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APPENDIX C 59 Social Security or Railroad Retirement Pensions from other sources Supplemental Security Income; whether because of disability; ever applied Social Security Disability Insurance; whether because of disability; ever applied Welfare, AFDC, or General Assistance; number of months received Interest income Dividend or property income Child support Any other source Total combined family income from all sources Who authorized to receive food stamps; months authorized (amounts not ascertained) [Note: There are no questions on welfare program participation prior to the previous year.] Health And Health Care Use As reported by family respondent, information about family members on: Health status and limitation of activities Injuries in past 3 months Access to health care (whether family member didn't get care or delayed in seeking care because couldn't afford it) Hospital utilization in past 12 months Health care contacts in 2-week period Whether any family member received care 10 or more times in past 12 months For adults, extensive questions on: Health conditions (long list, some ever reported, some last 12 months, some last 3 months) Emotional feelings in last 30 days (e.g., hopeless, nervous) Health indicators (e.g., days lost from work, days bedridden, health better or worse) Limitation of activities (e.g., walking, bending) and related health conditions Health behaviors (tobacco use, exercise, alcohol use) Access to health care Dental care Health care provider contacts in past 12 months Immunizations (flu shots and pneumonia vaccinations) For children, questions on: Conditions, limitation of activity, health status Mental health Access to health care Dental care Health care provider contacts in last 12 months Immunizations Health Insurance Coverage Whether health insurance offered through workplace Who in family has coverage; type Type of Medicare coverage; whether signed up with an HMO For Medicaid, whether can see any doctor; whether need referrals For private coverage, whether obtained through employer or union; who pays premiums; how much
APPENDIX C 60 family spent for premiums including payroll deductions; whether HMO, IPA, PPO, or other type of plan If no coverage, when last was covered; reasons for no longer having coverage Whether ever lacked coverage in previous 12 months; number of months Total family expenditures for medical care (excluding premiums, non-prescription drugs, costs for which expect to be reimbursed)
