/* SHORT TITLE: Codebook for Patient Quest-Time 4 Specific Data */
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* W E S T A T C O D E B O O K *
* ----------- --------------- *
* *
* STUDY OF HEALTH CARE COSTS *
* WESTAT ADULT QUESTIONNAIRE - TIME 4 - 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 4 - PUBLIC USE *
* 30 JUNE 1994 *
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(0)
27 Jun. 1994
Record 01
STUDY OF HEALTH CARE COSTS
WESTAT ADULT QUESTIONNAIRE - TIME 4 - PUBLIC USE
30 JUNE 1994
Question Column
Name Number(s)
________ _________
GPID01 001-009 PATIENT ID NUMBER
_________________
000000001-
999999999 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
GREC01 010-011 RECORD NUMBER
_____________
01 = NUMBER
GSREC01 012-013 SUBRECORD NUMBER
________________
00 = NOT A REPEATING RECORD
GITYPE 014 WHAT IS THE INSTRUMENT TYPE?
_____________________________
G = TIME 4 QUESTIONNNAIRE
GRTYPE 015 RESPONDENT TYPE
_______________
1 = STUDY SUBJECT
2 = PROXY
GLANG 016 QUESTIONNAIRE LANGUAGE VERSION
______________________________
1 = ENGLISH
2 = SPANISH
GREFDT (017-022) REFERENCE BEGIN DATE
____________________
GREFMO 017-018 MONTH OF BEGIN REFERENCE DATE
_____________________________
01-12 = MONTH
(1)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GREFDY 019-020 DAY OF BEGIN REFERENCE DATE
___________________________
01-31 = DAY
GREFYR 021-022 YEAR OF BEGIN REFERENCE DATE
____________________________
91-92 = YEAR
GENDDT (023-028) REFERENCE END DATE
__________________
GENDMO 023-024 MONTH OF END DATE
_________________
01-12 = MONTH
GENDDY 025-026 DAY OF END DATE
_______________
01-31 = DAY
GENDYR 027-028 YEAR OF END DATE
________________
91-92 = YEAR
T4_STAT 029-030 QUESTIONNAIRE STATUS
____________________
CO = COMPLETE, WITH RESPONDENT
PR = COMPLETE, WITH PROXY
DD = COMPLETE, WITH PROXY PATIENT DECEASED AT TIME OF INTERVIEW
OBSDAYS4 031-033 OBSERVATION DAYS WITHIN REFERENCE PERIOD EXCLUDING PERIODS OF INELIGIBILITY
___________________________________________________________________________
001-600 = NUMBER
999 = NOT ASCERTAINED
(2)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GAP4FLAG 034 PATIENT HAD TIME GAP DURING REFERENCE PERIOD
____________________________________________
+ = INAPPLICABLE, NO TIME GAP
1 = YES TIME GAP
ADM4 035-036 NUMBER OF INPATIENT ADMISSIONS (UNSTANDARDIZED)
_______________________________________________
00 = NONE
01-99 = NUMBER OF ADMISSIONS
IPNGT4 037-039 NUMBER OF INPATIENT NIGHTS (UNSTANDARDIZED)
___________________________________________
000 = NONE
001-999 = NUMBER OF NIGHTS
AMBVS4 040-042 NUMBER OF AMBULATORY VISITS, INCLUDES HOSPITAL CLINIC, OTHER CLINIC AND PRIVATE MD
(UNSTANDARDIZED)
________________
000 = NONE
001-999 = NUMBER OF AMBULATORY VISITS
ERVS4 043-045 NUMBER OF EMERGENCY ROOM VISITS (UNSTANDARDIZED)
________________________________________________
000 = NONE
001-999 = NUMBER OF EMERGENCY ROOM VISITS
HCVS4 046-048 NUMBER OF HOSPITAL CLINIC VISITS (UNSTANDARDIZED)
_________________________________________________
000 = NONE
001-999 = NUMBER OF HOSPITAL CLINIC VISITS
OCVS4 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)
________ _________
MDVS4 052-054 NUMBER OF PRIVATE MD VISITS (UNSTANDARDIZED)
____________________________________________
000 = NONE
001-999 = NUMBER OF PRIVATE MD VISITS
GHSEHOLD (055-129) HOUSEHOLD COMPOSITION
_____________________
GA01CT 055-056 COUNTER OF PEOPLE LISTED IN Q A1
________________________________
* 00 = NONE
01-99 = NUMBER OF PEOPLE LISTED
* SKIP GA1REL1 - GA1SST10
PERSON1 (057-062) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL1 057-058 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX1 059 SEX
___
+ = INAPPLICABLE,PATIENT LIVES ALONE
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(4)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE1 060-061 AGE
___
+ = INAPPLICABLE,PATIENT LIVES ALONE
00 = NEWBORN TO 11 MONTHS
01-96 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST1 062 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON2 (063-068) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL2 063-064 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX2 065 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(5)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE2 066-067 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST2 068 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON3 (069-074) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL3 069-070 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX3 071 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(6)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE3 072-073 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST3 074 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON4 (075-080) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL4 075-076 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX4 077 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(7)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE4 078-079 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST4 080 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON5 (081-086) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL5 081-082 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX5 083 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(8)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE5 084-085 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST5 086 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON6 (087-092) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL6 087-088 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX6 089 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(9)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE6 090-091 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST6 092 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON7 (093-098) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL7 093-094 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
99 = NOT ASCERTAINED
GA1SEX7 095 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(10)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE7 096-097 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST7 098 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON8 (099-104) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL8 099-100 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX8 101 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(11)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE8 102-103 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST8 104 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON9 (105-110) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL9 105-106 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX9 107 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(12)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE9 108-109 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST9 110 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON10 (111-116) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
GA1REL10 111-112 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SEX10 113 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(13)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA1AGE10 114-115 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA1SST10 116 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GABOX1 (117-118) BOX A -1
________
GABOX1A 117 CHILDREN LISTED?
_________________
1 = YES
2 = NO
GABOX1B 118 SPOUSE/PARTNER LISTED?
_______________________
* 1 = YES
2 = NO
* SKIP GA2 - GA4
(14)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA2 119 ARE YOU CURRENTLY LEGALLY MARRIED, WIDOWED, DIVORCED, SEPARATED, OR HAVE YOU NEVER BEEN
MARRIED?
_________
+ = INAPPLICABLE, CODED 1 IN GABOX1B.
* 1 = MARRIED
2 = WIDOWED
3 = DIVORCED
4 = SEPARATED
5 = NEVER MARRIED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GA3
GA3 120 ARE YOU CURRENTLY INVOLVED IN A COMMITTED RELATIONSHIP WITH ONE OTHER PERSON?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GABOX1B; OR CODED 1 IN GA2
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GA4
GA4 121 HAS (YOUR SPOUSE/THAT PERSON) ALSO BEEN DIAGNOSED AS BEING HIV POSITIVE?
_________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GABOX1B; OR CODED 2, 7, 8 OR 9 IN GA3
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(15)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA5 122-123 PLEASE LOOK AT THIS CARD, WHICH DESCRIBES DIFFERENT TYPES OF PLACES WHERE PEOPLE LIVE.
SINCE (REF. DATE), IN WHICH ONE OF THESE TYPES OF PLACES DID YOU LIVE MOST OF THE TIME?
CODE ONE.
__________
01 = APARTMENT OR HOUSE WHICH YOU OWN OR HOLD THE LEASE
02 = APARTMENT OR HOUSE OF ANOTHER IN WHICH YOU PAY RENT BUT DON'T HOLD THE
LEASE
03 = "DOUBLED UP" WITH FRIEND OR RELATIVE ON SOFA, FLOOR, ETC.
04 = SINGLE ROOM OCCUPANCY (SRO) OR 'WELFARE HOTEL'
05 = SPECIALIZED AIDS HOUSING
06 = SHELTERS
07 = STREET OR OTHER PUBLIC PLACE
08 = HOSPITAL, NURSING HOME, RESIDENTIAL CARE FACILITY
09 = IN FOSTER HOMES
10 = LIVES WITH SOMEONE ELSE
11 = JAIL
12 = PUBLIC HOUSING
13 = TRAILER/HOUSE UNKNOWN IF OWNED/LEASED
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GA6 (124-129) PLEASE LOOK AT THIS CARD. SINCE (REF. DATE) DID YOU LIVE IN ANY OF THESE PLACES OR
SITUATIONS? (CODE ALL 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).
GA6A 124 TEMPORARILY "DOUBLED UP" WITH FRIEND OR RELATIVE ON SOFA, FLOOR, ETC.
______________________________________________________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(16)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GA6B 125 SINGLE ROOM OCCUPANCY (SRO) OR 'WELFARE HOTEL'
______________________________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GA6C 126 SPECIALIZED AIDS HOUSING
________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GA6D 127 SHELTERS
________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GA6E 128 STREET OR OTHER PUBLIC PLACE
____________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GA6F 129 NONE
____
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(17)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GINSCOVR (130-219) INSURANCE COVERAGE
__________________
GB1 130 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 GBBOX2
GBBOX2 131 TIME 3 = PRIVATE INSURANCE
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB1.
* 1 = YES
** 2 = NO
* SKIP GBBOX3
** SKIP GBBOX3 - GB6
GBBOX3 132 TIME 3 = PRIVATE INSURANCE
__________________________
+ = INAPPLICABLE, CODED 1 IN GB1.
* 1 = YES
** 2 = NO
* SKIP GB2 - GB4L
** SKIP GB2 - GB10
(18)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB2 133 IS THIS THE SAME PRIVATE HEALTH INSURANCE PLAN YOU TOLD ME ABOUT LAST TIME?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED GBBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB3 - GB4L
GB3 134 HAVE YOU BEEN COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL TODAY, OR ONLY PART OF THE
TIME?
______
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED GBBOX3; OR CODED 2, 7 OR 9 IN
GB2.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB4A - GB10
GB4 (135-146) SINCE (REF. DATE), IN WHICH MONTHS WERE YOU COVERED BY PRIVATE INSURANCE FOR THE ENTIRE
MONTH? CIRCLE THE CODE FOR ALL MONTHS THAT APPLY.
CODER: AT LEAST ONE MONTH MUST BE CIRCLED.IF NONE ARE CIRCLED CODE 9 FOR EACH MONTH.IF
AT LEAST ONE IS CIRCLED,CODE 1 FOR ALL CIRCLED MONTH(S).CODE 2 FOR ALL UNCIRCLED
MONTH(S).
GB4A 135 JANUARY
_______
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(19)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB4B 136 FEBRUARY
________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4C 137 MARCH
_____
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4D 138 APRIL
_____
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4E 139 MAY
___
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(20)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB4F 140 JUNE
____
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4G 141 JULY
____
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4H 142 AUGUST
______
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4I 143 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(21)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB4J 144 OCTOBER
_______
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4K 145 NOVEMBER
________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB4L 146 DECEMBER
________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED IN GBBOX3; OR CODED 2, 7 OR 9
IN GB2; OR CODED 1, 7, 8 OR 9 IN GB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO TO GB12
GB5 (147-150) WHEN DID YOUR (PREVIOUS) HEALTH INSURANCE COVERAGE END?
CODER: IF GB5YR EQUALS 97, 98 OR 99, CODE 99 IN GB5MO.
(22)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB5MO 147-148 MONTH
_____
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED 2 IN GBBOX3; OR CODED 1 OR 8 IN
GB2.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GB5YR 149-150 YEAR
____
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED 2 IN GBBOX3; OR CODED 1 OR 8 IN
GB2.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GB6 151 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED 2 IN GBBOX3; OR CODED 1 OR 8 IN
GB2.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GBBOX4 152 LOOK AT Q. B-1. R ANSWERED:
______________________________
+ = INAPPLICABLE, CODED 2 IN GBBOX2; OR CODED 2 IN GBBOX3; OR CODED 1 OR 8 IN
GB2.
1 = YES
* 2 = NO
* SKIP GB7 - GB10
(23)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB7 153 IS YOUR CURRENT PLAN INDIVIDUAL OR FAMILY COVERAGE?
____________________________________________________
+ = INAPPLICABLE, CODED ONLY IF GBBOX2 = 2; OR GBBOX4 = 1.
1 = INDIVIDUAL PLAN
2 = FAMILY PLAN
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB8 154-155 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 ONLY IF GBBOX2 = 2; OR GBBOX4 = 1.
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
GB9 (156-159) WHEN DID YOUR CURRENT HEALTH INSURANCE BEGIN?
CODER: IF GB9YR EQUALS 97, 98 OR 99, CODE 99 IN GB9MO.
