement. Thus no records 

that are protected from disclosure are required by the Freedom 

of Information Act to be released to anyone. 

Because the U.S. Bureau of the Census is the data collection agent of NCHS, it is required to abide by the above laws 

and regulations. In addition, it is bound by the confidentiality 

provisions of Titles 13 and 42. 

64 
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I 

lNational Center for Health Statistics: The statistical design of the 

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73-1270. Public Health Service. Washington. U.S. Government 

Printing Office, Jam 1969. 

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65 
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34C. O. Gibson, G. M. Shapiro, L. R Murphy, and G. J. Strmlax 

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pp. 251-256. American Statistical Association, 1978. 

35D. C. Cowan, L. R Murphy, and J. Weiner: Effects of supplemental 

questions on victimization estimates from the National Crime Survey, 

Proceedings of the Section on Survey Research Methods, pp. 277-

282. American Statistical Association, 1978, 

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/’ 

66 
Appendixes 

I. Census regions, census divisions, and States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

IL Tabulation areas.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

111, Control and experimental questiomaire data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

IV. 

v. 

VI. 

VII. 

VIII. 

IX. 

x, 

XI. 

XII. 

Selected supplements, 1975–83. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

FamilyMedical Expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

CostofHealthCare, 1974 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Costof Healti Care. 1977 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Subsarnple selectionintewiew aids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Preinterview letterto sample households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Postintewiew letter to sample households. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

ObservationReport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

HIS reinterviewforms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Reinterview Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

68 

69 

70 

73 

73 

75 

78 

81 

84 

88 

92 

93 

95 

96 

97 

97 

ReconciliationRecord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 

Summary ReportofHIS Reinterview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 

Forms for recording interviewer errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 

HIS Tally ofNondiagnostic Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 

HIS Diagnostic Errors onConditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 

HIS Diagnostic Errors onDoctorVisits/Hospitalizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 

HIS Production Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 

Summary ofHISInterviewerPerforrnance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . 125 

XIII, Notification ofInterviewerPerforrnance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 

XIV. Transcriptionsheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 

Table 

1,	 Comparison of statistics produced by the control and experimental questionnaires, fourth quarter, 1979, unweighed 

data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 
Appendix 1 

Census regions, 

census divisions, and States 

Northeast Region 

New England Division 

Comecticut New Hampshire 

Maine Rhode Island 

Massachusetts Vermont 

Middle Atlantic Division 

New Jersey Pennsylvania 

New York 

North Central Region 

East North Cantral Division 

Illinois Ohio 

Indiana Wisconsin 

Michigan 

West North Central Division 

Iowa Nebraska 

Kansas North Dakota 

Minnesota South Dakota 

Missouri 

South Region 

South Atlantic Division 

Delaware North Carolina 

District of Columbia South Carolina 

Florida Virginia 

Georgia West Virginia 

Maryland 

East South Central Division 

Alabama Mississippi 

Kentucky Tennessee 

Wast South Central Division 

Arkansas Oklahoma 

Louisiana Texas 

West Region 

Pacific Division 

Alaska Oregon 

California Washington 

Hawaii 

Mountain Division 

Arizona Nevada 

Colorado New Mexico 

Idaho Utah 

Montana Wyoming 

68 
I 

Appendix II 

Tabulation areak 

Tabulation areas consist of the 11 sections, each divided 

into 3 parts, plus the largest self-representing standard metropolitan statistical areas (SMSA’S). The number of sections and 

divisions has been constant over the course of the surveyq the 

number of large self-representing SMSA’S has changed. 

Eleven sections 

The 11 sections exclude self-representing SMSA’S and 

each is divided into 3 parts: 

Section 1 New England 

01 Aggregate of SMSA’S 

02 Other urban 

03 Rural 

Section 2 Middle Atlantic 

Section 3 East North Central, Eastern Part 

Section 4 East North Central 

Section 5 West North Central 

Section 6 South Atlantic, Upper Part 

Section 7 South Atlantic, Lower Part 

Section 8 East South Central 

Section 9 West South Central 

Section 10 Mountain Section 

Section 11 Pacific Section 

Large self-representing SMSA’S 

Boston 

New Yorkb 

Philadelphia 

Pittsburgh 

Detroit 

Chicagoc 

Cincinnati 

Los Angeles-bng Beach 

San Francisc&Oakland 

Baltimore 

Atlanta 

Buffalo 

Cleveland 

Minneapolis-St. Paul 

Milwaukee 

Kansas City 

St. Louis 

Houston 

Dallas 

Washington, D.C. 

Seattle-Everett 

San Diego 

Anaheim-Santa Aria-Garden Grove 

Miami 

Denver 

San Bernardino-Riverside-Ontario 

Indianapolis 

San Jose 

New Orleans 

Tampa-St. Petersburg 

Portland, Oreg. 

%ortheestem New Jersey Consolidated Area. 

%TorthwestemIndiana Consolidated Area. 

69 
Appendix 1II 

Control and experimental 

questionnaire data 

Table 1. Comparison of statistics producad by the control and experimental questionnaires, fourth querter, 1979, unweighed data 

[Caution should be exercised in drawing inferences from the comparisons of the experimental and control questionnaires to the final instrument fielded in 1982, especially 

on estimates coming from topics that had such changea. Estimates on disability daya associated with conditions are not shown because the questionnaire approach 

was very different in the experimental questionnaire; this approach was changed after the evaluation test to be verv similar to the wav it was in tha control 

questionnaire] 

NHIS NHIS 

control Experimental control Experimental 

Topic and person characteristic questionnaire questionnaire Topic and person characteristic questionnaire questionnaire 

HOSPITAL DISCHARGES PERSONS WITH ANY LIMITATION 

PER 100 PERSONS OF ACTIVITY, I PERCENT 

All persons . . . . . . . . . . . . . . . . . . . . . . 14.0 13.9 Allperaons . . . . . . . . . . . . . . . . . . . . . . 14.4 13.6 

Age Male 

Under 17yaars . . . . . . . . . . . . . . . . . . . 6.6 6.9 Alleges . . . . . . . . . . . . . . . . . . . . . . . . . 14.8 13.5 17-24 years . . . . . . . . . . . . . . . . . . . . . 15.2 12.4 

25-34 years . . . . . . . . . . . . . . . . . . . . . 15.4 15.5 Under 17yaars . . . . . . . . . . . . . . . . . . . 4.7 5.3 

35-44 years . . . . . . . . . . . . . . . . . . . . . 13.2 14.1 17-44 years . . . . . . . . . . . . . . . . . . . . . 9.0 6.9 

45-64 years . . . . . . . . . . . . . . . . . . . . . 16.4 17.5 

45-64 years . . . . . . . . . . . . . . . . . . . . . 25.8 24.8 

65 years and over . . . . . . . . . . . . . . . . . 25.8 25.6 65 years and over . . . . . . . . . . . . . . . . . 48.5 36.7 

Female Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.6 11.7 Alleges . . . . . . . . . . . . . . . . . . . . . . . . . 14.1 14.0 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . 16.2 15,8 Under 17 years . . . . . . . . . . . . . . . . . . . 3.0 5.1 

17-44 years . . . . . . . . . . . . . . . . . . . . . 8.3 8.8 

45-64 years . . . . . . . . . . . . . . . . . . . . . 22.5 24.9 

AVERAGE LENGTH OF 65 years and over . . . . . . . . . . . . . . . . . 43.2 32.7 

HOSPITAL STAY, DAYS 

All persons, . . . . . . . . . . . . . . . . . . . . . 7.7 6.9 PERSONS WITH MAJOR 

ACTIVITY LIMITATION,’ PERCENT 

Sex All persons . . . . . . . . . . . . . . . . . . . . . . 10.7 9.0 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1 7.1


Female . . . . . . . . . . . . . . . . . . . . . . . . . . 6.8 6.7 Male


Alleges . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 9.0 

PERSONS WITH ONE OR MORE Under 17 years . . . . . . . . . . . . . . . . . . . 2.5 3.4 

HOSPITAL EPISODES, PERCENT 17-44 years . . . . . . . . . . . . . . . . . . . . . 5.4 6.4 

45-64 years . . . . . . . . . . . . . . . . . . . . . 20.9 20.0 All persons . . . . . . . . . . . . . . . . . . . . . . 7.7 6.9 65 years and over . . . . . . . . . . . . . . . . . 43.0 14.9 

Sex Female 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1 7.1 Alleges . . . . . . . . . . . . . . . . . . . . . . . . . 10.3 9.0 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . 6.8 6.7 

Under 17 years . . . . . . . . . . . . . . . . . . . 1.3 3.0 

NUMBER OF NIGHTS IN 45-64 years . . . . . . . . . . . . . . . . . . . . . 16.9 18.4 

HOSPITAL—PERCENT OF PERSONS 65 years and over . . . . . . . . . . . . . . . . . 35.2 17.6 

REPORTING STAYS 

RESTRICTED ACTIVITY DAYS 

Age PER PERSON PER QUARTER 

l-3 years . . . . . . . . . . . . . . . . . . . . . . . 36.5 36.8 All persons . . . . . . . . . . . . . . . . . . . . . . 4.9 4.6 

4-5 years . . . . . . . . . . . . . . . . . . . . . . . 20.2 20.6 

6-7 years . . . . . . . . . . . . . . . . . . . . . . . 14.3 14.4 Male 

8-14years . . . . . . . . . . . . . . . . . . . . . . 

15-21 years . . . . . . . . . . . . . . . . . . . . . 

18.6 

5.4 

17.4 

5.3 Us ages . . . . . . . . . . . . . . . . . . . . . . . . . 4.3 4.2 

22-30 years . . . . . . . . . . . . . . . . . . . . . 2.4 2.3 Jnder17 years . . . . . . . . . . . . . . . . . . . 2.9 3.6 

17-44 years . . . . . . . . . . . . . . . . . . . . . 5.4 5.6 

31 years and over . . . . . . . . . . . . . . . . . 2.7 2.9 17-24 yaars . . . . . . . . . . . . . . . . . . . . . 3.1 3.3 

lQuestionnaira topic in which major changea were made after evaluation test. 

70 
Table 1. Comparison of statistics produced by the control and axparimental questionnairea, fourth quartar, 1979, unweighed data—Con. 

[Caution should be exeroised in drawing infarcmces from the comparisons of the exparimantal and control questionnaires to the final instrument fialded in 1982, eapscielly 

on estimates coming from topice that had such changas. Eatimataa on disability days aasociatad with conditions ara not ahown bacauaa the questionnaire approach 

waa vaw diffarent in the experimental cruestionnair~ this armroach waa changed after the evaluation tast to be vew similar to the wav it was in the control 

qusationnaire] 

NHIS NHIS 

control Experimental control Experimental 

Topic and person characteristic questionnaire questionnaire Topic and person characteristic questionnaire questionnaire 

RESTRICTED ACTIVITY DAYS DOCTOR VISITS 

PER PERSON PER QUARTER—Con. PER 100 PERSONS 

Male—Con. All persons . . . . . . . . . . . . . . . . . . . . . . 120 130 

26-44 years n,ti. ,$, .o, . .,.,$..,.. 3.5 3.7 Age 

46-64 years, .,, . . . . . . . . . . . . . . . . . 6.3 5.3 Under 17 years .,, , . ., . . . . . . . . . . . , 110 110 . 

65yesrs and over. . . . . . . . . . . . . . . . . 8.9 6.1 17-24 years . . . . . . . . . . . . . . . . . . . . . 100 120 

25-44 years . . . . . . . . . . . . . . . . . . . . . 120 130 

Female 45-64 years . . . . . . . . . . . . . . . . . . . . . 130 150 

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . 5,5 5.0 65 years and over, ,,, .,.,..... .,, . 150 180 

Under 17yaars, . . . . . . . . . . . . . . . . . . 3.1 4.2 Sex 

17-24 yeare . . . . . . . . . . . . . . . . . . . . . 

25-44 yeare . . . . . . . . . . . . . . . . . . . . . 

4.0 

5.2 

3.6 

4.7 Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 110 

45-64 ye8rs . . . . . . . . . . . . . . . . . . . . . 7.1 5.9 Female. ., . .,, . . . . . . . . . . . . . . . . . . . 130 150 

65yeara and over. . . . . . . . . . . . . . . . . 10.3 7.3 

PERCENT INDICATING DOCTOR 

ACTUALLY SEEN 

BED DAYS Yes . . . . . . . . . . . . . . . . . . . . . . . . . . ,. 86 79 

All persons.,..,,...,...,..,..,.. 1.8 1.8 No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 19 

Male PL4CE OF DOCTOR 

CONTACT, PERCENT AT— 

Alleges ..,,.,....,..,..,,..,.. . . 1.4 1.5 Doctor’s office . . . . . . . . . . . . . . . . . . . 69 52 

Under 17yeers, ,,, , . ., .,, ..,..... 1.2 1.2 Telephone, . . . . . . . . . . . . . . . . . . . . . . 12 17 

17-24 yeers, , . . . . . . . . . . . . . . . . . . . 1.2 1.0 Home . . . . . . . . . . . . . . . . . . . . . . . . . ,. 0.3 2 

25-44 years . . . . . . . . . . . . . . . . . . . ., 1.0 1.3 Hospital . . . . . . . . . . . . . . . . . . . . . . . . . 13 18 

45-64 yaars . . . . . . . . . . . . . . . . . . . . . 1.7 1.7 

65 years and over, . . . . . . . . . . . . . . ,. 3.3 3.0 DOCTOR CONTACTS PER 100 

PERSONS ACCORDING TO 

Female PHYSICIAN SPECIALTY 

Alleges . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 2.0 General practitioner. . . . . . . . . . . . . . . 56.0 54.6 

Under 17yaars, . . . . . . . . . . . . . . . . ,. 1.5 1.6 Pediatrician . . . . . . . . . . . . . . . . . . . . . . 12.6 10.8 

17-24 yeers . . . . . . . . . . . . . . . . . . . . . 

25-44 years . . . . . . . . . . . . . . . . . . . . . 

45-64 yeers . . . . . . . . . . . . . . . . . . . ,. 

1.7 

2.3 

2.3 

1.5 

1.9 

2.3 

Obstetrician/gynecologist . . . . . . . . . . 

Dermatologist . . . . . . . . . . . . . . . . . . . . 

Psychiatrist . . . . . . . . . . . . . . . . . . . . . . 

7.7 

2.2 

1.0 

7.9 

2.2 

3.1 

65 years and over . . . . . . . . . . . . . . . . . 3.4 3.6 Ophthalmologist . . . . . . . . . . . . . . . . . . 2.3 4.1 

Other, . . . . . . . . . . . . . . . . . . . . . . . . . . 23.6 37.7 

WORK-LOSS DAYS 12-MONTH BED DAYS 

All persona . . . . . . . . . . . . . . . . . . . . . . 1.2 1.6 o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1-7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

53 

35 

56 

32 

Male 8-30 . . . . . . . . . . . . . . . . . . . . . . . . . . . 

310r more . . . . . . . . . . . . . . . . . . . . . . 

9 

2 

9 

2 

Alleges .,.........,.,.......,,. . 1.2 1.5 

17-24 years . . . . . . . . . . . . . . . . . . . . . 

25-44 yesrs . . . . . . . . . . . . . . . . . . . . . 

1.2 

1.0 

1.2 

1.3 

12-MONTH DOCTOR VISITS, 

PERCENT REPORTING— 

45-64 yaars . . . . . . . . . . . . . . . . . . . . . 1.4 2.0 None . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.0 24.7 

65yeara and over. . . . . . . . . . . . . . . . . 1.4 0.8 1-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.2 37.5 

3-4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.9 15.1 

Female 5-12 . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.9 16.4 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 1.9 

17-24 years, . .,, . . . . . . . . . . . . . . . , 0,9 1.6 

25-44 yeere . . . . . . . . . . . . . . . . . . . . . 1.5 1.9 HEALTH STATUS,l PERCENT 

45-64 years, . . . . . . . . . . . . . . . . . . . . 1.2 1.8 REPORTING— 

65years end over. . . . . . . . . . . . . . . . . 1.5 2.3 

Excellent . . . . . . . . . . . . . . . . . . . . . . . . 48.0 36.0 

Very good . . . . . . . . . . . . . . . . . . . . . . . NA 28.0 

SCHOOL-LOSS DAYS Good . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Fair . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

39.0 

10.0 

21.0 

All agea. ,, ., .,, . . . . . . . . . . . . . . . . . 1.3 1.8 130r more . . . . . . . . . . . . . . . . . . . . . . 4.8 4.3 

Peraons under 17 years, . . . . . . . . . . . 1.6 1.5 Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.0 % 

71 
Table 1. Comparison ofstatistics produced bythecontrol endexperimentel questionnairaa, founh quatier, 1979, unweighted dete—Con, 

[Caution should be exercised in drawing inferences from the comparisons of the experimental and control questionnairaa to the final inatrumant fielded In 1982, @apacl@lly 

onestlmates coming from topics that hadsuch changea. Estimates ondiaability dayaasaociated with conditions are not shown becauas thequastionneire approech 

waa vary differant in tha experimental queationnaira; this approach was changed aftar the evaluation test to be very similar to the way it was in the control 

questionnaire] 

NH/S NHIS 

control Experimental control Experimental 

Topic and person characteristic questionnaire questionnaire Topic and person characteristic questionnaire questionnaire 

ACUTE CONDITION INCIDENCE, SELECTED CHRONIC CONDITIONS, 

NUMBER PER 100 PERSONS NUMBER PER 100 PERSONS 

All persons.,.,,.,.,,..,....,,,.. 59 55 Chronic bronchitis, .,..,,,,,.,,, ., 4 5 

Heart conditions . .,, . . . . . . . . . . . . ., 8 10 

Age Views] impairment . ..0..0.. .0 . . . . . 4 3 

Under 6 years . ., . . . . . . . . . . . . . . . ., 97 99 Hernia . . . . . . . . . . . . . . . . . . ,,, ..,., 2 2 

6-16 yesra .,, ., ., .,, . .,, ..,..,. , 77 68 Arthritis ..,,,,,,,, ,,, ,,, ,,, ,, ,,, , 12 13 

17-44 yeara . . . . . . . . . . ...,,.,, . . . 63 53 Diabetes .,, ,,, , . .,, ,, . .,, ,., ..,, 2 2 

45yeere and over,.......,...,.. ,, 34 36 

72 
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Appendix IV 

Selected supplements 

1975-83 

O.M.B. f40. 68-RISQO; Approval Expires March 31, 1976 

FORM HIS-l A(AS) NOTICE - All information which would permit identification of the individual will be held in strict 

,.,,.,4, confidence, will be used only by perscms engaged i“ and for the purposes of the survey, and will us. DEPARTMENT OF COMMERCE not be disclosed or released to others for any purposes. sOCIAL AND ECONOMIC STATISTICS 

ADMINISTRATION a. Psu b. ~mmd c. Serial d. P&&r n. Name of person f. BUREAU OF THE CENSUS 

AC,, NG As .0!-! .!s.,,.. A..., ,0. ,!4s 

number 

“.s. PUSLIC HE4L71+ SERVICE 

ACCIDENT SUPPLEMENT 

U.S. HEALTH INTERVIEW SURVEY I I I I I Page of page 

) Complete o seporate column t each occident in questi.an3 of the INJuRY PAGE, fflS-l, pag.e 30. 

a. You ~;$)rne that had_ accidents since 

On about what date did he have the 

(last, next) ac;ident? 

L	 Which olthese accidents cauaedthe. ..you 

Ioldmeabout earlief? (Record therrumbe~of 

the Condition !n the appropriate column.) 

BI 

la, How many times did see or tal~$ a do;tor 

as a result of the accident on 

b.	 How many days did cut down for as much as a day? 

la.	 Where did FIRST aee or talk to the doctor - at a clinic, hospital, doctor’s office, or some 

other place? 

Ifhospltal: Wasitahoapital outpatient clinic 

or the emergency room? 

lfclinirx Wasitahospital otttpatieotctinic, 

a company clinic, otaome other kind of clinic? 

b.	 As a result of thie aesident, did ever go to 

a hospital emergency room? 

ia.	 How many days did cut down for as much aa a day? 

b.	 How many days did Ihls accident keep him 

in bed all or most of the day? 

