/* SHORT TITLE: Codebook for Patient Quest-Time 1 Specific Data */
********************************************************************************
* W E S T A T C O D E B O O K *
* ----------- --------------- *
* *
* STUDY OF HEALTH CARE COSTS *
* WESTAT ADULT QUESTIONNAIRE TIME 1 - PUBLIC USE *
* 30 JUNE 1994 *
********************************************************************************
********************************************************************************
* W E S T A T C O D E B O O K *
* ----------- --------------- *
* *
* STUDY OF HEALTH CARE COSTS *
* WESTAT ADULT QUESTIONNAIRE TIME 1 - PUBLIC USE *
* 30 JUNE 1994 *
********************************************************************************
(0)
27 Jun. 1994
Record 01
STUDY OF HEALTH CARE COSTS
WESTAT ADULT QUESTIONNAIRE TIME 1 - PUBLIC USE
30 JUNE 1994
Question Column
Name Number(s)
________ _________
APID01 001-009 PATIENT ID NUMBER
_________________
000000001-
999999999 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
AREC01 010-011 RECORD NUMBER
_____________
01 = NUMBER
ASREC01 012-013 SUBRECORD NUMBER
________________
00 = NOT A REPEATING RECORD
AITYPE 014 WHAT IS THE INSTRUMENT TYPE?
_____________________________
A = TIME 1 QUESTIONNAIRE
ARTYPE 015 RESPONDENT TYPE
_______________
1 = STUDY SUBJECT
2 = PROXY
ALANG 016 QUESTIONNAIRE LANGUAGE VERSION
______________________________
1 = ENGLISH
2 = SPANISH
AREFDT (017-022) REFERENCE BEGIN DATE
____________________
AREFMO 017-018 REFERENCE BEGIN MONTH
_____________________
01-12 = MONTH
(1)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AREFDY 019-020 REFERENCE BEGIN DAY
___________________
01-31 = DAY
AREFYR 021-022 REFERENCE BEGIN YEAR
____________________
91-92 = YEAR
AENDDT (023-028) REFERENCE END DATE
__________________
AENDMO 023-024 REFERENCE END MONTH
___________________
01-12 = MONTH
AENDDY 025-026 REFERENCE END DAY
_________________
01-31 = DAY
AENDYR 027-028 REFERENCE END YEAR
__________________
91-92 = YEAR
T1_STAT 029-030 QUESTIONNAIRE STATUS
____________________
CO = COMPLETE, WITH RESPONDENT
PR = COMPLETE, WITH PROXY
DD = COMPLETE, WITH PROXY PATIENT DECEASED AT TIME OF INTERVIEW
OBSDAYS1 031-033 OBSERVATION DAYS WITHIN REFERENCE PERIOD EXCLUDING PERIODS OF ELIGIBILITY
_________________________________________________________________________
001-600 = NUMBER
999 = NOT ASCERTAINED
(2)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GAP1FLAG 034 PATIENT HAD TIME GAP DURING REFERENCE PERIOD
____________________________________________
+ = INAPPLICABLE, NO TIME GAP
1 = YES TIME GAP
ADM1 035-036 NUMBER OF INPATIENT ADMISSIONS (UNSTANDARDIZED)
_______________________________________________
00 = NONE
01-99 = NUMBER OF ADMISSIONS
IPNGT1 037-039 NUMBER OF INPATIENT NIGHTS (UNSTANDARDIZED)
___________________________________________
000 = NONE
001-999 = NUMBER OF NIGHTS
AMBVS1 040-042 NUMBER OF AMBULATORY VISITS, INCLUDES HOSPITAL CLINIC, OTHER CLINIC AND PRIVATE MD
(UNSTANDARDIZED)
________________
000 = NONE
001-999 = NUMBER OF AMBULATORY VISITS
ERVS1 043-045 NUMBER OF EMERGENCY ROOM VISITS (UNSTANDARDIZED)
________________________________________________
000 = NONE
001-999 = NUMBER OF EMERGENCY ROOM VISITS
HCVS1 046-048 NUMBER OF HOSPITAL CLINIC VISITS (UNSTANDARDIZED)
_________________________________________________
000 = NONE
001-999 = NUMBER OF HOSPITAL CLINC VISITS
OCVS1 049-051 NUMBER OF OTHER CLINIC VISITS (UNSTANDARDIZED)
______________________________________________
000 = NONE
001-999 = NUMBER OF OTHER CLINIC VISITS
(3)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
MDVS1 052-054 NUMBER OF PRIVATE MD VISITS (UNSTANDARDIZED)
____________________________________________
000 = NONE
001-999 = NUMBER OF PRIVATE MD VISITS
ADEMINFO (055-074) DEMOGRAPHIC INFORMATION
_______________________
AA1 055-056 WHICH ONE OF THESE SIGNS OR SYMPTOMS OF HIV-RELATED ILLNESS DID YOU FIRST EXPERIENCE?
______________________________________________________________________________________
01 = NIGHT SWEATS
02 = SHORTNESS OF BREATH
03 = DIARRHEA
04 = LOST A GREAT DEAL OF WEIGHT WITHOUT WANTING TO
05 = CHILLS SO BAD THAT YOU SHOOK
06 = A FEVER THAT LASTED FOUR DAYS OR MORE
07 = ANY WEAKNESS OR NUMBNESS IN YOUR ARMS AND LEGS
08 = A SEIZURE
09 = MORE TROUBLE REMEMBERING THINGS OR CONCENTRATING THAN YOU FEEL IS NORMAL
* 10 = NONE
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP AA2MO - AA2YR
AA2 (057-060) WHEN WAS THAT?
CODER: IF AA2YR, EQUALS 97, 98 OR 99, CODE 99 IN AA2MO.
AA2MO 057-058 MONTH OF FIRST EXPERIENCE
_________________________
+ = INAPPLICABLE, CODED 10, 97, 98 OR 99 IN AA1.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(4)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AA2YR 059-060 YEAR OF FIRST EXPERIENCE
________________________
+ = INAPPLICABLE, CODED 10, 97, 98 OR 99 IN AA1.
76-91 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AA3 061-062 WERE YOU FIRST TOLD THAT YOU WERE INFECTED WITH THE AIDS VIRUS IN A HOSPITAL, IN A
CLINIC, IN A DOCTOR'S OFFICE, OR IN SOME OTHER PLACE?