GB9MO 156-157 MONTH
_____
+ = INAPPLICABLE, CODED ONLY IF GBBOX2 = 2; OR GBBOX4 = 1.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(24)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB9YR 158-159 YEAR
____
+ = INAPPLICABLE, CODED ONLY IF GBBOX2 = 2; OR GBBOX4 = 1.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GB10 160 IS THIS PLAN A HEALTH MAINTENANCE ORGANIZATION OR HMO?
_______________________________________________________
+ = INAPPLICABLE, CODED ONLY IF GBBOX2 = 2; OR GBBOX4 = 1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB12 161 AT ANY TIME SINCE (REF. DATE) HAVE YOU BEEN COVERED BY (MEDICAID/STATE NAME FOR
MEDICAID)?
___________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB13 - GB14L
GB13 162 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 GB12.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB14A - GB14L
(25)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB14 (163-174) 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 MONTH MUST BE CIRCLED.IF NONE ARE CIRCLED CODE 9 FOR EACH MONTH.IF
AT LEAST ONE IS CIRCLED,CODE 1 FOR ALL CIRCLED MONTHS.CODE 2 FOR ALL UNCIRCLED MONTH(S).
GB14A 163 JANUARY
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14B 164 FEBRUARY
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14C 165 MARCH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(26)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB14D 166 APRIL
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14E 167 MAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14F 168 JUNE
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14G 169 JULY
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(27)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB14H 170 AUGUST
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14I 171 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14J 172 OCTOBER
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB14K 173 NOVEMBER
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(28)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB14L 174 DECEMBER
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB12; OR CODED 1, 7, 8 OR 9 IN GB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO TO GB19
GBBOX5 175 TIME 3 = MEDICAID
_________________
+ = INAPPLICABLE, CODED 1 IN GB12.
1 = YES
* 2 = NO
* SKIP GB16MO - GB16YR
GB16 (176-179) WHEN DID YOUR (MEDICAID/STATE NAME FOR MEDICAID) COVERAGE END?
CODER: IF GB16YR EQUALS 97, 98 OR 99, CODE 99 IN GB16MO.
GB16MO 176-177 MONTH
_____
+ = INAPPLICABLE, CODED 1 IN GB12; OR CODED 2 IN GBBOX5.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GB16YR 178-179 YEAR
____
+ = INAPPLICABLE, CODED 1 IN GB12; OR CODED 2 IN GBBOX5.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(29)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB17 180 HAVE YOU (RE-)APPLIED FOR MEDICAID?
____________________________________
+ = INAPPLICABLE, CODED 1 IN GB12.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB18
GB18 181 HAVE YOU BEEN TURNED DOWN FOR MEDICAID?
________________________________________
+ = INAPPLICABLE, CODED 1 IN GB12; OR CODED 2, 7, 8 OR 9 IN GB17.
1 = YES
2 = NO/ NO DECISION YET
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB19 182 SINCE (REF. DATE), HAVE YOU BEEN COVERED BY MEDICARE? MEDICARE IS A SOCIAL SECURITY
HEALTH INSURANCE PROGRAM FOR DISABLED PERSONS AND FOR PERSONS 65 YEARS OLD AND OLDER.
______________________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB21 183 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 GBBOX6
(30)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GBBOX6 184 TIME 3 = OTHER PUBLIC ASSISTANCE
________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB21.
* 1 = YES
** 2 = NO
* SKIP GBBOX7
** SKIP GBBOX7 - GBBOX8
GBBOX7 185 TIME 3 = OTHER PUBLIC ASSISTANCE
________________________________
+ = INAPPLICABLE, CODED 1 IN GB21.
* 1 = YES
** 2 = NO
* SKIP GB22 - GB24L
** SKIP GB22 - GB27YR
GB22 186 IS THIS THE SAME PUBLIC ASSISTANCE PROGRAM YOU TOLD ME ABOUT LAST TIME?
________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB23 - GB24L
GB23 187 HAVE YOU BEEN COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL TODAY, OR ONLY PART OF THE
TIME?
______
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB24A - GB27YR
(31)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB24 (188-199) SINCE (REF. DATE), IN WHICH MONTHS WERE YOU COVERED BY (OTHER PUBLIC ASSISTANCE PROGRAM)
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 MONTH.IF AT
LEAST ONE IS CIRCLED,CODE 1 FOR ALL CIRCLED MONTH(S).CODE 2 FOR ALL UNCIRCLED MONTH(S).
GB24A 188 JANUARY
_______
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24B 189 FEBRUARY
________
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24C 190 MARCH
_____
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(32)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB24D 191 APRIL
_____
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24E 192 MAY
___
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24F 193 JUNE
____
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24G 194 JULY
____
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(33)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB24H 195 AUGUST
______
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24I 196 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24J 197 OCTOBER
_______
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB24K 198 NOVEMBER
________
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(34)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB24L 199 DECEMBER
________
+ = INAPPLICABLE, CODED 2 IN GBBOX6; OR CODED IN GBBOX7; OR CODED 2, 7, 8 OR
9 IN GB22; OR CODED 1, 7, 8 OR 9 IN GB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO TO GBBOX9
GB25 (200-203) (LAST TIME YOU TOLD ME YOU WERE COVERED BY SOME PUBLIC ASSISTANCE PROGRAM.) WHEN DID YOUR
COVERAGE UNDER THAT PROGRAM END?
CODER: IF GB25YR EQUALS 97, 98 OR 99, CODE 99 IN GB25MO.
GB25MO 200-201 MONTH
_____
+ = INAPPLICABLE, CODED ONLY IF GBBOX7 = 1; OR GB22 = 2, 7, 8 OR 9.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GB25YR 202-203 YEAR
____
+ = INAPPLICABLE, CODED ONLY IF GBBOX7 = 1; OR GB22 = 2, 7, 8 OR 9.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(35)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GBBOX8 204 LOOK AT Q B-21. R ANSWERED:
_____________________________
+ = INAPPLICABLE, CODED ONLY IF GBBOX7 = 1; OR GB22 = 2, 7, 8 OR 9.
1 = YES
* 2 = NO
* SKIP GB26 - GB27YR
GB26 205-206 WHAT IS THE NAME OF THIS CURRENT PROGRAM?
__________________________________________
+ = INAPPLICABLE, CODED ONLY IF GBBOX6 = 2; OR GBBOX8 = 1.
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 = GOVT FUNDED PROGRAM, NOS
77 = COMMUNITY PROGRAM -FUNDING UNKNOWN
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GB27 (207-210) WHEN DID YOUR COVERAGE UNDER THIS CURRENT PROGRAM BEGIN?
CODER: IF GB27YR EQUALS 97, 98 OR 99, CODE 99 IN GB27MO.
GB27MO 207-208 MONTH
_____
+ = INAPPLICABLE, CODED ONLY IF GBBOX6 = 2; OR GBBOX8 = 1.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(36)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB27YR 209-210 YEAR
____
+ = INAPPLICABLE, CODED ONLY IF GBBOX6 = 2; OR GBBOX8 = 1.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GBBOX9 211 TIME 3 - CHAMPUS/CHAMPVA
________________________
1 = YES
* 2 = NO
* SKIP GB28
GB28 212 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)?
_________________________________
+ = INAPPLICABLE, CODED 2 IN GBBOX9.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB29 213 ARE YOU CURRENTLY PARTICIPATING IN ANY CLINICAL TRIALS FOR ANY MEDICATIONS?
____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GB31A1 - GB31B2
GB31 (214-219) HOW LONG HAVE YOU BEEN PARTICIPATING IN THIS/THESE TRIALS?
___________________________________________________________
(37)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB31A (214-216) LENGTH OF TIME IN FIRST TRIAL
_____________________________
GB31A1 214-215 LENGTH OF FIRST TRIAL
_____________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB29.
01-92 = LENGTH
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GB31A2
GB31A2 216 UNIT OF FIRST TRIAL
___________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB29; OR CODED 97, 98 OR 99 IN
GB31A1.
1 = DAYS
2 = WEEKS
3 = MONTHS
4 = YEARS
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GB31B (217-219) LENGTH OF TIME IN SECOND TRIAL
______________________________
GB31B1 217-218 LENGTH OF SECOND TRIAL
______________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB29; OR ONLY ONE TRIAL.
01-90 = AMOUNT
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GB31B2
(38)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GB31B2 219 UNIT OF SECOND TRIAL
____________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GB29; OR CODED 97, 98 OR 99 IN
GB31B1; OR ONLY ONE TRIAL.
1 = DAYS
2 = WEEKS
3 = MONTHS
4 = YEARS
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GIPSTAYS (220-224) INPATIENT HOSPITAL STAYS
________________________
GD1A 220 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 GD1B
GD1B 221-222 HOW MANY TIMES HAVE YOU BEEN IN THE HOSPITAL OVERNIGHT OR LONGER SINCE (REF. DATE)?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GD1A.
01-10 = NUMBER OF TIMES
GD05CT 223-224 NUMBER OF INPATIENT STAY RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
GHURSHOM (225-229) NURSING HOME/RESIDENTIAL CARE STAYS
___________________________________
(39)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GE1A 225 HAVE YOU BEEN A PATIENT IN A RESIDENTIAL CARE FACILITY, A NURSING HOME OR HOSPICE
OVERNIGHT OR LONGER?
CODER: SHOULD BE CODED YES IF THE RESPONDENT IS CURRENTLY IN A RESIDENTIAL CARE
FACILITY, NURSING HOME OR HOSPICE.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASGERTAINED
* SKIP GE1B
GE1B 226-227 HOW MANY TIMES HAVE YOU BEEN IN A RESIDENTIAL CARE FACILITY, NURSING HOME OR HOSPICE
OVERNIGHT OR LONGER SINGE (REF. DATE)?
________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GE1A.
01-96 = NUMBER OF TIMES
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GE07CT 228-229 NUMBER OF NURSING HOME/RESIDENTIAL CARE RECORDS
_______________________________________________
00 = NONE LISTED
01-99 = NUMBER
GMEDVIST (230-249) MEDICAL VISITS
______________
GF1 230 SINCE (REF. DATE ) DID YOU GO TO A HOSPITAL EMERGENCY ROOM FOR MEDICAL CARE?
______________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GF1A
(40)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GF1A 231-232 HOW MANY DIFFERENT EMERGENCY ROOMS DID YOU VISIT SINCE (REF. DATE)?
_____________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GF1.
01-96 = NUMBER OF EMERGENCY ROOMS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GF09CT 233-234 NUMBER OF EMERGENCY ROOM RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
GF2 235 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 GF2A
GF2A 236-237 HOW MANY DIFFERENT HOSPITAL CLINICS AND-OR HOSPITAL OUT-PATIENT DEPARTMENTS DID YOU VISIT
SINCE (REF. DATE)?
____________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GF2.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GF10CT 238-239 NUMBER OF HOSPITAL CLINIC RECORDS
_________________________________
00 = NONE LISTED
01-99 = NUMBER
(41)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GF3 240 HAVE YOU BEEN TO ANY OTHER MEDICAL CLINIC, FOR EXAMPLE, A COMMUNITY CLINIC OR A
NEIGHBORHOOD HEALTH CENTER? THESE VISITS COULD INCLUDE BLOOD TESTS, OR OTHER LAB WORK,
OR SCANS LIKE MRI'S OR X-RAY PROCEDURES.
_________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GF3A
GF3A 241-242 HOW MANY DIFFERENT MEDICAL CLINICS DID YOU VISIT SINCE (REF. DATE)?
_____________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GF3.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GF11CT 243-244 NUMBER OF MEDICAL CLINIC RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
GF4 245 HAVE YOU BEEN TO A PRIVATE DOCTOR'S OFFICE FOR MEDICAL CARE? THESE VISITS COULD ALSO
INCLUDE BLOOD TESTS, OTHER LAB WORK, OR SCANS LIKE MRI'S OR X-RAY PROCEDURES.
______________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GF4A
GF4A 246-247 HOW MANY DIFFERENT PRIVATE DOCTOR'S OFFICES DID YOU VISIT SINCE (REF. DATE)?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GF4.
01-05 = NUMBER OF PROVIDERS
(42)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GF12CT 248-249 NUMBER OF PRIVATE DOCTOR'S OFFICE RECORDS
_________________________________________
00 = NONE LISTED
01-99 = NUMBER
GOTHPROV (250-267) OTHER HEALTH CARE PROVIDERS
___________________________
GG1 250 SINCE (REF. DATE) HAVE YOU ATTENDED A SUPPORT GROUP, OR RECEIVED ANY PSYCHOLOGICAL
COUNSELING OR THERAPY? PLEASE DO NOT INCLUDE TREATMENT RECEIVED FOR PROBLEMS RELATED TO
DRUG OR ALCOHOL USE.
_____________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GG1A
GG1A 251-252 HOW MANY DIFFERENT SUPPORT GROUPS OR PSYCHOLOGICAL COUNSELORS DID YOU VISIT SINCE (REF.
