TABLE 13: Health Utility Index

The Health Utility Index is a general index of overall health. It is based on the Comprehensive Health Status Measurement System developed at McMaster University’s Centre for Health Economics and Policy Analysis. Based on responses to the following questions, the Health Utility Index translates overall responses to a summary health value indicating the percentage of fully healthy.

Items

Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses? (Yes, No)

Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses? (Yes, No)

Are you able to see at all? (Yes, No)

Ar you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses? (Yes, No)

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses? (Yes, No)

Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid? (Yes, No)

Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid? (Yes, No)

Are you able to hear at all? (Yes, No)

Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid? (Yes, No)

Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid? (Yes, No)

Are you usually able to be understood completely when speaking with strangers in your own language? (Yes, No)

Are you able to be understood partially when speaking with strangers? (Yes, No)

Are you able to be understood completely when speaking to those who know you well? (Yes, No)

Are you able to be understood partially when speaking with those who know you well? (Yes, No)

Are you able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches? (Yes, No)

Are you able to walk at all? (Yes, No)

Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood? (Yes, No)

Do you require the help of another person to be able to walk? (Yes, No)

Do you require a wheelchair to get around? (Yes, No)

How often do you use a wheelchair? (Always, Often, Sometimes, Never)

Do you need the help of another person to get around in the wheelchair? (Yes, No)

Are you usually able to grasp and handle small objects such as a pencil and scissors? (Yes, No)

Do you require the help of another person because of limitations in the use of hands or fingers? (Yes, No)

Do you require the help of another person with (Some tasks?, Most tasks?, Almost all tasks?, All tasks?)

Do you require special equipment, for example, devices to assist in dressing because of limitations in the use of hands or fingers? (Yes, No)

Would you describe yourself as being usually (Happy and interested in life?, Somewhat happy?, Somewhat unhappy?, Unhappy with little interest in life?, So unhappy that life is not worthwhile?)

How would you describe your usual ability to remember things? Are you (Able to remember most things?, Somewhat forgetful?, Very forgetful?, Unable to remember anything at all?)

How would you describe your usual ability to think and solve day to day problems? Are you (Able to think clearly and solve problems?, Having a little difficulty?, Having some difficulty?, Having a great deal of difficulty?, Unable to think or solve problems?)

Are you usually free of pain or discomfort? (Yes, No)

How would you describe the usual intensity of your pain? (Mild, Moderate, Severe)

How many activities does your pain or discomfort prevent? (None, A few, Some, Most)

TABLE 14: Frequency of Physical Activity Lasting More Than 15 Minutes

In the past 3 months, how many times did you participate in:

TABLE 15: Physical Activity Index

This index is based on the reported number of times a respondent engaged in an activity over a 12 month period, the average duration of the activity, and the energy cost of the activity expressed as kilocalories per kilogram of body weight per hour of activity. The descriptor of active is used for those who averaged at least 3.0 kilocalories per kilogram per day of energy expenditure; the value for moderate was between 1.5 and 2.9, and descriptor of inactive was used for those with an energy expenditure less than 1.5.

TABLE 16: Pain & Discomfort Index

Based on responses to the following questions: Are you usually free of pain or discomfort? (Yes, No) and How many activities does your pain or discomfort prevent? (None, A few, Some, Most).

TABLE 17: Mobility Index

Based on responses to the following questions: Are you able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches? (Yes, No), Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood? (Yes, No), Do you require a wheelchair to get around? (Yes, No), and Are you able to walk at all? (Yes, No).

TABLE 25: Number of Childhood and Adult Stressors

Items

The next few questions ask about some things that may have happened to you while you were a child or a teenager, before you moved out of the house. Please tell me if any of these things happened.

Did you spend 2 weeks or more in the hospital? (Yes, No)

Did your parents get a divorce? (Yes, No)

Did your father or mother not have a job for a long time when they wanted to be working? (Yes, No)

Did something happen that scared you so much you thought about it for years after? (Yes, No)

Were you sent away from home because you did something wrong? (Yes, No)

Did either of your parents drink or use drugs so often that it caused problems for the family? (Yes, No)

Were you ever physically abused by someone close to you? (Yes, No)

TABLE 26: Adjusted Total Number of Chronic Stressors

This index reports on the total number of stressors to which people were exposed. An adjustment was made based on respondents’ personal situation—that is, each respondent’s score was adjusted according to the number of questions asked that were relevant to the respondent. For example, for individuals without children, questions about children were not part of their index score.

Items (all answered True or False)

The next portion of the questionnaire deals with different kinds of stress. Although the questions may seem repetitive, they are related to various aspects of a person’s physical, emotional, and mental health. I’ll start by describing situations that sometimes come up in people’s lives. As there are no right or wrong answers, the idea is to choose the answer best suited to your personal situation. I’d like you to tell me if these things are true for you at this time by answering true if it applies to you now or false if it does not.

You are trying to take on too many things at once.

There is too much pressure on you to be like other people.

Too much is expected of you by others.

You don’t have enough money to buy the things you need.

Your partner doesn’t understand you.

Your partner doesn’t show enough affection.

Your partner is not committed enough to your relationship.

You find it is very difficult to find someone compatible with you.

One of your children seems very unhappy.

A child’s behaviour is a source of serious concern to you.

Your work around the home is not appreciated.

Your friends are a bad influence.

You would like to move but you cannot.

