2021 National Health Interview Survey (NHIS) Questionnaire Contents 1. Introduction This National Health Interview Survey (NHIS) questionnaire report provides the questions administered to NHIS respondents in the order they were asked. It is organized hierarchically into these parts: Contents, Index, and NHIS questionnaire, which in turn includes the Roster, Adult and Child modules. 2. Section Index A section index is provided for each of the three modules: Roster, Adult, and Child. The index can be navigated via the Bookmarks pane to quickly get information about the different sections in the module. The display pane lists information about each section in the module including the three-letter section name, the section description, the type of content in the section (annual core, rotating core, sponsored or emerging content) and the page range in this document for each section for ease of printing. 3. NHIS questionnaire: Roster, Adult and Child modules The questionnaire is the main part of the report and provides detailed information about each question in the survey. The hierarchy in the Bookmarks pane has three levels: module (Roster, Adult, Child), sections within each module, and questions within each section represented by the variable name in the instrument. The sections and questions are listed in questionnaire order. Selecting a specific question in the Bookmarks pane will display a detailed report for that question in the display pane while selecting a section abbreviation will display the report for the first question in the section. In the question text field of the report, text displayed in bold and in blue font is an interviewer instruction which is sometimes followed by optional text in gray, italic font. Information provided for each question includes: - Question ID: unique alphanumeric code for each question beginning with the 3-letter section abbreviation - Variable: instrument variable name for the question - Interview Module: module where the question is located: Roster, Adult, or Child - Content Type: indicates whether the question is part of the Annual Core, Rotating Core, Sponsored Content or Emerging Content - Question Text: question wording administered to respondent with indicators for fills; may also include interviewer instructions - Fills: table of contextual text substitutions that are filled into the question text - Response: table of possible responses to the question - Universe: group of respondents who received the question - Skip Instructions: instructions for moving to the next question in the questionnaire Additional information may include: - Hard Edit: prompt received when response entered is not allowed; response must be changed in order to proceed - Soft Edit: prompt received when response entered is questionable; must follow instructions in order to proceed - Replicate To: indicates family-level information obtained in the Sample Adult interview that is copied to a replicated variable in the Sample Child and vice versa for efficiency when the Sample Child and the Sample Adult are in the same family. Page 1 Questions added in 2021 Q2 Adult:ASP (Aspirin) Question ID Section Name Variable Question Text ASP.0010.00.2 ASP ASPMEDEV_A Has a doctor or other health professional EVER told you to take a low-dose aspirin each day to prevent or control heart disease? If the respondent volunteers they have been told to take an aspirin every other day or "regularly" for these reasons, enter 1 for "yes." ASP.0020.00.2 ASP ASPMEDNOWN_A Are you NOW following this advice? If the respondent provides an answer such as "sometimes," "occasionally," or "from time to time," enter '1' for "yes." ASP.0030.00.2 ASP ASPMEDSTP_A Did a doctor or other health professional advise you to stop taking a low-dose aspirin every day? ASP.0040.00.2 ASP ASPONOWN_A On your own, are you now taking a low-dose aspirin each day to prevent or control heart disease? Page 2 Questions added in 2021 Q2 Adult:IMS (Immunization) Question ID Section Name Variable Question Text IMS.0061.00.3 IMS SHTCVD19_A The next questions are about coronavirus or COVID-19 vaccination. Have you had a COVID-19 vaccination? Read if necessary: The COVID-19 vaccination has been available since 2020. IMS.0062.00.3 IMS SHTCVD19NM_A How many COVID-19 vaccinations have you received? IMS.0063.01.3 IMS CVDVAC1M_A 1 of 2 During what month and year did you receive your most recent COVID-19 vaccination? Enter month of most recent COVID-19 vaccination. IMS.0063.02.3 IMS CVDVAC1Y_A 2 of 2 Enter year of most recent COVID-19 vaccination. IMS.0064.01.3 IMS CVDVAC2M_A 1 of 2 During what month and year did you receive your next most recent COVID-19 vaccination? Enter month of the next most recent COVID-19 vaccination. IMS.0064.02.3 IMS CVDVAC2Y_A 2 of 2 Enter