If 17+, ask: 

C. HOWmany days didthis accident keep --from work? 

(Fnr females): notcorrnting work around tho house? 

If 6-16, ask: 

d.	 How many days did this accident keep 

from school? 

ia.	 At the time of the accident, what part of the body 

was hurt? 

b, What kind of inJury was it? 

c. Did he have any other injuries in this accident? 

1, Whefedid the accident happen? 

1.	 Was-- atworkat hisjobor business when the 

accident happened? 

Month Date Year Month Date Year 

197 _ 197_ . . . . . . . . . . . .-.”.”--.--.-””- .— —-------- ------. 

� 1+ conditions circled in item C(2) 

mNoconditions circled in item C(s) 

Condition number 

� Condition number in 2 (9) 

� No condition number in 2 (q 

_ Visits f4) 000 fg None 

—	 Oays f5b) 

00D None (Next ace.) 

on While inpatient in hospital 

! �	 Doctor’s office (group pfactice or doctor’s clinic) 

zU Telephone


So Hospital outpatient clinic


4(3 Home


sn Hospital emergency room(s)


GU Company nr industry clinic 

7 � Other - .Wec}fy 

lY 2N 

_ Oays 

IO � Nnne (6) 

_ Days 

ooig None 

— Oays (6) 

ao � None (6) 

—.—Days 

so � None 

Pan of bcdy ~ 

1 

I aAthome (inside house) 

2 � At home (adjacent premises) 

3fg	 Street and highway (includes roadway 

and orrblic sidewalk) 

4D Farm 

s~lndrrstr!al place (mcludasprem!ses) 

Em School (irrcludes premises) 

7 ~ Place of recreabon and sports, except school 

s ~ Other - S@c/fy i 

1 Y (12) 3 _JWhde in ArmedSerwces 112) 

2 N frz) 4~ Under 17 at time of accident 112J 

continue on reverse side 

Condition number 

u Condition number in 2 (9) 

� No condition number in 2 f3) 

_ Visits (4) ocmn None . 

_ Days (5bJ 

)oU N0rV2(Nextacc.) 

o � While inpatient in hospital 

I �	 Doctor’s office (group practice or 

doctor’s clinic) 

zfg Telephone 

30 Hospital outpatient clinic


40 Home


so Hospital emergency room(q


6fg Company or industry clinic 

7 fg Other - specify 

IY 2N 

— Oays

N � None (6) 

_ Days 

~n None 

— Oays (6) 

)on N0h(6) 

_ Oays 

10= None 

Part of body I Kind of injury 

I 

1 

1 

I � At home (inside house) 

2U At home [adJacent pramises) 

3a	 Street andhighway (includes roadway 

and !xrbiic sidewalk) 

4~ Farm


so Irrduskial place (includes prem!ses)


6 � School (includes premises)


70 place ofrecreat[on andsports, except school 

e � Other - .sF@fy J 

I Y (f2J 3 � While in Armed Services (72) 

2 N (12) 4~ Under 17 at time of accident ffz, 

73 
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--------------------------------- --------------------------------- ----- ----

--------------------------------- --------------------------------

--

--------------------------------- -------------------------------- -------------------------------

--------------------------------- -------------------------------- -------------------------------

-- --------------------------------- ------------------------------- -------------------------------

--------------------------------- -------------------------------- -------------------------------

--

1,	 Howmany times did--aee ortalkto a doctor 

aaaresult of the accident on (dafe) ? _ Visits 000 � None [11) 

Da. Where did FIRST see or talk to the doctor - on Wrile inpatient in hospital 

at a clinic, hospital, doctor’s office, orsorne I � Doctor’s office (group practice other place? or doctor’s clinic) 

If hospital: Waaitahoapltal outpatient clinic znTelephone 

or the emergency room? an Hosp{tal outpatient clinic 

4D Home 

If clinic: Wasitahospltal orrtpafient clinic, e � Hospital emergencyroomf 11) 

a company clinic, or some other kind of clinic? 6D COMp+Iy or industry ChfllC 

7 � Other- XIfY 

_vlslh omn None(11) 

on While inpaherd in ho:pital 

I �	 Doctor’s office (group prachce 

or doctor’s chmc) 

2U Telephone 

3 � Hospital outpatient clinic 

~nHome 

5 � Hospital emergencyroom(111 

6D COMP20yor industry CiliIIC 

7 � Other - .spacIry 

. . . 

b.	 Aa a result of Ibis accideot, did ever go to a hoepital emergency room? lY ZN 9Y 2N 

If accident happened in paat 2 weeks, go to 12. 

la. :fl m;; days did cut down for as much —Days —Days 

ow � None(12) ocon None (12) - . . 

b.	 How many days did this accident keep him in bed 

all or moat of the day? 

If 17+ ask: 

c.	 How manydaya did thla accident keep -- fromwork? 

(For femaleah nol counting work aroundthe hwse? 

[f 6-16, ask: 

d.	 How many daya did this accident keep 

from school? 

?a. Was a car, truck, bus or ofher motor vehicle 

involved in the accident in any way? 

b. Waa more than one vehicle involved? 

c. Was it (either one) moving at the time? 

— Days —Days 

ocen	 None :-g-None 

_Days (12) —Oays (72) 

cm � None(12) m � ‘one (’2J -

—Dsys —Days 

cca DNone c.ma None 

lY 2 N (14) lY 2 N (14) 

Y N Y f! 

IY 2N IY 2N 

)a.	 Waa -- outside the Vehicle, gett[ng in or out of it, I � Outalde (b) 3 � Passengerfc) t � Outside(b) 9 � Passenger(c) 

a passenger, or waa the driver? z= Getting in or out(o) 4nDriverfcJ z= Getting inoroutfo) 4DOrwer (c) 

b.	 What kind(s) of motor vehicle was frrvolved? ! � Car 4a Truck ! � Car 4nTruck 

ZD Taxi (74) 5 I_J Motorcycle 2D Taxi f14) 5 � Motorcycle (14 3DfNa } •Other-s@f~ }“ “4’ 3U Brra } � Other - SpSCIVJ 

} 

c. What kind of motor vehicle was in (getting 1� Car 41g Truck I � Car 4D Truck in or out of)?	 2D Taxi s � Motorcycle ZD Taxi s � Motorcycle 

3D em u Other - spaclti~ au Bus � Other - .SpaC/fYX, 

1. What was-- doing atthetime of the accident? 

5. Howdidthe accident happen? 

6.	 What product orobject came into contact with-­

and actually caused the injury? 1. 1. 

2. 2. 

3. 3. 

1.What olherproducts orobjects were involved 

in the accident? Anything else? 1. 1. 

2. 2. 

3. 3. 

3.	 Didanything else contribrrte totheaccident, such Y (Srsdfy) N (Next Acc.J Y (Srxci$f) N fNexl Ace. 1 

as weather, lighting conditions, and$m forth? L s 

FORM .1,., .,,,, ,9. !,.74) 

74 
O.M. B. N0.68-R16W, Appr0val Expires March 31, 1% 

1. NOTICE -All Informadon which would pefmit identification of the individual will beheld instrict .onfldence, will be.sed


only by persons en;ased in and for the purposes of the survey, and will not be disclosed or released to others for any purposes. Book_ of _books


FOJ407:IS-I(F) 2. R.O. number 3. Sample 4. Control number

Psu Segment Serial 

U.S. DEPARTNENTO FCOMMERCE 

� “REAU OF ,“C CSNSUS 

ACTING AS COLLECTING AG=NT FOR TM. 

U.S. PUBLIC HEALTH SERVICE 

5. Interviewer’s name , Code 

INFLUENZA SUPPLEMENT 1 

, 

U. S. HEALTH INTERVIEW SURVEY	 i 

I 

FOOTNOTES 

75 
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--

--

--

--

-------------------------------------------------------------------- ---

----------------------------------------------------------------------------- ---- -----------------

----

� 

AL Enter names andages ofallhousehold members from HIS-I. Age 

_______ Last name 

B3. Refer to all completed Condition pages-questions I and3a only. Mark the first appropriate *“ , � Flu 

box for each person and indicate condition number. [Influenza) 

$% , n &,we 

3� Virus C#d.

4 � Cold +“ 

snBronchNls } _ 

6 I_J None of the above 

It “None of the above” marked ;n B go to NP; Otherwise ASK: 

11. Earlier you told m- had (condition marked inB) inthopasttwoweoks. 1. IY 2N 

When had the . . . did he have a fwor? 

2L Did have a headache, muscle ache, cough, sore throat or runny nose? 2. ,y *N 

~ 31. Did havo diarrhta? 3. tY 2N 

If ‘‘Flu” or ““Grippe” marked in B go to NP; Otherwise ASK: 

4L During the past two wcsks (the two we~ks outlined in rcd on th~ calendctr) did havt 4. ,Y 2 N (NP) 

the flu (influenza) or grippe? 

5i. When did first notic* his . . . ? 5. , � Last week 

(Was it during th. past two we~ks or before that time?) 2 � Week Lwfore 

3 � F&sj;r::ks -

4 � 2 weeks-3 months 

s � Over 3 mcalhs 

6< i. When had the . . . did hc have a fovor? 6. lY 2N

7,‘. Did h.vc a h.adache, musclo ache, cough, sore throat or runny nose? 7. !Y 2N 

8.:. Did have diarrhea? 8. IY ZN 

9.‘. Has had a flu shot since August 1? 9. IY z N (NP) 

100I. When WaS this shot recsivcd? 10. 1 � In interview week 

(Was it during the past two wa*ks or bofart that time?) (Reask 10) 

2 � Last week ENTER ANSWER FOR FIRST SHOT IF MORE THAN ONE RECEIVED s � Wsek&fore 

4 � pasj;,$eks -

5 � 2 WeekS-l month 

s � Over 1-3 months 

7 H Over 3-6 months 

8 � OveI 6 months 

s � Never 

11.. Whert did reccivc th. flu shot? 11. t � Ooctor’s office 

(GrouP Pratt ice or DOctc#s clinic) 

z � Hospital outpatient 

Clinic or Efnxgency 

Rocin 

3 ~ Public Health Cl Inic 

b 13 Work 

s n School 

6 ~ Military Installation 

7 la Other -

specify 

12L How much did pay for the shot? 

12. LJJ.M 

0000 � NO char& 

13,L Was this shot for the swine flu? 13. IY ZN 9 OK 

c:. Transcri be for each person after I caving household c. 

1.	 Race (Qla] 1. IV/ 2B 3 OT ____ 

2. Sex (Qla) 2. ,M 2F - . 

3. Number of bed days (Q6 Cond. Page specified in B) 3. _ Days 00 � None 

ss � ~BdiN~; spec. 

. -_____________________________________________________________________________ _ 

4. Onset (Q9 Condition Page specified in B) 4. lo .~ 

20 so 

30 60 

Fe!,“” ... .

“,s. ... ,( .=, ,..,... ,. -. ”, . Paz. 2 

76 
------------ ------------ -------------

-------------------

-------------------

------------------ -----------------

------------------ -----------------

----------------- -----------------

-----------------

------------------- ------------------ ----------------- ------------------

First name @ ]Age 

1name 

L-­

last


I �	 Flu 

(Infloenza) 

2 I_J Grlpps C:od. 

lDVIIUS =}! 4nCold +’ 

s � Bronchitis } _ 

6 � None of the above 6 � Noneof the above

tY 2N JY 2N 

IY 2N IY 2N 

lY 2N lY 2N 

lY 2 N (NP) lY 2 N (NPJ 

t � Last
 week t � Last week

2 n Week before 2 � Week before


3 �pKs~f,geks - 3 � P&sj;,ps -


4 � 2 weeks-3 months 4 I_J 2 weeks-3 months


511 Over 3 months s � Over 3 months


lY 2N lY 2N 

IY 2N !Y 2N 

IY 2N lY 2N 

lY 2 N (NP) lY 2 N (NP) 

I �	 In interview week I � In interview week 

(Reask 10) (Reask 10J 

2 � fast week 2 � bst week 

* Q Week before 3 � Week before 

6 � ~Ksj;,:eks - 4 � ~Ksj:,~.!?ks -

5 � 2 WCek3-1 month s � 2 weeks-1 month 

6 � Over 1-3 months 6 � Over 1-3 months 

7 � Over 3-6 months 7 � Over 3-6 months 

a � Over 6 months 8 � Over 6 months 

s � Never s � Never 

1 � Ooctw’s office t � Doctor’s of flea 

(Group Practice or (Group Practice or 

Ooctor’s Clinic) Doctor’s Clinic] 

2 �	 Hospital outpatient 2 � Hospital outpatient 

clinic or Emergercy ::;: or Emergemy 

Rocm 

3 � Publ Ic Health Clinic 3 � Public Health Clinic 

4 � Work 4 � Work 

s � Schaol s � School 

6 � M[iNarY Installation 6 � MllNary Installation 

7 �	 Other - 7 I-J :;g,f; 

Spsclfy 

*mm ,m.m 0000 � No ch,,ge OOOD� No charge 

lY ZN SDK 

IW 2B 3 OT to ZB 30T 

tM 2F !M 2F 

_ Days 00 � None _ Days 00 � None 

w o :nogdi;:; spec. 99 � :nogdi;;; spec. 

~o 40 10 to 20 so 20 50 

Su f’n 30 6D 

FORM HIS. !,,, ,.-24-76, 

A. ‘“S’‘am” @ Age First name @ Age 

IL 

Last name Last name 

v [ B. , � Flu ? � Flu 

(Influenza) (Influenza] 

20 Grime C;d. 20 Grippe C&d. E}~ 3 � virus

6 � None of the abme 

I

lY 2N 

I,Y 2N 

I,Y ,N 

lY 2 N (P4P) 

1 � Last week 

2 � Week before 

3 �	 Past 2 weeks -

DK which 

4 � 2 weeks-3 months 

5 � Over 3 months 

lY 2N I 

lY 2N 

I!Y .?N 

I lY 2 N (NP) 

! �	 In Interview week 

(Reask 10) 

2 � Last week 

3 � Week b?fore 

4 �	 Past 2 weeks -

DK which 

5 � 2 weeks-1 month 

6 � Over 1-3 months 

7 n Over 3-6 months 

8 � Over 6 months 

9 � Never 

I � Orxtor’s office 

(GrouP Practice or 

Doctor’s Clinic) 

z � Hospital outpatient 

;::: or Emergemy 

30 Public Health Clinic 

4 � Work 

5 � 3chool 

6 � Miiifary installation 

7 � Other -

SPaclly I 

I ,m.m 

0000 � No charge 

3nVlrus


t D Cold +’


s O Bronchitis }_


6 lg None of the above


l.l Y 2N 

4., Y 2 N (NPJ 

5. I � Last week 

2 D Week kfore 

3 �	 Past 2 weeks -

OK which 

6.IIY ZN ! 

7.IIY 2N 

8.IIY 2N 

2 � Last week 

3 D Week before 

4 � &sj;,:ek5 -

5 � 2 YKKA(3-1 nmnth 

6 � Over 1-2 months 

7 � Over 3-6 nmntbs 

8 � Over 6 months 

s � Never 

I 1.1 �	 OoctOr’s office 

(Group Practice or 

Doctor’s Clinic) 

z �	 Hospital outpatient 

Clinic or Em.wgcncy 

Roam 

3 � Public Health Clinic 

4 � Work 

s � School 

6 D Military Installation L
7 � cii,;

‘2”1D&m 

4 � Cold +“ 

5 a BronchNls } _ 

6 � None of the afmve 

!Y 2N 

IY 2N 

IY 2N 

lY 2 N (NP) 

1 � Last week 

2 � Week before 

3 n	 Past 2 weeks -

DK which 

402 weeks-3 nmnths 

5 n Over 3 months 

!Y 2N 

lY 2N 

tY ZN 

lY 2 N (NP) 

1 �	 In interview week 

(Reask 10) 

2 D Last week 

3 � Week before 

4 a	 Past 2 weeks -

DK which 

5 � 2 weeks-1 nmnth 

6 � Over 1-3 months 

70 Over 3-6 mcmttts 

8 D over 6 months 

9 � Never 

1 I-J	 Olxtol’s office 

(Group Practice w 

Dc4t0r’s Clinic) 

z �	 Hospital outpatient 

gll&c or Emergency 

3 � PubNc Health Clinic 

4 D Work 

s � School 

6 � Militsfy Installation 

7DOther ­

sfwclfy 

JM.CQ 

moo � No char’e 

tw 2B 3 DT 

. 

tM 2F -

— Oays 00 � flont 

99 �	 Cond. not spec. 

in B INP) 

10 40 

2U so 

en 60 

IY 2N 9 DK 

I 

!W 2B 3 OT l.l W 2B s OT 

;.i M 

I 

!M 2F - +----.------------- 2F 

_ Days 00 � Ncoe 3. _ Days 00 � None 

99 � ~“O&(N~; spec. 99 � Cond. not s!xc. 

in B (NP) 

l-~----i~--------­

Zn 

to 

50 

40 i.20 so 

t 30 Go T 30 so 

Page 3 

77 
FoRM HIS-1 B(a) 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

PUBLIC HEALTH SERVICE 

HYATTSVI LLE, MARYLAND 20782 

NATIONAL CENTER FOR 

HEALTH STATISTICS 

Dear Friend: 

Your household has just taken part in a health interview conducted by the Bureau of the 

Census for the U.S. Public Health Service. We greatly appreciate your cooperation in providing us with this information. 

As you know there is a great concern in our country about providing health care to persons who need it. There is also an urgent need to know how much money persons are 

spending for medical care. Only you can provide accurate information about the amount 

you pay for medical expenses. We, therefore, are asking you to tel I us the amount of 

money you and your family have spent for medical care during 1977 by answering the 

few questions on this form, If you cannot give the exact amounts from your records, 

give the best estimate you can. 

The survey is authorized by title 42, United States Code, section 242K. The information 

collected in this voluntary survey is confidential and will be used only to prepare statistical summaries. No information that will identify an individual or a family will be 

released. 

Because this is a sample survey, your answers represent not only your household, but 

also hundreds of other households like yours. For this reason, your participation is 

extremely important to ensure the completeness and accuracy of the final resu Its. Each 

unanswered question reduces the accuracy of the information COIIected. 

Please answer all the questions as soon as possible, preferably within FIVE DAYS, and 

return the questionnaire in the enclosed postage-paid envelope. 

Thank you for your cooperation. 

Sincerely yours,


Robert R. Fuchsberg


Director


Division of Health Interview Statistics


FOR OFFICE uSE ONLY: 

D a. Psu : b. Segment : c. serial d. Col. of head e. Interviewer’s name	 . code f. Follow-up m m # a m m m , m m � w m 

O.M. B. No. 66-RI 600 

HRA-74-2a Approval Expires March 31, 1979 

78 
. .

5 

I � If the person did not have any expenses, mark the “none” box with an “X.” first name ; first name first name fmt name 

last name last name 

I I E=Il m 

Include all expenses related to doctor office visits and the amounts paid .. 

for doctors and suraeons while this Demon was a o=mt in the hOsDital. 2 ,......,,:.:.:.:,.,; ‘“or: I_J none or: � none or: � n&ne 

-$ 1$ ] 2. AMOUN’i PAID FOR HOSPITAL EXPENSES I m 

OK � n... 

‘ I

3. AMOUNT PAID FOR DENTAL EXPENSES ““’~: n m 

Include all expenses related to dental office visits for this person. 

> ,.,.,:.:.; oc � none OK l_JnOne 

D m 

0. � none or: � none 

5. AMOUNT PAID FOR PRESCRIPTION MEDICINES m m 

Include all expenses for medicine obtainad with a doctor’s or dentist’s or: � none or: � none prescription for this person. 

6. AMOUNT PAID FOR OTHER ME EC.& = 

6 
. . . .. .. . .. . . .. . . ... ... . . . . . . . .. . . . . ..... . . . .......... ...... .... .... .. . ......... ..... ........ ........... 

....................................................................................... ........................................................................................ .................. .................. .:.: ................... ................................................................................. .................. .................................................................................. .................. ................ :.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:. ................. :. :.:.:.:. ...................

.

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................ .................. .................. .................. .................. ................. .................. ........ ..................

