| |
PERSID |
1-12 |
ALPHA |
PERSON ID NUMBER |
| C2 |
NUMDAYS |
13-16 |
NUMERIC |
HOW MANY DAYS PER WEEK LEAVE HOME |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
0 NEVER LEAVES HOME |
| |
|
|
|
1-7 NUMBER OF DAYS/WEEK LEAVE HOME |
| C3 |
SEEHEAR |
17-20 |
NUMERIC |
BLINDNESS,DEAFNESS,VISION/HEARG IMPAIRED |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C3 |
BASICACT |
21-24 |
NUMERIC |
CONDITION THAT LIMITS BASIC PHY ACTIVITY |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C4 |
MEMORY |
25-28 |
NUMERIC |
DIFFICULTY LEARN,REMEMBERING,CONCENTRATING |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C4 |
MOBILE |
29-32 |
NUMERIC |
DIFFICULTY DRESSING,BATHING,GET AROUND |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C4 |
GOOUT |
33-36 |
NUMERIC |
DIFFICULTY GOING OUTSIDE HOME ALONE |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C4 |
DIFFJOB |
37-40 |
NUMERIC |
DIFFICULTY WORKING AT A JOB/BUSINESS |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C5 |
SPECEDU |
41-44 |
NUMERIC |
RECEIVE SPECIAL EDUCATION SERVICES |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C5A |
DIFFSEV |
45-48 |
NUMERIC |
CONSIDER THESE CONDITIONS MILD,MOD,SEVER |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 MILD |
| |
|
|
|
2 MODERATE |
| |
|
|
|
3 SEVERE |
| C5B |
WHICHIS |
49-52 |
NUMERIC |
THIS IS A VISION,HEARING IMPAIR, OR BOTH |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 VISION |
| |
|
|
|
2 HEARING |
| |
|
|
|
3 BOTH |
| C6 |
NEEDHELP |
53-56 |
NUMERIC |
NEED SPECIAL ASSISTANCE/EQUIP TO TRAVEL |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP1 |
57-60 |
NUMERIC |
ASSISTANCE FRM PERSON WHILE INSIDE HOME |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP2 |
61-64 |
NUMERIC |
ASSISTANCE FRM PERSON WHILE OUTSIDE HOME |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP3 |
65-68 |
NUMERIC |
INTERPRETER |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP4 |
69-72 |
NUMERIC |
PROFESSIONAL CARE(REHAB OR COUNSELING) |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP5 |
73-76 |
NUMERIC |
SERVICE ANIMAL |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP6 |
77-80 |
NUMERIC |
MANUAL WHEELCHAIR |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP7 |
81-84 |
NUMERIC |
ELECTRIC SCOOTER OR WHEELCHAIR |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP8 |
85-88 |
NUMERIC |
CANE,CRUTCHES OR WALKER |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP9 |
89-92 |
NUMERIC |
LEG,ARM,BACKBRACE |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP10 |
93-96 |
NUMERIC |
PROSTHETIC DEVICE |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP11 |
97-100 |
NUMERIC |
AUTOMOTIVE ADAPTIVE AID |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP12 |
101-104 |
NUMERIC |
PUBLIC TRANSPORTATION AID |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP13 |
105-108 |
NUMERIC |
HEARING AID |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP14 |
109-112 |
NUMERIC |
MAGNIFIERS OR HIGH-POWERED GLASSES |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP15 |
113-116 |
NUMERIC |
OXYGEN |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP16 |
117-120 |
NUMERIC |
MEDICATION |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP17 |
121-124 |
NUMERIC |
OTHER (SPECIFY) |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP18 |
125-128 |
NUMERIC |
HOME MODIFICATIONS |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYP19 |
129-132 |
NUMERIC |
OTHER MEDICAL EQUIPMENT |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C7 |
HLPTYPOS |
133-162 |
ALPHA |
KIND ASSISTANCE/EQUIP-OTHER SPECIFY |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
A-Z OTHER
SPECIFY |
| C8 |
HAVEPROB |
163-166 |
NUMERIC |
DIFFICULT GETTING TRANSPORTATION NEED |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB1 |
167-170 |
NUMERIC |
DON'T HAVE A CAR |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB2 |
171-174 |
NUMERIC |
NO/LIMITED PUBLIC TRANSPORTATION |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB3 |
175-178 |
NUMERIC |
NO/LIMITED TAXI SERVICE |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB4 |
179-182 |
NUMERIC |
BUSES DON'T RUN ON TIME |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB5 |
183-186 |
NUMERIC |
BUSES DON'T RUN WHEN NEEDED |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB6 |
187-190 |
NUMERIC |
BUS STOPS ARE TOO FAR AWAY |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB7 |
191-194 |
NUMERIC |
TRANSPORTATION DOESN'T ACCOM SPEC EQUIP |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB8 |
195-198 |
NUMERIC |
DISABILITY MAKES TRANSPRTN HARD TO USE |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB9 |
199-202 |
NUMERIC |
COSTS TOO MUCH |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB10 |
203-206 |
NUMERIC |
DON'T WANT ASK HELP/INCONVENIENCE OTHERS |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB11 |
207-210 |
NUMERIC |
THERE'S NO ONE I CAN DEPEND ON |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB12 |
211-214 |
NUMERIC |
FEAR OF CRIME STOPS ME FROM GOING PLACES |
| |
|
|
|
-1 INAPPLICABLE |
| |
|
|
|
-7 REFUSED |
| |
|
|
|
-8 DK |
| |
|
|
|
-9 NOT ASCERTAINED |
| |
|
|
|
1 YES |
| |
|
|
|
2 NO |
| C9 |
TRNPRB13 |
215-218 |
NUMERIC |
OTHER (SPECIFY) |
| |
|
|
|