______________________________________________________
01 = HOSPITAL
02 = CLINIC
03 = DOCTOR'S OFFICE
04 = PRISON/JAIL/HALFWAY HOUSE
05 = DRUG PROGRAM/REHABILITATION
06 = RED CROSS/DONATING BLOOD/BLOOD BANK
07 = BOARD OF HEALTH/HEALTH DEPT/PUBLIC HEALTH SERVICE
08 = COMMUNITY HEALTH PROJECTS-STUDIES
10 = ARMED SERVICES EXAM/ INSURANCE CO EXAM
11 = MEDICAL SETTING (NOT OTHERWISE SPECIFIED)
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(5)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AA4 063-064 WHAT IS THE HIGHEST GRADE OR YEAR OF REGULAR SCHOOL THAT YOU HAVE EVER COMPLETED?
__________________________________________________________________________________
00 = NO FORMAL SCHOOLING
01 = ONE YEAR ELEMENTARY SCHOOL
02 = TWO YEARS ELEMENTARY SCHOOL
03 = THREE YEARS ELEMENTARY SCHOOL
04 = FOUR YEARS ELEMENTARY SCHOOL
05 = FIVE YEARS ELEMENTARY SCHOOL
06 = SIX YEARS ELEMENTARY SCHOOL
07 = SEVEN YEARS ELEMENTARY SCHOOL
08 = EIGHT YEARS ELEMENTARY SCHOOL
09 = ONE YEAR HIGH SCHOOL
10 = TWO YEARS HIGH SCHOOL
11 = THREE YEARS HIGH SCHOOL
12 = FOUR YEARS HIGH SCHOOL
13 = ONE YEAR COLLEGE AND GRADUATE SCHOOL
14 = TWO YEARS COLLEGE AND GRADUATE SCHOOL
15 = THREE YEARS COLLEGE AND GRADUATE SCHOOL
16 = FOUR YEARS COLLEGE AND GRADUATE SCHOOL
17 = FIVE YEARS COLLEGE AND GRADUATE SCHOOL
18 = SIX OR MORE YEARS COLLEGE AND GRADUATE SCHOOL
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AA5 065 ARE YOU CURRENTLY LEGALLY MARRIED, WIDOWED, DIVORCED, SEPARATED, OR HAVE YOU NEVER BEEN
MARRIED?
_________
* 1 = MARRIED
2 = WIDOWED
3 = DIVORCED
4 = SEPARATED
5 = NEVER MARRIED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP AA6
(6)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AA6 066 ARE YOU CURRENTLY INVOLVED IN A COMMITTED RELATIONSHIP WITH ONE OTHER PERSON?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN AA5.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AA7
AA7 067 HAS (YOUR SPOUSE/THAT PERSON) ALSO BEEN DIAGNOSED AS BEING HIV POSITIVE?
_________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AA6.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AA8 068 DO YOU HAVE ANY LIVING CHILDREN?
_________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AA9 - AA12
AA9 069-070 HOW MANY LIVING CHILDREN?
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AA8.
01-15 = NUMBER OF CHILDREN
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(7)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AA10 071 ARE ANY OF THESE CHILDREN CURRENTLY LIVING WITH YOU?
_____________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AA8.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AA11 072 (HAS YOUR CHILD/HAVE ANY OF YOUR CHILDREN) ALSO BEEN DIAGNOSED AS BEING HIV POSITIVE?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AA8.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AA12
AA12 073-074 HOW MANY CHILDREN ARE POSITIVE?
________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AA8; OR CODED 2, 7, 8 OR 9 IN AA11.
01-05 = NUMBER OF CHILDREN
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AINSCOVR (075-113) INSURANCE COVERAGE
__________________
AB1 075 SINCE (REF. DATE), HAVE YOU BEEN COVERED BY ANY PRIVATE HEALTH INSURANCE PLAN, INCLUDING
AN HMO, THAT PAYS FOR ANY PART OF HOSPITAL BILLS, DOCTOR BILLS, OR SURGEON BILLS?
__________________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB2 - AB4
(8)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB2 076 IS THIS AN INDIVIDUAL OR FAMILY COVERAGE?
__________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB1
1 = INDIVIDUAL PLAN
2 = FAMILY PLAN
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB3 077-078 PEOPLE GET HEALTH INSURANCE IN DIFFERENT WAYS, FOR EXAMPLE THROUGH JOBS, RETIREMENT
BENEFITS FROM JOBS, OR THROUGH UNIONS. HOW DO YOU GET YOUR HEALTH INSURANCE OR HEALTH
PLAN- THROUGH AN EMPLOYER OR FAMILY BUSINESS, A UNION, OR SOME OTHER GROUP, OR DIRECTLY
FROM AN INSURANCE COMPANY?
___________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB1
01 = EMPLOYER/FAMILY BUSINESS
02 = UNION
03 = INSURANCE COMPANY
04 = SCHOOL/ALUMNI GROUP/PROFESSIONAL GROUP/OTHER SPECIAL INTEREST GROUP
05 = MEDICAL OR PUBLIC ASSISTANCE
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AB4 079 IS THE PLAN A HEALTH MAINTENANCE ORGANIZATION OR HMO?
______________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB5 - AB6YR
(9)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB5 080 HAVE YOU EVER HAD ANY PRIVATE HEALTH INSURANCE?
________________________________________________
+ = INAPPLICABLE, CODED 1 IN AB1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB6MO - AB6YR
AB6 (081-084) WHEN WAS THE LAST TIME THAT YOU WERE COVERED BY PRIVATE HEALTH INSURANCE?
CODER: IF AB6YR EQUALS 97, 98 OR 99 CODE 99 IN AB6MO.
AB6MO 081-082 LAST MONTH THAT YOU WERE COVERED BY PRIVATE HEALTH INSURANCE.
______________________________________________________________
+ = INAPPLICABLE, CODED 1 IN AB1; OR CODED 2, 7, 8 OR 9 IN AB5.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AB6YR 083-084 LAST YEAR YOU WERE COVERED BY PRIVATE HEALTH INSURANCE.
________________________________________________________
+ = INAPPLICABLE, CODED 1 IN AB1; OR CODED 2, 7, 8 OR 9 IN AB5.
59-91 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(10)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB7 085 AT ANY TIME SINCE (REF. DATE) HAVE YOU BEEN COVERED BY (MEDICAID OR STATE NAME FOR
MEDICAID)? PEOPLE COVERED BY (MEDICAID/STATE NAME FOR MEDICAID) USUALLY HAVE A CARD THAT
LOOKS LIKE THIS.