:.:.:...:.; .:.:. .:. :.:.:.:.:.:.:~ ,,............. ............. :,;, ..........,.,.,,.............,,...,...,:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:. ........................................................................................................................ .......................................... ............. ,,,,,.,,,,,,, ............ ,.,..,,,..,,, :.:.:.:.:.:.: :.:.:.:.:.:.:.:.:........... ,:,~.}:,:,:, ............,.,.,.,......................... ...,,..:.:.:.: .,.::.:.:.:.:.:.:..:,,.;,:,:. ................................................................................................................................... ,:,:.:,:,:.;,:.:, .......................... ..,.,,,.,,.,. ,,,,,...,..,, ................................................................................................................................... :.:,:,:,:,:.:,:.: ,,,.,,,,.,,,,.................., .. ’. ’...’...’ ...

.

....

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..

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..

.

................... :.x.:.:.:.:.:.:.:,. ......... . . . . . . . . . . . . . . . . . . ......... ......... . . . . . . . . 

............. ;.:,:,:......,.,. ............................ ,. ............................................... ,.,..., ,,.,.,.,,,.,,,.,.,.,., ................... ..:.:.:.:.:.: .:. :.:. :.~ : .:.:.:.:.: ................................................................. .................... 

................... ~~~ .................... ‘.::::::::::::::::::: ::::::::::::::::::::: :::::::: :::::::::::::::::::::::::::::::::::::::::::::::: .................... .................... . . . . . . . .................... . . . . .................... 

. :.:.:.:,: x.:.: .

.

.

. .:.:.:.:.: ... . . .:,:.:.:,:.:.:.:.:.:.:.:’:.:,:.: . INSURANCE in 1977 for persons listed on page 2? ‘,:.:, . . ,:.:.:.:.:.:.:.:..:. . .. . w.:.:.:.:.;.:.:.:.:.:.: . ‘.:.:.:.:.W.:,.:.: .:.:.:.:.:..x. . .

.

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. ...

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.

.

. .:.:.:.:.:.:. :.:. .. :.*. :.:.:.:’:+::.:.:. ‘.:.:.:.:.:.:.:.::.:.:.: 

.:.:,:.:.:.:.:.:.:.:.:.:.:.:.:.: .:,x+:.:.x. ;:.:.:.:.: ...: .’.’.’........................................................... ...................

.

. Include: .: ::::::::::.’
 ....................
 ....................
 ....................
 ....................
 .................... � paycheck deductions for health insurance
 ....................
 ....................
 ....................
 .................... � Social Security check deductions for Medicare ....................
 ............
 ....................
 ....................
 ....................
 .................... � amounts paid directly to health insurance plans or to Social Security
 ....................
 .................... ............
 ............ .

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. for Medicare ............ .................... .................... .................................................... .................... :.:.:.: :.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.y..:.:.: :.~.:.:.:.:,:.:.:. .................... .................................................................................... .................... .................... .:.:.:.:.:.:+:.:.x .:.:.:.:.:.:.:.:. :.:.:.:.:.:.:.:. Y..:.:.:.:.:.:.:. x.:.:.:.:.: ....................................................................................... :::::::::::::::::::: Do@ include: .:.:.:.:.:.:.:.:. :++:+:+: .x.:.:.:.:.:.:. x.:.: +x.:.: .:.:+.:.:.:.:. :.:. .................... ......................................................................................... .................... ..:~:::::::::::::::::::::::::~.:::::::~:::::::::::::::::~ :~::::::::::: � accident insurance .............................................................................................. .

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. ..:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.x.:.:.:.:.:.:.:.:.:

:::~ .................................................................................................... ..............................’.... .................... ....................................................

":":":":":":":":":':':":':':`:`:":":" .................................................. ..

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. ................................

........................................................................................ :,:.:.:.:.:.:.:.:.:. ......................................................................................................... ......................... ........................................................................................................... 

.................................................................................................................................................................... ................................... ............................. .:.:.~.:.:.:.x.:.:.x’:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:

............................................................................................................................. :::::::::::::::::::: “.::::::::::::::: ::::::::::::::::: ::j::~jj::::::::::::::::::::::: yjjjjjjj$~yf i::.: :::::::: y.

::::::::::::::::::::


:::
 ::::::::~
 ....................
 ,:::::::::::::::::::


,x+:.:.:.:.:+:


:::::::::::::::::::
 03:!+:+:+ ,,,,...... :::::::::::::::::::: � persons Iiving here now, but not listed on page 2 :::::::::::: :jfjjj$:::::::: :::::::::::: .......... :.:.:.:.:.:.:,:.:.:, .*


:::::::::::::::::::: � anyone who lived here in 1977, but does not live here now ............


..........
 ::::::::::::::::::: � children now away at school or elsewhere
 .

...........................
 :::::::::::
~ :::::::::::::::::::: :~~fi:jj W.:.:.:.:.:.:.: question 10. ~ .:.:.:.:.:. x.:.:.:.: \:::::::::y..:.:. :::::::::::::::::::: ~.) . parents, other relatives, or friends now deceased ,:.:.:.:. ..::::::::: j::::: ~.~.:.:.:.:.:.:.:.:.:.:.:.:>:}~.:.:.:.:.:.:.:.:.:.:.:.:.:.: ::::::::::: ~.: ,.:~::~::::::..:::::::::::::::::::::::::y :::::~:~:: ~.:::::::::::::::::::::::::::::::: ......... 

‘.::~,:::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::: ::::::::::::::::. }.::::::::::::::::::: ".".:. m.:.:.:. x:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:. :::::::::~ ..

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. ::::::::::::::::::: 

::::::::: ~ ::::::: yjjj::: ::::::::::::::::::: :~::fi
 .:.:.:.:.:.:.’. PAID DURING 1977 FOR ALL TYPES OF MEDICAL
 .

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 ::::::::::::::::::: .

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. (Remember to subtract amounts you get back from health insurance.) ..:::::::::::::::::::::::::::::::: :::: ................... ::::.:::::::::::: :::::::::::::::::::::::::: :::::::::;:::;::: :.:.x.:.: :.:.:.:.:.:.:,:.:,:.: :.:.:.:.:.:.:.:.:.:.:.:. ,.,.,.,.,.,.,.,.,., ..:.:. .:.:.:.:.:.:. .:.:.:.:.:.:.:.:.:.:. :.:.:.: 

:.:.:. = .:.:.:.:.:.:.: .................................. :.:.:.:.:.:.:.:.:.:.:.:.:,:, ................................................................................................................................................ . .. .............................. ..:.:.:.:,:.:.:.:.:.:,:.:.:.:.:.:, ;.:.:.:.:.:,:.:. .:.:.:,: 

................,................. .....

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.. ......................................................................................................................................... ........ ............ ,.,.,.,., .,. ................... ........................... ,.,.,.,.,.,, ................... ....................... ............ ................... Checked records for all dollar ............ ................... 

amounts entered cm tfis form.	 ~ 

............ 

your name 

80

() -..... M R- -. .

No ... --fiX.RlfiM- . Annrnwsl F.niro. M..,+-,, “., w lWII ..””-. .. FP, -.”, ._,, F,,-= ,.”,, .-v. 

ORM HIS-1(S) (1980) 

1-28-801 

U.S. DEPARTMENT OF COMMERCE 

BUREAU OF THE CENSUS 

ACTING AS COLLECTING AGENT FOR THE 

U.S. PUBLIC HEALTH SERVICE 

U.S. HEALTH INTERVIEW SURVEY 

SMOKING SUPPLEMENT 

INTERVIEWER - For this supplement, interview sample persons to 

accept household respondent as proxy. Footnote reason and column number of respondent. 

‘OOTNOTES 

NOTICE -AII information which would permit identification of the individual 1.


will beheld in strict confidence,will. bausedonly bypersons errgaged in and


for thepurposes ofthasurvey, and wdlnotbe disclosed orreleased to others Book of Books


for any purposes.


2.	 R.O. number 1 3,4 3. Sample I 5-7 4. Control number 

Psu 8-10 Segment 11-14 Serial E 

5.	 Interviewer’s name j Code I 17, 18 6. Telephone (Q 15) lS 

1 lY 

i 2N 

Code Blank ONLY. However, if SP is unable respond because of health, 

02 

. ..... .

d. Regular OR King size OR 100 Millimeter? d. IUR 2~K 3 I-J 100 E d. IUR zOK 3 � 100 k d. l~R 2DK 3U1OO 52 

S4 S4 1 � “~” in da (Np) 

p S4 I � “N” in 4a (NP) ~ S4 ! � “N” in 4a (NP) L5iJ 

2 � “Y” in 4a 2 � “Y” in 4a 2 � “Y” in 4a 

8a.	 Have you ever made a serious attempt to 8a. & 8a. b 8a. ~ 

stop smoking cigarettes? lY 2 N (NP) lY 2 N (NP) lY 2 N (NP) 

b.	 About how many times would you say you b. o � Never (NP) p b. o � Never (NP) k b“ o u Never (NP) ~ 

made a fairly serious attempt to stop 12345+ 12345+ 12345+ smoking cigarettes entirely? 

c.	 During the past 12 months, fhat is since 56 ~, 56 c. & 

(d~e) a year ago, abaut how many times would c“ 

you say you made a fairly serious attempt to 012345+ 012345+ 012345+ 

stop smoking cigarettes entirely? 

9.	 How long ago was the START of the LAST 9. 2 � Days I 57-59 9. 2 � Days 157-59 9. 2 � Days I 57-59 

time you tried to stop entirely? 3 � Weeks 3 � Weeks 3 � Weeks 

—Number 4 � Months —Number 4 � Months —Number 4 � Months 

5 � Years s � Years 5 � Years 

10.	 Haw long did you actually stay off cigarettes 10. 2 � Days 160-62 10. 2 � Days 160-62 10. 2 � Days \ 60-62 

the last time? 3 � Weeks 3 � Weeks 3 � Weeks 

Number 4 � Months Number 4 � Months Number 4 � Months 

5 � Years 5 � Years 5 � Years 

000 U Did not stay off 000 � Did not stay off 000 � Did not stay off 

,.. , ,,.,,,.:.,.:..,.,’: ::;,:,. ,..:.,,:...:....: ... . .. ,,... 

~ S5. 

leaving household. 

la. Highest grade attended in school 

la. Elem: 12345678 la. Elem: 12345678 la. Elem: 12345678 

(Q 2a, p. 48) High: 9 10 11 12 High: 9 10 11 12 High: 9 10 11 12 

College: 1 2 3 4 5 6+ College: 1 2 3 4 5 6+ College: 123456+ 

Transcribe for each sample person /7+ after 55 00 � None 

S5 00 � None 000 None 

b. Finished grade (Q 2b, O. 48) b. ,Y ZN 16J b. ,Y 2N ~ b> ,Y 2N & 

2. Racial background (Q 4a, b, p. 48) 2. 1 2 3 4 5- Spec/fy ~ 2, 1 2 3 4 5-spec/fy & 2. 1 2 3 4 5- Spec/fy ~ 

(If single entry in 4a, transcribe that entry. i Y K 

It multiple entry in 4a, transcribe entry in 4b.) 

3. Family income (Q 12, p. 52) 3. 

o1OB 050F 09DJ 

Oznc 06DG IODK 

030D 07DH 

S6 1 � Complete-Personal visit S15 1 � Complete-Personal visit $6 1 � Complete-Personal visit 

2 � Complete-telephone 2 � Complete-telephone z � Complete-telephone 

3 � Refused 3 � Refused 3 � Refused 

4 � Not at home-Repeated calla .4� Not at home-RepeateP calls 4 � Not at home-Repeated calls 

5 � Temporarily absent s � Temporarily absent ; 5 � Temporarily absent 

a � Other - Spdfy 

lL 

e l_J Other - 5pec/ 

%; 8 � Other - Spat/fy 

i 

\ 

,i 

ORM H (S-1 [5) [9.26-00) m... . 
FORM HIS-l B (a) (FM) 

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

PUBLIC HEALTH SERVICE 

HEALTH RESOURCES ADMINISTRATION 

ROCKVILLE, MARYLAND 20852 

NATIONAL CENTER FOR 

HEALTH STATISTICS 

Dear Friend:


Your household has just taken part in a health interview conducted by


the Bureau of the Census for the U.S. Public Health Service. We greatly


appreciate Your cooperation in providing us with thie information,


Another area of great concern today is the cost of health care in our


country. We, therefore, ask you to provide us with information about


the amount of money you, your family, and other relatives living with


you spent for medical care during 1974 by anewering the few questions


on thie form, Pleaee use any records such as bills, receipts, or check


stubs, that would help you in answering the questions. If you cannot


suPply the exact amounts from your records , give the best estimate 

you can. 

We would appreciate your completing the attached questionnaire


within FIVE DAYS, and returning it in the enclosed preaddressed envelope


which requires no postage. If a delay cannot be avoided and you cannot


answer and return your form during this time, please fill in tha 

information and return it as soon as possible. Since this study is


based on a scientific sample of the total population, it is important


that each household return a completed questionnaire. ,.


Please be assured that the Bureau of the Census and the U.S. Public


Health Service hold as confidential all the information you provide,


Thus, the results of this voluntary survey will be iseued only in


the form of statistical totals from which no individual can ba


identified.


Thank you for your cooperation,


Sincerely youra,


Rr&##lf+


Robert R, Fuchsberg


Director


Division of Health Interview Statistics


ASSURANCE OF CONFIDENTIALITY: Allinformationwhich woLdd permiticlcnti
 fcation


of the indivklual willbe helclin strict conficlence,
 willbe used only by personsen$agcdin


and for the purposes of the suwey, and will not be rlisclosml or released to others for any 

purposes. 

FOR OFFICE USE ONLY: 

a. PSU lb. Segment~c.Serial d. Col.of hesd e. f“tep{&#@s “a,~e ; Code 

I


I I

I I


O.M.a.
NO.58.R1600 HRA-74 (10/74) @ProVslExpires:3-31-76 

84

1.	 Fill a separate page for the family member whose 

name is entered at the top. Answer all questions 

on the page even though the person may not have 

had any =dical or dental expenses in 1974. If


the person did not have any expense of a certain


kind during 1974, mark the “No bills paid” box.


The amunts you give should only include what


TBIS FAMILY paid, NOT any payments made by health


insurance or some other person or agency. IF


EXACT AMOUNTS ARS NOT KNOWN, PLEASE ENTER YOUR


BEST ESTIMATE.


2. DO not include any amounts paid (or to be paid) by:


Health insurance


Workmen’s compensation


Non-profit organizations such as the “Polio


Foundation”


Charitable or Welfare Organizations


Military Services


Veterans Administration


Federal, State, City, or County Governments


3.	 If there are any babies in the household who were


born during the past 12 months, the hospital and


doctor bills relating to the baby’s birth should


be reported on the page for the mther. All other


medical expenditures relating to the baby’s health


should be reported on the page for the baby.


85

.. . .

Plesse snswcr the following questions for PU.5.QD&ul 

3. Howmuch did THIS FAMILY spend onhospital bills forthis person d.ring 1974? 

~ 

lNCLUDE amounts sp-t for: 

Room and boord 

G?.rating and 

Anesthesia 

Tests 

.5pWi.l trrntm..ts 

AnYothwhospit.l s.,vi.cs � No hos~tol bill. 

d.liv.ry room. X-rays paid for this p.rson n 

4.	 About howmuch did THISFMILY s~ndonmAicim fmfiis~~n duri~l974thtiwos 

purchased on a DOCTOR’S OR DENTIST’S PRESCRIPTION? 

INCLUDE omounts spent for:


Mdicincs~y if they were preserib.d byadectorordantist


+&j

w>. ~w~%~~ ““””; .,*ii*iY<:; PAYMENTSMADEFOR EYEGLASSES,CONTACT LENSESOR OPTOMETRIST’SBILLS“~”””” . 

5. Durin 1974 how much did THIS FAMILY spend on eyeglasses, contact lenses, or optometrists’ 

fees f%r this person? 

I=z=l 

I � No mount p.id for th.s. itmns 

.........$ PAYMENTSMADE FOR “OTHER” MEDICAL BILLS:” ““;” “;:” ““ ..:,::.. ,:.,::

60. How much did THIS FAMILY spend on othet medical expenses for this person during 1974? 

i I w any .xponsw% which YOU hovm already rm.ordd. ~ mmo””ts *pint for 

--Y kind. 

INCLUDE amounts x snt for such .xp.nses as: 

Chiropractorsc or Po J tatrists’ fees Physical or Spech Th.rapy 

Hcorin aid *..i.l nurstng car9 

%~$~i~~fii~~ .h..lchair Nursing Home or Convalescent 

Horn= cars 

6b. What type of medical expense did this person have? 

Type of Medical Expense 

7. Check one of the following boxes: 

1 � Refarmd to r..erds for .11 dell., amounts .“t.r.d c.. this page. 

2 � R*forr.d to rscords for sore. but not all dollar amounts ..t.md O. this p.ge, 

3 � Did not r.fsr to any c.c.rds. 

e; 

� No amc;nt paid far 

thctc it~s u 

HRA-74 (t 0/74) 

I 
1.	 Durimr 1974, how muchdid THIS FAMILY srxmd on health insurance premiums for plans that PaY for any part of a hospital 

bill o;a doctor’s bill? 

Ez3El 

G	 This fmnijdid not 

pay any insurance 

pr*miums 

PAYMENTS MADE 

Include:


Amount deducted from paycheck for health insurance premiums


Amount ded. cted from Social Security check for Medic.re


Am.a.nt paid directly to health insurance plans or to Social Security for Medicare


Do not include: —— 

Health ins., . . . . PI... that pay cmly i“ the case of accidents 

Employer or .n, on contributions 

FOR PERSONS NOT LISTEDON THlSQUESTlONNAlRE 

2. During 1974 did THISFAMl LY pay any medical expenses for anyone whose name does Nf)T appear on this questionnaire? 

This might include expenses for children now away at school orpar.mt., othmr relatives or f,iends now in nursing homes or elsewhere, 

or who or. dece. s.d. 

Thas*expensesrnay include bills from do.tors, dentists, optometrists, hospitals, “.rsinghornes, health insurance premiums, cost of 

pr..criptio. m.di.i.e, eyegl ass... .nd so forth. 

� No � Yes 

(Check one box) 

\ Anmtmt This Family 

Paid 

TYPE OF MEDICAL EXPENSE 

~ 

p!rq

DOLLARS ICENTS 

3. Please print below the name of the person or parsons who completed this form. 

Nama 

Name 

NOTE: Before returning this questionnaire, please check to see that you have filled in ananswer for EACH question for 

EACH person listed on the questionnaire, even though the person did not have any medical or dental expenses 

during 1974. 

HRA.74 (10/74) 

87 
FORM HIS-2S(al 

U.S. DEPARTMENT OF HEALTH, EOUCATION, ANO WELFARE


PUBLIC HEALTH SERVICE


HYATTSVILLE, MARYLAND 20782


NATIONAL CENTER FDR 

HEALTH STATISTICS 

Dear Friend: 

Your household has just taken part in a health interview conducted by the Bureau of the Census 

for the U.S. Public Health Service. We greatly appreciate your cooperation in providing us with 

this information. 

Another area of great concern today is the cost of health care in our country. We, therefore, ask 

you to provide us with information about the amount of money you, your family, and other 

relatives living with you spent for medical care during the past 12 months, that is, from January 

1, 1977 to December 31, 1977, by answering the few questions on this form. Please use any 

records such as bills, receipts, or check stubs, that would help you in answering the questions. If 

you cannot supply the exact amounts from your records, give the best estimate you can. 

We would appreciate your completing the attached questionnaire within FIVE DAYS, and 

returning it in the enclosed preaddressed envelope which requires no postage. If a delay cannot 

be avoidad and you cannot answer and raturn your form during this time, please fill in the 

information and return it as soon as possible, Since this study is based on a scientific sample of 

the total population, it is impottant that each household return a complated questionnaire. 

Pleasa be assuredthat the Bureau of the Censusand U.S. Public Health Service hold as confidential all the information you provide. Thus, the results of this voluntary survey will be issued 

only in the form of statistical totals from which no individual can be identified. 

Thank you for your cooperation. 

Sinceraly yours, 

ROBERT R. FUCHSBERG 

Director 

Division of Health Interview Statistics 

ASSURANCE OF CONFIDENTIALITY: lnrormation contained on this form which would permit identification of a“y 

individual or establishment has been collected with a guarantee that it will be held in strict confidence, will be used only 

for purposes staled for this study, and will not be disclosed or released to others without the consent of the individual or 

the establishment in accordance with section 308(d) of the Public He81th Service Act (42 USC 242m). 