DATE)?
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GG1.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GG13CT 253-254 NUMBER OF MENTAL HEALTH PROVIDER RECORDS
________________________________________
00 = NONE LISTED
01-99 = NUMBER
(43)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GG2 255 HAVE YOU RECEIVED CARE FROM ANY MEDICAL PRACTICIONERS SUCH AS OPTOMETRISTS, FOOT DOCTORS,
OR CHIROPRACTORS?
__________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GG2A
GG2A 256-257 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 GG2.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GG14CT 258-259 NUMBER OF MEDICAL PRACTITIONER RECORDS
______________________________________
00 = NONE LISTED
01-99 = NUMBER
GG3 260 HAVE YOU RECEIVED TREATMENT FROM ANY ALTERNATIVE THERAPIST, A PRACTICIONER OF HOLISTIC
MEDICINE, A NUTRITIONIST, OR ANY OTHER ALTERNATIVE THERAPY LIKE BIOFEEDBACK?
_____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GG3A
(44)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GG3A 261-262 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 GG3.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GG15CT 263-264 NUMBER OF ALTERNATIVE THERAPIST RECORDS
_______________________________________
00 = NONE LISTED
01-99 = NUMBER
GG4 265 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
GG16CT 266-267 NUMBER OF MEDICAL EQUIPMENT PROVIDER RECORDS
____________________________________________
00 = NONE LISTED
01-99 = NUMBER
GHOMHLTH (268-271) HOME HEALTH CARE
________________
(45)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GH1 268 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. SINCE (REF. DATE), HAVE YOU RECEIVED ANY OF
THESE KINDS OF SERVICES AT HOME? (CIRCLE THE PROVIDER TYPE IN COLUMN A.)
_________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GH2 269 HAVE YOU RECEIVED HELP AT HOME BY ANY OTHER PEOPLE NOT SHOWN ON THE CARD? (SPECIFY THE
PROVIDER TYPE IN COLUMN A.)
___________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GH18CT 270-271 NUMBER OF HOME HEALTH PROVIDER RECORDS
______________________________________
00 = NONE LISTED
01-99 = NUMBER
G_NONMED (272-297) NON - MEDICAL SERVICES
______________________
GI1 272 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. 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
(46)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GI20CT 273-274 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH HOUSING
____________________________________________________
00 = NONE
01-99 = NUMBER
GI2 275 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. 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
GI21CT 276-277 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH LEGAL SERVICES
___________________________________________________________
00 = NONE
01-99 = NUMBER
GI3 278 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. 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
GI22CT 279-280 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH CHILD CARE
_______________________________________________________
00 = NONE
01-99 = NUMBER
(47)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GI4 281 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. 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
GI23CT 282-283 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH TRANSPORTATION
___________________________________________________________
00 = NONE
01-99 = NUMBER
GI5 284 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR AGENCY, GROUP OR
ORGANIZATION WITH OBTAINING FOOD, EITHER GROCERIES YOU WERE GIVEN OR MEALS YOU WERE
SERVED OUTSIDE YOUR HOME.
__________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GI24CT 285-286 NUMBER OF RECORDS FOR PROVIDERS HELPING OBTAIN FOOD
___________________________________________________
00 = NONE
01-99 = NUMBER
GI6 287 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. 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
(48)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GI25CT 288-289 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH FINANCIAL ASSISTANCE
_________________________________________________________________
00 = NONE
01-99 = NUMBER
GI7 290 ARE YOU CURRENTLY RECEIVING TREATMENT OR COUNSELING FOR PROBLEMS RELATED TO ALCOHOL OR
DRUG USE?
__________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GI26CT 291-292 NUMBER OF RECORDS FOR ALCOHOL/DRUG TREATMENT PROVIDERS
______________________________________________________
00 = NONE
01-99 = NUMBER
GDNTLSRV (293-297) DENTAL SERVICES
_______________
GJ1 293 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 GJ1A
GJ1A 294-295 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 GJ1.
01-96 = NUMBER
(49)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GJ28CT 296-297 NUMBER OF DENTAL VISIT RECORDS
______________________________
00 = NONE
01-99 = NUMBER
GWMNHLTH (298-351) WOMEN'S HEALTH CARE
___________________
GKSEX 298 SEX OF PATIENT (MALE OR FEMALE)
_______________________________
* 1 = MALE
2 = FEMALE
* SKIP GK1 - GK10B
GK1 299-300 YOU TOLD US THAT YOU HAD A POSITIVE BLOOD TEST FOR THE HIV (AIDS) VIRUS. WHERE DID YOU
HAVE THAT BLOOD TEST?
______________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
01 = HOSPITAL
02 = CLINIC
* 03 = DOCTOR'S OFFICE
* 04 = JAIL
* 05 = LAB
* 06 = HEALTH DEPT
* 07 = MOBILE VAN/UNIT
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GK1A
(50)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK1A 301-302 PLEASE LOOK AT THIS CARD. AT WHICH KIND OF CLINIC DID YOU HAVE THAT BLOOD TEST?
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED > 02 IN GK1.
01 = SEXUALLY TRANSMITTED DISEASE (STD) CLINIC
02 = OB - GYN CLINIC
03 = PRENATAL CLINIC
04 = DRUG TREATMENT
05 = MEDICAL CLINIC
06 = INPATIENT STAY
07 = EMERGENCY ROOM
08 = HOSPITAL NOT OTHERWISE SPECIFIED
09 = LAB
10 = HEALTH DEPT
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GK2 (303-309) IN THE PAST 5 YEARS HAS A DOCTOR EVER TOLD YOU THAT YOU HAD ...
________________________________________________________________
GK2A 303 A SEXUALLY TRANSMITTED DISEASE, AN STD, LIKE SYPHILIS, CHANCROID OR GONORRHEA?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK2B 304 CHRONIC VAGINITIS?
___________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(51)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK2C 305 PID, PELVIC INFLAMMATORY DISEASE?
__________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK2D 306 HERPES SIMPLEX
______________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK2E 307 VAGINAL CANDIDIASIS OR A "YEAST INFECTION"?
____________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK2F 308 HPV, HUMAN PAPILLOMAVIRUS?
___________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(52)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK2G 309 AN ABNORMAL PAP TEST
____________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK3 310 ARE YOU PREGNANT NOW?
______________________
+ = INAPPLICABLE, CODED 1 IN GKSEX.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GK4
GK4 311 SINCE MARCH 1, 1991, HAVE YOU BEEN PREGNANT?
_____________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3.
* 1 = YES
** 2 = NO
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP GK5A - GK10A
** SKIP GK5A - GK10B
GK5A 312 ARE YOU CURRENTLY RECEIVING PRENATAL CARE?
___________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED IN GK4.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GK6PROV - GK9A
(53)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK6APROV 313-319 PROVIDER ID
___________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3.
0000001-
9999996 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
9999997 = REFUSED
9999998 = DK
9999999 = NOT ASCERTAINED
GK7A (320-327) HOW IS THIS CARE PAID FOR?
CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF
ONE IS CIRCLED CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S).
GK7AA 320 MEDICAID
________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7AB 321 OTHER PUBLIC ASSISTANCE
_______________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(54)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK7AC 322 PRIVATE INSURANCE
_________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7AD 323 MEDICARE
________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7AE 324 SELF PAY
________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7AF 325 OTHER
_____
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = CIRCLED
* 2 = NOT CIRCLED
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GK7AFOS
(55)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK7AFOS 326-327 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A; OR CODED 2, 7, 8 OR 9 IN GK7AF.
01 = RESEARCH STUDY
03 = FLAT FEE
05 = GAY AIDS TASK FORCE/AIDS NETWORK
14 = FAMILY/FRIEND
29 = COMMUNITY HEALTH PROJECT
46 = PROVIDER
47 = PRIVATE CHARITY/GRANT FROM AIDS FOUNDATION
50 = DRUG COMPANY
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GK8A 328 DURING YOUR PRENATAL CARE ARE YOU BEING GIVEN ANY SPECIAL COUNSELING RELATING TO YOUR HIV
INFECTION?
___________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK9A 329 HAVE YOU HAD PRENATAL CARE SINCE YOU FIRST KNEW YOU WERE PREGNANT?
___________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 2,
7, 8 OR 9 IN GK5A.
* 1 = YES
2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GK10A - GK10B
(56)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK10A 330-331 WHAT KINDS OF PROBLEMS ARE YOU FACING IN RECEIVING PRE-NATAL CARE? RECORD VERBATIM.
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 2, 7, 8 OR 9 IN GK3; OR CODED 1,
7, 8 OR 9 IN GK9A.
* 01 = NO PROBLEMS
* 02 = DIDN'T WANT TO GO FOR CARE
* 03 = NONE BECAUSE TERMINATED PREGNANCY OR ABORTION
* 04 = HAD MISCARRIAGE
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GK5B - GK10B
GK5B 332 DID YOU RECEIVE PRENATAL CARE?
_______________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GK6PROV - GK9B
GK6BPROV 333-339 PROVIDER ID
___________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
0000001-
9999996 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
9999997 = REFUSED
9999998 = DK
9999999 = NOT ASCERTAINED
GK7B (340-347) HOW WAS THIS CARE PAID FOR?
CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF
ONE IS CIRCLED CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S).
(57)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK7BA 340 MEDICAID
________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7BB 341 OTHER PUBLIC ASSISTANCE
_______________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7BC 342 PRIVATE INSURANCE
_________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7BD 343 MEDICARE
________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(58)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK7BE 344 SELF PAY
________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK7BF 345 OTHER
_____
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = CIRCLED
* 2 = NOT CIRCLED
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GK7BFOS
GK7BFOS 346-347 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B; OR CODED 2, 7, 8 OR 9 IN GK7BF.
01 = RESEARCH STUDY
03 = FLAT FEE
05 = GAY AIDS TASK FORCE/AIDS NETWORK
14 = FAMILY/FRIEND
29 = COMMUNITY HEALTH PROJECT
46 = PROVIDER
47 = PRIVATE CHARITY/GRANT FROM AIDS FOUNDATION
50 = DRUG COMPANY
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(59)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GK8B 348 DURING YOUR CARE WERE YOU BEING GIVEN ANY SPECIAL COUNSELING RELATING TO YOUR HIV
INFECTION?
___________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GK9B 349 DID YOU HAVE PRENATAL CARE SINCE YOU FIRST KNEW YOU WERE PREGNANT?
___________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 2, 7, 8 OR 9 IN GK5B.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GK10B
GK10B 350-351 WHAT KINDS OF PROBLEMS DID YOU FACE IN RECEIVING PRE-NATAL CARE? RECORD VERBATIM.
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GKSEX; OR CODED 1 IN GK3; OR CODED 2, 7, 8 OR 9
IN GK4; OR CODED 1, 7, 8 OR 9 IN GK9B.
01 = NO PROBLEM
02 = DIDN'T WANT TO GO FOR CARE
03 = NONE BECAUSE TERMINATED PREGNANCY OR ABORTION
04 = HAD MISCARRIAGE
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GDRGSECT (352-436) HIV - RELATED MEDICINES
_______________________
(60)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL2 352 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
GL3 353 SINCE (REF. DATE) HAVE YOU TAKEN ANY OTHER PRESCRIPTION MEDICINES OR DRUGS? IF YES TO
L-2 OR L-3, RECORD NAMES IN COLUMN A. IF NAME IS UNKNOWN, PROBE FOR CONDITION AND RECORD
IN COLUMN A. IF MEDICINE NAME OR CONDITION IS UNKNOWN, PROBE FOR DRUG PROVIDER NAME AND
ADDRESS. ASK B THROUGH I FOR EACH DRUG LISTED BEFORE MOVING TO NEXT DRUG.
___________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GL31CT 354-355 NUMBER OF PRESCRIPTION DRUG RECORDS
___________________________________
00 = NONE LISTED
01-99 = NUMBER
GL4 356 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
GL32CT 357-358 NUMBER OF NON-PRESCRIPTION DRUGS/NON-TRADITIONAL SUBSTANCES LISTED IN Q. K-5
_____________________________________________________________________________
* 00 = NO DRUGS LISTED
01-99 = NUMBER OF DRUGS LISTED
* SKIP GL5A - GL6
(61)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL5 (359-430) WHAT ARE THE NAMES OF THE NON-PRESCRIPTION DRUGS OR NON-TRADITIONAL SUBSTANCES THAT YOU
ARE TAKING?