year of next most recent COVID-19 vaccination. IMS.0065.00.3 IMS SHTCVD19AV_A Did a doctor or other health professional tell you that you need an additional dose of the COVID-19 vaccination? Page 3 2021 National Health Interview Survey (NHIS) Questionnaire Navigate to the module of interest in the Bookmarks pane to see information about all the sections in the module in questionnaire order. The display pane will show a table with the following information for each section: - Section abbreviation: a short, 3 letter abbreviation for the section, e.g., INS - Section description: a description of the topic area for questions in the section - Content type: a list of values indicating if the questions in the section come from annual core, rotating core, sponsored content or emerging content - Page Range: range of pages in this document containing the content for each section Page 4 Page 5 2021 National Health Interview Survey (NHIS) Questionnaire Interview Module:Roster Section Name Section Description Content Type Page Range ROS Roster Annual Core 12-13 HHC Household Composition Annual Core 14-43 REL Relationship of children to parents Annual Core 44-47 FAM Family Composition Annual Core 49-64 Page 6 2021 National Health Interview Survey (NHIS) Questionnaire Interview Module:Adult Section Name Section Description Content Type Page Range VFY Sample Adult Verification Annual Core 65-103 HIS Health Status Annual Core 104-104 LS1 Satisfaction with life first section Sponsored Content 105-105 HYP Hypertension Annual Core 106-110 CHL Cholesterol Annual Core 111-113 CVC Cardiovascular Conditions Annual Core 114-117 ASP Aspirin Rotating Core 118-121 AST Asthma Annual Core 122-125 CAN Cancer Annual Core 126-139 DIB Diabetes Annual Core 140-154 Sponsored Content CON Other Chronic Conditions Annual Core 155-159 RCN Rotating Conditions Emerging Content 160-166 Sponsored Content ISN Immunosuppression Emerging Content 167-168 EPI Epilepsy Sponsored Content 169-172 ALG Allergies Rotating Core 173-179 BMI Current pregnant, height, weight Annual Core 180-187 VIS Vision Annual Core 188-190 HEA Hearing Annual Core 191-195 Rotating Core MOB Mobility Annual Core 196-209 COM Communication Annual Core 210-211 Rotating Core COG Cognition Annual Core 212-215 UPP Self-care and Upper Body Annual Core 216-218 SOC Social Functioning Annual Core 219-221 ADO Age of Disability Onset Sponsored Content 222-222 INS Health Insurance Annual Core 223-302 PAY Difficulty Paying for Health Care Annual Core 303-306 CVD Positive COVID-19 Diagnosis Emerging Content 307-311 TSC Taste and Smell - COVID Sponsored Content 312-315 UTZ Utilization Annual Core 316-326 ACC Access to Care Emerging Content 327-330 CNV Cancer COVID-19 Sponsored Content 331-334 PMD Prescription Medication Annual Core 335-339 PRV Preventive Screening Rotating Core 340-379 Sponsored Content IMS Immunization Annual Core 380-412 Sponsored Content CGR Caregiving Received Emerging Content 413-417 Rotating Core ANX Anxiety Annual Core 418-420 Page 7 DEP Depression Annual Core 421-423 MHC Mental Health Care Annual Core 424-428 SPD Serious Psychological Distress Rotating Core 429-435 PAI Chronic Pain Rotating Content 436-446 REP Repetitive Strain Injury Rotating Core 447-454 INJ Injury Rotating Core 455-476 TSM Taste and Smell Sponsored Content 477-485 CIG Cigarettes and E-cigarettes Annual Core 486-493 OTB Other Tobacco Sponsored Content 494-500 SOS Social Support Emerging Content 501-503 LS2 Satisfaction with life second section Sponsored Content 504-504 ORN Sexual Orientation Annual Core 505-506 MAR Marital Status Annual Core 507-519 VET Veterans Status Annual Core 520-525 NAT Nativity Annual Core 526-531 SCH Schooling Annual Core 532-533 EMP Employment Annual Core 534-542 EMD Detailed Employment Rotating Core 543-548 JOB Work arrangements Sponsored Content 549-557 SDW Social distancing at work Sponsored Content 558-567 FEM Employment of family members Annual Core 568-570 INC Family Income Annual Core 571-591 FOO Food Related Programs Annual Core 592-600 Sponsored Content FDS Food Security Sponsored Content 601-611 HOU Housing Annual Core 612-614 REC Person's name Annual Core 615-617 TEL Telephone Use Annual Core 618-621 LNK Linkage Annual Core 622-625 THX Thanks Annual Core 626-626 Page 8 2021 National Health Interview Survey (NHIS) Questionnaire Interview Module:Child Section Name Section Description Content Type Page Range VFY Verification and demographic details Annual Core 627-665 HIS Health Status Annual Core 666-666 LS1 Satisfaction with life first section Sponsored Content 667-667 AST Asthma Annual Core 668-672 DIB Diabetes Annual Core 673-674 DLD Developmental and Learning Disabilities Annual Core 675-684 ALG Allergies Rotating Core 685-691 VIS Vision Annual Core 692-694 HEA Hearing