FGR INTERVIEWER USE ONLY: 

a.	 PSU :b. Segment : c. serial d. Col. of head e. Interviewer-s name recode f. FOIIOW.” P m : : : 

, : ~ 

: : 

o.M.a. NO. 6S-R1600 

NRA-74.3a Approval Expires March 31, 1979 

88 
GENERAL INSTRUCTIONS 

1.	 Fill aseparate page forthefarni lymember whose name is entered 

at the top. Answer all questions on the page even though the 

person maynot have had any medical or dental expenses during 

the past Iz months. If theperson didnothave any expense of a 

certain kind dwing that period, mark the “Nob ills paid” box. 

The amounts you give should only include what THIS FAMILY 

paid, NOT any payments made by health insurance or some 

other person or agency. IF EXACT AMOUNTS ARE NOT 

KNOWN, PLEASE ENTER YOUR BEST ESTIMATE. 

2. Do NOTinclude anyamounts paid (ortobepaid) by: 

Health insurance 

Workmen’s compensation 

Non-profit organizations such as the “Polio 

Foundation” 

Charitable or Welfare Organizations 

Mi I itary Services 

Veterans Administration 

Federal, State, City, or County Governments 

3.	 Ifthere are any babies inthehousehold whowere born during 

the past 12 months, the hospital and doctor bills relating to 

the baby’s birth should be reported on the page for the mother, 

Al I other medical expenditures relating tothe baby's health 

should be reported on thepage for the baby. 

4. PLEASE COMPLETE THE BACK PAGE BEFORE MAILING. 

Page 2 

89 
Please answer the following questions for Person No. m 

mg~,<, ‘Vy$‘!~-...<~~~~A~B~~~~FIA~~ ,“”;,”::””””””’ “:;;’”’””’” ,,.

‘ 

1.	 Howmuch did THIS FAMILY spend 

that is, frem January 31, 1977 to 

INCLUDE amounts spent for: 

Cleanings Straighioning 

Fillings X-rays 

2. Hew much did THIS FAMILY spend 

INCLUDE amounts spent foc 

ondental &llsfor this person during thepast12 months, ~, 

December 31, 1977? 

Dental surgery Bridgewcwk


Extractions Dental Laboratory fees %’%7%,@:­


on doctor bills for this person during the past 12 months? 

~ 

Routine doctor visits Doctor fees while a Deliveries Shots


Treatments patient inq hospitel Pregnancy core Other services by a � No doc;~r bills paid


Check-ups Operations Laboratory fees medical doctor for this person
 m 

INCLUDE amounts spent for: 1’ or ‘1 

4. About howmuch did THIS FAMILY spend onmedicine forthis person during thepast12 months 

that	 was purchased on a DOCTOR’S OR DENTIST’S PRESCRIPTION? ~ 

INCLUDE amounts spent for: � ~4g~{;~d&$f~ediMedicines ONLY if they were prescribed byadoctor or dentist 

this person m . ... , PAYMENTS MADE FOR EYEGLASSES, CONTACT LENSES OR OPTOMETRlST'SBlLLS ‘.” ‘ 

5. During the post 12months, howmuchdid THlS FAMILY spend on eyeglasses, contact lenses, 

or optometrists’ fees for this person? 

6a.	 Howmuch did THIS FAMILY spend onother medical expenses forthis person during the 

past 12 months? 

DO NOT INCLUDE ony expenses which you have already recorded. DO NOT “NCLUDE amounts 

spent for merllcines of any kind. 

INCLUDE amounts spent for zuch expenses as:


Chiropractors” o,r Podiatrists’ fees Physical or Spe. ch Therapy


H*a,in aid Sp9ciol nursing care


Specia$ broces, trusses, wheelchair Nursing Home or Conval.s.ent


orartiflclal limbs Home care


6b. What type of medical �xpenses did this person have? 

Typaof Medical Expense 

7. Chock ono’oftho following boxes: 

1 R* f.rrcd tor.cords for ALL dollar amo.nts .ntoradon this pagt. 

2 Rafarr*d toracords for SOME butnotoll dollar omounts .rrt.red on this page. 

3 Did NOTrefar to ANY records. 

e 

� No amo;nt paid for 

these items n 

L 3 

�	 No .mo;nt paid for 

these items 

I� All 

2 � SOme 

3 � None 

m


90 

I 
IE!zrl 

Cj	 This faml;j did not 

pay any insurance 

premiums 

INCLUDE:


Amount deducted from poy.he.k for heolih i“s. ron.e premiums


Amo.”t deducted from Social Security check for Medicare


Arnou”t paid directly ?. hc.alfh insurance PI.”. or to So. iol Securi?y for Medicore


DO NOT INCLUDE:


Heelth insurance plans thoi pay only in the case of accidents


Employer or .nio” .c.ntrib.ticms


2.	 During the past 12 months, that is, from January 1, 1977 to December 31, 1977 did THIS FAMILY pay any 

medical expenses for anyone whose name does NOT appear on this questionnaire? 

This might include expenses for children “OW .woy ot s.hool+r pmre.?s, other relative. or frio”ds “OW i“ nursing homes o. 

elsawhere, or who are deceosed. 

These expenses may i“cl.de bills from doctors, dentists, optometrists, hospitals, nursing homes, health i“suronce pr=miums, 

cost of prescription medicine, ey. glas. es, ond so forth. 

(Check one box) 

\ TYPE OF MEoICAL EXPENSE 

3. Plaase print below the name of the person or persons who completed this form 

Name 

Name 

NOTE:	 Before returning this questionnaire, please check to see that you have filled in an answer for EACH 

question for EACH person listed on the questionnaire, even though the person did not have any medical 

or dental expenses during the past 12 months, that is, from January 1, 1977 to December 31, 1977. 

Page 12 

91 
1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

Appendix V 

Subsample selection 

intervieweraids 

7.	 Use Flashcard X, Y, or Z as indicated on HIS-1 Household Composition pa9e. 

Circle that letter below. AJso, circle the total number of persons. 

CARD X CARD Y 

If the number the following person(s) 

of persons will be the sample 

is — person(s): 

— 

2 1 2 

3 3 1 

4 2 3 

5 1 and 4 2 and 5 

6 3 and 6 1 and 4 

7 2 and 5 3 and 6 

8 1,4, snd7 2, 5, and 8 

9 3, 6, and 9 1,4, and7 

10 2, 5, and 8 3, 6, and 9 

11 1,4,7, and10 2,5,8, and 11 

12 3,6,9, and 12 1,4,7, and10 

13 2, 5,8, and 11 3,6, 9, and 12 

14 1,4,7,10, and13 2,5, 8,11, and14 

15 3,6, 9,12, and15 1,4. 7,10. and13 

If more than 15 persons, call your regional office for sample person selection instructions. 

NUMBER OF CHILDREN 

CARD Z 

If the number the following person(s) 

of persons will be the sample 

is — oerson(s): 

1 1 

2 

6 2 and 5 

7 1,4, and7 

8 3 and 6 

6 2, 5, and 8 

10 1,4,7, and10 

11 3, 6, and 9 

12 2, 5, 8, and 11 

13 1,4,7,10, md13 

14 3,6, 9, and 12 

15 2,5,8, 11, and14 

IN FAMILY 1234567 89+ 

SELECT THE 122422546 

045824 

92 
Appendix VI 

Preinterview letter to sample 

households 

,’1, 

a 

w . 

t“4+’”2’ “~,~~~ ~~~~~~ ~~~~~~MENT OF COMMERCE 

HIS-600 (DETROIT) . Bureau of the Census 

(143) %3.. J Washington. D.C. 20233 

‘>4?,, & #“ 

OFFICE OF THE DIRECTOR 

FROM THE DIRECTOR 

BUREAU OF THE CENSUS 

The Bureau of the Census is conducting the National Health Interview Survey for the 

Naticinal Center for Health Statistics, which is part of the U.S. Public Health Service. This 

program is a major part of the National Health Survey, authorized by Congress because of 

the urgent need for up-todate statistics on the health of our people. 

The National Health Interview Survey collects current information on the occurrence of 

illness and disease, injuries, hospitalizations, and visits to the doctor, as well as information 

on age, occupation, education, and related information used in analyzing the health data. 

This vital information will help the U.S. Public Health Service and other health-related 

organizations plan more effective y for the health needs of our Nation. In a few days a 

representative of the Bureau of the Census, who wi II show you an official identification 

card, will call upon you for this survey. 

The survey is authorized by title 42, United States Code, section 242k. Participation is 

voluntary and both agencies will treat the information collected as confidential. No information reported in this survey that could identify an individual or family will be released 

by either agency. 

Because this ii a sample survey, your answers represent not only you and your household, 

but also hundreds of other households like yours. For this reason, your participation in this 

survey is extremely important to ensure the completeness and accuracy of the final results. 

Although there are no penalties for failure to answer any question, each unanswered 

question’ substantial y lessens the accuracy of the final data. Your cooperation in this 

important survey wi II be appreciated greatly. 

On the other side of this letter are answers to some of the questions most frequently asked 

about the survey, 

Sincerely, 

642+2-% 

BRUCE CHAPMAN


Further information


may be obtained from:


Mr. Robert G. McWilliam


Regional Director


Bureau of the Census


Federal Bldg. & U.S. Courthouse


231 W. Lafayette, Room 565


Detroit, Michigan 48226


Telephone: (313) 226–7742


93 
1. Why is � National Health Sumey needed? 

The needs of the Nation and its responsibility to protect the health of its citizens require knowledge of the 

number of people with health problems, the nature of their illnesses or disabilities, the extent and type of 

care they are receiving, and the cost and financing of this care. 

Today, chronic illness and disability constitute our greatest public health challenge. They lower the earning 

power, living standards, and the general well-being of individuals and families. They burden individuals, 

families, and communities with high costs of care and assistance. Accidental injuries in the home and on 

the highways are also extremely costly to society. Better information on chronic illness and disabili~, as 

wsll as on accidental injuries, will assist in the development of more effective Prevention programs. 

Healthy people are one of the Nation’s greatest resources. Comprehensive health statistics are needed to 

keeptrack
of this vital resource. Data from the National Health Interview Sutvey provide information for 

many purposes including: 

a.	 Statistics to help government, university, and private health planners and researchers recognize health 

problems and how best to use the available money and people to attempt to solve these health problems. 

b.	 Statistics to study how age, sex, education, marital status, and income are related to disease, disability, 

and the use of health services. 

c.	 Measurement of time lost from work because of illness or injury and its effect on the economy of 

the Nation. 

d.	 Statistics to show how people use doctors, dentists, hospitals, and other medical setvices so that these 

services can be provided as efficiently as possible. 

. . Statistics on the number of persons with specific diseases and how these diseases arfect people. 

Information collected in the National Health Interview Survey is used to direct health research effons to 

areas where needs are greatest, to provide sufficient health workers and faciliites to deal with the problems, 

and to see that each person receives the best medical care and preventive health services possible. 

2 How are specific households chosen to be interviewed by the National Health Interview Survey? 

Every month several thousand addresses are chosen by scientific sampling methods to represent a cross 

section of the whole United States, and the people at those addresses are interview to obtain the 

necessa~ information. The household at each sample address represenk thousands of households throughout the countsy. Each person in the sample represents approximately 1,800 persons within our Nation. 

3. Why not interview the house across the street? 

For the National Health Interview Survey, about 42,000 households or approximately 130,000 people are 

interviewed in any one year. Since the population of the Nation is over. 200 million, our relatively small 

sample cannot be used to represent all the various types of persons unless each address, which is originally 

selected, is retained in the sample. For example, the house across the street or next door, where the people 

are usually at home, may be representative of persons who are older or sicker than those at the sample 

address, where perhaps all family members are working. If we made this type of substitution, our statistics 

might be represen=tive of the people who are.usually at home, but not of the total population. Therefore, 

we would not obtain the kinds of information we need from the survey. 

4. I’m not sick - why should I be included in the survey? 

If we are to measure the amount of illness in the United States, the sample must bs representative of the 

entire civilian population — both the well and the sick. We must determine how many people are sick or 

lose time from work in relation to the total population. 

5. Will the data be held confidential? 

All information obtained in this survey which would permit identification of any individual or establishment is collected with a guarantee that it will be held in strict confidence, will be used only for purposes 

stated for this study, and will not tns disclosed or released to others without the consent of the individual 

or the establishment in accordanm with section 308(dl of the public Health *rVi@ Act (42 U.S.C. 242m)~ 

Hla.eoo ( 1.831 

94 
Appendix VII 

Postinterview letter to sample 

households 

U.S, DEPARTMENT OF


HEALTH AND HUMAN SERVICES


Public Health Service


National Center for Health Statistics


3700 East-West Highway


Hyattsville, Maryland 20782


(301) 436-7016


. . . for the assistance you have given the Census Bureau interviewer who 

just visited you. 

It is only through the cooperation of you and others who are being visited 

that a health survey such as this one can be carried on, and we thought you 

would like to know how the information you have given will be used. 

It will, of course, be held in confidence. When combined with information 

given by other persons in this and other communities, it will reflect health 

conditions throughout the United States and provide new knowledge to 

improve the health of the American people. It is because such knowledge 

was lacking that Congress authorized the National Health Survey-of which 

the interviewing in this area is a part. 

The National Health Survey will be collecting information on other aspects 

of health, and it is possible that we may wish to ask for your further 

cooperation at some time in the future. Meanwhile, thank you for your 

help today. 

Manning Feinleib, M.D., Dr. P.H.


Director


National Center for Health Statistics


HIS.601 

95 
Appendix VII I 

Observation Report 

HIS-103 

(JanuarY . 1982) 

;oRMHIS-OM U.S. O15PARTKEtiT OF COMME;kE 1. Rezional Office {104!3. *0$ � UREAU OF THE CENSUS 

1 2. Date observed 

—- 1 

‘;7% !% 

6.	 TIME OBSERVEO 

From I To 

a.m. , 

II a.m C 

---m;::-:~-

. . 

(Mark “X” type(s), 

—-. .. . 3. Name of Intefievfer OBSERVATION REPCJRT I c~e

HEALTH INTERVIEW SURVEY 

4.	 REASON FOR OBSERVATION 

Initial ~Gen.”1 Performance 

� N-1 � N-3 � Other - spodty 4 

� N-2 � N-4 

7.	 REFERENCE NOTES FOR SPECIAL ATTENTION -

from last observation, transmiwal recwd, etc. 

~~Pw” ‘A 

O. SPECIFIC PERFORMANCE AREAS 

(Evaluate each item for the entire observation) 

D/d interviewer correctly -

:*7 I 

Ty{:teA ;:: Productlon 

L3 },s+@r


*, y ~~, ,q~’ 

8. SEGMENT COVE RAGE 

s. 

Revlewv Period 

~:t 

:$r 

e.g., notes 

9 

enter nUmbe?S and circle those Ilsted 

E:pi:i:


� Permit . . . . . . . .


� CEN-SUP . . . . . . 

9. TALLY OF HOUSEHOLDS OBSERVED 

Interviewed	 Type A Type B or C 

or callback 

Mark “X’” one column for �ach Item 

(Explain eny ““No*” answers in Remarks) 

YES NO t4/A Remarks 

A Use maps, locate segments, locate sample addresses?


B List and update?


c Verify listing in addresq and permit segments?


D	 Follow area segment procedures (check 

canvass, determine year built. etc.)? 

E Handle extras and mergers?


F Handle other listing or coverage activity?


G Plan efficient itinerary?


H Gain cooperation, display business-like


I Listen carefully, allow reasonable time


J Ask questions as worded?


K Understand HIS concepts?


L Plan callbacks?


M Handle nortinterviews? 

boundaries, 

attitude? 

for reply? 

N Have current revised pages inserted in manual? 

o	 Complete payrol I accurately? 

P Accept suggestions and criticism? 

Q Fol IOW Privacy Act procedures? a 

96 
------------------ --------

----------------------------------------------------------------------

-------------------------------------------------

--------------------------------------------------------------------

--------------------------------------------------------------------

---------------------------------- ------------------------------------

------ -----

---

----

Appendix IX 

HIS reinterviewforms 

O.M. B. N.. 68-R1600 APPr..d ExDtreS M.WCh 31. 1980 

NOTICE - In formatmn ccmtamed on this fcmn wh,ch would pxmtt ,dentdf, cation of y individual M establishment has been collected with a guar?mtee 1. 

hat tt WI II k held m Stflct confidence, WI I I k used only for purposes stated for th!s stwdy, and wII I not k disclosed or released to otkrs vnthout the 

:Msenl of the mdlwdual or the Wabhshrmnl in accordance with section 3081d) of the Pubhc Heallh Service Act (42 USC 242m). 8ook _ Of_ books 

OIIXI HIS-R-1 (1979) 2. R.O. 3. Sample 4. Segment type 5. Control number 1$...,”! number 

u.S. DEPARTMENT OF COMMERCE [‘ I Area . .. EA. OF THE .,.s”s 

.c,, NG AS COLLECTING AGENT FCJR ,$4, [:] Perm,t PSU , Segment , Serial 

u.S. WLILIC HEALTH SERVICE [ . .

I Address , ,

t 

REINTERVIEW QUESTIONNAIRE EJ Cen-Sup 

I 

, 

1 ~ Special place I 1 

U.S. HEALTH INTERVIEW SURVEY 1 

a. What IS your �xact address? (Include house No.. Apt. No., or other identification and ZIP code),, Llstlng 18. Noninterview reason 

1 

,Sheet I ;No. — ! U Refusal – Describe in a fomom 

Cfi~--------------------------------------FSt=;e-------7ZlF-~o6~--- ~Line 2 D NO One at home — repeated calls 

1 1 ;No. _ 3 u Temporarily absent 

~Sheet .. —_________________________________ TYPE A 

b.	 Is this your mailing oddr*ss? � Same ;S 6a 4 D Other – Specify T Mark box or specify if different. Include ZIP code. 

TYPE B 

City ~;t;;e-------j-Zl F ‘c; K---

1 I 1 I a Vacant - nonseasonal 

1 2 � Vacant - seasonal 

i 

c.	 Special place name ~Sample unit number ~Type code 

I I 9 � USUal residence elsewhere 

a a Armed forces 

YEAR BUILT � Ask T � Do NOT ask 5 U Other - SPecify7 

Whtn was this stru.tur* originally built? 

O	 Before 4-1-70 m After 4.[ -7o (Go to 9c, complete 

(Continue Interview) lfrequired and end Interview) TYPE C 

. Type of llvlngquarters — I � Housing unit 2 � OTHER unit I n Unused line of listing sheet 

2 u Demolished , Area segments ONLY 

a � Merged R a. Are th.re any occupied or vacant living q.artms besides your own in this building? t u Outside segment 

Y (Fill Table X) N s � Built after April 1, 1970 

~ b. Arc thorc any occupied or vacant living q.artcrs besides your own on this floor? 6 � Other- %eCify7 

Y (Fill Table X) N 

o c. Is there any other buildin~ on this prop.rty for people to live in - �ither eccupicd or vacant? 

Y (Fill Table X) N 19. Reinterviewed’s name ~Code 

o d. None 1 

1. Record of calls 

1 Corn. 2 COm. 3 Cm. 4 Corn. 5 corm 6 co” 

,1* 

,,s0”.1 

c.lephone 

a, W* have Ii$ted as living here: (Read only names and relationships) 

Mark if ~wlgn ,elntewiaw Name Rel at~eydhip co Race sex No, WyJer.on (We B, OT) (M m F) Age 

[a) (d (d) (e) (f) (k) 

b.	 Is there anyone �lse who usually lives here who is away now? Y (Add to item 210) N . . . . . . . . 

c. Is there anyone else staying here now? Y (Add to item 210) N .	 . ‘--” "----------------------V l17;GCG 6;u>ZK01Z;;;Fe~ 27a-w-a ‘ --G----------------­

d.	 Do any of these people have a home anywhere else? I;ne through name in item 210) . . __ ., ________________________________________ -

Check on personal characteristics of each household member os shown !n item 210. 

. .	 I have the head of the household listed os (Reed age. ) 

Is this information correct or incorrect? (Cross through incorrect entrtes and record correct in formotton.) 