____________
GL5A 359-361 NON - PRESCRIPTION DRUG 1
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
GL5B 362-364 NON - PRESCRIPTION DRUG 2
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5C 365-367 NON - PRESCRIPTION DRUG 3
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5D 368-370 NON - PRESCRIPTION DRUG 4
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
(62)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL5E 371-373 NON - PRESCRIPTION DRUG 5
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5F 374-376 NON - PRESCRIPTION DRUG 6
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5G 377-379 NON - PRESCRIPTION DRUG 7
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5H 380-382 NON - PRESCRIPTION DRUG 8
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; OR NO
OTHER NON-PRESCRIPTION DRUG/SUBSTANCE LISTED.
001-720 = NON - PRESCRIPTION DRUG CODES
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(63)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL5I 383-385 NON - PRESCRIPTION DRUG 9
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5J 386-388 NON - PRESCRIPTION DRUG 10
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5K 389-391 NON - PRESCRIPTION DRUG 11
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5L 392-394 NON - PRESCRIPTION DRUG 12
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
(64)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL5M 395-397 NON - PRESCRIPTION DRUG 13
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5N 398-400 NON - PRESCRIPTION DRUG 14
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5O 401-403 NON - PRESCRIPTION DRUG 15
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5P 404-406 NON - PRESCRIPTION DRUG 16
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
(65)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL5Q 407-409 NON - PRESCRIPTION DRUG 17
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5R 410-412 NON - PRESCRIPTION DRUG 18
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5S 413-415 NON - PRESCRIPTION DRUG 19
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5T 416-418 NON - PRESCRIPTION DRUG 20
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
(66)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL5U 419-421 NON - PRESCRIPTION DRUG 21
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5V 422-424 NON - PRESCRIPTION DRUG 22
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5W 425-427 NON - PRESCRIPTION DRUG 23
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
GL5X 428-430 NON - PRESCRIPTION DRUG 24
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4; AND CODED 00 IN GL32CT; 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
(67)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GL6 431-436 WE'RE INTERESTED IN THE TOTAL AMOUNT YOU SPENT ON (MEDICINE). HOW MUCH DID YOU PAY FOR
(MEDICINES IN Q L-5) SINCE (REF. DATE)?
CODER: CODE AMOUNTS IN WHOLE DOLLARS.
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GL4.
000000 = NONE
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
GFUNCTN (437-480) FUNCTIONAL STATUS
_________________
GM1 437 IN GENERAL, WOULD YOU SAY THAT YOUR HEALTH IS EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR?
_________________________________________________________________________________________
1 = EXCELLENT
2 = VERY GOOD
3 = GOOD
4 = FAIR
5 = POOR
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2 (438-453) I AM GOING TO READ YOU SOME PROBLEMS PEOPLE CAN HAVE IN THEIR DAILY LIVES. THINKING
ABOUT YOUR LIFE SINCE (REF. DATE), PLEASE TELL ME WHETHER THESE PROBLEMS HAVE BEEN TRUE
FOR YOU MOST OF THE TIME. (READ ITEMS A-P). HAS THAT BEEN TRUE FOR YOU MOST OF THE
TIME.
______
GM2A 438 I HAVE PAIN AT NIGHT
____________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(68)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM2B 439 I TAKE TABLETS TO HELP ME SLEEP
_______________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2C 440 I HAVE UNBEARABLE PAIN
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2D 441 I AM TIRED ALL THE TIME
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2E 442 I FIND IT PAINFUL TO CHANGE POSITION
____________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2F 443 I'M IN PAIN WHEN I WALK
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(69)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM2G 444 I'M WAKING UP IN THE EARLY HOURS OF THE MORNING
_______________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2H 445 EVERYTHING IS AN EFFORT
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2I 446 I LIE AWAKE FOR MOST OF THE NIGHT
_________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2J 447 I'M IN PAIN WHEN I'M STANDING
_____________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2K 448 IT TAKES ME A LONG TIME TO GET TO SLEEP
_______________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(70)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM2L 449 I SOON RUN OUT OF ENERGY
________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2M 450 I'M IN CONSTANT PAIN
____________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2N 451 I'M IM PAIN WHEN GOING UP AND DOWN STAIRS
_________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2O 452 I SLEEP BADLY AT NIGHT
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM2P 453 I'M IN PAIN WHEN I'M SITTING
____________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(71)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM3 (454-459) I'M GOING TO READ YOU A LIST OF ACTIVITIES. PLEASE TELL ME HOW LONG, IF AT ALL, YOUR
HEALTH HAS LIMITED YOU IN EACH ACTIVITY. (READ ITEM) HAS YOU HEALTH LIMITED YOU FOR MORE
THAN 3 MONTHS, LESS THAN 3 MONTHS, OR NOT LIMITED YOU AT ALL.
______________________________________________________________
GM3A 454 THE KINDS OR AMOUNTS OF VIGOROUS ACTIVITIES YOU CAN DO, LIKE LIFTING HEAVY OBJECTS,
RUNNING OR PARTICIPATING IN STRENUOUS SPORTS
____________________________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM3B 455 THE KINDS OR AMOUNTS OF MODERATE ACTIVITIES YOU CAN DO LIKE MOVING A TABLE, CARRYING
GROCERIES OR BOWLING
____________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM3C 456 WALKING UPHILL OR CLIMBING A FEW FLIGHTS OF STAIRS
__________________________________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM3D 457 BENDING, LIFTING, OR STOOPING
_____________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(72)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM3E 458 WALKING ONE BLOCK
_________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM3F 459 EATING, DRESSING, BATHING OR USING THE TOILET
_____________________________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM4 460 SINCE (REF. DATE) HAS YOUR HEALTH KEPT YOU FROM WORKING AT A JOB, DOING WORK AROUND THE
HOUSE, OR GOING TO SCHOOL?
___________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GM5
GM5 461 DID YOUR HEALTH ALSO KEEP YOU FROM DOING THESE KINDS OF ACTIVITIES BEFORE (REF. DATE)?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GM4.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(73)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM6 462 SINCE (REF. DATE) HAVE YOU BEEN UNABLE TO DO CERTAIN KINDS OR AMOUNTS OF WORK,
HOUSEWORK, OR SCHOOLWORK BECAUSE OF YOUR HEALTH?
_________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GM7
GM7 463 WERE YOU ALSO UNABLE TO DO THESE KINDS OF ACTIVITIES BECAUSE OF HEALTH BEFORE (REF.
DATE)?
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GM6.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM8 464 IN THE PAST MONTH, HOW OFTEN HAVE YOU SPENT TIME WITH OR TALKED TO RELATIVES OR FRIENDS
-- DAILY, SEVERAL TIMES A WEEK, SEVERAL TIMES A MONTH, ONCE OR TWICE, OR NOT AT ALL?
(CIRCLE ONE ONLY)
_________________
1 = DAILY
2 = SEVERAL TIMES A WEEK
3 = SEVERAL TIMES A MONTH (WEEKLY)
4 = ONCE OR TWICE
5 = NOT AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(74)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM9 465 DURING THE PAST MONTH, HOW MUCH OF THE TIME HAS YOUR HEALTH LIMITED YOUR SOCIAL
ACTIVITIES LIKE VISITING WITH FRIENDS OR RELATIVES? PLEASE LOOK AT THIS CARD AND TELL ME
THAT ANSWER THAT SHOWS HOW MUCH OF THE TIME YOU HAVE BEEN LIMITED.
___________________________________________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM10 (466-470) PLEASE LOOK AT THIS CARD AGAIN AND TELL ME THE ANSWER THAT COMES CLOSEST TO THE WAY
YOU'VE BEEN FEELING. DURING THE PAST MONTH, HOW MUCH OF THE TIME:
___________________________________________________________________
GM10A 466 HAVE YOU BEEN A VERY NERVOUS PERSON?
_____________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM10B 467 HAVE YOU BEEN CALM AND PEACEFUL?
_________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(75)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM10C 468 HAVE YOU FELT DOWNHEARTED AND BLUE?
____________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM10D 469 HAVE YOU BEEN A HAPPY PERSON?
______________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM10E 470 HAVE YOU FELT SO DOWN IN THE DUMPS THAT NOTHING COULD CHEER YOU UP?
____________________________________________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM11 471-472 LOOK AT THE FLAP. (NOT INCLUDING YOUR SPOUSE/PARTNER), HOW MANY FAMILY MEMBERS OR
FRIENDS, IF ANY, CAN YOU CONFIDE IN AND TALK TO ABOUT PERSONAL FEELINGS AND PROBLEMS?
______________________________________________________________________________________
00 = NONE
01-96 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(76)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM12 473 WHAT WAS YOUR MOST RECENT T4 COUNT? WAS IT: PROBE: YOUR CD4 COUNT?
______________________________________________________________________
1 = 000 - 100
2 = 101 - 200
3 = 201 - 300
4 = 301 - 500
5 = GREATER THAN 500
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GM13DT (474-479) WHAT WAS THE DATE OF YOUR MOST RECENT T4 TEST?
CODER: IF GM13YR EQUALS 97, 98 OR 99, CODE 99 IN GM13MO AND GM13DY.
GM13MO 474-475 MONTH
_____
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GM13DY 476-477 DAY
___
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GM13YR 478-479 YEAR
____
85-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(77)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GM14 480 SINCE YOU FIRST KNEW YOU WERE INFECTED, HAS YOUR T4 COUNT EVER BEEN LESS THAN 200
_________________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GCAREACS (481) ACCESS AND BARRIERS TO CARE
___________________________
GN1 481 IS THERE A PARTICULAR CLINIC, HEALTH CENTER, DOCTOR'S OFFICE, OR OTHER PLACE THAT YOU
USUALLY GO FOR MEDICAL CARE OR ADVICE ABOUT YOUR HEALTH?
_________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN2A - GN8YRS
GN2 (482-490) WHAT KIND OF PLACE IS THAT - A CLINIC, A HOSPITAL, A DOCTOR'S OFFICE, OR SOME OTHER
PLACE? CODE ONLY ONE. PLEASE GIVE ME THE NAME OF THAT PLACE.
_______________________________________________________________
GN2A 482-483 PROVIDER TYPE
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1.
01 = CLINIC
02 = HOSPITAL
03 = DOCTOR'S OFFICE
91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GN2PROV
(78)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN2PROV 484-490 PROVIDER ID
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1; OR CODED 97, 98 OR 99 IN GN2A.
0000001-
9999996 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
9999997 = REFUSED
9999998 = DK
9999999 = NOT ASCERTAINED
GN3 491 IS THERE A PARTICULAR DOCTOR THAT YOU USUALLY SEE AT (PLACE IN N2)?
____________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN4 492 DOES (PLACE IN N2) HAVE SOMEONE WHO HELPS YOU FILL OUT FORMS FOR MEDICARE, HEALTH
INSURANCE, OR PUBLIC ASSISTANCE PROGRAMS SUCH AS (MEDICAID OR STATE NAME FOR MEDICAID)?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN5 493-494 HOW DO YOU USUALLY GET THERE - BY WALKING, DRIVING, BEING DRIVEN BY SOMEONE ELSE, BY
TAXI, OTHER PUBLIC TRANSPORTATION, OR SOME OTHER WAY? CODE ONLY ONE.
______________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1.
01 = WALKING
02 = DRIVING
03 = BEING DRIVEN
04 = TAXI
05 = OTHER PUBLIC TRANSPORTATION
06 = AMBULETTE/AMBULANCE/OTHER MEDICAL TRANSPORT
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(79)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN6 (495-499) ABOUT HOW LONG DOES IT USUALLY TAKE YOU TO GET THERE?
______________________________________________________
GN6MIN 495-497 MINUTES
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1; OR CODED IN GN6HRS
* 001-150 = NUMBER
* 997 = REFUSED
* 998 = DK
* 999 = NOT ASCERTAINED
* SKIP GN6HRS
GN6HRS 498-499 HOURS
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1; OR CODED IN GN6MIN
01-05 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GN7 500 WHEN YOU GO THERE, DO YOU USUALLY HAVE AN APPOINTMENT AHEAD OF TIME, DO YOU JUST WALK IN,
OR DO YOU SOMETIMES HAVE AN APPOINTMENT AND SOMETIMES NOT?
___________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1.
1 = HAS APPOINTMENT
2 = JUST WALKS IN
3 = SOMETIMES HAS APPOINTMENT
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN8 (501-504) HOW LONG HAVE YOU BEEN GOING TO (PLACE IN N2)?
_______________________________________________
(80)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN8MOS 501-502 MONTHS
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1; OR CODED IN GN8YRS
* 01-78 = NUMBER
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GN8YRS
GN8YRS 503-504 YEARS
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN1; OR CODED IN GN8MOS
01-35 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GN9 (505-584) THERE ARE MANY HEALTH CARE SERVICES THAT PEOPLE NEED WHICH THEY SOMETIMES DO NOT RECEIVE.