_________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB8 - AB11YR
AB8 086 HAVE YOU BEEN COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL TODAY, OR ONLY PART OF THE
TIME?
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB9A - AB9L
AB9 (087-098) SINCE (REF. DATE), IN WHICH MONTHS WERE YOU COVERED BY (MEDICAID/STATE NAME FOR
MEDICAID) FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS THAT APPLY.
CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED, CODE 9 FOR EACH ITEM.
IF AT LEAST ONE IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM(S) CODE 2 FOR ALL UNCIRCLED
ITEM(S).
AB9A 087 JANUARY
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(11)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB9B 088 FEBRUARY
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9C 089 MARCH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9D 090 APRIL
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9E 091 MAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(12)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB9F 092 JUNE
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9G 093 JULY
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9H 094 AUGUST
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9I 095 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(13)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB9J 096 OCTOBER
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9K 097 NOVEMBER
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB9L 098 DECEMBER
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7; OR CODED 1, 7, 8 OR 9 IN AB8.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB11 (099-102) WHEN WERE YOU FIRST COVERED BY (MEDICAID/STATE NAME FOR MEDICAID)?
CODER: IF AB11YR EQUALS 97, 98 OR 99, CODE 99 IN AB11MO.
AB11MO 099-100 MONTH FIRST COVERED BY MEDICAID
_______________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(14)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB11YR 101-102 YEAR FIRST COVERED BY MEDICAID
______________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB7.
* 57-91 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP AB12 - AB13
AB12 103 HAVE YOU APPLIED FOR MEDICAID?
_______________________________
+ = INAPPLICABLE, CODED 1 IN AB7
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB13
AB13 104 HAVE YOU BEEN TURNED DOWN FOR MEDICAID?
________________________________________
+ = INAPPLICABLE, CODED 1 IN AB7; OR CODED 2, 7, 8 OR 9 IN AB12.
1 = YES
2 = NO/ NO DECISION YET
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AB14 105 SINCE (REF. DATE) HAVE YOU BEEN COVERED BY MEDICARE? MEDICARE IS A SOCIAL SECURITY
HEALTH INSURANCE PROGRAM FOR DISABLED PERSONS 65 YEARS OLD AND OLDER.
______________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(15)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB16 106 SINCE (REF. DATE), HAVE YOU BEEN COVERED BY ANY OTHER PUBLIC ASSISTANCE PROGRAM (BESIDES
MEDICAID/STATE NAME FOR MEDICAID OR MEDICARE) THAT PAYS FOR MEDICAL CARE?
__________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB17
AB17 107-108 WHAT IS THE NAME OF THAT PROGRAM?
__________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB16.
70 = DRUG ASSISTANCE PROGRAM
71 = ASSISTANCE FROM PROVIDER-FUNDING UNKNOWN
72 = CITY FUNDED PROGRAM
73 = COUNTY FUNDED PROGRAM
74 = STATE FUNDED PROGRAM
75 = FEDERALLY FUNDED PROGRAM
76 = GOVERNMENT FUNDED PROGRAM, NOS
77 = COMMUNITY PROGRAM -FUNDING UNKNOWN
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AB18 109 ARE YOU NOW COVERED BY CHAMPUS (WHICH COVERS BOTH ACTIVE DUTY AND RETIRED CAREER MILITARY
PERSONNEL, THEIR DEPENDENTS AND SURVIVORS) OR CHAMPVA (WHICH COVERS DISABLED VETERANS,
THEIR DEPENDENTS AND SURVIVORS)?
_________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(16)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AB19 110 ARE YOU CURRENTLY PARTICIPATING IN ANY CLINICAL TRIALS FOR ANY MEDICATIONS?
____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AB21A - AB21B
AB21 (111-113) HOW LONG HAVE YOU BEEN PARTICIPATING IN THIS/THESE TRIALS?
___________________________________________________________
AB21A 111-112 LENGTH OF TIME
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB19.
01-90 = AMOUNT
* 91 = OTHER CODE RESERVED FOR 2 DRUGS WITH 2 SEPARATE LENGTHS/UNITS OF TIME
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP AB21B
AB21B 113 UNIT OF TIME
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AB19; OR CODED 91, 97, 98 OR 99 IN
AB21A.
1 = DAYS
2 = WEEKS
3 = MONTHS
4 = YEARS
AIPSTAYS (114-118) INPATIENT HOSPITAL STAYS
________________________
(17)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AC1 114 SINCE (REF. DATE), HAVE YOU BEEN A PATIENT IN A HOSPITAL OVERNIGHT OR LONGER?
_______________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AC2
AC2 115-116 HOW MANY TIMES HAVE YOU BEEN IN THE HOSPITAL OVERNIGHT OR LONGER SINCE (REF. DATE)?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AC1
01-95 = NUMBER OF TIMES
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AC04CT 117-118 NUMBER OF INPATIENT STAY RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
ANURSHOM (119-123) NURSING HOME/RESIDENTIAL CARE STAYS
___________________________________
AD1 119 SINCE (REF. DATE), HAVE YOU BEEN A PATIENT IN A RESIDENTIAL CARE FACILITY, A NURSING
HOME OR HOSPICE OVERNIGHT OR LONGER?
_____________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AD2
(18)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AD2 120-121 HOW MANY TIMES HAVE YOU BEEN IN A RESIDENTIAL CARE FACILITY, NURSING HOME OR HOSPICE
OVERNIGHT OR LONGER SINCE (REF. DATE)?
________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AD1.
01-96 = NUMBER OF TIMES
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AD06CT 122-123 NUMBER OF NURSING HOME/RESIDENTIAL CARE STAY RECORDS
____________________________________________________
00 = NONE LISTED
01-99 = NUMBER
AMEDVIST (124-143) MEDICAL VISITS
______________
AE1A 124 SINCE (REF. DATE), DID YOU GO TO A HOSPITAL EMERGENCY ROOM FOR MEDICAL CARE? INCLUDE
ANY VISITS TO THE EMERGENCY ROOM, (EVEN IF YOU WERE ADMITTED TO THE HOSPITAL FROM THERE).
__________________________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AE1B
AE1B 125-126 HOW MANY DIFFERENT EMERGENCY ROOMS DID YOU VISIT SINCE (REF. DATE)?
