Social Determinants of Health
Data and Summary Table
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Client ID Number | 1. What is your living situation today? | 2. Think about the place you live. Do you have problems with any of the following? | 3. Within the past 12 months, you worried that your food would run out before you got money to buy more. | 4. Within the past 12 months, the food you bought just didn't last and you didn't have money to get more. | 5. In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living? | 6. In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home? | 7. How often does anyone, including family and friends, physically hurt you? | 8. How often does anyone, including family and friends, insult or talk down to you? | 9. How often does anyone, including family and friends, threaten you with harm? | 10. How often does anyone, including family and friends, scream or curse at you? | 11. How hard is it for you to pay for the very basics like food, housing, medical care, and heating? Would you say it is: | 12. Do you want help finding or keeping work or a job? | 13. If for any reason you need help with day-to-day activities such as bathing, preparing meals, shopping, managing finances, etc., do you get the help you need? | 14. How often do you feel lonely or isolated from those around you? | 15. Do you speak a language other than English at home? | 16. Do you want help with school or training? For example, starting or completing job training or getting a high school diploma, GED or equivalent. | 17. In the last 30 days, other than the activities you did for work, on average, how many days per week did you engage in moderate exercise (like walking fast, running, jogging, dancing, swimming, biking, or other similar activities)? | 18. On average, how many minutes did you usually spend exercising at this level on one of those days? | 19. How many times in the past 12 months have you had 5 or more drinks in a day (males) or 4 or more drinks in a day (females)? One drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits. | 20. How many times in the past 12 months have you used tobacco products (like cigarettes, cigars, snuff, chew, electronic cigarettes)? | 21. How many times in the past year have you used prescription drugs for non-medical reasons? | 22. How many times in the past year have you used illegal drugs? | 23a. Little interest or pleasure in doing things? | 23b. Feeling down, depressed, or hopeless? | 24. Stress means a situation in which a person feels tense, restless, nervous, or anxious, or is unable to sleep at night because his or her mind is troubled all the time. Do you feel this kind of stress these days? | 25. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? (5 years old or older) | 26. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping? (15 years old or older) |
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153150 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | Yes | No | Sometimes | Rarely | Never | Rarely | Not hard at all | Yes, help finding work | I get all the help I need | Rarely | Yes | No | 3 | 30 | Never | Never | Never | Never | Several days | Not at all | A little bit | No | No |
153111 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I get all the help I need | Never | Yes | No | 0 | 10 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153186 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | Yes | Yes | Never | Never | Never | Never | Somewhat hard | Yes, help keeping work | I don’t need any help | Never | Yes | Yes | 6 | 30 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153194 | I have a steady place to live | Mold | Sometimes true | Sometimes true | Yes | No | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I don’t need any help | Never | Yes | Yes | 3 | 40 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153188 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | No | Never | Never | Never | Never | Not hard at all | I do not need or want help | I don’t need any help | Never | Yes | No | 5 | 20 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153225 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | No | Never | Never | Never | Never | Very hard | Yes, help keeping work | I don’t need any help | Never | Yes | Yes | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153228 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Sometimes true | Yes | No | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I don’t need any help | Never | Yes | Yes | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | Yes |
153229 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | Yes | No | Never | Never | Never | Never | Somewhat hard | Yes, help keeping work | I don’t need any help | Never | Yes | No | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153231 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | Yes | No | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I don’t need any help | Never | Yes | No | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153160 | I have a steady place to live | None of the above | Never true | Never true | Yes | No | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I get all the help I need | Sometimes | Yes | No | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | A little bit | No | No |
153255 | I have a place to live today, but I am worried about losing it in the future | None of the above | Often true | Often true | No | Yes | Never | Rarely | Sometimes | Rarely | Very hard | Yes, help finding work | I don’t need any help | Sometimes | No | No | 6 | 0 | Never | Never | Never | Never | Nearly every day | Nearly every day | Very much | Yes | Yes |