Conttoue m check age for each member of household. 

Check race and sex by observ.t,on whenever possible. 

Page ! 

97 
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BED DAYS DV HOSP. L Ask C9nd,ticm list_. 

� None n None � None 1. Record the number of Bed Days, Doctor Visits and Hospitalizations. 

c Number Number Number 

2. Record each condition with the question number(s) where it was reported. Q. No. Condition 

1 

1 \ 

Reference dates I 

2-week period I 

I \ 12-month Bed Days and Doctor Visit probe I 

1 Hospital probe 

I 

I 

This survey is being conducted to collect information on the Nation’s health. I will ask about visits to 

doctors, illnesses, and other health related item.. (HAND CALENDAR) 

The next few questions refer.to the 2-weeks outlined in red on that calendar, 

beginning Monday, (date) , and ending Sunday, . (date) . Y (5bJ 

50. During those 2 weeks, did stay i“ bed because of any illness or iniury? 5.. ~. ~ If age: _______________________________________________________________________________ ___ 17 + (6J 

6-16 (7] b. During that 2.week period, how many days did stay in bed all or most of the day? b. _ Days } Under 6 (9) 

6. During those 2 weeks, how many days did illness or i“iury keep from work? 6. _ WL days (8) 

(For females): not counting work around the house? 00 � Nom (9) 

SL days 

7. During those 2 weeks, how many days did illness or iniury keep from school? 7. GO N.”, (P, 

If one or more days in 5b, ask 8; otherwise go to 9. 

— o~ys 

8. On how many of these days lost from did stay in bed all or most of the day? 8, 00 � None {QJ 

in bed 

9.3. (NOT COUNTING the day(s) lost from work ) 9.3. IY 

lost from school 

Were there any (other) 

{ } 

days during the 2 weeks outlined in red on that calendar that cut down 2 N (10] 

on the things he usually does because of illness or iniury? 

in bed 

b. (Again, not co.nti”g the day(s) lost from work ) b. — DaYS lost from school { } 

During that period, how many (other) days did he cut down for os much os a day? 00 � None 

If one or more days in 5-9, ask 10: otherwise go to I I . 

Enter c.nd, tmn ,. ,tem C 

Oa. What conditien mused to during th= 2 weeks outlined in red on that cclcndar? 100. Ask 10b 

{!!%%,} 

stay in bed Y 

b.	 Did any other condition cause him to miss work during that period? b. 

miss school N (11) 

{} cut down ____________ .__. ___________________ 

~. Enter c..dsfmn m ,mm C (lObJ

C. What condition? 

Fill km C, (Bed days), from 5b 

Y Ila. During the 2 weeks outlined i“ red on that calendar did have 11.. 

any (other) accidents or ini. ries? . N (14) --------------— -. Injury 

c.	 What was the iniury? c. 

.-. 

Y fReosk I Ic) 

d. Did have any other occidents or iniuries during that period? d. N 

If “’accident or injury,” ask: Y (Enter m,ury r, femC 

� , As a result of the accident, did see a doctor or did he cut down on the things he usually does? � . N 

00 � None 

4. During the 2 weeks outlined in red on that calendar how many times did sce o medical doctor? 14. 

Do not count doctors seen while a pat!enr In a maspttal. _ Number of VO,,M 

(Besides those visits) Y 

50, During that 2.week period did go to a doctor’s office or 15a. N (16J 

clinic for shots. X-rays, tests, or examinations? -

If “Yes,” ask: 

d. How many times did visit the doctor during that period? d. _ Number of visits 

“,s..., !,, .,.>,, Page 1 

98 
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6a, During that period, did get any medical advice from o doctor over the telephone? AL 

If “Yes,’” astc 

d. How many t+hon. CCIIIZ wer. mode to C@ medical advice about --? 

Fill item C. (Doctor visits), from 14–16.


Ask 17a if reintwview sample person has visits in DV box.


7a, For whet comditien did see or talk to a doctor during the 2 weeks outlined in red on that calendar? ___________________________________________________________________________ ___ 

b. Did s“ or talk to o doctor about any specific condition? 

c.	 What cmwhiom? _____________________________________________________________________________ . 

d.	 During th~ pwiod. did see or talk to o doctor about any othe, condition? .. ___ . . 

r. During tfw 2 weeks outlined in red on that colendar was sick b=caus= of h=r pregnancy? 

f. What was ifw matter? 

8b.	 Prior to (date of interview week), ABOUT how long was it since LAST 

sow or talked to a medical doctor? 

Include doctors seen while a patient in a hospital. 

120TNOTES 

>“M 1+,,. R., {! 2.,.,,, Page 3 

16.3, y $4 (17! 

d. _ Number of calls -+-------------------­

cl Condition (ll;NC,7d, 

[--1 Pregnancy ~17e 

170. ~ ] No c.ndmi.on 

b. ~ N Ii?b I .-	 —-_ — __________________ 

Enter co.drricm i. r-em C 

c. end asl, 17d 

.--- ___- _—_— —___________ 

d. Y (17.1 N IIfibl 

e. Y N /!7d9 (---

f. En,,< condition ,. t[em C (!7d,

18b. I ~ 2*eek Dv 

2 m	 Past 2 weeks not 

reprxced f! 4 ond 17 I 

3 ~ 2 weeks-6 month, 

4 r] Over 6-12 months 

5 u I yew 

6 L-] 2-4 years 

7 ~ 5+ years 

8 C] Ne”,r 
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19a. What WOS doing MOST OF THE PAST 12 MONTHS - (For males): working or doing something �lse? 19. 

(For females): keeping house, working, or doing & 

Ages If “something else, ” ask: something else? 20. s � worklnz (z40J 

17+ b. What was doing? 7.� Keeping house (24b) 

If 45+ years and was not “working,”” keeping house,” or “going to school, ” ask 3 � Reti,ed, health (23) ~. IS retired? 

d. If “retired,” ask Oid he retirm because of his health? 4 D Retired, other (23) 

II s a Golnz to school (26) 200. What wos doing MOST OF THE PAST 12 MONTHS - going to school or doing something �lse? Ages If “’something else,” ask: 6 n 17+ Somethi.z else (23J 

6-16 b. Whet was doing? 7 � 6-16 Sc.nmthlng else(25J 

tl 1 

Ages � I-5 years (21) 

under 6 [1o �

0 Under I (22) I 210. Is able to take part at all in ordinary play with other children? 210. y 1 N (28) 

. 

b. Is he limited in the kind of play he con do because of his health? b. 2 Y (28) N 

c.	 Is he limited in the amount of ploy bscause of his health? ,-0 2 Y (28) N (27) 

-1 

1221J. Is limited inanywoybeca.s= ofhisheolth? 

k:-1:-~------:-l-~=-l 

b. In what way is he limited? Record limitation, not condition. b. (28) 

23a. Does health now keep him from working? 23a. 1 Y (28) N . 

b. Is he limited in the kind of work he could do because of his health? b. 2 Y (28) N 

I c.	 Is he limited in the amount of work he could do because of his health? 2 Y (281 N --=: 

d. IS he limited in the kind or amount of other activities because of his health? 1} d. s Y (281 N (27) { 

24a. Does NOW hove a iob? 24a. Y (24,) N 

b. In terms of health, is NOW able to (work - keep house) at all? b. Y t N (28) 

c. is he limited in the kind of (work - housework) he can do because of his health? c. I

2 Y (28) N

d.	 Is hc limited in the amount of (work - housework) he can do because of his health? d. 2 Y (28) N -

� . Is he limited in the kind or amount of other activities because of his health? � . 3 Y (28) N (27) 

25. In tmns of health would be able to go to school? 25. Y t N (28) 

26a.	 Ooes (would) have to go to a certain type of school because of his health? 26.. 2 Y (28) N 

_______________________________________________________________________________ 

b. Is he (would he be) limited in school attendance b-cause of his health? b. 2 Y (28J N 

C. Is he limited in the kind or amount of other activities because of his health? c. 3 Y (28) N 

27a.	 Is limited in ANY WAY because of o disability or health? 27a. 4’f s N (29J 

_________________________________________________________ -. 

b. In what way is hc limited? Record limitation, not condition. I b, 

loo � Less than I month been limited in 

la. About how long has he been unable to 28., 

{ had to go to a certain type of school? } I _ Mo., 2_ Yrs. 

~: ---------- ~------------------------------------------------------- --bb. What (other) condltic.n causes this [Imitation? Enter co.d,fmn m ,Iem C 

c. If 

t“ and osk 2Lk 

If ““old age” only, ask Is this limitation caused by any specific condition? � Old age only (291 

J--- Y (Re.ask N this limitation caused by any other condition? c. 28b and C) 

I � O“IY I c.ndklon Mark box or ask I d. Which of these conditions would you soy is the MAIN cause of his limitation? d. Enter mam Condllion 

RM HIS-R., ,,2.5 .,8) Page 4 

100 
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!90.	 WIM a patient in o hospital at ~ny time since Y N (Item C) 

.-__. .____ .___ --______ -_______ --. —_ -—_______ (date) .____ o year 090? _ _ - _ - _ —---— 

29., 

— _ -

I 

b. How many times was in a hospital since (date) a,7ear a90? b, _Times (Item C) 

10tJ. Was in a nursing home, convalescent home, or similar place since (date) a year ago? 300< Y N (31) _--_ -___ _---_--—-

-----i--­

c. During that period, how many times was in a nursing home or similar place? c. _ Times (Item C) 

If baby I year or under is listed and either the mother or baby is the reinterview sample person, 

ask 3 la if date of birth is on or after reference date. 

I1O. Was born in a hospital? 310. Y N (32) 

If “Yes,” and no hospitalizations entered, enter “1 “ in 29b and item C. 

If “Yes,” and a hospitalization is entered, ask 31b. 

---------I---L b.	 Is this hospitalization included in the number you gave me? b- Y N If “No,” correct entries in 29 ?nd item C. . 

— 

~ 

32a. DURING THE PAST 12 MONTHS, did 

-have - A. Gallstones? 0. Any other stomach trouble? . .-

Enter name of condition and letter B. Any other gallbladder trouble? P. Enteritis? of line where reported in item C. ---. .. — — —- — —--- -

I Ccmdi tlons affecting the C. Cir,hosis of the liver? Q. Diverticulitis?
 digestive system, . — .-


Make no entry in item C for cold, flu, D. Fatty liver? R. Colitis? 

or grippe even - if reported in question 32. - — 

E. Hop@itis? S. Spastic colon? 

. —---------- — —-------- .-

F. Yellow @malice? T. FREQUENT constipation? 

— — - .-

G. Any other liver trouble? U. Any other bowel trouble? ——-------- -———_—- —— — . .-

H. Diabetes? V. Any other intestinal trouble? 

.--- ———------- —-. — .-

W. Cancer of the stomach, 

1. Any disease of the pancreos? colon or rectum? 

X. During the past 12 months, 

did have any othar condition J. Ulcer? 

--_- _-____ —--- _________ -—---- of the digestive system? 

If “Yes, ” ask What was 

the condition? (Enter in item C) 

K. Hernia or rupture? 

L. A disease of the esophogus? 

_____________________________ 

M. Gostritis? 

N. FREQUENT indigestion? 

FO” M .,s..., !,2.6 .,,, 

101 

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2a. Does NOW hove - L	 Permanent stiffness or any defotmity of the foot, leg, fingers, arm or back? 

(Permanent stiffness – joints will not move at all) 

Enter name of condition and letter of


I ine where reported in item C. 3. Paralysis of any kind?
 — 

2d. DURING THE PAST 12 MONTHS, did C. Arthritis of any kind or Rheumatism? O. A tumor, cyst or growth of the skin? 

__________________________________ -. have -

Enter name of condltton and letter of 

). Gout? 

i} ‘“ “’em” “’~~~~$sis) . -. 

lsne where reported in item C. ?. Lumbago? Q. TROUBLE with dry or itching skin? 

-. 

Conditions C-N and V are conditions 

affecting the bone and muscle. 

F. Osteomyelitis? 

(os-tee.oh.my-.h-l ite-iss) it 

R. TROUBLE with acne? 

.- L A bone cyst or bone spur? I IS. A ski. ulcer? 

Conditions O-U and W-Z are conditions .- affecting the ski n. H.	 Any other diseose of the T. Any kind of skin allergy? bone or cartilage? H 

1. Trick knee? I IU. Denrmtitisoranyotherski” trouble? 

TRWBLE with fallen arches, J. A slipped or ruptured disc? It V. 

flatfeet or clubfoot? .- W. TROUBLE with ingrown toenails 

K. Curvature of the spine? It or fingernails? .-. ~.	 REPEATEO trouble with X. TROUBLE with bunions, corns, 

neck, back, or spine? Itor calluses? . -. M. Bursitis or Synovitis? Y. A disease of the hair or scalp? 

(sin..h-vite-iss) II —--------------------------- . -. Z. Any disease of the lymph or N. Any disease of the muscles or tendons? 

m 2a. ~aU~fNG THE PAST 12 MONTHS, did A. Goiter or other thyroid t,ouble? I 1) Glandular B. Oiab@es? H} disorders 

Enter name of condition and letter of


I ine where reported in i tern C, C. Cystic fibrosis? J
 D. Anemia? Blood disorder 

E, Epilepsy? 

F. Multiple sclerosis? Conditions affecting 

the nervous system 

G. Migraine? } 

1. > 

H. Neuralgia or neuritis? 

I	 I Lco.ditionsaffectingthe nervous system 1. Sciatica?

,	 1- IJ J. Nephritis? 

K. Kidney stones? 

L. Any other kidney trouble? 

Genito-urinary M. Bladder trouble? . conditions 

N. Prostate trouble? 

0. Disease of the uterus or ovary? 

_____________________________ 

P. Any other fem. lo trouble? 

<.! 112. S.7S1 Pa~e 6 

102 
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32a. Does NOW have - A. Deafness in .wte or both �ars? N. A missing (breast), kidney or lung? 

—-

Enter name of condition and letter B. Any other trouble hearing with one or 

both ears? 0. .x cerebral palsy? where reported in item C. ---_ Palsy ___- ———_________ t __ 

C. Tinnitus or ringing in fhe ears? P. Paralysis of any kind? 

A-L are conditions hearing ..------------------ . —-—-----—- .— ______________________________ ___ 

affecting . . . . . . . . . . vision D. Blindness in me or both eyes? Q. Curvature of the spine? 

speech __ — _ ---- —_________ ___ 

{} E. Cataracts? R. REPEATED trouble with back or spine? 

4 .------ .-. ..------ —. —- .--—---—- -. -.. --. -— — ___ 

Conditions O-W are impairments. S. Any TROUBLE with fallen arches or 

F. Glmrccmm? flatfeef? 

Conditions X and Y affect the . . . ..-. — 

nervous system. G. Color bli”dess? T. A clubfoot? 

.---------------- ___ - —_________ ___ 

(Permanent stiffness – joints will H. A detached retina or any other condition U. PERMANENT stiffness or my 

not move at all) of the retina? deformity of the back, foot, or leg? 

1. Any c.thm trcwbl= seeins with one or both V. PERMANENT stiffness or any 

eyes � ven when wearing .glosses? deformity of the fingers, hand, or arm? 

--.-—_—— .- .- ——-— —————_—_-_ ——_——_ —_ ———____ ___ 

J. A cle~ palate or harelip? W. Mental retardation? 

-— .. —- —- ——— — 

X. Any condition caused by an old accident 

or iniury? If ““Yes, ” ask: What is the 

K. Stammering or stuttering? condition? 

-—------------------------.—-—- I - —_ —------------ —--__ -_----— ._— I L.	 Any other speech defect? Y. Epilepsy? 

———---- —-- —— — — 

M. A missing finger, hand, or arm, toe, foot, Z. REPEATED convulsions, seizures, .x 

or leg? blackouts? 

* 

I 

32a. Has EVER had - A. Rheumatic fever? G. Stroke .x o cerebrc.vascular accident? 

------i-- I Enter name of co.dition and letter of 

line where reported in !tem C. B. Rheumatic heart disease? H. Hemorrhage of the brain? 

C. Hardening of the arteries I Conditions affecting the heart or arteriosclerosis? 1. Angina pectoris? and circulatory system. 

I I I D. Congenital heart disease? J. Myocardial infarction? 

1 II E. C.aronorY heart disease? K. Any other heart dttack? 

---------------------------——- . 

5 F. High blood pressure? t I I 

)

32a, D#JING THE PAST 12 MONTHS, did L. Domoged heart va Ives? R. Gangrene? 

- 1 I II 

Enter name of condition and letter of M. Tachycardia or rapid heart? S. Varicose veins? I line where reported in item C. 1 1 Conditions affecting the heart N. Heart murmur? T. Hemorrhoids or piles? 

and circulatory system. 

0. A“y other heort trouble? U. Phlebitis or thrombophlebitis? 

-. 

1 1 H P. Aneurysm? V. A“y other condition affecting I 1 1 

- blood circulation? H Q. Any blood clots? 

ORM HIS. R. I !l.?.0.7t Page 7 
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32o. DURING THE PAST 12 MONTHS, did 

hove -

Enter name of condition and letter of 

line where reported i“ item C. 

Conditions affecting the 

respiratory system, 

Make no entry in item C for cold; flu; 

red, sore, or strep throat or “virus” 

reported in answer to question 32. 

A. Bronchitis? 4--

B. Bronchie.tosis? (brong ke.ek toh-sis) 

C. Asthma? 

D. Hay fever? 

. 

E. NasrJl pOl)$P? 

- 4 

F. Sinus trouble? ____________________________ -

G. Deflect*d or dsviated nasal septum? .-- _,-----------------------------

H. * Tonsillitis or enlargerrmnt of the 

tonsils or adenoids? 

1. * Laryngitis? 

* If reported in question 32 only, ask 

J. Tumw, cyst, or growth of the 

bronchial tube or lung? .-

K. Emphysema? 

L. Pletnisy? 

.-

M. Tuberculosis? 

. 

N. Abscess of the lung? 

.-

0.	 Tumor, cyst, w growth of the 

throat, larynx, or trachco? 

P.	 Any work. relat.d r.s iratory condition 

such as dust on th. fungs, 

Silica*is or pnau-mo-co-ni-e-s is? -. 

Q. During the past 12 months did hav. 

any .athw respiratory, lung, 

.- or pulmonary condition? 

If ‘Yes, ” ask What was th. 

condition? (Enter in item C) 

. 

. 

. 

. 

6 

— 

1.	 How many tirn.s did have . . . in the past 12 months? - If 2+ enter in item C. 

If only I time, aslc 

2.	 How long did it last? - If [ month or longer, enter in item C, 

.lf less than I month, do not record. 

If tonsils or adenoids removed during the past 12 months, enter condition causlngremoval In item C. 

Make no entry In item C for cold; flu; red, sore, or strep throau or “virus” reported 

in answer to question 32. 

For persons 17 years old or over, show who responded for (or was present during the asking of) Q.’s 5-32. ] I I � Responded for sa[f.emi,a 

R If person responded for self, show whether entirely or partly. For persc.( under 17, show who R z~ Responded for self.p.rtly 

Q.’s 5-32 responded for him. Person _was respondent 

FOOTNOTES 

>R1.!HIS..., !12.,.7$, Paze 8 

104 
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CONDITION 1 

1. Person number Nom. of condition 

1 

!. When did last see or talk to a doctor abovt his . . .? 

I In Interview I \ I Past 2 wks. ,1,,,,, , I s 1 { 2-4 yrs. 

week ,R,..,. . ,,1 z I ] 2 wks. -6 “,0S. 61 15! yrs. 

3 I I Over 6-12 mos. , I I Never 

41 Ilyr. a I I OK If Or. seen 

9 I I DK when Dr. see 

Examme “Name of condltlon’” entry and mark 

Al (-; Color blindness (NC) I-J On Card C (A2) 

I [~] Acctdent or tnjury (A2) [ZI Neither (30) 

If “Doctor not talked to, ” transcribe entry from item 1. 

If “Doctor talked to, ” ask: 

3.. What did the doctor soy it was? - Did he give it o medical name? 

. . . . .. —-.- . -- . - . -.-—.-... ..-- ———_-. —.__-—---—. Do not ask for Cancer O On Card C (A2) 

b.	 What was the cause of . . .? 