_____________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AE1A.
01-96 = NUMBER OF EMERGENCY ROOMS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AE1BCT 127-128 NUMBER OF EMERGENCY ROOM RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
(19)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AE2A 129 SINCE (REF. DATE), DID YOU GO TO A HOSPITAL CLINIC OR HOSPITAL OUT-PATIENT DEPARTMENT
FOR MEDICAL CARE? THESE VISITS COULD INCLUDE AN AEROSOL PENTAMIDINE CLINIC, AN EYE
CLINIC, A LABORATORY WHERE THEY MIGHT CONDUCT BLOOD TESTS, OR A THERAPIST WHO WORKS IN A
HOSPITAL.
__________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AE2B
AE2B 130-131 HOW MANY DIFFERENT HOSPITAL CLINICS DID YOU VISIT SINCE (REF. DATE)?
______________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AE2A.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AE2BCT 132-133 NUMBER OF HOSPITAL CLINIC RECORDS
_________________________________
00 = NONE LISTED
01-99 = NUMBER
AE3A 134 BESIDES THE CARE WE'VE TALKED ABOUT, HAVE YOU BEEN TO ANY OTHER MEDICAL CLINIC, FOR
EXAMPLE, A COMMUNITY CLINIC OR A NEIGHBORHOOD HEALTH CENTER?
_____________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AE3B
(20)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AE3B 135-136 HOW MANY DIFFERENT MEDICAL CLINICS DID YOU VISIT SINCE (REF. DATE)?
_____________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AE3A.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AE3BCT 137-138 NUMBER OF MEDICAL CLINIC RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
AE4A 139 BESIDES WHAT WE'VE TALKED ABOUT, HAVE YOU BEEN TO A PRIVATE DOCTOR'S OFFICE FOR MEDICAL
CARE?
______
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AE4B
AE4B 140-141 HOW MANY DIFFERENT PRIVATE DOCTOR'S OFFICES DID YOU VISIT SINCE (REF. DATE)?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AE4A.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AE4BCT 142-143 NUMBER OF PRIVATE DOCTOR OFFICE RECORDS
_______________________________________
00 = NONE LISTED
01-99 = NUMBER
AOTHPROV (144-168) OTHER HEALTH CARE PROVIDERS
___________________________
(21)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AF1A 144 (OTHER THAN WHAT WE'VE TALKED ABOUT) SINCE (REF. DATE) HAVE YOU ATTENDED A SUPPORT
GROUP, OR RECEIVED ANY PSYCHOLOGICAL COUNSELING OR THERAPY? PROBE: THAT IS, HAVE YOU
SEEN A PSYCHIATRIST, PSYCHOLOGIST, PSYCHIATRIC SOCIAL WORKER, CLERGYMAN, OR SOMEONE ELSE?
__________________________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AF1B
AF1B 145-146 YOU TOLD ME YOU USED THE SERVICES OF A (PROVIDER). HOW MANY DIFFERENT (PROVIDERS) DID
YOU VISIT SINCE (REF. DATE)?
______________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AF1A.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AF1BCT 147-148 NUMBER OF MENTAL HEALTH PROVIDER RECORDS
________________________________________
00 = NONE LISTED
01-99 = NUMBER
AF1SG (149-155) ANONYMOUS SUPPORT GROUPS (CODE ALL THAT APPLY)
CODER: IF NONE ARE CIRCLED, CODE 2 FOR EACH GROUP. CODE CIRCLED GROUP(S) = 1.
AF1SGA 149 AA (ALCOHOLICS ANONYMOUS)
_________________________
1 = CIRCLED
2 = NOT CIRCLED
(22)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AF1SGB 150 HIV - ANONYMOUS
_______________
1 = CIRCLED
2 = NOT CIRCLED
AF1SGC 151 NA (NARCOTICS ANONYMOUS)
________________________
1 = CIRCLED
2 = NOT CIRCLED
AF1SGD 152 CDA
___
1 = CIRCLED
2 = NOT CIRCLED
AF1SGE 153 OTHER
_____
1 = CIRCLED
* 2 = NOT CIRCLED
* SKIP AF1SGEOS
AF1SGEOS 154-155 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 2 IN AF1SGE.
02 = ACOA
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(23)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AF2A 156 SINCE (REF. DATE), HAVE YOU RECEIVED CARE FROM ANY MEDICAL PRACTITIONERS SUCH AS
OPTOMETRISTS, FOOT DOCTORS, OR CHIROPRACTORS?
______________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AF2B
AF2B 157-158 YOU TOLD ME YOU USED THE SERVICES OF A (PROVIDER). HOW MANY DIFFERENT (PROVIDERS) DID
YOU VISIT SINCE (REF. DATE)?
______________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AF2A.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AF2BCT 159-160 NUMBER OF MEDICAL PRACTITIONER RECORDS
______________________________________
00 = NONE LISTED
01-99 = NUMBER
AF3A 161 SINCE (REF. DATE), HAVE YOU RECEIVED TREATMENT FROM ANY ALTERNATIVE THERAPIST, A
PRACTITIONER OF HOLISTIC MEDICINE, A NUTRITIONIST, OR ANY OTHER ALTERNATIVE THERAPY LIKE
BIOFEEDBACK?
_____________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AF3B
(24)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AF3B 162-163 YOU TOLD ME YOU USED THE SERVICES OF A (PROVIDER). HOW MANY DIFFERENT (PROVIDERS) DID
YOU VISIT SINCE (REF. DATE)?
______________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AF3A.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AF3BCT 164-165 NUMBER OF ALTERNATIVE THERAPIST RECORDS
_______________________________________
00 = NONE LISTED
01-99 = NUMBER
AF4A 166 SINCE (REF. DATE), DID YOU BUY OR REPLACE ANY SPECIAL MEDICAL EQUIPMENT LIKE EYEGLASSES,
A CANE OR A NEBULIZER?
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AF4BCT 167-168 NUMBER OF MEDICAL EQUIPMENT PROVIDER RECORDS
____________________________________________
00 = NONE LISTED
01-99 = NUMBER
AHOMHLTH (169-172) HOME HEALTH CARE
________________
(25)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AG1 169 SOMETIMES WHEN PEOPLE ARE ILL, THEY NEED TO RECEIVE HELP AT HOME. THIS HELP COULD BE FOR
MEDICAL PROBLEMS, FOR HELP WITH PERSONAL CARE OR HOUSEKEEPING, OR FOR OTHER SERVICES THEY
MIGHT NEED. PLEASE LOOK AT THIS CARD. IT SHOWS SOME OF THE DIFFERENT KINDS OF PEOPLE
WHO PROVIDE HELP AT HOME. SINCE (REF. DATE), HAVE ANY OF THESE PEOPLE HELPED YOU AT
HOME? (CIRCLE THE PROVIDER TYPE IN COLUMN A.)