153120 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Sometimes | Never | Rarely | Not hard at all | I do not need or want help | I don’t need any help | Sometimes | Yes | No | 0 | 0 | Never | Never | Never | Never | Several days | Several days | Quite a bit | Yes | No |
153266 | I have a steady place to live | None of the above | Never true | Sometimes true | No | No | Never | Fairly often | Never | Rarely | Very hard | Yes, help finding work | I don’t need any help | Always | Yes | No | 4 | 30 | Monthly | Never | Never | Never | More than half the days | Nearly every day | Very much | Yes | No |
153268 | I have a steady place to live | None of the above | Never true | Never true | Yes | No | Never | Sometimes | Never | Fairly often | Somewhat hard | I do not need or want help | I get all the help I need | Sometimes | No | No | 5 | 40 | Never | Never | Never | Never | Several days | Several days | A little bit | No | No |
153125 | I have a steady place to live | None of the above | Never true | Never true | Yes | No | Never | Sometimes | Rarely | Fairly often | Somewhat hard | I do not need or want help | I get all the help I need | Rarely | No | No | 2 | 10 | Once or Twice | Daily or Almost Daily | Once or Twice | Never | More than half the days | Several days | A little bit | Yes | Yes |
153124 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | Yes | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I don’t need any help | Rarely | No | No | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | A little bit | No | No |
153123 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I get all the help I need | Rarely | No | No | 2 | 30 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153115 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | Yes | Never | Fairly often | Never | Sometimes | Somewhat hard | I do not need or want help | I don’t need any help | Sometimes | No | No | 3 | 30 | Never | Never | Never | Never | Several days | Several days | A little bit | No | No |
153116 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Rarely | Rarely | Sometimes | Not hard at all | I do not need or want help | I don’t need any help | Rarely | No | No | 5 | 60 | Never | Never | Never | Never | Not at all | Not at all | A little bit | No | No |
153185 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Never | Rarely | Rarely | Rarely | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | No | No | 1 | 20 | Never | Once or Twice | Never | Never | Several days | Several days | Somewhat | No | No |
153250 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Never | Never | Never | Not hard at all | I do not need or want help | I don’t need any help | Never | No | No | 3 | 30 | Never | Never | Never | Never | Not at all | Not at all | A little bit | No | No |
153251 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Sometimes | Rarely | Fairly often | Somewhat hard | I do not need or want help | I get all the help I need | Often | No | No | 1 | 20 | Never | Never | Monthly | Never | More than half the days | More than half the days | Quite a bit | Yes | Yes |
153222 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Never | Never | Never | Not hard at all | Yes, help finding work | I get all the help I need | Rarely | No | No | 0 | 0 | Never | Never | Never | Never | Not at all | Several days | A little bit | No | No |
153263 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | Yes | Never | Never | Never | Never | Very hard | I do not need or want help | I don’t need any help | Rarely | No | No | 0 | 0 | Never | Never | Never | Never | Several days | Several days | Somewhat | Yes | No |
153164 | I have a steady place to live | None of the above | Sometimes true | Never true | No | No | Never | Frequently | Never | Sometimes | Somewhat hard | I do not need or want help | I don’t need any help | Sometimes | Yes | No | 1 | 40 | Once or Twice | Never | Never | Never | Not at all | Not at all | Somewhat | No | No |
153104 | I have a steady place to live | Mold, Smoke detectors missing or not working, Water leaks | Sometimes true | Sometimes true | Yes | Yes | Never | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I don’t need any help | Never | No | No | 1 | 30 | Never | Never | Never | Never | More than half the days | Several days | Quite a bit | Yes | Yes |
153138 | I have a steady place to live | Pests such as bugs, ants, or mice, Mold | Often true | Often true | Yes | No | Never | Sometimes | Rarely | Sometimes | Very hard | Yes, help finding work | I could use a little more help | Always | No | Yes | 0 | 0 | Weekly | Daily or Almost Daily | Never | Never | Nearly every day | Nearly every day | Very much | Yes | Yes |
153155 | I have a steady place to live | None of the above | Sometimes true | Never true | No | Yes | Never | Sometimes | Rarely | Sometimes | Somewhat hard | I do not need or want help | I don’t need any help | Often | Yes | No | 0 | 0 | Never | Never | Never | Never | Several days | Several days | Very much | Yes | No |
153181 | I have a steady place to live | Pests such as bugs, ants, or mice | Sometimes true | Never true | Yes | Yes | Never | Sometimes | Never | Sometimes | Very hard | I do not need or want help | I don’t need any help | Sometimes | No | No | 0 | 0 | Never | Never | Never | Never | Several days | Several days | Quite a bit | Yes | No |
153260 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | Yes | Never | Never | Never | Never | Somewhat hard | I do not need or want help | I don’t need any help | Sometimes | No | No | 2 | 20 | Never | Never | Never | Never | Several days | Not at all | Not at all | No | No |
