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Do you have any longstanding health problem or disability?

1: Yes
2: No
3: Refusal


Which of the following categories would best describe your health condition?

Note: if more than one condition exists, then code the "main" one - whichever the respondent feels to be the most
important or troublesome.

01: Problems with arms or hands (which include arthritis or rheumatism)
02: Problems with legs or feet (which include arthritis or rheumatism)
03: Problems with back or neck (which include arthritis or rheumatism)
04: Difficulty in seeing
05: Difficulty in hearing
06: Speech impediment
07: Skin conditions (including disfigurement or allergies)
08: Chest or breathing problems (including asthma or bronchitis)
09: Heart, blood pressure or circulation problems
10: Stomach, liver, kidney or digestive problems
11: Diabetes
12: Epilepsy
13: Mental, nervous or emotional problems
14: Other progressive illnesses (including cancers, MS, HIV, Parkinsons disease etc.)
15: Other longstanding health problems
16: Refusal

Note: Multiple responses not allowed