______________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AG2 170 SINCE (REF. DATE), HAVE YOU BEEN HELPED AT HOME BY ANY OTHER PEOPLE WHO ARE NOT SHOWN ON
THE CARD? (SPECIFY THE PROVIDER TYPE IN COLUMN A.)
___________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AGACT 171-172 NUMBER OF HOME HEALTH PROVIDER RECORDS
______________________________________
00 = NONE LISTED
01-10 = NUMBER
A_NONMED (173-196) NON - MEDICAL SERVICES
______________________
AH1A 173 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
FINDING OR KEEPING A PLACE TO LIVE?
____________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(26)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AH1ACT 174-175 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH HOUSING
____________________________________________________
00 = NONE
01-99 = NUMBER
AH2A 176 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
LEGAL SERVICES?
________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AH2ACT 177-178 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH LEGAL SERVICES
___________________________________________________________
00 = NONE
01-99 = NUMBER
AH3A 179 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
CHILD CARE?
____________
1 = YES
2 = NO
3 = NO CHILDREN
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AH3ACT 180-181 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH CHILD CARE
_______________________________________________________
00 = NONE
01-99 = NUMBER
(27)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AH4A 182 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
TRANSPORTATION?
________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AH4ACT 183-184 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH TRANSPORTATION
___________________________________________________________
00 = NONE
01-99 = NUMBER
AH5A 185 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
OBTAINING FOOD?
________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AH5ACT 186-187 NUMBER OF RECORDS FOR PROVIDERS HELPING OBTAIN FOOD
___________________________________________________
00 = NONE
01-99 = NUMBER
AH6A 188 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
FINANCIAL ASSISTANCE?
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(28)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AH6ACT 189-190 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH FINANCIAL ASSISTANCE
_________________________________________________________________
00 = NONE
01-99 = NUMBER
AH7A 191 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
OBTAINING NEEDED CLOTHING OR HOUSEHOLD ITEMS?
______________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AH7ACT 192-193 NUMBER OF RECORDS FOR PROVIDERS HELPING OBTAIN CLOTHING OR HOUSEHOLD ITEMS
__________________________________________________________________________
00 = NONE
01-99 = NUMBER
AH8A 194 SINCE (REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
KICKING A DRUG OR ALCOHOL HABIT?
_________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AH8ACT 195-196 NUMBER OF RECORDS FOR ALCOHOL/DRUG TREATMENT PROVIDERS
______________________________________________________
00 = NONE
01-99 = NUMBER
ADNTLSRV (197-201) DENTAL SERVICES
_______________
(29)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AI1 197 SINCE (REF. DATE), HAVE YOU SEEN A DENTIST, ORAL SURGEON, OR OTHER PROFESSIONAL DENTAL
CARE PROVIDER?
_______________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AI2
AI2 198-199 SINCE (REF. DATE), HOW MANY TIMES HAVE YOU SEEN A DENTIST, ORAL SURGEON, OR OTHER
PROFESSIONAL DENTAL CARE PROVIDER?
___________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AI1.
01-15 = NUMBER
AI3CT 200-201 NUMBER OF DENTAL VISIT RECORDS
______________________________
00 = NONE CODED 2, 7, 8 OR 9 IN AI1
01-10 = NUMBER
ADRGSECT (202-286) HIV - RELATED MEDICINES
_______________________
AJ1 202 SINCE (REF. DATE), HAVE YOU TAKEN ANY OF THE MEDICINES OR DRUGS LISTED ON THIS CARD?
(RECORD NAMES IN COLUMN A.)
___________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(30)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ2 203 SINCE (REF. DATE), HAVE YOU TAKEN ANY OTHER PRESCRIPTION MEDICINES OR DRUGS? (IF YES TO
QUESTION J-1 OR J-2, RECORD NAMES IN COLUMN A. IF NAME UNKNOWN, PROBE FOR CONDITION AND
RECORD IN COLUMN A. IF MEDICINE NAME OR CONDITION UNKNOWN, PROBE FOR DRUG PROVIDER NAME
AND ADDRESS.
_____________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AJACT 204-205 NUMBER OF PRESCRIPTION DRUG RECORDS
___________________________________
00 = NONE LISTED
01-99 = NUMBER
AJ3 206 SINCE (REF. DATE), HAVE YOU TAKEN ANY NON-PRESCRIPTION MEDICINES OR DRUGS OR ANY
NON-TRADITIONAL SUBSTANCES TO HELP DEAL WITH HIV/AIDS RELATED ILLNESSES?
_________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AJ3CT 207-208 NUMBER OF NON-PRESCRIPTION DRUGS/NON-TRADITIONAL SUBSTANCES LISTED IN Q. J-4.
_______________________________________________________________________________
* 00 = NO DRUGS LISTED
01-24 = NUMBER OF DRUGS LISTED
* SKIP AJ4A - AJ5
AJ4 (209-280) WHAT ARE THE NAMES OF THE NON-PRESCRIPTION DRUGS OR NON-TRADITIONAL SUBSTANCES THAT YOU
ARE TAKING?
____________
(31)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ4A 209-211 NON - PRESCRIPTION DRUG 1
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4B 212-214 NON - PRESCRIPTION DRUG 2
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4C 215-217 NON - PRESCRIPTION DRUG 3
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4D 218-220 NON - PRESCRIPTION DRUG 4
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(32)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ4E 221-223 NON - PRESCRIPTION DRUG 5
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4F 224-226 NON - PRESCRIPTION DRUG 6
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4G 227-229 NON - PRESCRIPTION DRUG 7
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4H 230-232 NON - PRESCRIPTION DRUG 8
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(33)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ4I 233-235 NON - PRESCRIPTION DRUG 9
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4J 236-238 NON - PRESCRIPTION DRUG 10
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4K 239-241 NON - PRESCRIPTION DRUG 11
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4L 242-244 NON - PRESCRIPTION DRUG 12
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(34)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ4M 245-247 NON - PRESCRIPTION DRUG 13
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4N 248-250 NON - PRESCRIPTION DRUG 14
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4O 251-253 NON - PRESCRIPTION DRUG 15
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4P 254-256 NON - PRESCRIPTION DRUG 16
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(35)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ4Q 257-259 NON - PRESCRIPTION DRUG 17
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4R 260-262 NON - PRESCRIPTION DRUG 18
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4S 263-265 NON - PRESCRIPTION DRUG 19
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4T 266-268 NON - PRESCRIPTION DRUG 20
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(36)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ4U 269-271 NON - PRESCRIPTION DRUG 21
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4V 272-274 NON - PRESCRIPTION DRUG 22
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4W 275-277 NON - PRESCRIPTION DRUG 23
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AJ4X 278-280 NON - PRESCRIPTION DRUG 24
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3, AND CODED 00 IN AJ3CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(37)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AJ5 281-286 WE'RE INTERESTED IN THE TOTAL AMOUNT YOU SPENT ON (MEDICINE). HOW MUCH DID YOU PAY FOR
(MEDICINES IN Q J-4) SINCE (REF. DATE)?
