CHIS 2007 Adult Questionnaire Version 5.2 February 10, 2011 CHIS 2007 Adult Questionnaire Version 5.2 February 10, 2011 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 Public Health Institute 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: 0925-0578 Copyright © 2007-2008 by the Regents of the University of California CHIS 2007 Adult Questionnaire Version 5.2 February 10, 2011 Table of Contents for the CHIS 2007 Adult Questionnaire SECTION A – DEMOGRAPHIC INFORMATION, PART I ...........................................................5 Age ........................................................................................................................................................................... 5 Gender ...................................................................................................................................................................... 6 Ethnicity .................................................................................................................................................................... 6 Race ......................................................................................................................................................................... 7 Marital Status .......................................................................................................................................................... 13 SECTION B –HEALTH CONDITIONS ....................................................................................... 14 General Health........................................................................................................................................................ 14 Asthma .................................................................................................................................................................... 14 Diabetes .................................................................................................................................................................. 16 Gestational Diabetes .............................................................................................................................................. 18 Hypertension ........................................................................................................................................................... 18 Heart Disease ......................................................................................................................................................... 18 Flu Shot .................................................................................................................................................................. 19 Colon Cancer Screening ........................................................................................................................................ 19 Elderly Falls ............................................................................................................................................................ 21 SECTION C – HEALTH BEHAVIORS ....................................................................................... 24 Moderate and Vigorous Physical Activity ............................................................................................................... 24 Dietary Intake .......................................................................................................................................................... 26 Tobacco Use, Secondhand Smoke ........................................................................................................................ 27 Alcohol Use ............................................................................................................................................................. 28 SECTION D – GENERAL HEALTH, DISABILITY, AND SEXUAL HEALTH ............................. 30 Height and Weight .................................................................................................................................................. 30 Disability ................................................................................................................................................................. 30 Sexual Partners, Sexual Orientation ...................................................................................................................... 32 HIV testing, Other STI Testing ................................................................................................................................ 33 Infertility, Male Response ....................................................................................................................................... 34 SECTION E – WOMEN’S HEALTH ........................................................................................... 35 Age at Menarche .................................................................................................................................................... 35 Pregnancy and Infertility (Female Response) ........................................................................................................ 35 Hysterectomy .......................................................................................................................................................... 36 Pap Smear .............................................................................................................................................................. 36 HPV ........................................................................................................................................................................ 38 Emergency Contraception ...................................................................................................................................... 41 Mammography ........................................................................................................................................................ 41 Hormone Replacement Therapy ............................................................................................................................ 42 SECTION F – MENTAL HEALTH .............................................................................................. 43 Mental Health Assessment ..................................................................................................................................... 43 Access & Utilization ................................................................................................................................................ 47 A - 2 CHIS 2007 Adult Questionnaire Version 5.2 February 10, 2011 SECTION G – DEMOGRAPHIC INFORMATION, PART II ........................................................ 51 Country of Birth ....................................................................................................................................................... 51 Language Spoken at Home .................................................................................................................................... 53 Additional Language Use ....................................................................................................................................... 54 Citizenship and Immigration ................................................................................................................................... 55 Child and Teen Selection ....................................................................................................................................... 56 Paid Child Care, Cost ............................................................................................................................................. 57 Educational Attainment ........................................................................................................................................... 58 SECTION H – HEALTH INSURANCE ....................................................................................... 61 Usual Source of Care ............................................................................................................................................. 61 Emergency Room Visits ......................................................................................................................................... 61 Medicare coverage, Medicare supplemental plan .................................................................................................. 62 Medi-Cal coverage.................................................................................................................................................. 66 Healthy Families coverage ..................................................................................................................................... 67 Employer-based coverage ...................................................................................................................................... 67 Private Coverage .................................................................................................................................................... 68 Availability of Employer-based