Behavioral Risk Factor
Survey Data, 2016
Core 01: Health Status
C01.01 Would you say that in general your health is:
Core 02: Healthy
Days—Health-Related Quality of Life
C02.01 Now thinking about your physical health, which includes
physical illness and injury, for how many days during the past 30 days was your
physical health not good?
C02.02 Now thinking about your mental health, which includes
stress, depression, and problems with emotions, for how many days during the
past 30 days was your mental health not good?
the past 30 days, for about how many days did poor physical or mental health
keep you from doing your usual activities, such as self-care, work, or
Core 03: Health Care Access
C03.01 Do you
have any kind of health care coverage, including health insurance, prepaid
plans such as HMOs, or government plans such as Medicare, or Indian Health
C03.02 Do you
have one person you think of as your personal doctor or health care provider?
C03.03 Was there a time in the past 12 months when you needed to
see a doctor but could not because of cost?
C03.04 About how long has it been since you last visited a doctor
for a routine checkup? [A routine checkup is a general physical exam, not an
exam for a specific injury, illness, or condition.]
Core 04: Exercise
the past month, other than your regular job, did you participate in any
physical activities or exercises such as running, calisthenics, golf,
gardening, or walking for exercise?
Core 05: Sleep
average, how many hours of sleep do you get in a 24-hour period?
Core 06: Chronic Health
C06.01 Ever told you that you had a heart attack also called a
told you had angina or coronary heart disease?
told you had a stroke?
told you had asthma?
C06.05 Do you still have
told you had skin cancer?
told you had any other types of cancer?
told you have (COPD) chronic obstructive pulmonary disease, emphysema or
told you have some form of arthritis, rheumatoid arthritis, gout, lupus, or
told you have a depressive disorder including depression, major depression,
dysthymia, or minor depression?
told you have kidney disease? Do NOT include kidney stones, bladder infection
told you have diabetes?
C06.13 How old were you
when you were told you have diabetes?
Core 07: Dental Care
C07.01 How long has it
been since you last visited a dentist or a dental clinic for any reason?
C07.02 How many of your
permanent teeth have been removed because of tooth decay or gum disease?
Core 08: Demographics
C08.08 Do you own or rent
county do you live in?
C08.14 Have you ever
served on active duty in the United States Armed Forces, either in the regular
military or in a National Guard or military reserve unit?
C08.22 Are you
deaf or have serious difficulty hearing?
C08.23 Are you
blind or do you have serious difficulty seeing, even when wearing glasses?
of a physical, mental, or emotional condition, do you have serious difficulty
concentrating, remembering or making decisions?
C08.25 Do you
have serious difficulty walking or climbing stairs?
C08.26 Do you
have difficulty dressing or bathing?
of a physical, mental, or emotional condition, do you have difficulty doing
errands alone such as visiting a doctor's office or shopping?
Core 08: Tobacco Use
C09.01 Have you
smoked at least 100 cigarettes in your entire life?
C09.02 Do you
now smoke cigarettes every day, some days, or not at all?
the past 12 months, have you stopped smoking for one day or longer because you
were trying to quit smoking?
C09.04 How long has it been since you last smoked a cigarette, even
one or two puffs?
C09.05 Do you
currently use chewing tobacco, snuff, or snus every day, some days, or not at
all? (Snus (Swedish for snuff) is a moist smokeless tobacco)
Core 10: E-Cigarettes
you ever used an e-cigarette or other electronic vaping product, even just one
time, in your entire life?
C10.02 Do you
now use e-cigarettes or other electronic vaping products every day, some days,
or not at all?
Core 11: Alcohol Consumption
the past 30 days, how many days did you have at least one drink of any
drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink
with one shot of liquor. During the past 30 days, on the days when you drank,
about how many drinks did you drink on the average?
Considering all types of alcoholic beverages, how many times during the past 30
days did you have 5 or more drinks for men or 4 or more drinks for women on an
C11.04 During the past 30
days, what is the largest number of drinks you had on any occasion?
Core 12: Immunization
C12.01 During the past 12
months, have you had either a flu shot or a flu vaccine that was sprayed in
pneumonia shot or pneumococcal vaccine is usually given only once or twice in a
person’s lifetime and is different from the flu shot. Have you ever had a
C12.04 Since 2005, have
you had a tetanus shot?
Core 13: Falling
C13.01 In the past 12 months, how many times have you fallen?
C13.02 How many of these falls caused an injury?
Core 14: Seat Belts
C14.01 How often do you use seat
belts when you drive or ride in a car?
Core 15: Drinking and Driving
C15.01 During the past 30 days, how many times have you
driven when you have had perhaps too much to drink?
Core 16: Mammogram
C16.01 A mammogram is an x-ray of each breast to look for
breast cancer. Have you ever had a mammogram?
C16.02 How long has it been since you had your last
C16.03 A Pap test is a test for
cancer of the cervix. Have you ever had a Pap test?
C16.04 How long has it been since you had your last Pap test?
C16.05 An HPV test is sometimes
given with the Pap test for cervical cancer screening. Have you ever had an HPV
C16.06 How long has it been since you had your last HPV test?
C16.07 Have you had a hysterectomy?
Core 17: PSA
C17.01 Has a doctor, nurse, or other
health professional ever talked with you about the advantages of the PSA test?
C17.02 Has a doctor, nurse, or other
health professional ever talked with you about the disadvantages of the PSA
C17.03 Has a doctor, nurse, or other
health professional ever recommended that you have a PSA test?
C17.04 Have you ever had a PSA test?
C17.05 How long has it been since you had your last PSA test?
C17.06 What was the main reason you
had this PSA test?