CODER: CODE AMOUNTS IN WHOLE DOLLARS.
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AJ3.
* 000000 = NOTHING
* 000001-999996 = AMOUNT
* 999997 = REFUSED
* 999998 = DK
* 999999 = NOT ASCERTAINED
AEMPLYMT (287-341) EMPLOYMENT AND INCOME
_____________________
AK1 287 HAVE YOU EVER WORKED FULL-TIME AT A JOB OR BUSINESS FOR MORE THAN TWO WEEKS?
_____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK2 - AK13
AK2 288 ARE YOU CURRENTLY WORKING FULL-TIME, PART-TIME, OR ARE YOU CURRENTLY NOT WORKING?
__________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1.
1 = FULL - TIME
2 = PART - TIME
* 3 = NOT WORKING
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK3 - AKBOX1
(38)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK3 289-291 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 3, 7, 8 OR 9 IN AK2.
001-080 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
AK45OCC 292-295 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN CENSUS ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL
EDITION, 1983.
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 3, 7, 8 OR 9 IN AK2.
0001-9990 = 1983 CENSUS OCCUPATIONAL CODES
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
AKBOX1 296 BOX 1: R IS WORKING FULL-TIME (GREATER THAN 35 HOURS) OR R IS: WORKING PART TIME (LESS
THAN 35 HOURS).
________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 3, 7, 8 OR 9 IN AK2.
* 1 = WORKING FULL -TIME
2 = PART TIME
* SKIP AK6 - AK11YR
AK6 297 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK?
_______________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 1 IN AKBOX1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(39)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK78OCC 298-301 WHAT WAS YOUR OCCUPATION AT YOUR MOST RECENT FULL-TIME JOB? WHAT WERE YOUR MAJOR
ACTIVITIES AT THAT JOB?
CODER: USE CODES IN CENSUS ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL
EDITION, 1983.
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 1 IN AKBOX1.
0001-9990 = 1983 CENSUS OCCUPATIONAL CODES
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
AK9 302-303 DID YOU STOP WORKING AT YOUR LAST FULL-TIME JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR
DISABILITY LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, OR FOR SOME OTHER REASON?
_________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 1 IN AKBOX1.
01 = LEAVE OF ABSENCE/DISABILITY LEAVE
02 = QUIT
03 = LAID OFF
04 = FIRED
05 = JOB ENDED/BUSINESS CLOSED, MOVED, OR WAS SOLD
06 = PREGNANCY
07 = ARRESTED/PRISON
08 = RETIRED
09 = KEPT SAME JOB, CHANGED TO PART TIME
10 = MOVED, LEFT AREA
11 = MEDICAL REASONS
12 = SCHOOL
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK10 304 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 1 IN AKBOX1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(40)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK11 (305-308) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT JOB?
CODER: IF AK11YR EQUALS 97, 98, 99, CODE 99 IN AK11MO.
AK11MO 305-306 MONTH LEFT THAT JOB
___________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 1 IN AKBOX1.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK11YR 307-308 YEAR THAT LEAVE BEGAN
_____________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 1 IN AKBOX1.
65-91 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK12 309 SINCE YOUR DIAGNOSIS, HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU
DO BECAUSE OF YOUR ILLNESS?
____________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK13
(41)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK13 310-311 WHAT TYPE OF CHANGE DID YOU MAKE? RECORD VERBATIM.
____________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK1; OR CODED 2, 7, 8 OR 9 IN AK12.
01 = STOPPED/QUIT WORKING/ UNABLE TO WORK DUE TO HEALTH PROBLEMS
02 = CANT DO WHAT I USED TO DO
03 = CHANGED TYPE/AMOUNT OF WORK
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK14 312-313 WOULD YOU PLEASE LOOK AT THIS CARD AND TELL ME WHICH NUMBER REPRESENTS YOUR TOTAL INCOME
BEFORE TAXES FOR THE PAST MONTH. INCLUDE INCOME FROM ALL SOURCES: YOUR SALARIES, WAGES,
SOCIAL SECURITY, WELFARE AND ANY OTHER INCOME. IF YOU SHARE OR RECEIVE INCOME FROM A
SPOUSE/ PARTNER, PLEASE INCLUDE IT HERE.
_________________________________________
01 = $ 0 -200/MO
02 = $ 201 -350/MO
03 = $ 351 -500/MO
04 = $ 501 -750/MO
05 = $ 751 -900/MO
06 = $ 901 -1,150/MO
07 = $ 1,151 -1,300/MO
08 = $ 1,301 -1,450/MO
09 = $ 1,451 -1,600/MO
10 = $ 1,601 -1,750/MO
11 = $ 1,751 -2000/MO
12 = $ 2,001 -3000/MO
13 = $ 3,001 -4,000/MO
14 = $ 4,001 OR MORE/MO
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK15 314 PLEASE LOOK AT THIS CARD AND TELL ME WHICH NUMBER REPRESENTS YOUR TOTAL INCOME BEFORE
TAXES FOR 1990. INCLUDE SALARIES, WAGES, SOCIAL SECURITY, WELFARE AND ANY OTHER INCOME.
_________________________________________________________________________________________
1 = LESS THAN $5,000
2 = $5,000 - $9,999
3 = $10,000 - $19,999
4 = $20,000 - $39,999
5 = $40,000 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(42)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK16 315 NOW THINK ABOUT THE YEAR BEFORE THAT AND TELL ME WHICH NUMBER REPRESENTS YOUR TOTAL
INCOME BEFORE TAXES FOR 1989.