~ Accident or injury {A2J 

--_- ____-_-_ --_- __---- __---- _—_-—_--____—_ —-—— _- If the entry tin 3a or 3b includes the words: 

Alhnenl Ccmditi.m Disorder Tr..ble 

A..mtio Cy.1 G,mvlh Tumor Ask c 

Asthma Defect Measles ulcer 

Attack Disease Rupture } 

c. What kind of . . , is it? 

-.--------------------------------..------————-— 

For allergy or stroke, ask: 

d. How does the all&gy (stroke) affect him? 

~---,--- ,-----------— —---—~---- ~------- . If in 3a-d there IS an !mpa!rment or any of !he followlng entr! es: 

Abscess Dmmge Paralysis 

Ache (except heed or ear) Growth Rupture 

Bleeding Henm,rh.age Sore 

Blood clot I. fectlom S.r.”ess 

Boll In flml”otlon Tumor Ask e, 

cm.., N.urolgl. Ulcer 

Crmnf)s(Wept Neurifls Varicose veins 

menstruol) Poln Week 

cyst Palsy W..akne, s } 

c. Whet part of the body is affected? 

Show the follow!ng detail: 

Head . . . . . . . . . . . . . . . . . . . . . . . skull, s.alp, f.ce 

Back/splnc/vert~bra . . . . . . . . ., . . . upper, middle, lower 

Ear.rey, ,,, . . . . . . . . . . . . . . . . one or both 

Arm . . . . . . . . . . . . . . . . . . . . . . . .	 oneorboth; shoulder, .ppe 

elbow, lower, wrist, hand 

Leg, . . . . . . . . . . . . . . . . . . . . . . .	 oneorboth; hip, upper, kn. 

low-r, ankle, foot 

Ask rema!n!ng questions as appropriate for the 

condi tion entered In: 

A2 

I I Item I I I Q. 3b I lQ.3d 

I IQ.3a : IQ.3c ;“l Q.3e 

4.	 During the 2 weeks outlined in red on that 

cole”d.ar did his . . . cause him to cut down BY 2 N {,, J 

on the things he usually does? 

5.	 Duriq thot period, how many days did he cut —D.Ys down for .ss much as a day? 00 [ I None (<!) 

6. h;ing that 2-week period, how many cloys did 

.	 . . keep him in bed all or most of the day? —Days 

00 I I None 

Ask if 17+ years: 

7.	 HOW many days did his . . . keep him from work _ Days (9) 

during that 2.week period? (For females): not 

counting work around the house? 00 L-] None 19) 

Ask if 6–!6 years: _ Days 8. How many days did his . . . keep him from 00 L1 None school during that 2-week period? 

9.	 When did first notice his . . .? 

t � Last week a � 2 weeks–3 months 

2 u Week before 5 � Over 3–I 2 months 

3 u Past 2 weeks–DK which s � More than 12 months ago 

(Was it during the past 12 months or before that time?) 

(Was it during the post 3 months or befor= that time?) 

(Was it during the 2 weeks outlined in red on *hot calendar or before that time?) 

A4 � Accident or injury � Other (NC) 

170. Did the accident happen during the past 2 years or before that time? 

� Ouring the past 2 years � Before 2 years (18.) 

-—-—-——-----.-. —--. —- — b. When did the accident happen? 

u Last week u Over 3-12 months 

� Week before � I -2 years 

u 2 weeks–3 months 

18.a.	 At the time of the accident what part of the body was hurt? 

What kind of i“iury was it? Anything else? 

I Part(s) of t.cdY I Kind of injury 

1- -----1--------- If accident happened more than 3 months ago, ask: 

b.	 What part of the body is affected now? 

How is his affected? 15 he affected in any other way? 

Part(s) of body Present affects 

..- -.-.-

105

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------------------------------------------------

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CONDITION 2 

Person number Name of condition 

1 

, When did last see or talk to a doctor about his . . .? 

I ~] In interview I c.] Past 2 wks. (11~~ CJ 5 u 2–4 ~~s. 

week (Rc. sk 2) z f~l 2 wks.-6 mos. d ~-~ 5+ yrs. 

3 ~] Over 6-12 mos. 7 L~ Never 

4 Lq I yr. 8 ~ OK if Or. seen 

s u DK when Or. seen 

Examine ‘“Name of condition” entry and mark 

Al � Color blindness (NC) m On Card C (A2) 

m Accident or iniury (A2J m Neither (30) 

If “Doctor not talked to,” transcribe entry from i tern 1. 

If “Doctor talked to, ” ask: 

3a. What did the doctor say it was? - Did he give it a medical name? 

Ask remaining questions as appropriate for the 

condition entered in: 

h2 ~]ltem I U Q. 3b U Q. 3d 

D Q. 3a U Q. 3C ~ Q. 3e 

4. During the2weeks outlined inredonthnt 

calendar did his.. . cause him to cut down IY 2 N (9) 

.“ the things he usually does? 

5.	 During that period, howmany days did he cut —DaYs down for as much as a day? I oOD None (9J 

6.	 ~),ring thot2-week period, howm.nydoys did 

. . . keep him in bed .11 or most of the day? —Days I 000 None 

7.	 Howmany days didhis. ..keephim from work 

during that 2-week period? (For females): not 

counting work around the house? 

8.	 Howmanydays did his. ..keep him from 

school during that 2-week period? ~ 

_________________________________________________ 9. When did-- first notice his...? 

Do not ask for Cancer u On Card C (A2) 

b.	 What was the cause of . . .? 

l=] Accident or injury (A2J 

If the entry in 3a or 3b includes the words: 

Ailment C.nd[tion Disorder T,.a.ble 

Anmmlo cyst Growth Tumor Asb < Asthmo Defect Meosles ulcer 

Attack Disease R.pt. r. } 

c. What kind of . . . is it? 

- For allergy or stroke, ask: 

d. How does the allergy (stroke) affect him? 

~---,--- ,----------------- ~---- ~---- if in 3a-d there IS an Impairment or any of the followlng entries: 

Abscess Dammge Pm.lysis 

Ache (except bad or em) G,.awth Rupture 

Bleeding Hemorrhage sore 

Blood clot I“fe.tion S.r.ne.. 

Boll I. flamm.tl.n Tumor Ask e: 

Co”c.r Neuralg!a ulcer 

Crolnp. (. XC.P* Neuritis varicose “.1”s 

rnensnu .1) Pin Weak 

cyst Palsy Weak”... } 

e. Whafpart of the body is affected? 

Show the following detail: 

Head . . . . . . . . . . . . . . . . . . . . . . . Sk.ll, scalp, face 

Back/spine/vertcbro . . . . . . . . . . . . upper, middle, lower 

Eoror.ye . . . . . . . . . . . . . . . . . . . oneorb.th 

Arm . . . . . . . . . . . . . . . . . . . . . . . .	 one or both; shoulder, uppel 

elbow, lower, wrist, h.nd 

Leg . . . . . . . . . . . . . . . . . . . . . . . . oneorboth; hip, upper, kne 

lower, ankle, foot 

FORM H,,.., , !,2.5 .7,, 

I m Last week a u 2 weeks–3 months 

2 L~ Week before s � Over 3-12 months 

3 u Past 2 weeks–DK which 6~M0re than 12 months ago 

(Was it d.rimg the past 12 months or before thaf time?) 

(Was it during the past 3 months or before that time?) 

(Was it during the 2 weeks outlined in red on that calendar or before that time?) 

I 

A4 I n Accident or injury u Other (NC) 

7a. Did the occident happen during the past 2 years or before that time? 

� During the past 2 years � Before 2 years (180) 

b. When did the accident happen? 

R Last week u Over 3- I 2 months 

u Week before a I–2 years 

� 2 weeks–3 months 

80.	 At the time of the accident what part of the body was hurt? 

What kind of iniury was it? Anything else? 

Part(s) of body K,nd of injury 

. 

If accident happened more than 3 months ago, ask: 

b.	 What part of the body is affected now? 

How is his affected? Is he affect.sd in any other way? 

Part(s) .af body Presem effects 

t t I I 

e 10 

106 
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CONDITION 3 

L P�rfon number Name of condition 

I 

!. When did lost see or talk to a doctor about his . . .? 

! ~ In Interview I U past 2 wks. (Item CI s 02-4 ~rs. 

week (Rwask 2) 2 ~ 2 wks. -6 mos. G � 5+ yrs. 

3 m Over 6–12 mos. T u Never 

4nlyr. a l_J DK if Dr. seen 

9 a DK when Dr. see 

Examine “Name of condition” entry and mark 

Al � Color blindness (NC) n On Card C (A2) 

I n Accident or injury (A2) ~ Neither (30) 

If “Doctor not talked to,” transcribe entry from item 1, 

If “Doctor talked to,,, ask: 

30. What did the doctor soy it was? - Did he give it a medical name? 

Ask remaining questions as appropriate for the 

condition entered in: 

A2 

I_J Item I U Q. 3b � Q. 3d 

u Q. 3a u Q. 3. � Q. 3e 

4.	 During the 2 weeks outlined in red on that 

calendar did his . . . cause him to cut down 

o. the things he usually does? 

5. During that period, how m.”y days did he cut 

~ 

6.	 During that 2-week period, how me”y do s did 

“ . . . keep him in bed all or most of t e cloy? 

7.	 How many days d,d his . . . keep him from work 

during that 2-week period? (For females): not 

counting work around th= house? 

= — Days 8.	 l-low many days did his . . . keep him from 00 � None school during that 2.week period? 

________________________________________________ 9. When did first notice his . . .? 

Do not ask for Cancer m On Card C (A2) I u Last week 4 D 2 weeks-3 months 

b. What was the cause of . . .? 2 0 Week before s O Over 3–12 months 

a Accident or injury (A2J 3 a Past 2 weeks–DK which 6 m More than 12 months ago 

. ________________________________________________ (W.s it during the past 12 months or before that time?)

If the entry in 3a or 3b includes the words: (Was it during the past 3 months or before that time?) 

Allmmt CondlNo” Disorder Tro.ble (Was it during the 2 weeks outlined i“ red on that calendar or before thot time?) 

An.mlm CY=I Growth Tumor Ask c Asthma Defect Measles ulcer A4 � Accident or injury � Other (NC) Attock Dlsa’ase R.pt. re } 

c.	 What kind bf . . . is it? 17.a. Did the occident happen during the post 2 years or before that time? 

________________________________________________ n During the past 2 years � Before 2 years (180) 

For allergy or stroke, ask 

d. How dots the allergy (stroke) affect him? 

Crmps 

Abscess Damage Paralysis 

Ache (wept hmd or �,) G,mvth Rupture 

B1.ading Hmmo,,hage sore Blood clot Inf.ctlon Soreness 

Boll l“flmnm.tlwl Tumor Ask ,, 

Conc*r Nmu,.ala[n ulcer 

(.xc.pt N..,M: V.,lces. ,.!”s rm”sttuol) P. In Weak 

cyst Palsy We.akmss 

c. What part of tha body is affect-d? 

Show the followlnz detail: 

Head . . . . . .. . . . . . . . . . . . . . . . . . skull, scalp, face 

Back/splnc/vwtcbr. ., , , . . . . . . . . . upper, middle, IWVer 

Earor eye.,......,.......,.. onec.rbc.th 

________________________________________________ b. When did the accident happen? 

I_J Last week u Over 3-12 months 

o Week before a I –2 years 

I_J 2 weeks-3 months 

180.	 At th~ time of the cccident what po,t of the kdy was hurt? 

What kind of iniury was it? Anything elss? 

Part(s) of body Kind..af I“i.cy 

I i If accident happened more than 3 months ago, ask 

b.	 What part of th= body is affected now? 

How is his affected? Is he affected in any other way? 

Arm . . . . . . . . . . . . . . . . . . . . . . . . o“eotboth; shoulder, upp,, I Part(s) of b.d. I Presmt effects 

�lbow, lower, wrist, hand 

Lag, , . .,, . . . . . . . . . . . . . . . . . . oneorboth; hip, upper, knm 

lower, ankle, foot . 

t t ,“M H,,. !!., /! 2.,.,,, Page 1I 

107 
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--------------- -------- ------ . ... .

Ask remaining questions as appropriate for the I CONDITION 4 condition entered in: 

A2 

c1 Item I n Q. 3b D Q. 3d 

2. When did last see or talk to a doctor about his ., .? 

1 .:	 [n antervtiew , Past 2 wks. {item C) s ~ 2–4 yrs. 

week (P. o .& .. . ~ ; 2 wks.-6 mos. 6 ~“ J 5+ yrs. 

3 ; Over 6-12 rnos. 7 ~] Never 

4:jlyr. s 1~ OK !f Dr. seen 

s u DK when Dr. seen 

Exam#ne “Name of condioon” entry and mark 

Al n Color bllndness (NC) a O. Card C (A2) 

rl Acc,dent or tnlury (A2) m Neither (30) 

If “Doctor not talked to, ” transcribe entry from item 1. 

If “Doctor talked to, ” ask: 

3c. Whet did the doctor soy it was? - Did he give it a medical n.anm? 

-.. .—. . . . . . ..- ...__ —_____________________________ 

El Q. 3a m Q. 3. ~ Q. 3e 

4.	 During the 2 weeks outlined in red on that 

calendar did his . . . ccmse him to cut down IIY 2 N f9J e. the thin.. he ....11. does? 

5.	 During that period, how many days did he cut _Days dew” for as much as a day? I 00 T I None (0) 

6. During that 2-week period, how many cloys did 

his	 . . . keep him in bed all or most of the day? _ Days 

00 ~{ None 

Ask if 17+ years: 

7.	 How many days did his . . . keep him from work _ Days (9) 

during that 2-w.ek period? (For females): not 

counting work around the house? 00 n None (9 I 

Ask if 6-16 years: _ Oays 8. How many days did his . . . keep him from 00 ~] None school during that 2-week period? 

9. When did first notice his . . .? 

Do not ask for Cancer � On Card C (A2) 

b.	 What was the cause of . . .? 

!; 1Accident or i“j”ry IA2) 

If the entry in 3a or 3b Includes the words: 

Ailment Condition Disorder ‘r,o”ble


A.emio cyst Growfh Tumor


Asthma Defect M..asles ulcer Ask c


Atl.ack Dlseo,e Rupture 1
 c. What kind of . . . is it? 

For allergy or stroke, ask 

d. How does the allergy (stroke) affect him? 

-----= ---, ---, ----------------- ,-----,------- .- If in 3a-d there IS an Impairment or any of the followlng entries: 

Abscess Damage P.r’dysl. 

Ache (..cq hod c+ em) Growth Rupture 

Bleeding Hemorchoge so,. Blood clef Infection soreness 

soil In flommotiml Tumor Ask e: 

c.”.., Neuralgia Ulcer 

Cramps (except Neuritis Voricose veins 

nl.snstr”.1) Pain Weak 

CYSI Palsy Weak. . . . } 

e. What part of the body is affected? 

Show the following deta,l: 

Heed . . . . . . . . . . . . . . . . . . . . . . . skull, scalp, f.ce 

Back/spine/vertebra , . . . . . ., . . . . . upper, middle, lower 

Ear or �ye . . . . . . . . . . . . . . . . . . . onc or both 

I D Last week ~ � 2 weeks-3 months 

2 u Week before s ~ Over 3-12 months 

3 U Past 2 weeks-DK which 6 ~ More than 12 months ago 

(Was it during the past 12 months or before th~t tine?) 

(Was it durin9 the past 3 months or before that time?) 

(Was it du,ing the 2 weeks outlined in red on that calendar or babe thot time?) 

A4 � Accident or injury D Other (NC) 

I

170. Did the accident happen during the past 2 years or before that time? 

� During the past 2 years � Before 2 years (1801 

b. When did the occident happen? 

u Last week Q Over 3-12 months 

u Week before � I -2 years 

� 2 weeks-3 months 

180.	 At the time of the accident what part of the bedy was hurt? 

What kind of iniury was it? Anything else? 

Part(s) of body Kind of.n.juw 

I l--------------- 4--------------------------------

If accident happened more than 3 months ago, ask: 

b.	 What part of the body is effected now? 

How is his affected? Is he affected in any other way? 

Part(s) of body Present effects 

Arm . . . . . . . . . . . . . . . . . . . . . . . ,	 onc or both; should~r, upper, 

�lbow, Iow*r, wrist, hand 

Leg .,, , . . . . . . . . . . . . . . . . . . . . ontorboth; hip, upper, knea 1 t lower, ankle, foot ...-.... 1 1 I I FORM M,S.R.1 ,!2. s.,8, Page I 2 

108 

I 
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2-WEEKS DOCTOR VISITS PAGE Person number I. Person nu”be, 

Earlier, you told me that had seen or talked to a doctor during the 2 weeks 

b.ginning Monday, (date), and �riding Sunday, (date). 2< 2< On what (oth.r) dates during that 2-week period did visit or talk to o doctor? Mm th -FK- M.. Ch z 

7777 � Lasl week 7777 � Last week 

OR OR 

_{ 8888 � Week before { 8888 � Week before 

. _ —______________ . 

Y (Reask 2.3 N (Ask 3-6 to, Y (Reask 2.s N rAsk 3-6 to, W.r. th.r. .“y other doctor visits for him duri”q that period? h and b) each vlslt) t and b) each VI.{*) 

Wh.re did he s.= the doctor on the (date), at a o ~ Wh!le inpatient i“ h.s$utal 3. ‘3 � Wh,le i“p.tienz t. hosp, ta 

clinic, hospital, doctor’s office, or some other place? (Next DV) (Next DV) 

~ � D..c. r’. office (vwp p,a.. 1 � Doctor’s office (grwp pm. 

If Hospital: Was it the outpatient clinic tic. or doct. r,s cl, ”ic) Czce or doctor% c1imc) 

or the �mergency room? 2 � Telephone 2 � Telephone 

3 0 Hospital Outpatient Clin, c 3 � Hospital Outpatie”c Clini, 

If Clinic: Was it a hospital outpatient 4 � Home 40 Home 

clinic, o company clinic, or some other 5 � HospI cal Err,ergemy Room 5 � Hospital Emergency R..II kind of clinic? 6 � Company or Industry Cl, ntc 6 � Company or Industry Clim 

7 ~ Other (Speclty) 7 � Ocher (Specify) 

7 7 

Why did he visit (call) the doctor on (date) ? ,0 la 

Write i“ reason 1 � Dig. ,X tm.tme.t (6.) 1 � Diag. or treatment (6,2) 

Mark appropriate box(es) 3 � G-ral .h..k.p mm 3 U General checkup (Eb) 

2 Cl Pre or postnatal care 2 � Pre w Posmatal care 

4 � Eye exam. (glasses) 4 � Eye exam. (glasses) 

5 � Immunization 5 ~ [Mm..i..t,.. 1 

6 � Othe, Nevx 6 � Other Nex 

2 J Dv 1

J 

I 

}

________________________________________________________ -. J - Was this for any specific condition? 1. Y (E”tw condition N (Next DV, b. Y [Enter co”dmon N (Next DVJ 

In 6a and change in 6a and changs 

to -Dlag. 0, to ‘,Dlag., or 

treatment,,) treatmont”J 

.- -. 

Mark box or ask � Ccmdition reported In 6a � Condltlon reported In ba 

Fo, “hQt ~ondltjon did “],it (Cell) th. dector on (date) ? C. c. 

I 

A Condition page is required for the condition in question 6. If there is no Condition page, enter condition in item C and ‘1I fill a page for it after completing columns for all required doctor visits, 

, .,s..., ,2.:..,8, Page I 3 
--

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HOSPITAL PAGE Person number 1. f%son number _ 

USE YOUR CALENDAR - f-fak sure the YEAR is correct you Scid kti was in me hospitol (rwrsimg home) during the post year. Month ,Date , Year t“knth ; Date I Year !. W&endid e~er the hospital (nursing home) (the last time)? I :19 _ 2. : :19_ 

Name Name 

street 

L ~atis~e name andaddres= of~ishospifal (nursing home)? City(or catmy) 

State ]state 

1. How many nights was -- in the hospital (nursing home)? — 4. Nizhis _ Ni;hts

Complete 5bfromentries in2and4 ifnotclear, asktheauestion. 

jb. ffow”manyof ~ese nights were during he ‘2weeks ouffined b. 

in red on fhat calendar? HNi~hts 5k. 