LOOK AT THIS CARD AND PLEASE TELL ME IF YOU FELT YOU NEEDED ANY OF THESE SERVICES SINCE
(REF. DATE) BUT FOR SOME REASON, YOU DID NOT RECEIVE THEM. CODE ALL THAT APPLY IN
COLUMN A. THEN ASK B-G FOR EACH SERVICE CODED.
________________________________________________
GN9AA 505 YOU FELT THAT YOU NEEDED EMERGENCY CARE, BUT DID NOT RECEIVE IT?
_________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9AB - GN9AG
(81)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9AB 506 YOU FELT THAT YOU NEEDED EMERGENCY CARE. DO YOU KNOW WHERE YOU CAN GO TO GET EMERGENCY
CARE?
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9AA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9AC 507 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR EMERGENCY CARE?
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9AA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9AD
GN9AD 508 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR EMERGENCY CARE YOURSELF?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9AA; OR CODED 1 IN GN9AC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9AE 509 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET TO AN EMERGENCY CARE
PROVIDER?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9AA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(82)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9AF 510 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE EMERGENCY CARE TO YOU?
________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9AA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9AG
GN9AG 511-514 WHY WERE YOU REFUSED EMERGENCY CARE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9AA; OR CODED 2, 7, 8 OR 9 IN
GN9AF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER THE QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9BA 515 YOU FELT THAT YOU NEEDED AN OVERNIGHT HOSPITAL STAY, BUT DID NOT RECEIVE IT?
_____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9BB - GN9BG
(83)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9BB 516 YOU FELT THAT YOU NEEDED AN OVERNIGHT STAY. DO YOU KNOW WHERE YOU CAN GO TO GET AN
OVERNIGHT STAY?
________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9BA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9BC 517 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR AN OVERNIGHT STAY?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9BA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9BD
GN9BD 518 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR AN OVERNIGHT STAY YOURSELF?
__________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9BA; OR CODED 1 IN GN9BC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9BE 519 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET TO AN OVERNIGHT STAY?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9BA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(84)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9BF 520 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE AN OVERNIGHT STAY TO YOU?
___________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9BA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9BG
GN9BG 521-524 WHY WERE YOU REFUSED AN OVERNIGHT STAY? RECORD VERBATIM.
__________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9BA; OR CODED 2, 7, 8 OR 9 IN
GN9BF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER THE QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9CA 525 YOU FELT THAT YOU NEEDED HOME SERVICES, BUT DID NOT RECEIVE THEM?
__________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9CB - GN9CG
(85)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9CB 526 YOU FELT THAT YOU NEEDED HOME SERVICES. DO YOU KNOW WHERE YOU CAN GO TO GET HOME
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9CA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9CC 527 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR HOME SERVICES?
__________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9CA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9CD
GN9CD 528 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR HOME SERVICES YOURSELF?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9CA; OR CODED 1 IN GN9CC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9CF 529 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE HOME SERVICES TO YOU?
_______________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9CA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9CG
(86)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9CG 530-533 WHY WERE YOU REFUSED HOME SERVICES? RECORD VERBATIM.
______________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9CA; OR CODED 2, 7, 8 OR 9 IN
GN9CF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9DA 534 YOU FELT THAT YOU NEEDED MENTAL HEALTH SERVICES, BUT DID NOT RECEIVE THEM?
___________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9DB - GN9DG
GN9DB 535 YOU FELT THAT YOU NEEDED MENTAL HEALTH SERVICES. DO YOU KNOW WHERE YOU CAN GO TO GET
MENTAL HEALTH SERVICES?
________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9DA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(87)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9DC 536 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR MENTAL HEALTH
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9DA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9DD
GN9DD 537 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR MENTAL HEALTH SERVICES YOURSELF?
_______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9DA; OR CODED 1 IN GN9DC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9DE 538 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET MENTAL HEALTH SERVICES?
_______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9DA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9DF 539 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE MENTAL HEALTH SERVICE TO YOU?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9DA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9DG
(88)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9DG 540-543 WHY WERE YOU REFUSED MENTAL HEALTH SERVICES? RECORD VERBATIM.
_______________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9DA; OR CODED 2, 7, 8 OR 9 IN
GN9DF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9EA 544 YOU FELT THAT YOU NEEDED RESIDENTIAL CARE, BUT DID NOT RECEIVE IT?
___________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9EB - GN9EG
GN9EB 545 YOU FELT THAT YOU NEEDED RESIDENTIAL CARE. DO YOU KNOW WHERE YOU CAN GO TO GET
RESIDENTIAL CARE?
__________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9EA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(89)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9EC 546 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR RESIDENTIAL CARE?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9EA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9ED
GN9ED 547 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR RESIDENTIAL CARE YOURSELF?
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9EA; OR CODED 1 IN GN9EC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9EE 548 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET RESIDENTIAL CARE?
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9EA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9EF 549 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE RESIDENTIAL CARE TO YOU?
__________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9EA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9EG
(90)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9EG 550-553 WHY WERE YOU REFUSED RESIDENTIAL CARE? RECORD VERBATIM.
_________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9EA; OR CODED 2, 7, 8 OR 9 IN
GN9EF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9FA 554 YOU FELT THAT YOU NEEDED PRESCRIBED MEDICATION, BUT DID NOT RECEIVE IT?
________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9FB - GN9FG
GN9FB 555 YOU FELT THAT YOU NEEDED PRESCRIBED MEDICATION. DO YOU KNOW WHERE YOU CAN GO TO GET
PRESCRIBED MEDICATION?
_______________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9FA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(91)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9FC 556 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR PRESCRIBED MEDICATION?
__________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9FA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9FD
GN9FD 557 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR PRESCRIBED MEDICATION YOURSELF?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9FA; OR CODED 1 IN GN9FC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9FE 558 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET PRESCRIBED MEDICATION?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9FA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9FF 559 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE ANY PRESCRIBED MEDICATION TO YOU?
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9FA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9FG
(92)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9FG 560-563 WHY WERE YOU REFUSED PRESCRIBED MEDICATION? RECORD VERBATIM.
______________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9FA; OR CODED 2, 7, 8 OR 9 IN
GN9FF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9GA 564 YOU FELT THAT YOU NEEDED DENTAL SERVICES, BUT DID NOT RECEIVE THEM?
____________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9GB - GN9GG
GN9GB 565 YOU FELT THAT YOU NEEDED DENTAL SERVICES. DO YOU KNOW WHERE YOU CAN GO TO GET DENTAL
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9GA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(93)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9GC 566 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR DENTAL SERVICES?
____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9GA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9GD
GN9GD 567 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR DENTAL SERVICES YOURSELF?
________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9GA; OR CODED 1 IN GN9GC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9GE 568 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET DENTAL SERVICES?
________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9GA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9GF 569 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE DENTAL SERVICES TO YOU?
_________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9GA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9GG
(94)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9GG 570-573 WHY WERE YOU REFUSED DENTAL SERVICES? RECORD VERBATIM.
________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9GA; OR CODED 2, 7, 8 OR 9 IN
GN9GF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9HA 574 YOU FELT THAT YOU NEEDED DRUG TREATMENT SERVICES, BUT DID NOT RECEIVE THEM?
____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9HB - GN9HG
GN9HB 575 YOU FELT THAT YOU NEEDED DRUG TREATMENT SERVICES. DO YOU KNOW WHERE YOU CAN GO TO GET
DRUG TREATMENT SERVICES?
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9HA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(95)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9HC 576 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR DRUG TREATMENT
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9HA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP GN9HD
GN9HD 577 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR DRUG TREATMENT SERVICES YOURSELF?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9HA; OR CODED 1 IN GN9HC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9HE 578 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET DRUG TREATMENT SERVICES?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9HA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GN9HF 579 SINCE (REF. DATE) HAS ANYONE REFUSED TO PROVIDE DRUG TREATMENT SERVICES TO YOU?
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9HA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GN9HG
(96)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GN9HG 580-583 WHY WERE YOU REFUSED DRUG TREATMENT SERVICES? RECORD VERBATIM.
________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GN9HA; OR CODED 2, 7, 8 OR 9 IN
GN9HF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE/WAITING LIST ETC
0003 = VARIATIONS OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER, ETC.
0004 = RESPONDENT WAS TOLD; NOT SICH ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GN9IA 584 YOU FELT THAT NO SERVICES WERE NEEDED?
_______________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GEMPLYMT (585-680) EMPLOYMENT AND INCOME
_____________________
GO1 585 ARE YOU CURRENTLY WORKING FULL-TIME, PART-TIME, OR ARE YOU CURRENTLY NOT WORKING?
__________________________________________________________________________________
* 1 = FULL - TIME
2 = PART - TIME
** 3 = NOT WORKING
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP GOBOX2 - GOBOX3
** SKIP GOBOX2
(97)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GOBOX2 586 R CURRENTLY WORKING PART-TIME. LOOK AT FACE SHEETS. LAST TIME R WAS:
_______________________________________________________________________
+ = INAPPLICABLE, CODED 1, 3, 7, 8 OR 9 IN GO1.
* 1 = WORKING FULL TIME (FT)
** 2 = WORKING PART -TIME (PT)
** 3 = NOT WORKING (NW)
* SKIP GOBOX3 - GO6
** SKIP GOBOX3 - GO15
GOBOX3 587 R CURRENTLY NOT WORKING. LOOK AT FACE SHEETS. LAST TIME R WAS:
_________________________________________________________________
+ = INAPPLICABLE, CODED 1 OR 2 IN GO1.
* 1 = WORKING FULL TIME (FT)
* 2 = WORKING PART -TIME (PT)
** 3 = NOT WORKING (NW)
* SKIP GO2 - GO21
** SKIP GO2 - GO27
GO2 588-590 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN GO1.
001-090 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
GO3O4 591-594 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION,
1983.
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN GO1.
0001-9990 = 1983 CENSUS OCCUPATIONAL CODES
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
(98)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO4A 595 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK?
WOULD YOU SAY IT WAS:
______________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN GO1.
1 = LESS THAN 25 PEOPLE
2 = 25 - 99 PEOPLE
3 = 100 - 499 PEOPLE
4 = 500 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO5 596 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO
BECAUSE OF YOUR ILLNESS?
_________________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN GO1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO6 - GO30
GO6 597-598 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN GO1; OR CODED 2, 7, 8 OR 9 IN GO5.
* 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO7 - GO30
(99)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO7 599-601 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
001-060 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
GO8O9 602-605 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION,
1983.
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
0001-9990 = 1983 CENSUS OCCUPATIONAL CODES
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
GO9A 606 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK?
WOULD YOU SAY IT WAS:
______________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
1 = LESS THAN 25 PEOPLE
2 = 25 - 99 PEOPLE
3 = 100 - 499 PEOPLE
4 = 500 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(100)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO10 607 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO11 608-609 DID YOU STOP WORKING AT YOUR (LAST) JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR DISABILITY
LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, WERE TOO ILL OR FOR SOME OTHER
REASON?
________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
01 = LEAVE OF ABSENCE/DISABILITY LEAVE
02 = QUIT
03 = LAID OFF
04 = FIRED
05 = TOO ILL
06 = PREGNANCY
07 = ARRESTED/IN PRISON
08 = RETIRED
09 = KEPT SAME JOB CHANGE TO PT
10 = MOVED/LEFT AREA
11 = JOB ENDED OR BUSINESS CLOSED/MOVED/WAS SOLD
12 = WENT TO SCHOOL
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO12 610 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(101)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO13 (611-614) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT (FULL TIME) JOB?
CODER: IF GO13YR EQUALS 97, 98, 99 CODE 99 IN GO13MO.
GO13MO 611-612 MONTH THAT LEAVE BEGAN
______________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO13YR 613-614 YEAR THAT LEAVE BEGAN
_____________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
88-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO14 615 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO
BECAUSE OF YOUR ILLNESS?
_________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO15 - GO30
(102)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO15 616-617 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 2 OR 3 IN GOBOX2; OR CODED 1, 2 OR
3 IN GOBOX3; OR CODED 2, 7, 8 OR 9 IN GO14
* 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO16 - GO30
GO16 618-620 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1 IN GOBOX2; OR CODED 1, 2 OR 3 IN
GOBOX3.
001-050 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
GO17O18 621-624 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION,
1983.
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1 IN GOBOX2; OR CODED 1, 2 OR 3 IN
GOBOX3.
0001-9990 = 1983 CENSUS OCCUPATIONAL CODES
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
(103)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO18A 625 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK?
WOULD YOU SAY IT WAS:
______________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1 IN GOBOX2; OR CODED 1, 2 OR 3 IN
GOBOX3.
1 = LESS THAN 25 PEOPLE
2 = 25 - 99 PEOPLE
3 = 100 - 499 PEOPLE
4 = 500 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO19 626 ARE YOU ACTIVELY LOOKING FOR FULL TIME WORK?