______________________________
1 = LESS THAN $5,000
2 = $5,000 - $9,999
3 = $10,000 - $19,999
4 = $20,000 - $39,999
5 = $40,000 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AK17 316 AND HOW ABOUT YOUR INCOME FOR 1988?
____________________________________
1 = LESS THAN $5,000
2 = $5,000 - $9,999
3 = $10,000 - $19,999
4 = $20,000 - $39,999
5 = $40,000 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
AK18 317 ARE YOU CURRENTLY RECEIVING SOCIAL SECURITY DISABILITY PAYMENTS?
_________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK19MO - AK19YR
AK19 (318-321) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST SOCIAL SECURITY DISABILITY PAYMENTS?
CODER: IF AK19YR EQUALS 97, 98 OR 99, CODE 99 IN AK19MO.
(43)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK19MO 318-319 MONTH YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
___________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK18.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK19YR 320-321 YEAR YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
__________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK18.
* 73-91 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP AK20 - AK21
AK20 322 HAVE YOU APPLIED FOR SOCIAL SECURITY DISABILITY PAYMENTS?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN AK18.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK21
AK21 323 HAVE YOU BEEN TURNED DOWN FOR SOCIAL SECURITY DISABILITY?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN AK18; OR CODED 2, 7, 8 OR 9 IN AK20.
1 = YES
2 = NO/NO DECISION YET
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(44)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AKBOX2 324 R HAS: NO CHILDREN LIVING WITH THEM (SECT. A, Q.10 = NO) OR 1 OR MORE CHILDREN (SECT.
A, Q.10 = YES) ALSO SEE "FLAP" (PERMISSION FORM INVENTORY) FOR QUESTION "R HAS CHILDREN
LIVING WITH HER/HIM?
_____________________
* 1 = NO CHILDREN LIVING WITH THEM
2 = 1 OR MORE CHILDREN LIVING WITH THEM
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK22 - AK23YR
AK22 325 DO YOU NOW RECEIVE ASSISTANCE THROUGH THE AID TO FAMILIES WITH DEPENDENT CHILDREN
PROGRAM, SOMETIMES CALLED AFDC OR ADC?
_______________________________________
+ = INAPPLICABLE, CODED 1, 7, 8 OR 9, IN AKBOX2.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK23MO - AK23YR
AK23 (326-329) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST AFDC PAYMENT?
CODER: IF AK23YR EQUALS 97, 98, 99, CODE 99 IN AK23MO.
AK23MO 326-327 MONTH YOU RECEIVED YOUR FIRST AFDC PAYMENT
__________________________________________
+ = INAPPLICABLE, CODED 1, 7, 8 OR 9, IN AKBOX2; OR CODED 2, 7, 8 OR 9 IN
AK22.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(45)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK23YR 328-329 YEAR YOU RECEIVED YOUR FIRST AFDC PAYMENT
_________________________________________
+ = INAPPLICABLE, CODED 1, 7, 8 OR 9 IN AKBOX2; OR CODED 2, 7, 8 OR 9 IN
AK22.
66-91 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK24 330 DO YOU NOW RECEIVE THE SUPPLEMENTAL SECURITY INCOME OR SSI CHECK?
__________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK25MO - AK25YR
AK25 (331-334) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST SSI PAYMENT?
CODER: IF AK25YR EQUALS 97, 98 OR 99, CODE 99 IN AK25MO.
AK25MO 331-332 MONTH YOU RECEIVED YOUR FIRST SSI PAYMENT
_________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK24.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
AK25YR 333-334 YEAR YOU RECEIVED YOUR FIRST SSI PAYMENT
________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK24.
68-91 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(46)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
AK26 335 SINCE (REF. DATE), HAVE YOU REGULARLY RECEIVED FINANCIAL SUPPORT OR MONEY TO PAY YOUR
BILLS FROM YOUR PARENTS, FRIENDS, OR FAMILY MEMBERS?
_____________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP AK27
AK27 336-341 HOW MUCH HAVE YOU RECEIVED SINCE (REF. DATE)?
CODER: CODE AMOUNTS IN WHOLE DOLLARS
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN AK26.
000001-999996 = AMOUNT RECEIVED
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
(47)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
INDEX OF VARIABLES PAGE 001
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== A =====
A_NONMED (173-196) Record 01 026
AA1 055-056 Record 01 004
AA10 071 Record 01 008
AA11 072 Record 01 008
AA12 073-074 Record 01 008
AA2 (057-060) Record 01 004
AA2MO 057-058 Record 01 004
AA2YR 059-060 Record 01 005
AA3 061-062 Record 01 005
AA4 063-064 Record 01 006
AA5 065 Record 01 006
AA6 066 Record 01 007
AA7 067 Record 01 007
AA8 068 Record 01 007
AA9 069-070 Record 01 007
AB1 075 Record 01 008
AB11 (099-102) Record 01 014
AB11MO 099-100 Record 01 014
AB11YR 101-102 Record 01 015
AB12 103 Record 01 015
AB13 104 Record 01 015
AB14 105 Record 01 015
AB16 106 Record 01 016
AB17 107-108 Record 01 016
AB18 109 Record 01 016
AB19 110 Record 01 017
AB2 076 Record 01 009
AB21 (111-113) Record 01 017
AB21A 111-112 Record 01 017
AB21B 113 Record 01 017
AB3 077-078 Record 01 009
AB4 079 Record 01 009
AB5 080 Record 01 010
AB6 (081-084) Record 01 010
AB6MO 081-082 Record 01 010