153102 | I have a steady place to live | Pests such as bugs, ants, or mice | Often true | Never true | No | Yes | Never | Fairly often | Fairly often | Never | Very hard | I do not need or want help | I could use a little more help | Often | Yes | No | 2 | 60 | Never | Weekly | Never | Never | More than half the days | Several days | Very much | Yes | No |
153121 | I have a steady place to live | None of the above | Never true | Sometimes true | Yes | No | Never | Never | Never | Never | Somewhat hard | Yes, help finding work | I don’t need any help | Never | Yes | Yes | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153129 | I have a steady place to live | None of the above | Never true | Sometimes true | No | No | Never | Never | Never | Never | Somewhat hard | Yes, help finding work | I don’t need any help | Never | Yes | Yes | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153130 | I have a steady place to live | None of the above | Never true | Sometimes true | No | No | Never | Never | Never | Never | Not hard at all | Yes, help finding work | I don’t need any help | Never | Yes | Yes | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153135 | I have a steady place to live | None of the above | Never true | Sometimes true | No | No | Never | Never | Never | Never | Not hard at all | Yes, help finding work | I don’t need any help | Never | Yes | Yes | 1 | 10 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153139 | I have a steady place to live | None of the above | Never true | Sometimes true | No | No | Never | Never | Never | Never | Somewhat hard | Yes, help finding work | I don’t need any help | Never | Yes | Yes | 0 | 0 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153141 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | Yes | Already shut off | Sometimes | Rarely | Never | Sometimes | Somewhat hard | I do not need or want help | I could use a little more help | Sometimes | Yes | No | 6 | 30 | Never | Never | Never | Never | Not at all | Several days | Somewhat | Yes | Yes |
153143 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | Yes | Sometimes | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 3 | 30 | Never | Never | Never | Never | More than half the days | Several days | Somewhat | No | Yes |
153144 | I have a place to live today, but I am worried about losing it in the future | Lack of heat | Sometimes true | Sometimes true | Yes | No | Sometimes | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 2 | 30 | Never | Never | Never | Never | Nearly every day | Several days | A little bit | No | No |
153145 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Never true | Sometimes true | Yes | No | Sometimes | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I don’t need any help | Sometimes | Yes | No | 4 | 30 | Never | Never | Never | Never | Not at all | Several days | A little bit | No | No |
153147 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Never true | Yes | No | Sometimes | Fairly often | Never | Sometimes | Somewhat hard | Yes, help keeping work | I don’t need any help | Often | Yes | No | 4 | 20 | Daily or Almost Daily | Never | Never | Never | Not at all | Several days | A little bit | No | No |
153148 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Never | Sometimes | Never | Fairly often | Somewhat hard | Yes, help keeping work | I could use a little more help | Rarely | Yes | No | 2 | 30 | Never | Never | Never | Never | Not at all | Several days | A little bit | No | No |
153148 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | Lack of heat | Sometimes true | Sometimes true | No | No | Rarely | Fairly often | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 3 | 30 | Never | Never | Never | Never | Several days | Several days | A little bit | No | No |
153151 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Sometimes | Never | Sometimes | Very hard | Yes, help keeping work | I get all the help I need | Rarely | Yes | No | 2 | 30 | Never | Never | Never | Never | Several days | Several days | Very much | No | Yes |
153152 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Never true | No | No | Rarely | Rarely | Never | Rarely | Not hard at all | Yes, help keeping work | I don’t need any help | Sometimes | Yes | No | 2 | 40 | Never | Never | Monthly | Never | Several days | More than half the days | Somewhat | No | No |
153153 | I have a place to live today, but I am worried about losing it in the future | None of the above | Never true | Sometimes true | No | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | Yes, help keeping work | I need a lot more help | Rarely | Yes | No | 3 | 40 | Never | Never | Never | Never | More than half the days | Several days | A little bit | No | No |
153156 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Rarely | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 3 | 40 | Once or Twice | Never | Never | Never | Several days | More than half the days | Quite a bit | No | No |
153157 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | No | No | Sometimes | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 3 | 30 | Once or Twice | Never | Never | Never | Several days | Several days | Quite a bit | Yes | Yes |
153158 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Often true | Often true | No | No | Sometimes | Sometimes | Never | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Rarely | Yes | No | 2 | 40 | Once or Twice | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153161 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Never true | Never true | No | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Rarely | Yes | No | 2 | 40 | Once or Twice | Never | Never | Once or Twice | Several days | Several days | Somewhat | No | No |