_____________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1 IN GOBOX2; OR CODED 1, 2 OR 3 IN
GOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO20 627 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO
BECAUSE OF YOUR ILLNESS?
_________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1 IN GOBOX2; OR CODED 1, 2 OR 3 IN
GOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO21 - GO30
(104)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO21 628-629 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1 IN GOBOX2; OR CODED 1, 2 OR 3 IN
GOBOX3; OR CODED 2, 7, 8 OR 9 IN GO20.
* 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO22 - GO30
GO22 630 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2, OR 3 IN GOBOX2; OR CODED 3
IN GOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO23 631-632 DID YOU STOP WORKING AT YOUR (LAST) JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR DISABILITY
LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, WERE TOO ILL OR FOR SOME OTHER
REASON?
________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2, OR 3 IN GOBOX2; OR CODED 3
IN GOBOX3.
01 = LEAVE OF ABSENCE/DISABILITY LEAVE
02 = QUIT
03 = LAID OFF
04 = FIRED
05 = TOO ILL
06 = PREGNANCY
07 = ARRESTED/IN PRISON
08 = RETIRED
09 = KEPT SAME JOB CHANGE TO PT
10 = MOVED/LEFT AREA
11 = JOB ENDED OR BUSINESS CLOSED/MOVED/WAS SOLD
12 = WENT TO SCHOOL
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(105)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO24 633 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2, OR 3 IN GOBOX2; OR CODED 3
IN GOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GO25 (634-637) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT JOB?
CODER: IF GO25YR EQUALS 97, 98, 99 CODE 99 IN GO25MO.
GO25MO 634-635 MONTH THAT LEAVE BEGAN
______________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2, OR 3 IN GOBOX2; OR CODED 3
IN GOBOX3.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO25YR 636-637 YEAR THAT LEAVE BEGAN
_____________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2, OR 3 IN GOBOX2; OR CODED 3
IN GOBOX3.
90-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(106)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO26 638 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO
BECAUSE OF YOUR ILLNESS?
_________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2, OR 3 IN GOBOX2; OR CODED 3
IN GOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO27 - GO30
GO27 639-640 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2 OR 3 IN GOBOX2; OR CODED 3 IN
GOBOX3; OR CODED 2, 7, 8 OR 9 IN GO26.
* 01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO28 - GO30
GO28 641 ARE YOU ACTIVELY LOOKING FOR FULL TIME WORK?
_____________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2 OR 3 IN GOBOX2; OR CODED 1 OR
2 IN GOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO29 - GO30
(107)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO29 642 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO
BECAUSE OF YOUR ILLNESS?
_________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2 OR 3 IN GOBOX2; OR CODED 1 OR
2 IN GOBOX3; OR CODED 2, 7, 8 OR 9 IN GO28.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO30
GO30 643-644 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN GO1; OR CODED 1, 2 OR 3 IN GOBOX2; OR CODED 1 OR
2 IN GOBOX3; OR CODED 2, 7, 8 OR 9 IN GO28; OR CODED 2, 7, 8 OR 9 IN GO29
01 = STOPPED/QUIT WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
02 = CAN'T DO WHAT I USED TO DO
03 = CHANGE TYPE/AMOUNT OF WORK
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(108)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO31 645-646 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 IN HERE. CIRCLE ONE CODE.
_____________________________________________________________
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
GOBOX4 647 R WORKING FULL TIME (Q.O-1)
___________________________
* 1 = YES
2 = NO
* SKIP GO32 - GO41YR
GO32 648 SINCE (REF. DATE) HAVE YOU RECEIVED ANY SOCIAL SECURITY DISABILITY PAYMENTS?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO33MO - GO33BX
GO33 (649-653) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST SOCIAL SECURITY DISABILITY PAYMENT?
______________________________________________________________________________________
(109)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO33DT (649-652) DATE YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
CODER: IF GO33YR EQUALS 97, 98 OR 99 CODE 99 IN GO33MO.
GO33MO 649-650 MONTH YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
___________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO32; OR CODED
IN GO33BX
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO33YR 651-652 YEAR YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO32; OR CODED
IN GO33BX
* 91-92 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO33BX - GO35
GO33BX 653 FIRST SOCIAL SECURITY DISABILITY PAYMENT BEFORE (REF. DATE)
____________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO32; OR CODED
IN GO33DT.
* 1 = CHECKED
* SKIP GO34 - GO35
(110)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO34 654 HAVE YOU APPLIED FOR SOCIAL SECURITY DISABILITY PAYMENTS?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 1 IN GO32;
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO35
GO35 655 HAVE YOU BEEN TURNED DOWN FOR SOCIAL SECURITY DISABILITY?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 1 IN GO32; OR CODED 2, 7, 8 OR
9 IN GO34.
1 = YES
2 = NO/NO DECISION YET
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
GOBOX5 656 R HAS: CHILDREN (SEE FLAP)
___________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4.
* 1 = NO CHILDREN LIVING WITH THEM (SEE FLAP)
2 = 1 OR MORE CHILDREN LIVING WITH THEM (SEE FLAP)
* SKIP GO36 - GO37BX
GO36 657 SINCE (REF. DATE) HAVE YOU RECEIVED ASSISTANCE THROUGH THE AID TO FAMILIES WITH
DEPENDENT CHILDREN PROGRAM, SOMETIMES CALLED AFDC OR ADC?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 1 IN GOBOX5
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO37MO - GO37BX
(111)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO37 (658-662) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST AFDC PAYMENT?
________________________________________________________________
GO37DT (658-661) DATE YOU RECEIVED YOUR FIRST AFDC PAYMENT
CODER: IF GO37YR EQUALS 97, 98, 99 CODE 99 IN G037MO.
GO37MO 658-659 MONTH YOU RECEIVED YOUR FIRST AFDC PAYMENT.
____________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 1 IN GOBOX5; OR CODED 2, 7, 8
OR 9 IN GO36; OR CODED 1 IN GO37BX
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO37YR 660-661 YEAR YOU RECEIVED YOUR FIRST AFDC PAYMENT
_________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 1 IN GOBOX5; OR CODED 2, 7, 8
OR 9 IN GO36; OR CODED 1 IN GO37BX.
* 91-92 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO37BX
GO37BX 662 FIRST AFDC PAYMENT BEFORE (REF. DATE)
______________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 1 IN GOBOX5; OR CODED 2, 7, 8
OR 9 IN GO36; OR CODED IN GO37DT.
1 = CHECKED
(112)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO38 663 SINCE (REF. DATE) HAVE YOU RECEIVED THE SUPPLEMENTAL SECURITY INCOME OR SSI CHECK?
____________________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO39MO - GO39BX
GO39 (664-668) IN WHAT MONTH DID YOU RECEIVE YOUR FIRST SSI PAYMENT?
______________________________________________________
GO39DT (664-667) DATE YOU RECEIVED YOUR FIRST SSI PAYMENT?
CODER: IF GO39YR EQUALS 97, 98 OR 99, CODE 99 IN GO39MO.
GO39MO 664-665 MONTH YOU RECEIVED YOUR FIRST SSI PAYMENT
_________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO38; OR CODED
1 IN GO39BX.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO39YR 666-667 YEAR YOU RECEIVED YOUR FIRST SSI PAYMENT
________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO38; OR CODED
1 IN GO39BX
* 91-92 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GO39BX
(113)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO39BX 668 FIRST SSI PAYMENT BEFORE (REF. DATE)
_____________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED IN GO39DT.
1 = CHECKED
GO40 669 SINCE (REF. DATE) HAVE YOU RECEIVED FOOD STAMPS?
__________________________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO41MO - GO41YR
GO41 (670-673) IN WHAT MONTH DID YOU FIRST RECEIVE FOOD STAMPS?
CODER: IF GO41YR EQUALS 97, 98 OR 99, CODE 99 IN GO41MO.
GO41MO 670-671 MONTH YOU FIRST RECEIVED FOOD STAMPS
____________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO40
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GO41YR 672-673 YEAR YOU FIRST RECEIVED FOOD STAMPS
___________________________________
+ = INAPPLICABLE, CODED 1 IN GOBOX4; OR CODED 2, 7, 8 OR 9 IN GO40
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(114)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GO42 674 SINCE (REF. DATE) HAVE YOU REGULARLY RECEIVED FINANCIAL SUPPORT, LIKE MONEY TO PAY BILLS
OR FOR FOOD OR RENT, FROM YOUR PARENTS, FRIENDS OR FAMILY MEMBERS?
___________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GO43
GO43 675-680 HOW MUCH HAVE YOU RECEIVED SINCE (REF. DATE)?
CODER: CODE AMOUNTS IN WHOLE DOLLARS
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GO42
000001-999996 = AMOUNT RECEIVED
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
GTIMEGAP (681-760) TIME GAPS
_________
GP1 681 SINCE MARCH 1, 1991, HAVE YOU BEEN OUT OF THE UNITED STATES FOR A PERIOD OF TWO WEEKS OR
LONGER?
________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GP2 - GP3R3YR
(115)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP2 682-683 HOW MANY DIFFERENT TIMES HAVE YOU BEEN OUT OF THE UNITED STATES FOR TWO WEEKS OR LONGER
SINCE MARCH 1, 1991?
_____________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
01-99 = NUMBER
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GP3L1MO - GP3R3YR
GP3 (684-719) WHAT WAS THE DATE YOU LEFT THE UNITED STATES THE (FIRST/NEXT) TIME? WHAT WAS THE DATE
YOU RETURNED TO THE UNITED STATES THE (FIRST/NEXT) TIME?
CODER: IF "YR" EQUALS 97, 98 OR 99, CODE 99 IN "MO" AND "DY".
TRIP1 (684-695) FIRST TRIP
__________
GP3L1MO 684-685 MONTH LEFT
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3L1DY 686-687 DAY LEFT
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(116)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP3L1YR 688-689 YEAR LEFT
_________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R1MO 690-691 MONTH RETURNED
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R1DY 692-693 DAY RETURNED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R1YR 694-695 YEAR RETURNED
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
TRIP2 (696-707) SECOND TRIP
___________
(117)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP3L2MO 696-697 MONTH LEFT
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3L2DY 698-699 DAY LEFT
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3L2YR 700-701 YEAR LEFT
_________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R2MO 702-703 MONTH RETURNED
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(118)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP3R2DY 704-705 DAY RETURNED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R2YR 706-707 YEAR RETURNED
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
TRIP3 (708-719) THIRD TRIP
__________
GP3L3MO 708-709 MONTH LEFT
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3L3DY 710-711 DAY LEFT
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(119)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP3L3YR 712-713 YEAR LEFT
_________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R3MO 714-715 MONTH RETURNED
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R3DY 716-717 DAY RETURNED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP3R3YR 718-719 YEAR RETURNEDD
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP1; OR CODED 97, 98 OR 99 IN GP2; OR
NO OTHER TRIPS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(120)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP4 720 SINCE MARCH 1, 1991, HAVE YOU BEEN IN JAIL OR PRISON FOR TWO WEEKS OR LONGER?
______________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GP5 - GP6EX3YR
GP5 721-722 HOW MANY DIFFERENT TIMES HAVE YOU BEEN IN JAIL OR PRISON FOR TWO WEEKS OR LONGER SINCE
MARCH 1, 1991?
_______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
01-99 = NUMBER
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP GP6EN1MO - GP6EX3YR
GP6 (723-758) WHAT WAS THE DATE YOU (FIRST/NEXT) TIME? WHAT WAS THE DATE YOU WERE RELEASED FROM JAIL
OR PRISON THE (FIRST/NEXT) TIME?
CODER: IF "YR" EQUALS 97, 98 OR 99, CODE 99 IN "MO" AND "DY".
PRISON1 (723-734) FIRST PRISON TERM
_________________
GP6EN1MO 723-724 MONTH ENTERED
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(121)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP6EN1DY 725-726 DAY ENTERED
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EN1YR 727-728 YEAR ENTERED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX1MO 729-730 MONTH EXITED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX1DY 731-732 DAY EXITED
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX1YR 733-734 YEAR EXITED
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(122)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
PRISON2 (735-746) SECOND PRISON TERM
__________________
GP6EN2MO 735-736 MONTH ENTERED
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EN2DY 737-738 DAY ENTERED
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EN2YR 739-740 YEAR ENTERED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX2MO 741-742 MONTH EXITED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(123)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP6EX2DY 743-744 DAY EXITED
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX2YR 745-746 YEAR EXITED
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
PRISON3 (747-758) THIRD PRISON TERM
_________________
GP6EN3MO 747-748 MONTH ENTERED
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO THER PRISON TERMS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EN3DY 749-750 DAY ENTERED
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(124)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GP6EN3YR 751-752 YEAR ENTERED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX3MO 753-754 MONTH EXITED
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX3DY 755-756 DAY EXITED
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GP6EX3YR 757-758 YEAR EXITED
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN GP4; OR CODED 97, 98 OR 99 IN GP5.