Ni;hts 

i. Forwhat condition did-- enter thehospital (nursing home)- , n Normal delivery 6. � Ncmal delivery 

& you know the medical name? If medical name unknown, D Normal at birth � Nwrnal u birth 

enter an adequate description. 

Condition 

rtt. Wete any operations performed on durin9 this 5W @he 

Show CAUSE, KIND, and PART OF BODY in same detail as required 

for the Condition page. ____________________ 

Cause � On Card C a Ace. Cause � G Card C � Am. 

or Inj. orIn 

For delivery, ask 

Was this a rsxmal delivery? Kind Kind If ““No,’” aslc What was the matter? For newbarn. ask 

Was the baby normal ot’birth? } Part of be+ Pal-cof b+ 

hospital (nursing home)? 

.Y o N (/??) 

7U. 

Y 0 N (w) -

b. what was the nome of the opemtion? L b. 

If	 name of operation is not known, describe what was done. - -. 

Y (Describe) Y (Describa) ~ N 7fN 

c. Any other operations during this stay? c. 1--1c,

I 

A Condition page is required if there is an entry of “I” or more nights in Sb. If there is no Condition page, enter condition P2 I in item C and fill a page fof it after completing columns for all required hospitalizations. 

‘OOTNOTES 

FORM“,*-R-, ,,2., -7., Paze I 4 

110 

I 
r 

FOOTNOTES 

,O”M ..),,. ”, ,,2.s .,,, Page I 5 

111 
---------------

E If this questionnaire is for on If in AREA SEGMENT LISTING SHEET 

EXTRA unit, enter Control Number also enter for FIRST unit Sheet number Lme number 

of original sample unft w I;sted on property_ 

TABLE X - LIVING QUARTERS DETERMINATIONS AT LISTED ADDRESS 

LOCATION OF UNIT USE OR CHARACTERISTICS CLASSIFICATION 

. If listed, enter If outside AREA SEGMENT Are these 

sheet and line boundav; mark box below, (specify location) OCCUPIEO ALL QUARTERS N - Not a separate 

Where ore these quarters located? number. STOP STOP and – quarters for more unit, add occuTable X and than one group Do these quarters in pants to this 

Enter exoct descnptmn or Iocatlon. continue � Go to next line of Table X. of peOpl*? Do the occupants of (specify location] have: questionnaire. 

e.g., basement, 2nd floor, rear. interview for if additional quarters these (specify location) (Complete 0 

i“e After entering description or location:	 original 

unit. 

determined. If “Yes,” 

for

fill quarters live and � at Diract access Complete kitchen separate ques­ sample one line with any other group from the outside facilities for tionnaire for 

Jo. . in Area Segment, go to (3) �	 If unlisted, 

OR each group. of people? or through a this unit only? each unrelated 

- and Area � Go to Household page, item9, common hall? person or 

� in other types of Segments, Segment, or Probe page, question I family group.) 

– If living quarters are not within go to 4. (as applicable). 

the same specific sample address and another type Separate unit­ (and structure, if Permit Segment) – – .f Segme,,t, HU Fill poge 1 of STOP TABLE X go to (5) OT } o blank HIS-R-1 - Otherwise, go to (3) 

1) (2) (3) (4) (5) (6) (7) (8) (9) 

Yes - Go to (9) No 

1 s_ L_ u Outside segment boundary Yes No and circle N Yes No Yes No N HU OT 

Yes - Go to (9) No 

2 s_ L_ u Outside segment boundary Yes No and circle N Yes No Yes No N HU OT 

Yes - Go to (9) No 

3 s— L_ u Outside segment boundary Yes No and circle N Yes No Yes No N HU OT 

NOTE: Be sure to continue interview for original sample unit. 

FOOTNOTES 
O.M.B. No. 0937-0021: Amxoval .. - —--. Exc.ires -----June —----- 3c. . 1---!484

MWA?IS-R-1-T (1983) 

U.S.DEPARTMENTOFCOMMERCE BUREAUOF THE CENSUS


ACTING AS COUEC71NG AGENT FORTHE


U.S.PuSLICHEALTHSERVICE 

RECONCILIATION RECORD 

U.S. HEALTH INTERVIEW SURVEY 

7. When was this structureoriginallybuilt? 

� BeforeApril 1, 1970 

� After April 1,1970 

4. Noninterviewreason 

TVPE A 

01 � Refusal 

02 � No one at home — repeated calls 

NOTICE - Informationcontainedon this form which would pamdt”idendficationof any individualor sstabkk 

ment has bssn collectedW-kha guaranteethat it will be held in strictconfidence,will bs used only for purposss 

stated for this study, and will not bs dkclosed or releasedto othsrs without ths conssot of ths individualor ths 

establishmentin accordancewhh sestion 308 (d) of the PublicHealthServiceAct [42 USC 242m). 

1. 2. :I:ber 3. Sample 4. Segment type 5. Control number 

Book _	 � Area 

•l Permit PSU ;Segment ~Serial 

of � Address I 

I I 

books � Cen Sup I 

•l Specialplace / 

11.Telephone number 13.Interviewername ~Code b. Date of original 

03 � Temporarily absent 

04 � Other — Specify 

d 

5. Recordof callsat household 

Date 

Beginningtime 

Ending time 

a.m. 

p.m. 

a.m. 

p.m. 

6.	 Original respondent for reinterview sample 

(from HIS-1, page 44, item R) 

o � Under 17 

I � Presentfor allquestions 

2 � Presentfor some questions OR 

3 � Not present 

Personnumber(s) of respondent(s) 

omments 

� None 

TYPE B 

05 •l Vacant — nonseasonal 

oa � Vacant — seasonal 

07 � Occupied antirelyby 

persona with URE 

os � Occupied entirely by Armed 

Forces members 

OSJ� Unfit or to be demolished 

10� Under construction, not ready 

II � Converted to temporary business 

or storage 

12 � Unoccupied tent site or trailer site 

13 � Permit granted, construction 

not started 

14 � Other — Specify 

J 

a.m. a.m. 

p.m. p.m. 

a.m. a.m. 

p.m. p.m. 

person 

Name of person providing nonintemiew 

information 

/ 

I interview 

I 

I 

TYPE C 

15 � Unused lineof listingsheet 

16 � Demolished 

17 � House or trailermoved 

1a � Outside segment 

19 �	 Converted to permanent 

business or storage 

20 � Merged 

21 � Condemned 

22 � Built after April 1, 1970 

23 � Other — Specify 

J 

a.m. a.m. a.m. 

p.m. p.m. p.m. 

a.m. a.m. a.m. 

p.m. p.m. p.m. 

17.If nonintervieworiginally,what is the 

correcttype of nonintewiew at time of 

originalinterview? 

� A – List in item 17a on form HIS-R-1 

allpersons who livehere 

� B 

� C 

113 

b 
i. RECONCILIATION SECTION FOR RESTRICTED ACTIVITY PAGE B. RECONCILIATION SECTION 

FOR CONDITIONS AND The original questionnaire ahowed . . . and I have ..., what is HOSPITALIZATIONS the correct information? 

REPORTED IN ONE lNTERVIEW BUT NOT BOTH 

INTERVIEWS 

Original Reconciliation 

b. Work – loss days 2b. Work – loss days We are interested in finding out 

� None � None more ebout conditions and 

lb. School. loss days 

� None 

3b. School. loss days 

� None 

hoepitalizations which ware 

reported at one time but not at 

another. Can you think of any 

lb. Bed days 4b. Bed days explanation for. . . not having 

� None � None been raported in (tha original 

lb. Cut-down days 6b. Cut-down days 

interview/our interviaw today)? 

� None � None 

:. RECONCILIATION SECTION FOR DIFFERENCES WITHIN MATCHED CONDITIONS 

The original questionnaire ahowad. . . and I hava . . .. what is the corract information? � None 

‘erson Match Check Item for matched condition Person Match Check Item for matched condition Person Match Check Item for matched condition 

No. � Only 1 condition reported in � Only 1 condition reported in No, � Only 1 condition reported in 

•1 original OR reinterview — Oo not 

reconcile 2, 5-9 ‘0” •1 original OR reinterview - Do not 

reconcile 2, 5 —9 •1 original OR reinterview — Do not 

reconcile 2, 5-9 

� Other - Reconcile 2,5-9 � Other – Reconcile 2,5-9 � Other - Reconcile 2,5-9 

Original Reconciliation Original Reconciliation Original Raconcihtion 

)rig. Cond. No. _ Reint. Cond. No. _ Orig. Cond. No. _ Reint. Cond. No. _ Orig. Cond. No. _ Reint. Cond. No. — 

!.	 1 � 2-wk. ref. pd. ~. I � 2.wk. ref. pd. 2. I � 2.wk. ref. pd. 2. I � 2.wk. ref. pd. 2. I � 2.wk. ref. pd. 2.1 � 2-wk. ref. pd. 

2 D 2 weeks–6 mos. 2 � 2 weeks—6 mos. 2 � 2 weeks—6 mos. 2 � 2 weeks—6 mos. 2 � 2 weeks—6 mos. 2 � 2 weeks-6 mos. 

3 � 0ver6-12mos. 3 � 0ver6—12mos. 3 � 0ver6—t2mos. 3 � 0ver6-12mos. 3 � 0ver6-12mos. 3 D 0ver6–12 mos. 

4 El l—2 years 4 El l–2 years 4 •l l—2 years 4 � l–2 years 40 l–2 years 4 � 1–2 years 

5 � 2-5years 5 � 2-5year3 5 � 2-5years 5 � 2-5 years 5 � 2-5 years 5 II 2-5years 

6 D 5+ years 6 � 5+ years 6 � 5+ years 6 � 5+ years 6 � 5+ years 6 n 5+ years 

7 � Dr. seen, DK when 7 � Or. seen, DK when 7 � Dr. seen, OK when 7 � Dr. seen, OK when 7 � Dr. see”, DK when 7 � Dr. seen, OK whe ----—- -—--—- .—— —- ——— —-—- —- -————__———__—- .—__— ——____ —__ ______________ _____________ 

8 � OK if Dr. seen 8 � OK if Dr. seen a � DK if Dr. seen 8 � DK if Dr. seen a � DK if Dr. seen s a DK if Or. seen 

9 0 Or. never seen 9 � Or. never seen 9 � Dr. never seen 9 � Or. never seen 9 IJ Or. ncwor seen 9 •l Or. nwer seen 

b. 3b. 3b. 

—-__ -— — ___________________ ___________________________ ___________________ . 

c, c, c. 

—-. .--- ——----- ——----—-— —-- -— —--. __ ——___— — ____________ -_______________ — _________ . 

d. d. d. 

---.——----—-——---———--—. .—— __ ———___— —__ ———__— —— ___ —___ __________________________ 

e. e. e. 

f. f. f. 

_- ——---_— ——-___ — __________ ___________________________ __________________________ . 

9. 9. 9. 

‘.	 1 � 2-wk. ref. pd. 5. 1 � 2.wk. ref. pd. 5. 1 � 2-wk. ref. pd. 5. 1 � 2.wk. ref. pd. 5. 1 � 2-wk. ref. pd. 5. 1 � 2.wk. ref. pd. 

2 � Over 2 wk$. -3 mos. 2 � 0ver2 wks, -3 mos. 2 � Over 2 wks, -3mos, 2 � Over 2 wks. —3 mos. 2 � Over 2 wks. –3 mos. 2 � OveJ 2 wks, -3 mo 

3 � Over 3 mos.- 1 yr. 3 � Over 3 mea,- 1 yr. 3 � 0ver3 mos. -l yr. 3 � 0ver3 mos. –l yr. 3 Cl 0ver3 mos. –l yr. 3 � 0ver3m0s, -1 yr. 

4 � Over 1 yr. —5 yrs. 4 •l Over 1 yr. -5 yrs. 4 � Over 1 yr. -5 yrs. 4 � Ovar 1 yr,- 5 yrs. 4 � Over 1 yr. –5 yrs. 4 •l Over 1 yr.- 5 yrs. 

5 � Over 5 yrs. 5 El Over 5 yrs, 5 � Over 5 yrs. 5 •l Over 5 yrs. 5 � Over 5 yrs. 5 •l Over 5 YIS. 

6a. 

‘a. El Yes H No 60. •l Yes � No 6’. � ‘f,, � No 6’. � Yes � No •l Yes � No 6“. � Yes � No 

‘b 

I Days

� None I 6b H None 

I Days 

j 

6b � None I Days 

~ 6b � None 

I Days 

~ 6b � None 

I Days 

~ 6b 

I Days � None ~ 

‘. � None ~Days 7. � None 

LOays 

I 7. � None 

i Days 

I 7. � None 

I Days 

I 7. � None 

1Oays 

I 7. 

I Oays � None ~ 

‘. 

1Oays

� None ~ ‘. � None \ “y’ 8. � None 

I Days 

I a. � None 

I Oays 

I 8“ � None 

I Oays 

; 8. 

I Oays 

H None / 

‘. 

I Days � None 1 ‘. D None 

I Days 

I 

9. � None I 

I Days 

‘. � NOM 

1Oays 

I 

9. � None I 

IDays 9. I DOYS � None ~ 

:omments 

.. . . . . . . . . . . . . . . 

114 
--

lame of cQndltlon Name of condition 

)ate of hospitalization ~Person number Date of hospitalization 1Person number 

I I 

I I 

1 1 

:xplanatlon Explanation 

�Original only – Sustained � Reinterview only – Sustained � Original only – Sustained � Reinterview only – Sustained 

� Orlglnal only – Deleted � Reinterview only – Deleted � Original only – Deleted � Reinterview only - Oeleted 

‘~oon Match Chock Item for matched condition 

� Only 1 condition reported in 

original OR reintewiew - Do not 

reconcile 2, 5-9 

� Other – Reconcile 2, 5–9 

� 

original R*cOnclliatiOn 

lrlg. Cond. No. Reint. Cond. No. — 

!.	 I Q 2.wk. ref. pd. 2. 1 � 2-wk. ref. pd. 

2 � 2 weeks–6 mos. 2 � 2 weeks– 6 mos. 

3 � 0ver6-12 mos. 3 � 0ver6—12mos. 

4 � l–2years 4 � l–2 years 

5 � 2-5 years 5 � 2–5 years 

6 � 5+ years 6 � 5+ yearS 

7 � Or. seen, DK when 7 � Dr. seen, DK when -——————————— .—— ——. —-- ——— -

8 � DK if Dr. seen 8 � DK if Dr. seen 

9 � Dr. never seen 9 � Dr. never seen 

b. 

c. 

——. ——— ——— —— ---

d. 

9. 

f. 

-—-—————————------—-————— 

9. 

“	 1 � 2-wk. ref. pd. 5” I � 2.wk, ref. pd. 

2 � Over 2 wks, -3 mos. 2 � Over 2 wks. –3 mos. 

Person Match Check Item for matched condition 

No. � Only 1 condition reported in 

original OR reinterview — Do not 

•1 reconcile 2, 5 —9 

� Other 

Original 

Orig. Cond. No. 

2. I � 2.wk. ref. pd. 

2 � 2 weeks—6 mos. 

3 � 0ver6—12 mos. 

4 � l–2 years 

5 � 2—5 years 

6 � 5+ years 

7 � Or. seen, OK when ————————————— 

8 � OK if Dr. seen 

9 H Dr. never seen 

3b. 

c. 

–	 Reconcile 2, 5–9 

Recmciliatim 

Reint. Cond. No. 

2.	 I � 2-wk. ref. pd. 

2 � 2 weeks—6 mos. 

3 � 0ver6–12m0s. 

4 � l–2 years 

5 � 2–5 years 

6 � 6+ y~~C3 

7 � Dr. seen, DK when ————————————— 

8 � DK if Or. seen 

9 � Or. never se6n 

———————————————————— -—————— 

d. 

0. 

f. 

� 

Person Match Check Item for matched condition 

No. � Only 1 condition reported in 

original OR reinterview - Do not 

reconcile 2, 5—9 

� Other – Reconcile 2,5-9 

Original RecOncifiatiOn 

Orig. Cond. No. _ Reint. Cond. No. — 

2.	 I � 2.wk. ,ef. pd. 2. I D 2-wk. ref. pd. 

2 � 2 weeks—6 mos. 2 � 2 weeks–6 mos. 

3 � 0ver6–12 mos. 3 � 0ver6—12 mos. 

4 •l l–2 years 4 � l–2 years 

5 � 2–5 years 5 � 2–5 years 

6 � 5+ years 6 � 5+ years 

7 � Dr. seen, DK when 7 � Dr. seen, DK when .—— ———-— ——— —— ——————_—————— 

8 � OK if D,. seen 6 � DK if Or. seen 

9 � Dr. never seen 9 � Dr. never seen 

3b. 

c. 

——————————————————.——————-

d. 

e. 

—————————-—————-————--———— 

f. 

——— ——— ——----— ——— ——— ——--— — -— ——— —.-. ——— —-- ——— ——--— —— —---

9. 9. 

s. 5“ 1 � 2.wk. ref. pd. 5” 1 � 2-wk. ref. pd. 5“ 1 � 2-wk. ref. pd. 1 � 2.wk. ref. pd. 

2 � Ove, 2 wks. -3 mos. 2 •l Over 2 wk5. -3 mos. 2 � Over 2 wks. -3 mos. 2 � Over 2 wks. -3 mos 

3 •l 0ver3 mos. -l yr. 3 � Over 3 mos. – 1 yr. 3 � Over 3 mos. – 1 Yr. 3 � Over 3 mos.- 1 yr. 3 •l Over 3 mos. —1 yr. 3 � Over 3 mos.- 1 Yr. 

4 U Over 1 yr. –5 yrs. 4 0 Over 1 yr.–5yrs. 4 � Over 1 yr. –5 yrs. 4 •l Over 1 yr. - 5 yrs. 4 � Over 1 yr. – 5 yrs. 4 � Over 1 yr.-5 yrs. 

5 � Over 5 yrs. 5 •l Over 5 yrs. 5 � Over 5 yrs. 5 � Over 5 yrs. 5 •l Over 5 yrs. 5 � Over 5 Yrs. 

‘“” � Yes � No 6’” � Yes � No 6“” � Yes � N. 6’” � Yes � No 6“” � Yes � No 60” � Yes � No 

‘b � None I 

I Days 

6b � None I 

I Days 

6b � None ~Days 6b � None I 

I Days 

6b � None I 

I Days 

6b � None ~ 

I Days 

“ � None 

I Days 

I 7“ H None 

I Oays 

I 

7. � None I 

I 

Days 7. � None 

I 

I 

Days 

7’ � None 

I Oays 

I 7“ � None i 

I Days 

“ � None 

I Days 

~ 

8. � NQ.e 

I Days 

~ 

8. � None 1 

I 

Oays 8. � None t 

I Days 8. � None 

I Days 

I 8“ � None 

1 

I 

Days 

1’ � None 

I Days 

I ‘“ H None 

I Days 

I ‘“ � None 

I Days 

I ‘“ � None 

! Oays 

I ‘“ � None 

I Days 

I g“ H None 

I Oays 

~ 

Page 2 

115 
------------------ ‘--”--------””---

� � 

me of condition ame of condition 

te of hospitalization 1Person numtmr 

[ 

I 

Nanation 

�Original only – Sustained � Reinterview only – Sustained 

�Original only - Deleted � Reinterview only – Oeleted 

me of condition 

,te of hospitalization 1Person number 

I 

planation 

H Original only – Sustained � Reintewiew only – Sustained 

� Original only - Oeleted � Reinterview only – Deleted 

ate of hospitalization	 1Person number 

I 

� Original only – Sustained � Reintewiew only – Sustained 

� Original only – Deleted � Reintewiew only – Deleted 

xplanation 

� Original only – Sustained �’Reintewtew only – Sustained 

� Original only – Deleted � Reinterwew only – Deleted 

. RECONCILIATION SECTION FOR DIFFERENCES WITHIN MATCHED HOSPITALIZATIONS 

The originel questionnaire showad... and I have . . .. what is the correct information? �. . . . 

