The Basics Survey

Original source question text
Which categories describe Person 1? Mark all boxes that apply AND print details in the spaces below. Note, you may report more than one group.

From which existing source was this question derived?
U.S. 2020 Census (original draft version race and ethnicity question)

Year of Original Source
2017

Brief Description
In 2017, in preparation for the 2020 Census, the U.S. Census Bureau tested new methods for capturing more accurate data on race and ethnicity than had been captured in previous census years. In 2018, the Census Bureau decided not to use the detailed versions of these questions.

URL
https://www.census.gov/

options and variations noted below (all options derived from U.S. 2020 Census (original draft version race and ethnicity question):

• American Indian or Alaska Native (For example: Aztec, Blackfeet Tribe, Mayan, Navajo Nation, Native Village of Barrow (Utqiagvik) Inupiat Traditional Government, Nome Eskimo Community, etc.)
  • Original source question text: American Indian or Alaska Native – Print name of enrolled or principal tribe(s), for example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc.

• Asian (For example: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, etc.)
  • Original source question text: Asian – Provide details below.

• Black, African American, or African (For example: African American, Ethiopian, Haitian, Jamaican, Nigerian, Somali, etc.)
  • Original source question text: Black or African Am. – Provide details below.

• Hispanic, Latino, or Spanish (For example: Colombian, Cuban, Dominican, Mexican or Mexican American, Puerto Rican, Salvadoran, etc.)
  • Original source question text: Hispanic, Latino, or Spanish – Provide details below.

• Middle Eastern or North African (For example: Algerian, Egyptian, Iranian, Lebanese, Moroccan, Syrian, etc.)
  • Original source question text: Middle Eastern or North African – Provide details below.

• Native Hawaiian or other Pacific Islander (For example: Chamorro, Fijian, Marshallese, Native Hawaiian, Tongan, etc.)
  • Original source question text: Native Hawaiian or other Pacific Islander – Provide details below.

• White (For example: English, European, French, German, Irish, Italian, Polish, etc.)
  • Original source question text: White – Provide details below.

Original source question text
What is your current gender identity? (Check all that apply)

From which existing source was this question derived?
Gender Identity in U.S. Surveillance (GenIUSS)

Year of Original Source
2014

Brief Description
To address gaps in federally-supported population health surveys in the identification of gender minorities, the Gender Identity in the U.S. Surveillance (GenIUSS) Group, offered recommendations for collecting information about sex assigned at birth and current gender identity. The questions are published in their 2014 report, “Best Practices for Asking Questions to Identify Transgender and Other Gender Minority Respondents on Population-Based Surveys.”

URL
https://williamsinstitute.law.ucla.edu/research/census-lgbt-demographics-studies/geniuss-report-sept-2014/

options and variations noted below:

• Are any of these a closer description to your gender identity? (Check all that apply)
  • Original source question text: Not applicable

Original source question text
Which of the following best represents how you think of yourself?

From which existing source was this question derived?
National Health Interview Survey (NHIS)

Year of Original Source
2016

Brief Description
The National Health Interview Survey (NHIS) is a program of the CDC’s National Center for Health Statistics. Since 1957, the NHIS has collected data on a variety of socioeconomic characteristics and health topics (e.g., conditions, medications, access to medical care, etc.) every 10-15 years.

URL
https://www.cdc.gov/nchs/nhis/

options and variations noted below:

• Are any of these a closer description of how you think of yourself?
  • Original source question text: What do you mean by something else?
  • From which existing source was this question derived? National Health Interview Survey (NHIS)
  • Year of Original Source: 2014
  • Brief Description: The National Health Interview Survey (NHIS) is a program of the CDC’s National Center for Health Statistics. Since 1957, the NHIS has collected data on a variety of socioeconomic characteristics and health topics (e.g., conditions, medications, access to medical care, etc.) every 10-15 years.
  • URL: https://www.cdc.gov/nchs/nhis/ h

Original source question text
Are you covered by health insurance or some other kind of health care plan?

From which existing source was this question derived?
National Health and Nutrition Examination Survey (NHANES)

Year of Original Source
2017

Brief Description
The National Health and Nutrition Examination Survey (NHANES) is a program conducted by the National Center for Health Statistics that aims to assess the health and nutritional status of the United States population. Approximately 5,000 participants from different counties across the nation complete the NHANES interview each year. Specific survey components include demographic, socioeconomic, dietary, and health-related questions.

URL
https://www.cdc.gov/nchs/nhanes/

options and variations noted below:

• Are you currently covered by any of the following types of health insurance or health coverage plans? Select all that apply from one group.
  • Original source question text: Is this person CURRENTLY covered by any of the following types of health insurance or health coverage plans? Mark “Yes” or “No” for EACH type of coverage
  • From which existing source was this question derived? U.S. 2020 Census
  • Year of Original Source: 2020
  • Brief Description: The U.S. Census is used to collect information about every resident in the United States and takes place every 10 years. The 2020 U.S. Census is anticipated to count 330 million residents across 140 million households.
  • URL: https://www.census.gov/

Original source question text
Is this person deaf or does he/she have serious difficulty hearing?