OR NO OTHER PRISON TERMS LISTED.
91-92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
GINTOBS (759-770) INTERVIEWER OBSERVATIONS
________________________
(125)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GR1 759 PLEASE INDICATE YOUR CONFIDENCE IN THE RESPONDENT'S TRUTHFULNESS.
__________________________________________________________________
* 1 = VERY CONFIDENT
* 2 = CONFIDENT
3 = UNSURE
4 = DOUBTFUL
5 = VERY DOUBTFUL
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GR2
GR2 760-761 WHY?
_____
+ = INAPPLICABLE, CODED 1, 2, 8 OR 9 IN GR1.
91 = FLAG FOR QUESTION ANSWERED
98 = DK
99 = NOT ASCERTAINED
GR3 762 PLEASE INDICATE YOUR CONFIDENCE IN THE RESPONDENT'S ACCURACY.
______________________________________________________________
* 1 = VERY CONFIDENT
* 2 = CONFIDENT
3 = UNSURE
4 = DOUBTFUL
5 = VERY DOUBTFUL
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP GR4
GR4 763-764 WHY?
_____
+ = INAPPLICABLE, CODED 1, 2, 8 OR 9 IN GR3.
91 = FLAG FOR QUESTION ANSWERED
98 = DK
99 = NOT ASCERTAINED
GR5 (765-770) GENERALLY THE RESPONDENT WAS:
______________________________
(126)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GR5A 765 ABLE TO UNDERSTAND QUESTIONS
____________________________
1-7 = DEGREE OF UNDERSTANDING
CODER: CODE 1 = ABLE TO UNDERSTAND QUESTIONS EASILY TO CODE 7 = HARDLY ABLE TO
UNDERSTAND THE QUESTION
8 = DK
9 = NOT ASCERTAINED
GR5B 766 COOPERATIVE
___________
1-7 = DEGREE OF COOPERATION
CODER: CODE 1 = COOPERATIVE TO CODE 7 = UNCOOPERATIVE
8 = DK
9 = NOT ASCERTAINED
GR5C 767 NO LANGUAGE PROBLEM
___________________
1-7 = DEGREE OF LANGUAGE PROBLEM
CODER: CODE 1 = NO LANGUAGE PROBLEM TO CODE 7 = SPOKE ENGLISH WITH DIFFICULTY
8 = DK
9 = NOT ASCERTAINED
GR5D 768 INTERVIEWED WITHOUT INTERRUPTION
________________________________
1-7 = DEGREE OF INTERRUPTIONS DURING INTERVIEW
CODER: CODE 1 = INTERVIEWED WITHOUT INTERRUPTION TO CODE 7 = INTERRUPTED OFTEN
8 = DK
9 = NOT ASCERTAINED
(127)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GR5E 769 SOBER
_____
1-7 = LEVEL OF SOBRIETY
CODER: CODE 1 = SOBER TO CODE 7 = INEBRIATED/HIGH
8 = DK
9 = NOT ASCERTAINED
GR5F 770 PHYSICALLY OR MENTALLY FATIGUED
_______________________________
1-7 = LEVEL OF PHYSICAL/MENTAL FATIGUE
CODER: CODE 1 = NOT PHYSICALLY OR MENTALLY FATIGUED TO CODE 7 = PHYSICALLY OR MENTALLY
FATIGUED
8 = DK
9 = NOT ASCERTAINED
(128)
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 =====
ADM4 035-036 Record 01 003
AMBVS4 040-042 Record 01 003
===== E =====
ERVS4 043-045 Record 01 003
===== G =====
G_NONMED (272-297) Record 01 046
GABOX1 (117-118) Record 01 014
GABOX1A 117 Record 01 014
GABOX1B 118 Record 01 014
GAP4FLAG 034 Record 01 003
GA01CT 055-056 Record 01 004
GA1AGE1 060-061 Record 01 005
GA1AGE10 114-115 Record 01 014
GA1AGE2 066-067 Record 01 006
GA1AGE3 072-073 Record 01 007
GA1AGE4 078-079 Record 01 008
GA1AGE5 084-085 Record 01 009
GA1AGE6 090-091 Record 01 010
GA1AGE7 096-097 Record 01 011
GA1AGE8 102-103 Record 01 012
GA1AGE9 108-109 Record 01 013
GA1REL1 057-058 Record 01 004
GA1REL10 111-112 Record 01 013
GA1REL2 063-064 Record 01 005
GA1REL3 069-070 Record 01 006
GA1REL4 075-076 Record 01 007
GA1REL5 081-082 Record 01 008
GA1REL6 087-088 Record 01 009
GA1REL7 093-094 Record 01 010
GA1REL8 099-100 Record 01 011
GA1REL9 105-106 Record 01 012
GA1SEX1 059 Record 01 004
GA1SEX10 113 Record 01 013
GA1SEX2 065 Record 01 005
GA1SEX3 071 Record 01 006
GA1SEX4 077 Record 01 007
GA1SEX5 083 Record 01 008
GA1SEX6 089 Record 01 009
GA1SEX7 095 Record 01 010
GA1SEX8 101 Record 01 011
GA1SEX9 107 Record 01 012
INDEX OF VARIABLES PAGE 002
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GA1SST1 062 Record 01 005
GA1SST10 116 Record 01 014
GA1SST2 068 Record 01 006
GA1SST3 074 Record 01 007
GA1SST4 080 Record 01 008
GA1SST5 086 Record 01 009
GA1SST6 092 Record 01 010
GA1SST7 098 Record 01 011
GA1SST8 104 Record 01 012
GA1SST9 110 Record 01 013
GA2 119 Record 01 015
GA3 120 Record 01 015
GA4 121 Record 01 015
GA5 122-123 Record 01 016
GA6 (124-129) Record 01 016
GA6A 124 Record 01 016
GA6B 125 Record 01 017
GA6C 126 Record 01 017
GA6D 127 Record 01 017
GA6E 128 Record 01 017
GA6F 129 Record 01 017
GBBOX2 131 Record 01 018
GBBOX3 132 Record 01 018
GBBOX4 152 Record 01 023
GBBOX5 175 Record 01 029
GBBOX6 184 Record 01 031
GBBOX7 185 Record 01 031
GBBOX8 204 Record 01 036
GBBOX9 211 Record 01 037
GB1 130 Record 01 018
GB10 160 Record 01 025
GB12 161 Record 01 025
GB13 162 Record 01 025
GB14 (163-174) Record 01 026
GB14A 163 Record 01 026
GB14B 164 Record 01 026
GB14C 165 Record 01 026
GB14D 166 Record 01 027
GB14E 167 Record 01 027
GB14F 168 Record 01 027
GB14G 169 Record 01 027
GB14H 170 Record 01 028
GB14I 171 Record 01 028
GB14J 172 Record 01 028
GB14K 173 Record 01 028
INDEX OF VARIABLES PAGE 003
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GB14L 174 Record 01 029
GB16 (176-179) Record 01 029
GB16MO 176-177 Record 01 029
GB16YR 178-179 Record 01 029
GB17 180 Record 01 030
GB18 181 Record 01 030
GB19 182 Record 01 030
GB2 133 Record 01 019
GB21 183 Record 01 030
GB22 186 Record 01 031
GB23 187 Record 01 031
GB24 (188-199) Record 01 032
GB24A 188 Record 01 032
GB24B 189 Record 01 032
GB24C 190 Record 01 032
GB24D 191 Record 01 033
GB24E 192 Record 01 033
GB24F 193 Record 01 033
GB24G 194 Record 01 033
GB24H 195 Record 01 034
GB24I 196 Record 01 034
GB24J 197 Record 01 034
GB24K 198 Record 01 034
GB24L 199 Record 01 035
GB25 (200-203) Record 01 035
GB25MO 200-201 Record 01 035
GB25YR 202-203 Record 01 035
GB26 205-206 Record 01 036
GB27 (207-210) Record 01 036
GB27MO 207-208 Record 01 036
GB27YR 209-210 Record 01 037
GB28 212 Record 01 037
GB29 213 Record 01 037
GB3 134 Record 01 019
GB31 (214-219) Record 01 037
GB31A (214-216) Record 01 038
GB31A1 214-215 Record 01 038
GB31A2 216 Record 01 038
GB31B (217-219) Record 01 038
GB31B1 217-218 Record 01 038
GB31B2 219 Record 01 039
GB4 (135-146) Record 01 019
GB4A 135 Record 01 019
GB4B 136 Record 01 020
GB4C 137 Record 01 020
INDEX OF VARIABLES PAGE 004
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GB4D 138 Record 01 020
GB4E 139 Record 01 020
GB4F 140 Record 01 021
GB4G 141 Record 01 021
GB4H 142 Record 01 021
GB4I 143 Record 01 021
GB4J 144 Record 01 022
GB4K 145 Record 01 022
GB4L 146 Record 01 022
GB5 (147-150) Record 01 022
GB5MO 147-148 Record 01 023
GB5YR 149-150 Record 01 023
GB6 151 Record 01 023
GB7 153 Record 01 024
GB8 154-155 Record 01 024
GB9 (156-159) Record 01 024
GB9MO 156-157 Record 01 024
GB9YR 158-159 Record 01 025
GCAREACS (481) Record 01 078
GDNTLSRV (293-297) Record 01 049
GDRGSECT (352-436) Record 01 060
GD05CT 223-224 Record 01 039
GD1A 220 Record 01 039
GD1B 221-222 Record 01 039
GEMPLYMT (585-680) Record 01 097
GENDDT (023-028) Record 01 002
GENDDY 025-026 Record 01 002
GENDMO 023-024 Record 01 002
GENDYR 027-028 Record 01 002
GE07CT 228-229 Record 01 040
GE1A 225 Record 01 040
GE1B 226-227 Record 01 040
GFUNCTN (437-480) Record 01 068
GF09CT 233-234 Record 01 041
GF1 230 Record 01 040
GF1A 231-232 Record 01 041
GF10CT 238-239 Record 01 041
GF11CT 243-244 Record 01 042
GF12CT 248-249 Record 01 043
GF2 235 Record 01 041
GF2A 236-237 Record 01 041
GF3 240 Record 01 042
GF3A 241-242 Record 01 042
GF4 245 Record 01 042
GF4A 246-247 Record 01 042
INDEX OF VARIABLES PAGE 005
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GG1 250 Record 01 043
GG1A 251-252 Record 01 043
GG13CT 253-254 Record 01 043
GG14CT 258-259 Record 01 044
GG15CT 263-264 Record 01 045
GG16CT 266-267 Record 01 045
GG2 255 Record 01 044
GG2A 256-257 Record 01 044
GG3 260 Record 01 044
GG3A 261-262 Record 01 045
GG4 265 Record 01 045
GHOMHLTH (268-271) Record 01 045
GHSEHOLD (055-129) Record 01 004
GHURSHOM (225-229) Record 01 039
GH1 268 Record 01 046
GH18CT 270-271 Record 01 046
GH2 269 Record 01 046
GINSCOVR (130-219) Record 01 018
GINTOBS (759-770) Record 01 125
GIPSTAYS (220-224) Record 01 039
GITYPE 014 Record 01 001
GI1 272 Record 01 046
GI2 275 Record 01 047
GI20CT 273-274 Record 01 047
GI21CT 276-277 Record 01 047
GI22CT 279-280 Record 01 047
GI23CT 282-283 Record 01 048
GI24CT 285-286 Record 01 048
GI25CT 288-289 Record 01 049
GI26CT 291-292 Record 01 049
GI3 278 Record 01 047
GI4 281 Record 01 048
GI5 284 Record 01 048
GI6 287 Record 01 048
GI7 290 Record 01 049
GJ1 293 Record 01 049
GJ1A 294-295 Record 01 049
GJ28CT 296-297 Record 01 050
GKSEX 298 Record 01 050
GK1 299-300 Record 01 050
GK1A 301-302 Record 01 051
GK10A 330-331 Record 01 057
GK10B 350-351 Record 01 060
GK2 (303-309) Record 01 051
GK2A 303 Record 01 051
INDEX OF VARIABLES PAGE 006
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GK2B 304 Record 01 051
GK2C 305 Record 01 052
GK2D 306 Record 01 052
GK2E 307 Record 01 052
GK2F 308 Record 01 052
GK2G 309 Record 01 053
GK3 310 Record 01 053
GK4 311 Record 01 053
GK5A 312 Record 01 053
GK5B 332 Record 01 057
GK6APROV 313-319 Record 01 054
GK6BPROV 333-339 Record 01 057
GK7A (320-327) Record 01 054
GK7AA 320 Record 01 054
GK7AB 321 Record 01 054
GK7AC 322 Record 01 055