AB6YR 083-084 Record 01 010
AB7 085 Record 01 011
AB8 086 Record 01 011
AB9 (087-098) Record 01 011
AB9A 087 Record 01 011
AB9B 088 Record 01 012
AB9C 089 Record 01 012
AB9D 090 Record 01 012
AB9E 091 Record 01 012
AB9F 092 Record 01 013
INDEX OF VARIABLES PAGE 002
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== A =====
AB9G 093 Record 01 013
AB9H 094 Record 01 013
AB9I 095 Record 01 013
AB9J 096 Record 01 014
AB9K 097 Record 01 014
AB9L 098 Record 01 014
AC04CT 117-118 Record 01 018
AC1 114 Record 01 018
AC2 115-116 Record 01 018
ADEMINFO (055-074) Record 01 004
ADM1 035-036 Record 01 003
ADNTLSRV (197-201) Record 01 029
ADRGSECT (202-286) Record 01 030
AD06CT 122-123 Record 01 019
AD1 119 Record 01 018
AD2 120-121 Record 01 019
AEMPLYMT (287-341) Record 01 038
AENDDT (023-028) Record 01 002
AENDDY 025-026 Record 01 002
AENDMO 023-024 Record 01 002
AENDYR 027-028 Record 01 002
AE1A 124 Record 01 019
AE1B 125-126 Record 01 019
AE1BCT 127-128 Record 01 019
AE2A 129 Record 01 020
AE2B 130-131 Record 01 020
AE2BCT 132-133 Record 01 020
AE3A 134 Record 01 020
AE3B 135-136 Record 01 021
AE3BCT 137-138 Record 01 021
AE4A 139 Record 01 021
AE4B 140-141 Record 01 021
AE4BCT 142-143 Record 01 021
AF1A 144 Record 01 022
AF1B 145-146 Record 01 022
AF1BCT 147-148 Record 01 022
AF1SG (149-155) Record 01 022
AF1SGA 149 Record 01 022
AF1SGB 150 Record 01 023
AF1SGC 151 Record 01 023
AF1SGD 152 Record 01 023
AF1SGE 153 Record 01 023
AF1SGEOS 154-155 Record 01 023
AF2A 156 Record 01 024
AF2B 157-158 Record 01 024
INDEX OF VARIABLES PAGE 003
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== A =====
AF2BCT 159-160 Record 01 024
AF3A 161 Record 01 024
AF3B 162-163 Record 01 025
AF3BCT 164-165 Record 01 025
AF4A 166 Record 01 025
AF4BCT 167-168 Record 01 025
AGACT 171-172 Record 01 026
AG1 169 Record 01 026
AG2 170 Record 01 026
AHOMHLTH (169-172) Record 01 025
AH1A 173 Record 01 026
AH1ACT 174-175 Record 01 027
AH2A 176 Record 01 027
AH2ACT 177-178 Record 01 027
AH3A 179 Record 01 027
AH3ACT 180-181 Record 01 027
AH4A 182 Record 01 028
AH4ACT 183-184 Record 01 028
AH5A 185 Record 01 028
AH5ACT 186-187 Record 01 028
AH6A 188 Record 01 028
AH6ACT 189-190 Record 01 029
AH7A 191 Record 01 029
AH7ACT 192-193 Record 01 029
AH8A 194 Record 01 029
AH8ACT 195-196 Record 01 029
AINSCOVR (075-113) Record 01 008
AIPSTAYS (114-118) Record 01 017
AITYPE 014 Record 01 001
AI1 197 Record 01 030
AI2 198-199 Record 01 030
AI3CT 200-201 Record 01 030
AJACT 204-205 Record 01 031
AJ1 202 Record 01 030
AJ2 203 Record 01 031
AJ3 206 Record 01 031
AJ3CT 207-208 Record 01 031
AJ4 (209-280) Record 01 031
AJ4A 209-211 Record 01 032
AJ4B 212-214 Record 01 032
AJ4C 215-217 Record 01 032
AJ4D 218-220 Record 01 032
AJ4E 221-223 Record 01 033
AJ4F 224-226 Record 01 033
AJ4G 227-229 Record 01 033
INDEX OF VARIABLES PAGE 004
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== A =====
AJ4H 230-232 Record 01 033
AJ4I 233-235 Record 01 034
AJ4J 236-238 Record 01 034
AJ4K 239-241 Record 01 034
AJ4L 242-244 Record 01 034
AJ4M 245-247 Record 01 035
AJ4N 248-250 Record 01 035
AJ4O 251-253 Record 01 035
AJ4P 254-256 Record 01 035
AJ4Q 257-259 Record 01 036
AJ4R 260-262 Record 01 036
AJ4S 263-265 Record 01 036
AJ4T 266-268 Record 01 036
AJ4U 269-271 Record 01 037
AJ4V 272-274 Record 01 037
AJ4W 275-277 Record 01 037
AJ4X 278-280 Record 01 037
AJ5 281-286 Record 01 038
AKBOX1 296 Record 01 039
AKBOX2 324 Record 01 045
AK1 287 Record 01 038
AK10 304 Record 01 040
AK11 (305-308) Record 01 041
AK11MO 305-306 Record 01 041
AK11YR 307-308 Record 01 041
AK12 309 Record 01 041
AK13 310-311 Record 01 042
AK14 312-313 Record 01 042
AK15 314 Record 01 042
AK16 315 Record 01 043
AK17 316 Record 01 043
AK18 317 Record 01 043
AK19 (318-321) Record 01 043
AK19MO 318-319 Record 01 044
AK19YR 320-321 Record 01 044
AK2 288 Record 01 038
AK20 322 Record 01 044
AK21 323 Record 01 044
AK22 325 Record 01 045
AK23 (326-329) Record 01 045
AK23MO 326-327 Record 01 045
AK23YR 328-329 Record 01 046
AK24 330 Record 01 046
AK25 (331-334) Record 01 046
AK25MO 331-332 Record 01 046
INDEX OF VARIABLES PAGE 005
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== A =====
AK25YR 333-334 Record 01 046
AK26 335 Record 01 047
AK27 336-341 Record 01 047
AK3 289-291 Record 01 039
AK45OCC 292-295 Record 01 039
AK6 297 Record 01 039
AK78OCC 298-301 Record 01 040
AK9 302-303 Record 01 040
ALANG 016 Record 01 001
AMBVS1 040-042 Record 01 003
AMEDVIST (124-143) Record 01 019
ANURSHOM (119-123) Record 01 018
AOTHPROV (144-168) Record 01 021
APID01 001-009 Record 01 001
AREC01 010-011 Record 01 001
AREFDT (017-022) Record 01 001
AREFDY 019-020 Record 01 002
AREFMO 017-018 Record 01 001
AREFYR 021-022 Record 01 002
ARTYPE 015 Record 01 001
ASREC01 012-013 Record 01 001
===== E =====
ERVS1 043-045 Record 01 003
===== G =====
GAP1FLAG 034 Record 01 003
===== H =====
HCVS1 046-048 Record 01 003
===== I =====
IPNGT1 037-039 Record 01 003
===== M =====
MDVS1 052-054 Record 01 004
===== O =====
OBSDAYS1 031-033 Record 01 002
INDEX OF VARIABLES PAGE 006
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== O =====
OCVS1 049-051 Record 01 003
===== T =====
T1_STAT 029-030 Record 01 002