153165 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | No | No | Never | Never | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 40 | Once or Twice | Never | Never | Never | Several days | More than half the days | Quite a bit | No | No |
153166 | I have a steady place to live | None of the above | Sometimes true | Never true | No | No | Rarely | Sometimes | Never | Never | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 30 | Once or Twice | Never | Never | Never | Several days | Several days | Somewhat | No | No |
153167 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | Yes | No | 2 | 30 | Once or Twice | Never | Never | Never | Several days | More than half the days | Somewhat | No | Yes |
153168 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Often true | Yes | No | Rarely | Rarely | Never | Sometimes | Very hard | Yes, help keeping work | I get all the help I need | Often | Yes | No | 2 | 40 | Once or Twice | Never | Never | Never | More than half the days | Several days | Somewhat | No | No |
153169 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Often true | Yes | No | Sometimes | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 40 | Once or Twice | Never | Never | Never | More than half the days | Not at all | Somewhat | No | No |
153170 | I have a steady place to live | None of the above | Sometimes true | Often true | Yes | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 2 | 30 | Once or Twice | Never | Never | Never | More than half the days | Several days | Somewhat | No | No |
153171 | I have a steady place to live | None of the above | Often true | Sometimes true | Yes | No | Never | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I get all the help I need | Often | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | Several days | A little bit | No | Yes |
153172 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Sometimes true | Yes | No | Rarely | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | Yes | No | 2 | 30 | Monthly | Monthly | Never | Never | More than half the days | Several days | A little bit | No | Yes |
153173 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Never true | Yes | No | Rarely | Sometimes | Never | Sometimes | Somewhat hard | Yes, help keeping work | I need a lot more help | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153174 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I get all the help I need | Often | Yes | No | 2 | 40 | Monthly | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153175 | I have a steady place to live | None of the above | Sometimes true | Often true | Yes | No | Rarely | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 2 | 30 | Once or Twice | Never | Never | Never | Several days | Several days | Somewhat | No | No |
153195 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Rarely | Rarely | Never | Rarely | Not hard at all | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | Several days | Several days | Somewhat | No | No |
153196 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Frequently | Never | Rarely | Somewhat hard | Yes, help keeping work | I get all the help I need | Often | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153177 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Fairly often | Sometimes | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 40 | Monthly | Never | Never | Never | More than half the days | Several days | Somewhat | No | No |
153198 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Often true | Yes | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | Nearly every day | Somewhat | No | No |
153199 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Never true | Yes | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 30 | Weekly | Never | Never | Never | Several days | More than half the days | Somewhat | No | No |
153234 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153235 | I have a steady place to live | None of the above | Sometimes true | Never true | Yes | No | Rarely | Sometimes | Never | Rarely | Somewhat hard | I do not need or want help | I could use a little more help | Rarely | Yes | No | 2 | 40 | Monthly | Never | Never | Never | Several days | Several days | Somewhat | No | No |
153236 | I have a steady place to live | None of the above | Sometimes true | Often true | Yes | No | Rarely | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153237 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Rarely | Sometimes | Never | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | Several days | Several days | Somewhat | No | No |
153238 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Never true | Yes | No | Sometimes | Rarely | Never | Sometimes | Somewhat hard | Yes, help keeping work | I get all the help I need | Often | Yes | No | 2 | 30 | Once or Twice | Never | Never | Never | More than half the days | Several days | Somewhat | No | No |
153239 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Sometimes true | No | No | Sometimes | Rarely | Frequently | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 2 | 30 | Once or Twice | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153240 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Often true | No | No | Rarely | Fairly often | Sometimes | Sometimes | Somewhat hard | Yes, help keeping work | I could use a little more help | Sometimes | Yes | No | 2 | 40 | Monthly | Never | Never | Never | More than half the days | More than half the days | Somewhat | No | No |