GK7AD 323 Record 01 055
GK7AE 324 Record 01 055
GK7AF 325 Record 01 055
GK7AFOS 326-327 Record 01 056
GK7B (340-347) Record 01 057
GK7BA 340 Record 01 058
GK7BB 341 Record 01 058
GK7BC 342 Record 01 058
GK7BD 343 Record 01 058
GK7BE 344 Record 01 059
GK7BF 345 Record 01 059
GK7BFOS 346-347 Record 01 059
GK8A 328 Record 01 056
GK8B 348 Record 01 060
GK9A 329 Record 01 056
GK9B 349 Record 01 060
GLANG 016 Record 01 001
GL2 352 Record 01 061
GL3 353 Record 01 061
GL31CT 354-355 Record 01 061
GL32CT 357-358 Record 01 061
GL4 356 Record 01 061
GL5 (359-430) Record 01 062
GL5A 359-361 Record 01 062
GL5B 362-364 Record 01 062
GL5C 365-367 Record 01 062
GL5D 368-370 Record 01 062
GL5E 371-373 Record 01 063
GL5F 374-376 Record 01 063
INDEX OF VARIABLES PAGE 007
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GL5G 377-379 Record 01 063
GL5H 380-382 Record 01 063
GL5I 383-385 Record 01 064
GL5J 386-388 Record 01 064
GL5K 389-391 Record 01 064
GL5L 392-394 Record 01 064
GL5M 395-397 Record 01 065
GL5N 398-400 Record 01 065
GL5O 401-403 Record 01 065
GL5P 404-406 Record 01 065
GL5Q 407-409 Record 01 066
GL5R 410-412 Record 01 066
GL5S 413-415 Record 01 066
GL5T 416-418 Record 01 066
GL5U 419-421 Record 01 067
GL5V 422-424 Record 01 067
GL5W 425-427 Record 01 067
GL5X 428-430 Record 01 067
GL6 431-436 Record 01 068
GMEDVIST (230-249) Record 01 040
GM1 437 Record 01 068
GM10 (466-470) Record 01 075
GM10A 466 Record 01 075
GM10B 467 Record 01 075
GM10C 468 Record 01 076
GM10D 469 Record 01 076
GM10E 470 Record 01 076
GM11 471-472 Record 01 076
GM12 473 Record 01 077
GM13DT (474-479) Record 01 077
GM13DY 476-477 Record 01 077
GM13MO 474-475 Record 01 077
GM13YR 478-479 Record 01 077
GM14 480 Record 01 078
GM2 (438-453) Record 01 068
GM2A 438 Record 01 068
GM2B 439 Record 01 069
GM2C 440 Record 01 069
GM2D 441 Record 01 069
GM2E 442 Record 01 069
GM2F 443 Record 01 069
GM2G 444 Record 01 070
GM2H 445 Record 01 070
GM2I 446 Record 01 070
GM2J 447 Record 01 070
INDEX OF VARIABLES PAGE 008
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GM2K 448 Record 01 070
GM2L 449 Record 01 071
GM2M 450 Record 01 071
GM2N 451 Record 01 071
GM2O 452 Record 01 071
GM2P 453 Record 01 071
GM3 (454-459) Record 01 072
GM3A 454 Record 01 072
GM3B 455 Record 01 072
GM3C 456 Record 01 072
GM3D 457 Record 01 072
GM3E 458 Record 01 073
GM3F 459 Record 01 073
GM4 460 Record 01 073
GM5 461 Record 01 073
GM6 462 Record 01 074
GM7 463 Record 01 074
GM8 464 Record 01 074
GM9 465 Record 01 075
GN1 481 Record 01 078
GN2 (482-490) Record 01 078
GN2A 482-483 Record 01 078
GN2PROV 484-490 Record 01 079
GN3 491 Record 01 079
GN4 492 Record 01 079
GN5 493-494 Record 01 079
GN6 (495-499) Record 01 080
GN6HRS 498-499 Record 01 080
GN6MIN 495-497 Record 01 080
GN7 500 Record 01 080
GN8 (501-504) Record 01 080
GN8MOS 501-502 Record 01 081
GN8YRS 503-504 Record 01 081
GN9 (505-584) Record 01 081
GN9AA 505 Record 01 081
GN9AB 506 Record 01 082
GN9AC 507 Record 01 082
GN9AD 508 Record 01 082
GN9AE 509 Record 01 082
GN9AF 510 Record 01 083
GN9AG 511-514 Record 01 083
GN9BA 515 Record 01 083
GN9BB 516 Record 01 084
GN9BC 517 Record 01 084
GN9BD 518 Record 01 084
INDEX OF VARIABLES PAGE 009
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GN9BE 519 Record 01 084
GN9BF 520 Record 01 085
GN9BG 521-524 Record 01 085
GN9CA 525 Record 01 085
GN9CB 526 Record 01 086
GN9CC 527 Record 01 086
GN9CD 528 Record 01 086
GN9CF 529 Record 01 086
GN9CG 530-533 Record 01 087
GN9DA 534 Record 01 087
GN9DB 535 Record 01 087
GN9DC 536 Record 01 088
GN9DD 537 Record 01 088
GN9DE 538 Record 01 088
GN9DF 539 Record 01 088
GN9DG 540-543 Record 01 089
GN9EA 544 Record 01 089
GN9EB 545 Record 01 089
GN9EC 546 Record 01 090
GN9ED 547 Record 01 090
GN9EE 548 Record 01 090
GN9EF 549 Record 01 090
GN9EG 550-553 Record 01 091
GN9FA 554 Record 01 091
GN9FB 555 Record 01 091
GN9FC 556 Record 01 092
GN9FD 557 Record 01 092
GN9FE 558 Record 01 092
GN9FF 559 Record 01 092
GN9FG 560-563 Record 01 093
GN9GA 564 Record 01 093
GN9GB 565 Record 01 093
GN9GC 566 Record 01 094
GN9GD 567 Record 01 094
GN9GE 568 Record 01 094
GN9GF 569 Record 01 094
GN9GG 570-573 Record 01 095
GN9HA 574 Record 01 095
GN9HB 575 Record 01 095
GN9HC 576 Record 01 096
GN9HD 577 Record 01 096
GN9HE 578 Record 01 096
GN9HF 579 Record 01 096
GN9HG 580-583 Record 01 097
GN9IA 584 Record 01 097
INDEX OF VARIABLES PAGE 010
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GOBOX2 586 Record 01 098
GOBOX3 587 Record 01 098
GOBOX4 647 Record 01 109
GOBOX5 656 Record 01 111
GOTHPROV (250-267) Record 01 043
GO1 585 Record 01 097
GO10 607 Record 01 101
GO11 608-609 Record 01 101
GO12 610 Record 01 101
GO13 (611-614) Record 01 102
GO13MO 611-612 Record 01 102
GO13YR 613-614 Record 01 102
GO14 615 Record 01 102
GO15 616-617 Record 01 103
GO16 618-620 Record 01 103
GO17O18 621-624 Record 01 103
GO18A 625 Record 01 104
GO19 626 Record 01 104
GO2 588-590 Record 01 098
GO20 627 Record 01 104
GO21 628-629 Record 01 105
GO22 630 Record 01 105
GO23 631-632 Record 01 105
GO24 633 Record 01 106
GO25 (634-637) Record 01 106
GO25MO 634-635 Record 01 106
GO25YR 636-637 Record 01 106
GO26 638 Record 01 107
GO27 639-640 Record 01 107
GO28 641 Record 01 107
GO29 642 Record 01 108
GO3O4 591-594 Record 01 098
GO30 643-644 Record 01 108
GO31 645-646 Record 01 109
GO32 648 Record 01 109
GO33 (649-653) Record 01 109
GO33BX 653 Record 01 110
GO33DT (649-652) Record 01 110
GO33MO 649-650 Record 01 110
GO33YR 651-652 Record 01 110
GO34 654 Record 01 111
GO35 655 Record 01 111
GO36 657 Record 01 111
GO37 (658-662) Record 01 112
GO37BX 662 Record 01 112
INDEX OF VARIABLES PAGE 011
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GO37DT (658-661) Record 01 112
GO37MO 658-659 Record 01 112
GO37YR 660-661 Record 01 112
GO38 663 Record 01 113
GO39 (664-668) Record 01 113
GO39BX 668 Record 01 114
GO39DT (664-667) Record 01 113
GO39MO 664-665 Record 01 113
GO39YR 666-667 Record 01 113
GO4A 595 Record 01 099
GO40 669 Record 01 114
GO41 (670-673) Record 01 114
GO41MO 670-671 Record 01 114
GO41YR 672-673 Record 01 114
GO42 674 Record 01 115
GO43 675-680 Record 01 115
GO5 596 Record 01 099
GO6 597-598 Record 01 099
GO7 599-601 Record 01 100
GO8O9 602-605 Record 01 100
GO9A 606 Record 01 100
GPID01 001-009 Record 01 001
GP1 681 Record 01 115
GP2 682-683 Record 01 116
GP3 (684-719) Record 01 116
GP3L1DY 686-687 Record 01 116
GP3L1MO 684-685 Record 01 116
GP3L1YR 688-689 Record 01 117
GP3L2DY 698-699 Record 01 118
GP3L2MO 696-697 Record 01 118
GP3L2YR 700-701 Record 01 118
GP3L3DY 710-711 Record 01 119
GP3L3MO 708-709 Record 01 119
GP3L3YR 712-713 Record 01 120
GP3R1DY 692-693 Record 01 117
GP3R1MO 690-691 Record 01 117
GP3R1YR 694-695 Record 01 117
GP3R2DY 704-705 Record 01 119
GP3R2MO 702-703 Record 01 118
GP3R2YR 706-707 Record 01 119
GP3R3DY 716-717 Record 01 120
GP3R3MO 714-715 Record 01 120
GP3R3YR 718-719 Record 01 120
GP4 720 Record 01 121
GP5 721-722 Record 01 121
INDEX OF VARIABLES PAGE 012
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== G =====
GP6 (723-758) Record 01 121
GP6EN1DY 725-726 Record 01 122
GP6EN1MO 723-724 Record 01 121
GP6EN1YR 727-728 Record 01 122
GP6EN2DY 737-738 Record 01 123
GP6EN2MO 735-736 Record 01 123
GP6EN2YR 739-740 Record 01 123
GP6EN3DY 749-750 Record 01 124
GP6EN3MO 747-748 Record 01 124
GP6EN3YR 751-752 Record 01 125
GP6EX1DY 731-732 Record 01 122
GP6EX1MO 729-730 Record 01 122
GP6EX1YR 733-734 Record 01 122
GP6EX2DY 743-744 Record 01 124
GP6EX2MO 741-742 Record 01 123
GP6EX2YR 745-746 Record 01 124
GP6EX3DY 755-756 Record 01 125
GP6EX3MO 753-754 Record 01 125
GP6EX3YR 757-758 Record 01 125
GREC01 010-011 Record 01 001
GREFDT (017-022) Record 01 001
GREFDY 019-020 Record 01 002
GREFMO 017-018 Record 01 001
GREFYR 021-022 Record 01 002
GRTYPE 015 Record 01 001
GR1 759 Record 01 126
GR2 760-761 Record 01 126
GR3 762 Record 01 126
GR4 763-764 Record 01 126
GR5 (765-770) Record 01 126
GR5A 765 Record 01 127
GR5B 766 Record 01 127
GR5C 767 Record 01 127
GR5D 768 Record 01 127
GR5E 769 Record 01 128
GR5F 770 Record 01 128
GSREC01 012-013 Record 01 001
GTIMEGAP (681-760) Record 01 115
GWMNHLTH (298-351) Record 01 050
===== H =====
HCVS4 046-048 Record 01 003
===== I =====
IPNGT4 037-039 Record 01 003
INDEX OF VARIABLES PAGE 013
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== M =====
MDVS4 052-054 Record 01 004
===== O =====
OBSDAYS4 031-033 Record 01 002
OCVS4 049-051 Record 01 003
===== P =====
PERSON1 (057-062) Record 01 004
PERSON10 (111-116) Record 01 013
PERSON2 (063-068) Record 01 005
PERSON3 (069-074) Record 01 006
PERSON4 (075-080) Record 01 007
PERSON5 (081-086) Record 01 008
PERSON6 (087-092) Record 01 009
PERSON7 (093-098) Record 01 010
PERSON8 (099-104) Record 01 011
PERSON9 (105-110) Record 01 012
PRISON1 (723-734) Record 01 121
PRISON2 (735-746) Record 01 123
PRISON3 (747-758) Record 01 124
===== T =====
TRIP1 (684-695) Record 01 116
TRIP2 (696-707) Record 01 117
TRIP3 (708-719) Record 01 119
T4_STAT 029-030 Record 01 002