Person number Match 1. Person number Match 

Original Reconchtion Original Raconcitistion 

Month Date Year 2. Month Date Year 2. Month Date Year 2. Month Date Year 

~Nights 3. ~Nights 3. ~Nights 3. I Nights 

� None I � None I � None I � None [ 

� Normal delivery 

� Normal at birth 

H No condition 

•l Cmditio” 

8. 1 i3 Yes 2DN0 

b.­

(1)


--------1


. Name of hospital 16. Name of hospital 6. Name of hospital 

Number and street } Number and street Number and street i Number and street ---t------------------” 

-————---——------——— ——————————————————— ——————————————————— City orcounty City orcounty City or county City or county 

——— ———-— t i------------------­——— ——— —---— —----—————————————— ——————————————————— _—— ——— ———__—_— ——— ——

State State State State t t 1 

116 
.apowl:ls.R.401A(1983) IJ.5, DEPT. OF COMM. 1. Interviewer name / Code ~ Telephone number 2. R.o. DUR. OF THE CEN. 1 I 

1 

3. Reinterviewer name [Code I Job title 4. Psu 

SUMMARY REPORTOF 1 ~� Program Supervisor 

HIS REINTERVIEW 1 � Alternate 

5. Reinterview date � %pervisory Field Re+I 6. SamPle 

(COVERAGE) 

n Other 

Sectionll - Section I - COVERAGE CHECK OF HOUSING AND OTHER UNITS HOUSEHOLD COMPOSITION CHECK 

Segmenttype Part B Number of persons 

P.arf A - Listing Check Segment Household Before . Area (Number 01 units) Number of numbw Serial No. rein cer- Added Delete< 

Se;ment � Address sample view 

Number � Permit 7A Listed units Miscel - (1) (2) (3) (4) (5) 

. Special NTA laneo”s* 

place Mixed before Added Oel=ted before 

reinterview reinterview 

� Cen-Sup)

(1) (2) (3) (4) 

otol this 

lint* rvi*w 1: 

Wrong households visited, noninterview misclassifications and 

[explanations of differences in sactions I and Il. (Give reference 

umbsr, Exp/a/nchttnges /nc/ass/f/caf/on of YEAR BUILT.) 

Section IV - DISCREPANCIES IN OTHER ITEMS 

Se:nmt Item 

No. Description of discrepancy 

Ser#al No. 

(1) (2) (3) 

totes 

(s) (6) (7) 

EXTRA units missed. 

tosection and segment 

Total this reinterview 

Pr=vio.s cumulative totol 

New cumulative ?otal 

Section V - REINTERVIEW FOLLOW-UP 

\ction taken w to be taken: Section (Mark X) 

I-A [.6 II 

Discussed errors . . . . . . . . . . . . . . . . . . . . 

Retrained interviewer . . . . . . . . . . . . . . . . 

Observed interviewer (OJT) . . . . . . . . . . . . . 

Supplemental reinterview . . . . . . . . . . . . . . 

Noactionteken . . . . . . . . . . . . . . . . . . . . 

Other - specify 

Copy dlstrlbuticm: WHITE - SM/QCB - Jeffersonville YELLOW - Regional Office 

117 
FORM fi15-R-401B(1983) u.S. DEPT. OF COMMERCE 1. Interviewer name ~ Code ~ Telephone number 2. R,O. 

[$. !0.8s, BUREAU OF THE CENSUS I I 

I 

3. Reinterviewed name i Code I Job title 4. Psu 

I 

SUMMARY REPORT OF I Cl prwamsupervisor I 1 � Alternate HIS REINTERVIEW 5. Reinterview date � %pervlsory F,eld Rep. b. ‘amp” 

(CONTENT) @ Other 

Section Ill - CONTENT CHECK (See reverse side for instructions) 

Part A - Restricted Activity Port B - Charoeteristics Port c - Nwnb.r of Cc.ndltlc.ns and 

PO g, Within Conditions Hospitollzatlons 

and Hospitalizations 

Se\ynt Household 

Ser,al No. 

Different Same Different Ssme 

respondent respondent respondent respondent 

Different Same 

respondent respondent 

Enter Enter 0 lffer - Nu~~)r of ~iffer. Number Of ~, ffer0-1,, if Dlffer- ‘-1” if c~e(~ =“=,, 

:b::;- D lffer- Accept. Diffr,r- a :.1: y e“ce~ 

Group I ‘n’es Group 2 ‘n=es checks e “c== base en=== 

(1) (2) (3) (4) (5) (6) (7) (8) (9) (lo) (11) (12) (13) (14) 

Total this reinterview 

Previous cumulative totnl 

New cumulative t.tol 

Section V - REINTERVIEW FOLLOW-UP 

Section (hfsrk X) Notes 

Action taken or to be taken: 

II I-A II I-B Ill-c 

Discussed errors . . . . . . . . . . . . . . . . . . . 

Retrained interviewer . . . . . . . . . . . . . . . . 

Observed interviewer (OJT) . . . . . . . . . . . . 

Supplemental reinterview . . . . . . . . . . . . . . 

No action taken . . . . . . . . . . . . . . . . . . . 

Other - Specify 

L I 

COPY distribution: WHITE - SM/QCB - Jeffersonv!lle YELLOW - Regional Office 

118 
INSTRUCTIONS FOR FILLING SECTION Ill - CONTENT CHECK 

Columns (1) Enter the segment number and household serial number for each un!t 

and (2) tntervt ewedinre!ntervi ew, except Omit Content Reconcl liatlon (OCR) cases. 

Part A - Restricted Activity Pt19e 

Column (3)	 Enter’’ l’” lf a Group I case–that is, the Same Adult is NOT!nterv!ewed 

in both vls!ts (Includes different parents responding for children under 

17). Otherwise Ieave blank. 

Col”m” (5)	 Enter “1’” if a Group 2 case – that is, the Same Adult IS interviewed 

In both vIs Its for themselves, for other adult sample persons, or for 

children under 17. Otherwise leave blank. 

Columns (4) Fill column(4) if””l”’ IS in column (3)on same Il”e. 

and (6) 

FIII column (6) if ““l” is t“column(5)o” same line. 

Include differences found in Section A of the HIS-R-I-T when the reinterview answer is correct, or neither the original nor reinterview answer is 

correct. Do not include differences where original interview answer is 

correct. The maximum number of differences is 3 for each person. 

Part B - Characteristics Within Conditions a“d Hospitalizations 

Columns (7) Fill column(7) if”l” is in column (3) on same line. 

�nd (9) 

FIII column (9) if “1” is in column (S) on same line. 

Enter the total number of Match boxes checked (./ ) in section C with 

the’’ Other’’ box marked in the Check Item and the Match boxes checked 

(v”) in section D if the HIS-R-I-T. This total represents the number of 

Match:d Conditions and/or Hospitalizations reported in both the original 

interv!ew and reinterview, for which characteristics are reconciled. 

Columns (8) Fill (8) if there is an entry in (7). 

and (10) 

Fill (10) if there is an entry in (9). 

Count only differences between original interview and reinterview for 

certain items within matched (./ ) Conditions which have the “Other” 

box marked in the Check Item (items 2,5,6a or b,7,8 or9) and within 

matched (,,. ) Hospitalizations (items 2.3, and6), The maximum number 

of differences for each Condition is 5,and for each Hospitalization is 3. 

Part C- Number of Conditions ond Hospitalizations 

Column (11) Fill column (1 1) if “’l”’ is in column (3).

Enter thenumber of checks (W) from column (7), plus those Conditions 

~d Hospitalizations reported in only one interview (original or reinterview) and sustained. 

Column (13) Fill column (13) if”’I’’ lsln column(S). 

Enter the number of checks (ti)frOm colurnn,(%. plus those conditions 

msd Hospitalizations reported in only one interview (original or reinterview) and sustained. 

Colutnnnn[~~] Fill column (12) if””l’’ is!n column(3). 

Fill column (14) if ““l’” is i“cc,lum” (5). 

Enter the number of Conditions and Hospitalizations reported unoriginal 

interview only and deleted after reconcil~ati on, plus the number reported 

in reinterview only tmd sustained after reconciliation. 

119 
Appendix X 

Forms for recording 

interviewer errors 

. . 

120 
--

IALTH lwnANcs Lot 

I , 1 w [ t 

1 I I i 10 I 3% 

2 11 

a 1 I i 12 

� ,a 1s 

s 1 I 1 14 I I 

Mvm7fVR 

M �OE 

I a 

a I I 4 U* I I 

121 
122 
----------------- -----------------------------------

-------- ------- ------- ------- ------- ----

-------- ------- ------- ------- ------- ----

- WS.?OSB U.&w -m c+ 2. Sulub & mu 1!2.16.s11 -6m 

HIS DIAGNOSTIC SRROR8 ON —- ::5’JXJ% 82.1 

DOCTORV181TS/HOSPITAUZATIONS Icbdc 

SAltOSAL MRALTH lfITISVISW SUSWV :4- I-? z.~lr **W Cc& 

H NC. luaKfl pu 

3	 1. -d-~1 

I 

4. Namd~ 

1- I 

eY. 

I w Id cl. 40 C4LLlmd SUED 03 

1


---.---

t t----l 

?lTALi2AT10N 

s, Told *N 4. Numet — 

3 e~.8 

t -----------------------------------------------t----i 

no SPITALIZATIOM s?. w 

~so. 

a.Ta# m@flla 4. Nmud — 

t -----------------------------------------------t----i f HOSPITALIZATION Em ­

~sb. 

a. TOu Iw4# 4.nAT9elmdlJc4! 

----.--

t t----l 

123 
-

CA


SW!CT—OF—l HEE TS 

,0”” 11.lmc I 

PROOUCTICN GUIDE FOR HIS I 1 I I I I 

+ Iimba d uses ,Nudwdsefmenk , Nca.!esidentml S4wllmnk2 Thm *SSIDMMI Cumuklwe 

-JSsl;nwnls 

US. DCPAMIMZM1 OF C-UL!RCC & M3r4klw :Cdi b. Rew7al Ofhce c. samplerumk A HomePSU (..,7.,., ..”CAU 0. 7“s ..”s”. ~ 

Prdlmtbn TWS A, kl.x v,*lld x “Idled 

tlstin~ m T,,ps CA7 

UntU m,”ue% Allonul Clalmd ‘Ahd Cl:uw: lath Sb,tw *MM PW(l) Pyyl ~, ymtwc ~ wimmJ b CM fw Inw. CA5 %Okly k ~~ ‘lt~ 

inlwdews V*W$ Viewilu Vlewml Llpllaltnl 1 

~, ““8, m,nut*s3 mkuk, mlnula $& 

m (2I (3) (4) {5) (6) (7) {1) (91 (10) [11) (12) [13) 04) 05) (16) [17) (18) (19) (al (211 {22) 

, z I 

1 I 1 i I I I I I I 1 I I ! 1 I I I 1 

I I I I I I I I I 1 I I I I I I I I 

t , 

WI Um(x M6 mm.xJVisiw -my 7U Ilatml w W6sliw 

2T860 vd *IY in mow tin � swbuntal dlcwt- Is snhcazmd. OFFICE TOTAL 

SC@. lkols. (4x5) � Cd& (6X7)+ cd:. (3X9)+ COW (1OX11) t cola. 112X13) � CoIs. Was) t Cdr. (16X17). *I 

Mint �ikw Remllks 

Dt I ~2 I ~4 

I I I I *dsbl* HTC-R9gi0.u10Hk9 W!UOS - mid, FIM DlvIsim 
\ 

mo~7:~3! (His) U.S. DEPARTMENT OF COMMERCE 1. Regional Office 2. Year 8URI!A” OP THE CENSUS 

/?81 

3.	 Name 4. Coda 

@*a

SUMMARY OF HIS INTERVIEWER PERFORMANCE s. 

(FM tirm H12.403J (From fom H13-70#9J (Fran fwm 11.102cJ (From fmm Hl&R-4Pl) (From hrm H12-408) 

Observation 

Type Results Total Percent Error Pro. 

ductlon Relntervlew s - Systematic E - Excallent 

vlewad Quamr 

�nd elrors minutes (Enter “AC) or ~W1l) SN - :P-al s - stuisf~tay 

tip: ;Xlrm 7X e 100 ~ 

f FR- Failad 

reinterview 

MI - Needs irn. 

provement 

u - ““~:t,~. 

1A Ic II 111A Ills Illc factory 

(a) (b) (c) (d) (e) (f) (;) (h) (i) (1) --., (k) (1) (m) (.) (0) (P) (q) (r) 

I at Qtr. /24 9 /87 ~ g~~ 08 w $j 735 yrlo,~ - 5 

htd Qtr. //d — 00 7 /39~ cl~ /4405/4370km 5 v~ 

)rd Qtr. # I )to // &5 /,79 A@ 9!,?77/@$ s 5 

lnter- T~~: t&a Number Base rate gl:ul: Payroll ratio I - Iniclal VG - very tood 

tth Qtr. 10?3 $.8 # 9’54j15 3~73 ~qj$’ la Iemarks 

$“..” 

-r, At.,.:l”,,l . . . . . . . . . -., . . . . wt41rm “., . . - --

R..l,,,..l . . . . . . . . . . riffle. . . . . . . 

YI!LLOW - Chlaf, Fl*ld 01v1810n - �ftw 3rd �nd 4th quarmr information has bton pos!ad. 

PINK - Chlof, Fidd Olvlsion - �ftw Ist �nd 2nd quartar Informatkm has baon posted, 
,-,,.” -------

Appendix Xl II 

Notificationof Interviewer 

Performance 

HIS-103


(March 1981)


PO*!.4 11-40 U.S. DEPARTMENT OF COMMCRCE 1. Intmviewer nsm i Coda Is.1O-7W muR=AU OF Tw17 CEM,”S 

@+62 

NOTIFICATION OF 3. Psriod COvemd 040. day, Yr.) 3.Regional Office 

INTERVIEWER PERFORMANCE Fro ~ 733/ *,	 ~;q,.r, I 

INSTRUCTIONS - Prepare an original and one COPY at the end of each period covered for all 

interviewers who have had che prescri~d experience. See the approp~iate program manual(s) 

for demled inswuctions for completion of this form. Send she original to she interviewer and 

I fi Ie the copy in the interviewer’s appropriate performance folder in she Regional Office. 

Perforrmrce ratnng 

surv*y Rata Numsrld Adjectiv. 

(a) (b) (c) (d) 

� Cvs a QHS 

� C8R � SOc 

Production Au a $&qj4+L 

u CPS ~ CMS 

$KJHIS � OTH ER -

Error /’4 79 &#.s2& 

w 

Sfsecltyg 

� NCS Noninterviewf /, D 

Remarks 

rFor CBR this r.fc,~ coCh. ,Vesponse ratci,: for �ll ether surveys this refers to the Tyge A nonintew!ew ram


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126 

I 
Appendix XIV


Transcription sheet


PERSON PAGE 

ITEM COL. CODE CODE CODE CODE CODE CODE CODE 

Record Type 1-2 2 0 2 0 2 0 2 0 2 0 2 0 2 0 

1.	 Person Number 34


1, Sample Child 5


1. Age 6-7 I - 1 1 I : 1. Race 8


1. Sex 9


2. Typeof Family 10


2. Relationship 11


2. Family Structure Code for Children 12


Month 13-14


3. Date 

of Day 15-16


Birth


Year 17-19


4. Marital Status 20


H, Status atlnitiallnterview 21


5a.b Bad Disability Days 22-23


6 Work.Loss Days 24-25


$ .g 7 School-Loss Days 26.27 

;$ ~	 Bad DaysCoinciding


With Time-LossDays 28-29


$ 9a
 Other Days 30 ~ 

9b Cut-Down Days 31-32


12d. No. of 2 Wk. Dental Visits 33-34


13. Interval Since Last Dentai Visit 35


14. 2 Week Doctor Visits 36-37


Shots-X Rays-Tests 38-39 1‘. Exams-2 Weeks 

16d.PhoneCallsto Doctor in 2 Wsaks 4041


18a, 12 Month Doctor Visits 4244


18b. Last Doctor Visit 45


19/20. Usual Activity Status 46


21/27a. Limitation of Activity 47


28a. Duration of Limitation of Activity 48-50
 I


33.	 Health Status 51


Check Item BD 52


34.	 Bed Days Past 12 Mos. 53


R. Respondent 54


R. Person Number of Respondent 55-56 I I 1 I I


127


*U. s.Government l?rinting Office 1988: 201-855/80000


I

1 
VW and Health Statistics 

series descriptions 

sERIES 1. Programs and Collection Procedures–Reports describing 

the general programs of the National Center for Health 

Statistics and its offices and divisions and the data COI. 

Iection methods used. They also include definitions and 

other material necessary for understanding the data. 

SERIES 2.	 Data Evaluation and Methods Research-Studies of new 

statistical methodology including experimental tests of 

new survey methods, studies of vital statistics collection 

methods, new analytical techniques, objective evaluations 

of reliability of collected data, and contributions to 

statistical theory. Studies also include comparison of 

U.S. methodology with those of other countries. 

SERIES 3.	 Analytical and Epidemiological Studies–Reports presenting analytical or interpretive studies based on vttal 

and health statistics, carrying the analysis further than 

thti expository types of reports in the other series. 

SERIES 4.	 Documents and Committea Reports–F !nal reports of 

major committees concerned with vital and health sta. 

t!stlcs and documents such as recommended model vital 

rtgistrdtion laws and revised birth and death certificates. 

SERIES 5,	 Comparative International Vital and Health Statistics 

Reports-Analytical and descriptive reports comparing 

U.S. vital and health statistics with those of other countries. 

SERIES 10.	 Data From the National Health Interview Survey–Stattstics on illness, accidental injuries, disability, use of hospit.11, medical, dental, and other services, and other 

Iwmlth.rekited topics, all based on data collected in the 

continuing national household Interview survey. 

SERIES 11.	 Data From the National Health Examination Suwey and 

the National Health and Nutrition Examination Suwey– 

Data from direct examination, testing, and measurement 

ot nmlonal samples of the civilian noninstitu tlonalized 

population provide the basis for (1) estimates of the 

mtdically defined prevalence of speclftc diseases In the 

LJnltccf States and the distributions of the population 

wtth respect to physical, physiological, and psycholtx_IIcal characteristics and (2) analysis of relattonshlps 

dmong the various measurements wnhout reference to 

,m lr\plwlt fmlte unwerse of persons. 

SERIES 12	 Data From the Institutionalized Population Survey s-D iscant!nued in 1975. Reports from these surveys are incluck! in Series 13. 

St:l+lrs 13	 Data on Health Resources Utilization–Stat ls~lcs on the 

uttlm, ttion of health manpower and faciiltles providing 

Iang.term care, ambulatory care, hospital care, and family 

}.!l,lnnlng scrwces. 

SERIES 14. 

SERIES 15. 

SERIES 20. 

SERIES 21. 

SERIES 22. 

SERIES 23. 

Data on Health Resources: Manpower and Facilities– 

Statistics on the numbers, geographic distribution, and 

characteristics of health resources including physicians, 

dentists, nurses, other health occupations, hospitals, 

nursing homes, and outpatient facilities. 

Data From Special Suweys–Statistics on health and 

health-related topics collected in special surveys that 

are not a part of the continuing data systems of the 

National Center for Health Statistics. 

Data on Mortality–Various statistics on mortality other 

than as included in regular annual or monthly reports. 

Special analyses by cause of death, age, and other demographic variables; geographic and time series analyses; 

and statistics on characteristics of deaths not available 

from the vital records based on sample surveys of those 

records. 

Data on Natelity, Marriage, and Divorce–Various stat]stlcs on natallty, marriage, and divorce other than as 

Included In regular annual or monthly reports. Special 

analyses by demograph IC variables; geographic and time 

series analyses; studies of fertility; and statistics on 

characteristics of births not available from the vital 

records based on sample surveys of those records. 

Data From the National Mortality and Natality Surveys– 

Dlscontlnued In 1975. Reports from these sample surveys 

based on wtal records are included in Series 20 and 21, 

respect wely, 

Data From the National Survey of Family Growth– 

Statistics on fertility, family formation and dissolution, 

fam!ly planrrlng, and related maternal and infant health 

topics derwed from a periodic survey of a nationwide 

probability sample of ever-married women 15-44 years 

of age. 

For answers to questions about th!s report or for a list of titles of 

reports published !n these series, contact. 

Scientific and Technical Information Branch


National Center for Health Statistics


Publlc Health Serwce


Hyattswlle, Md. 20782


301.436-8500