153241 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Often true | Yes | No | Sometimes | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Often | Yes | No | 2 | 30 | Weekly | Never | Never | Never | Several days | Several days | A little bit | No | No |
153246 | I have a place to live today, but I am worried about losing it in the future | None of the above | Sometimes true | Sometimes true | Yes | No | Rarely | Fairly often | Never | Rarely | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | More than half the days | Several days | A little bit | No | No |
153253 | I do not have a steady place to live (I am temporarily staying with others, in a hotel, in a shelter, living outside on the street, on a beach, in a car, abandoned building, bus or train station, or in a park) | None of the above | Sometimes true | Sometimes true | No | No | Rarely | Rarely | Never | Rarely | Somewhat hard | Yes, help keeping work | I could use a little more help | Rarely | Yes | No | 2 | 30 | Monthly | Never | Never | Never | Several days | Several days | Somewhat | No | No |
153269 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | No | Fairly often | Sometimes | Sometimes | Sometimes | Somewhat hard | Yes, help keeping work | I get all the help I need | Sometimes | Yes | No | 2 | 30 | Monthly | Never | Never | Never | Several days | More than half the days | Somewhat | No | No |
153111 | I have a steady place to live | None of the above | Often true | Sometimes true | No | No | Never | Never | Never | Never | Not hard at all | Yes, help keeping work | I don’t need any help | Never | Yes | No | 2 | 30 | Never | Never | Never | Never | Not at all | Not at all | Not at all | No | No |
153185 | I have a steady place to live | None of the above | Sometimes true | Sometimes true | No | No | Never | Sometimes | Never | Rarely | Somewhat hard | I do not need or want help | I could use a little more help | Sometimes | No | Yes | 1 | 10 | Never | Never | Never | Never | Several days | Several days | Somewhat | Yes | No |
153270 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Rarely | Never | Rarely | Not hard at all | I do not need or want help | I could use a little more help | Sometimes | No | No | 1 | 20 | Never | Never | Never | Never | Not at all | Several days | A little bit | No | Yes |
153179 | I have a steady place to live | None of the above | Never true | Never true | No | No | Never | Fairly often | Never | Rarely | Not hard at all | Yes, help finding work | I don’t need any help | Rarely | Yes | No | 0 | 0 | Never | Never | Never | Never | Several days | Several days | Not at all | No | No |
Client ID Number | 1. What is your living situation today? | 2. Think about the place you live. Do you have problems with any of the following? | 3. Within the past 12 months, you worried that your food would run out before you got money to buy more. | 4. Within the past 12 months, the food you bought just didn't last and you didn't have money to get more. | 5. In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living? | 6. In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home? | 7. How often does anyone, including family and friends, physically hurt you? | 8. How often does anyone, including family and friends, insult or talk down to you? | 9. How often does anyone, including family and friends, threaten you with harm? | 10. How often does anyone, including family and friends, scream or curse at you? | 11. How hard is it for you to pay for the very basics like food, housing, medical care, and heating? Would you say it is: | 12. Do you want help finding or keeping work or a job? | 13. If for any reason you need help with day-to-day activities such as bathing, preparing meals, shopping, managing finances, etc., do you get the help you need? | 14. How often do you feel lonely or isolated from those around you? | 15. Do you speak a language other than English at home? | 16. Do you want help with school or training? For example, starting or completing job training or getting a high school diploma, GED or equivalent. | 17. In the last 30 days, other than the activities you did for work, on average, how many days per week did you engage in moderate exercise (like walking fast, running, jogging, dancing, swimming, biking, or other similar activities)? | 18. On average, how many minutes did you usually spend exercising at this level on one of those days? | 19. How many times in the past 12 months have you had 5 or more drinks in a day (males) or 4 or more drinks in a day (females)? One drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits. | 20. How many times in the past 12 months have you used tobacco products (like cigarettes, cigars, snuff, chew, electronic cigarettes)? | 21. How many times in the past year have you used prescription drugs for non-medical reasons? | 22. How many times in the past year have you used illegal drugs? | 23a. Little interest or pleasure in doing things? | 23b. Feeling down, depressed, or hopeless? | 24. Stress means a situation in which a person feels tense, restless, nervous, or anxious, or is unable to sleep at night because his or her mind is troubled all the time. Do you feel this kind of stress these days? | 25. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? (5 years old or older) | 26. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping? (15 years old or older) |
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