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Behavioral Risk Factor Surveillance System
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Contact information:
Melissa Parsons
Program Director, BRFSS
701.328.2787

Demographics Module
 

Questions

2001

2002

2003

2004

2005

2006

Q1: What is your age?

2001-Q1

2002-Q1

2003-Q1

2004-Q1

2005-Q1

2006-Q1

Q2: Are you Hispanic or Latino?

2001-Q2

2002-Q2

2003-Q2

2004-Q2

2005-Q2

2006-Q2

Q3: Which one or more of the following would you say is your race: White, Black or African American, Asian, Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native, or other?

2001-Q3

2002-Q3

2003-Q3

2004-Q3

2005-Q3

2006-Q3

Q4: Which one of the following would you say best represents your race: White, Black or African American, Asian, Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native, or other?

2001-Q4

2002-Q4

2003-Q4

2004-Q4

2005-Q4

2006-Q4

Q5: Are you married, divorced, widowed, separated, never married, or a member of an unmarried couple?

2001-Q5

2002-Q5

2003-Q5

2004-Q5

2005-Q5

2006-Q5

Q6: How many children less than 18 years of age live in your household?

2001-Q6

2002-Q6

2003-Q6

2004-Q6

2005-Q6

2006-Q6

Q7: What is the highest grade or year of school you completed?

2001-Q7

2002-Q7

2003-Q7

2004-Q7

2005-Q7

2006-Q7

Q8: Are you currently employed for wages, self-employed, out of work for more than one year, out of work for less than one year, a homemaker, a student, retired, or unable to work

2001-Q8

2002-Q8

2003-Q8

2004-Q8

2005-Q8

2006-Q8

Q9: Is your annual household income from all sources, less than $10,000, $10,000 to less than $15,000, $15,000 to less than $20,000, $20,000 to less than $25,000, $25,000 to less than $35,000, $35,000 to less than $50,000, $50,000 to less than $75,000, or $75,000 or more

2001-Q9

2002-Q9

2003-Q9

2004-Q9

2005-Q9

2006-Q9

Q10: What county do you live in?

2001-Q10

2002-Q10

2003-Q10

2004-Q10

2005-Q10

2006-Q10

Q11: Sex of respondent

2001-Q11

2002-Q11

2003-Q11

2004-Q11

2005-Q11

2006-Q11

Q12: To your knowledge, are you now pregnant?

2001-Q12

2002-Q12

2003-Q12

2004-Q12

2005-Q12

2006-Q12

Q13: Number of adults in the household

2001-Q13

2002-Q13

2003-Q13

2004-Q13

2005-Q13

2006-Q13

Q14: Number of men in the household

2001-Q14

2002-Q14

2003-Q14

2004-Q14

2005-Q14

2006-Q14

Q15: Number of women in the household

2001-Q15

2002-Q15

2003-Q15

2004-Q15

2005-Q15

2006-Q15

Q16: On the average, how many hours per week, if any, do you work at a job or business?

 

 

 

 

2005-Q16

2006-Q16

Q17: Which of the following most accurately describes the type of work or business you currently work in most often?

 

 

 

2004-Q17

2005-Q17

2006-Q17

Q18: Excluding vacation days or other planned days off, during the past 12 months, how many days did you miss work due to physical or mental illness?

 

 

 

2004-Q18

2005-Q18

 

Q19:  Excluding vacation days or other planned days off, during the past 12 months, how many days did you miss work due to physical illness excluding mental or emotional illness?

 

 

 

 

 

2006-Q19

Q20: Excluding vacation days or other planned days off, during the past 12 months, how many days did you miss work due to mental or emotional illness?

 

 

 

 

 

2006-Q20

Q21: What do you consider to be? (Sexual Orientation)?

 

 

 

2004-Q21

2005-Q21

 

Q21A: Now I will read you a list of terms people sometimes use to describe themselves:  Heterosexual or straight, Homosexual or gay/lesbian, and Bisexual.  As I read the list again, please stop me when I get to the term that best describes how you think of yourself.

 

 

 

 

 

2006-Q21A

Q22:  During the past 12 months has your household been without telephone service for 1 week or more?

 

 

2003-Q22

2004-Q22

2005-Q22

2006-Q22

 

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