CHIS 2011-2012 Adult Questionnaire Version 10.3 March 24, 2014 Adult Respondents Age 18 and Older Collaborating Agencies: UCLA Center for Health Policy Research California Department of Health Care Services California Department of Public Health Contact: California Health Interview Survey UCLA Center for Health Policy Research 10960 Wilshire Blvd, Suite 1550 Los Angeles, CA 90024 Telephone: (866) 275-2447 Fax: (310) 794-2686 Web: www.chis.ucla.edu OMB Approval Number: 0925-0598 Copyright © 2010-2011 by the Regents of the University of California CHIS 2011-2012 Adult Questionnaire Version 10.3 March 24, 2014 Table of Contents Section A – Demographic Information, Part I ............................................................. 6 Age .................................................................................................................................. 6 Gender ............................................................................................................................ 7 Ethnicity .......................................................................................................................... 7 Race................................................................................................................................ 8 Marital Status ................................................................................................................ 13 Section B – Health Conditions ................................................................................... 14 General Health .............................................................................................................. 14 Asthma .......................................................................................................................... 14 Diabetes ........................................................................................................................ 18 Pre-Diabetes/Borderline Diabetes ................................................................................ 18 Gestational Diabetes .................................................................................................... 21 Hypertension ................................................................................................................. 21 Heart Disease ............................................................................................................... 22 Stroke............................................................................................................................ 23 Arthritis .......................................................................................................................... 23 Flu Shot......................................................................................................................... 24 Ederly Falls ................................................................................................................... 25 Section C – Health Behaviors .................................................................................... 29 Walking for Transportation and Leisure ........................................................................ 29 Dietary Intake ................................................................................................................ 30 Fast Food ...................................................................................................................... 32 Access to Fresh and Affordable Foods ........................................................................ 32 Cigarette Use ................................................................................................................ 33 Second Hand Smoke .................................................................................................... 34 Alcohol Use/Abuse ....................................................................................................... 34 Section D – General Health, Disability, and Sexual Health ...................................... 36 Height and Weight ........................................................................................................ 36 Disability........................................................................................................................ 36 Sexual Partners ............................................................................................................ 38 Sexual Orientation ........................................................................................................ 39 Registered Domestic Partner ....................................................................................... 40 Section E – Women’s Health ...................................................................................... 41 Pregnancy Status ......................................................................................................... 41 Mammography .............................................................................................................. 41 Section F – Mental Health ........................................................................................... 46 K6 Mental Health Assessment ..................................................................................... 46 Repeated K6 ................................................................................................................. 47 Sheehan Scale ............................................................................................................. 50 Access & Utilization ...................................................................................................... 51 Stigma ........................................................................................................................... 53 2 CHIS 2011-2012 Adult Questionnaire Version 10.3 March 24, 2014 Section G – Demographic Information, Part II .......................................................... 55 Country of Birth (Self, Parents) ..................................................................................... 55 Language Spoken at Home .......................................................................................... 58 Additional Language Use.............................................................................................. 58 Citizenship and Immigration ......................................................................................... 59 Spouse/Partner ............................................................................................................. 60 Living with Parents ........................................................................................................ 60 Child and Teen Selection.............................................................................................. 61 Paid Child Care ............................................................................................................. 62 Educational Attainment ................................................................................................. 63 Veteran Status .............................................................................................................. 63 Employment .................................................................................................................. 64 Employment (Spouse/Partner) ..................................................................................... 66 Section H – Health Insurance ..................................................................................... 68 Usual Source of Care ................................................................................................... 68 Emergency Room Visits ............................................................................................... 68 Medicare Coverage ...................................................................................................... 69 Medi-Cal Coverage ....................................................................................................... 74 Healthy Families Coverage........................................................................................... 74 Employer-Based Coverage .......................................................................................... 75 Private Coverage .......................................................................................................... 75 Employer Offer of Health Insurance ............................................................................. 78 CHAMPUS/CHAMP-VA, TRICARE, VA Coverage ...................................................... 79 Healthy Kids .................................................................................................................. 80 AIM, MRMIP, Family PACT, PCIP, Other Government Coverage ............................... 80 Other Coverage ............................................................................................................ 81 Indian Health Service Participation ............................................................................... 84 Spouse’s/Partner’s Insurance Coverage Type & Eligibility .......................................... 84 Managed-Care Plan Characteristics ............................................................................. 94 High Deductible Health Plans ....................................................................................... 97 Coverage over Past 12 Months .................................................................................... 98 Reasons for Lack 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