Core 18: Blood-stool?
C18.01 A blood stool test is a test
that may use a special kit at home to determine whether the stool contains
blood. Have you ever had this test using a home test kit?
C18.02 How long has it been since you had your last blood
stool test using a home kit?
C18.03 Sigmoidoscopy and colonoscopy are exams in which a
tube is inserted in the rectum to view the colon for signs of cancer or other
health problems. Have you ever had either of these exams?
C18.04 Was your most recent exam a sigmoidoscopy
C18.05 How long has it been since you had your last
sigmoidoscopy or colonoscopy?
Core 19: HIV
C19.01 Have you ever been
tested for HIV? Do not count tests you may have had as part of a blood
donation. Include testing fluid from your mouth.
C19.03 I am going to read
you a list. When I am done, please tell me if any of the situations apply to
you. You do not need to tell me which one.
Calculated Variables and Risk
Adults with good or better health
Three-level not good physical health status: 0 days, 1-13 days, 14-30 days
Three-level not good mental health status: 0 days, 1-13 days, 14-30 days
Respondents aged 18-64 that have any form of health care coverage
CLV04.01 Adults who
reported doing physical activity or exercise during the past 30 days other than
their regular job
CLV05.01 Respondents who
have ever reported having coronary heart disease or myocardial infarction
CLV06.02 Adults who have
ever been told they have asthma
CLV06.03 Adults who have
been told they currently have asthma
Computed asthma status
that have had a doctor diagnose them as having some form of arthritis
CLV07.01 Adults aged 18+
who have had permanent teeth extracted
CLV07.02 Adults aged 65+
who have had all their natural teeth extracted
CLV07.03 Adults who have
visited a dentist, dental hygienist or dental clinic within the past year
categories of Body Mass Index (BMI)
CLV08.20 Adults who have
a body mass index greater than 25.00 (overweight or obese)
smoker status: every day smoker, someday smoker, former smoker, never smoked
CLV09.02 Adults who are
e-cigarette smoker status
CLV10.02 Adults who
are current e-cigarette users
CLV11.01 Adults who
reported having had at least one drink of alcohol in the past 30 days
CLV11.03 Binge drinkers
(males having five or more drinks on one occasion, females having four or more
drinks on one occasion)
CLV11.05 Heavy drinkers
(adult men having more than two drinks per day and adult women having more than
one drink per day)
CLV12.01 Adults aged 65+
years who have had a flu shot within the past year
CLV12.02 Adults aged 65+
years who have ever had a pneumonia vaccination
CLV14.01 Always or nearly always wear seat belts
CLV14.02 Always wear seat belts
CLV15.01 Drinking and
respondents aged 40+ who have had a mammogram in the past two years
respondents aged 50-74 who have had a mammogram in the past two years
respondents aged 21-65 who have had a pap test in the past three years
respondents aged 40+ that have had a PSA test in the past two years
aged 50-75 that have had a blood stool test within the past year
aged 50-75 who have had a colonoscopy in the past 10 years
aged 50-75 that have had a blood stool test within the past three years
CLV18.04 Respondents aged
50-75 that have had a sigmoidoscopy within the past five years
aged 50-75 who have had a blood stool test within the past three years and a
sigmoidoscopy within the past five years
aged 50-75 who have fully met the USPSTF recommendation
CLV19.01 Adults who have
ever been tested for HIV
Module 07: Memory Loss
M07.01 During the past 12 months, have you experienced
confusion or memory loss that is happening more often or is getting worse?
M07.02 During the past 12 months, as a result of confusion or
memory loss, how often have you given up day-to-day household activities or
chores you used to do, such as cooking, cleaning, taking medications, driving,
or paying bills?
M07.03 As a result of confusion or memory loss, how often do
you need assistance with these day-to-day activities?
M07.04 When you need help with these
day-to-day activities, how often are you able to get the help that you need?
M07.05 During the past 12 months, how often has confusion or
memory loss interfered with your ability to work, volunteer, or engage in
social activities outside the home?
M07.06 Have you or anyone else discussed your confusion or
memory loss with a health care professional?
Module 08: Sugar-Sweetened
M08.02 During the past 30 days, how often did you drink
sugar-sweetened fruit drinks (such as Kool-Aid and lemonade), sweet tea, and
sports or energy drinks (such as Gatorade and Red Bull)?
Module 17: Cancer
M17.01 How many different types of cancer have you had?
M17.02 At what age were you told that you had cancer?
M17.03 What type of cancer was it?
M17.04 Are you currently receiving treatment for cancer? By
treatment we mean surgery, radiation therapy, chemotherapy, or chemotherapy
M17.05 What type of doctor provides
the majority of your health care?
M17.06 Did any doctor, nurse, or
other health professional ever give you a written summary of all the cancer
treatments you received?
M17.07 Have you ever received instruction form a doctor,
nurse, or other health professional about where you should return or who you
should see for routine cancer check-ups after completing treatment for cancer?
M17.08 Were these instructions written down or printed on
paper for you?
M17.09 Were you ever denied health insurance or life
insurance coverage because of your cancer?
M17.10 Did you participate in a
clinical trial as part of your cancer treatment?
M17.11 Do you currently have physical pain caused by your
cancer or cancer treatment?
M17.12 Is your pain currently under
Module 21: Sexual Orientation and
M21.01 Do you consider
yourself to be (sexual orientation)?
Do you consider yourself to be transgender?
Module 23: Asthma
a doctor, nurse or other health professional ever said that the child has
M23.02 Does the child
still have asthma?
Appendix A - Healthy
People 2020 in Indiana
B - 2016 Behavioral Risk Factor Surveillance
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