Your neighbourhood or community is too noisy or too polluted.

You have a parent, a child or partner who is in very bad health and may die.

Someone in your family has an alcohol or drug problem.

People are too critical of you or what you do.

TABLE 27: Adjusted Number of Recent Life Events

This index reports on the number of recent stressors (within the past 12 months) experienced by respondents or by those close to the respondents. An adjustment was made based on respondents’ personal situation—that is, each respondent’s score was adjusted according to the number of questions asked that were relevant to the respondent. For example, for individuals without children, questions about children were not part of their index score.

Items (all answered Yes or No)

Now I’d like to ask you about some things that may have happened in the past 12 months. Some of these experiences happen to most people at one time or another, while some happen to only a few. First, I’d like to ask about yourself or anyone close to you (that is, your spouse or partner, children, relatives or close friends).

In the past 12 months, was any one of you beaten up or physically attacked?

Now, I’d like you to think about just your family (that is, yourself and your spouse or partner, or children, if any)

In the past 12 months, did you or someone in your family have an unwanted pregnancy?

In the past 12 months, did you or someone in your family have an abortion or miscarriage?

In the past 12 months, did you or someone in your family have a major financial crisis?

In the past 12 months, did you or someone in your family fail school or a training program?

Now I’d like you to think about yourself and your spouse or partner.

In the past 12 months, did you or your partner experience a change of job for a worse one?

In the past 12 months, were you or your partner demoted at work or did either of you take a cut in pay?

In the past 12 months, did you have increased arguments with your partner?

Now, just personally, in the past 12 months, did you go on Welfare?

In the past 12 months, did you have a child move back into the house?

TABLE 29: Frequency of Emotional Distress

This index is based on items asking about distress in the past month. As normative data on the distribution of the total score is not readily available, we transformed the scores by using the 5 possible categories of item responses. Accordingly, a total score of 0 was transformed to None of the time, 1 to 6 was transformed to A little of the time, 7 to 12 was transformed to Some of the Time, 13-18 was transformed to Most of the time, and 19 to 24 was transformed to All of the time.

Items (All items answered with responses of All of the time, Most of the time, Some of the time, A little of the time, or None of the time)

During the past month, how often did you feel so sad that nothing could cheer you up?

During the past month, how often did you feel nervous?

During the past month, how often did you feel restless or fidgety?

During the past month, how often did you feel hopeless?

During the past month, how often did you feel worthless?

During the past month, how often did you feel that everything was an effort?

TABLE 30: Probability of Depression Caseness

The items used to assess depression are a subset of items taken from the CIDI. The version used in the NPHS operationalizes Criteria A, B, and C of the Major Depressive Episode (DSM-III-R) diagnosis, but ignores Criterion D (not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder NOS). Unfortunately, precise details regarding the derivation of the total depression score or the conversion to caseness probability levels are not provided in the NPHS database manual.

Items

During the past 12 months, was there ever a time when you felt sad, blue, or depressed for 2 weeks or more in a row? (Yes, No)

For the next few questions, please think of the 2-week period during the past 12 months when these feelings were worst. During that time how long did these feelings usually last? (All day long, Most of the day, About half of the day, Less than half of the day)

How often did you feel this way during those 2 weeks? (Every day, Almost every day, Less often)

During those 2 weeks did you lose interest in most things? (Yes, No)

Did you feel tired out or low on energy all of the time? (Yes, No)

Did you gain weight, lose weight or stay about the same? (Gained weight, Lost weight, Stayed about the same, Was on a diet)

About how much did you lose or gain? (in kilograms)

Did you have more trouble falling asleep than you usually do? (Yes, No)

How often did that happen? (Every night, Nearly every night, Less often)

Did you have a lot more trouble concentrating than usual? (Yes, No)

At these times, people sometimes feel down on themselves, no good, or worthless. Did you feel this way? (Yes, No)

Did you think a lot about death—either your own, someone else’s, or death in general? (Yes, No)

Reviewing what you just told me…About how many weeks did you feel this way in the past 12 months?

Think about the last time you felt this way for 2 weeks or more in a row. In what month was that?

During the past 12 months, was there ever a time lasting 2 weeks or more when you lost interest in most things like hobbies, work, or activities that usually give you pleasure? (Yes, No)

For the next few questions, please think of the 2-week period during the past 12 months when you had the most complete loss of interest in things. During that 2-week period, how long did the loss of interest usually last? (All day long, Most of the day, About half of the day, Less than half the day)

How often did you feel this way during those 2 weeks? (Every day, Almost every day, Less often)

During those 2 weeks did you feel tired out or low on energy all the time? (Yes, No)

Did you gain weight, lose weight, or stay about the same? (Gained weight, Lost weight, Stayed about the same, Was on a diet)

About how much weight did you lose? (in kilograms)

Did you have more trouble falling asleep than usual? (Yes, No)

How often did that happen during those 2 weeks? (Every night, Nearly every night, Less often)

Did you have a lot more trouble concentrating than usual? (Yes, No)

At these times, people sometimes feel down on themselves, no good, or worthless. Did you feel this way? (Yes, No)

Did you think a lot about death—either your own, someone else’s, or death in general? (Yes, No)

Reviewing what you just told me…About how many weeks did you feel this way in the past 12 months?

Think about the last time you felt this way for 2 weeks or more in a row. In what month was that?

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