From which existing source was this question derived?
American Community Survey

Year of Original Source
2018

Brief Description
The American Community Survey collects long-form census data such as ancestry, citizenship, education, income, disability, employment, etc. on a monthly basis and is aggregated yearly. This survey adds detail that was previously difficult to collect in the decennial census.

URL
https://www2.census.gov/programs-surveys/acs/methodology/questionnaires/2019/quest19.pdf

Original source question text
Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?

From which existing source was this question derived?
American Community Survey

Year of Original Source
2018

Brief Description
The American Community Survey collects long-form census data such as ancestry, citizenship, education, income, disability, employment, etc. on a monthly basis and is aggregated yearly. This survey adds detail that was previously difficult to collect in the decennial census.

URL
https://www2.census.gov/programs-surveys/acs/methodology/questionnaires/2019/quest19.pdf

Original source question text
Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions?

From which existing source was this question derived?
American Community Survey

Year of Original Source
2018

Brief Description
The American Community Survey collects long-form census data such as ancestry, citizenship, education, income, disability, employment, etc. on a monthly basis and is aggregated yearly. This survey adds detail that was previously difficult to collect in the decennial census.

URL
https://www2.census.gov/programs-surveys/acs/methodology/questionnaires/2019/quest19.pdf

Original source question text
Does this person have serious difficulty walking or climbing stairs?

From which existing source was this question derived?
American Community Survey

Year of Original Source
2018

Brief Description
The American Community Survey collects long-form census data such as ancestry, citizenship, education, income, disability, employment, etc. on a monthly basis and is aggregated yearly. This survey adds detail that was previously difficult to collect in the decennial census.

URL
https://www2.census.gov/programs-surveys/acs/methodology/questionnaires/2019/quest19.pdf

Original source question text
Does this person have difficulty dressing or bathing?

From which existing source was this question derived?
American Community Survey

Year of Original Source
2018

Brief Description
The American Community Survey collects long-form census data such as ancestry, citizenship, education, income, disability, employment, etc. on a monthly basis and is aggregated yearly. This survey adds detail that was previously difficult to collect in the decennial census.

URL
https://www2.census.gov/programs-surveys/acs/methodology/questionnaires/2019/quest19.pdf

Original source question text
Because of a physical, mental, or emotional condition, does this person have difficulty doing errands alone such as visiting a doctor’s office or shopping?

From which existing source was this question derived?
American Community Survey

Year of Original Source
2018

Brief Description
The American Community Survey collects long-form census data such as ancestry, citizenship, education, income, disability, employment, etc. on a monthly basis and is aggregated yearly. This survey adds detail that was previously difficult to collect in the decennial census.

URL
https://www2.census.gov/programs-surveys/acs/methodology/questionnaires/2019/quest19.pdf

Original source question text
Are you currently…?

From which existing source was this question derived?
Behavioral Risk Factor Surveillance System (BRFSS)

Year of Original Source
2016

Brief Description
The Behavioral Risk Factor Surveillance System (BRFSS), established in 1984, is an annual national health-related telephone survey. Each year, data is collected on approximately 400,000 adults across the United States. about health-related risk behaviors, chronic health conditions, and use of preventive services.

URL
https://www.cdc.gov/brfss/

options and variations noted below:

• What is your work street address?
  • Original source question text: Not applicable
  • From which existing source was this question derived? This question was developed specifically for use within the All of Us Research Program
  • Year of Original Source: Not applicable
  • Brief Description: Not applicable
  • URL: Not applicable

Original source question text
Do you own or rent your home? (Home is defined as the place where you live most of the time/the majority of the year.)

From which existing source was this question derived?
Behavioral Risk Factor Surveillance System (BRFSS)

Year of Original Source
2016

Brief Description
The Behavioral Risk Factor Surveillance System (BRFSS), established in 1984, is an annual national health-related telephone survey. Each year, data is collected on approximately 400,000 adults across the United States. about health-related risk behaviors, chronic health conditions, and use of preventive services.

URL
https://www.cdc.gov/brfss/

options and variations noted below:

• Where are you currently living?
  • Original source question text: Where are you currently living?
  • From which existing source was this question derived? National Health Care for the Homeless Council (NHCHC)
  • Brief Description: A report from the National Health Care for the Homeless Council issued in October 2016 provides a list of seven questions as examples of ways to ask about housing status in the health care setting.
  • URL: https://www.nhchc.org/2016/10/new-publication-ask-code-documenting-homelessness-throughout-the-health-care-system/