Topical Survey Front/Roster Update/End Instrument Content
Language Welcome! Thank you for participating in this survey as a member of the Household Trends and Outlook Pulse Survey. You will receive $5 by email for completing this survey. Within two weeks of survey closing, you will receive an email containing a link to redeem your $5 at a variety of stores.
June 2025 Topical: <This month’s survey includes content from the Household Pulse Survey. It will be about 20 minutes and will concentrate on economic issues and events.>
August 2025 Topical: < This month’s survey includes content from the Household Pulse Survey. It will be about 20 minutes and will concentrate on health-focused content.>
This
survey is available in English and Spanish. Please select the
language in which you prefer to complete the survey.
If
you would like to change your language selection later, please use
the drop-down menu in the upper right corner of each page to select
the language in which you prefer to complete the survey.
English (1)
Español (2)
PRA
The
authority for the collection of this information for the Household
Trends and Outlook Pulse Survey (0607-1029) is provided under Title
13, Sections 141, 182, and 193.
June 2025 Topical: <The information collected in the June topical survey includes content from the Household Pulse Survey and focuses on economic issues and events.>
August 2025 Topical: <The information collected in the August topical survey includes content from the Household Pulse Survey, focusing on health-focused content.>
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Staff (employees and contractors) received training on privacy and confidentiality policies and practices; access to Personally Identifiable Information (PII) is restricted to authorized personnel only. Personally identifiable information collected includes name, address, telephone/cell phone number, DOB or age, email address, race or ethnicity.
FedRAMP-approved computer systems that maintain sensitive information are in compliance with the Federal Information Security Management Act. Unsecured telecommunications to transmit individually identifiable information is prohibited. Information will only be shared with staff and contractors that are special sworn status and sponsors of reimbursable surveys.
Furnishing this information is voluntary. Failure to do so will result in no consequences to you.
We estimate that completing this voluntary monthly survey will take 20 minutes on average. Send comments regarding this estimate or any other aspect of this survey to adrm.pra@census.gov. The U.S. Census Bureau is required by law to protect your information. The Census Bureau is not permitted to publicly release your responses in a way that could identify you. Federal law protects your privacy (Title 5, U.S. Code, Section 552a) and keeps your answers confidential (Title 13, United States Code, Section 9). Per the Federal Cybersecurity Enhancement Act of 2015, your data are protected from cybersecurity risks through screening of the systems that transmit your data. This collection has been approved by the Office of Management and Budget (OMB). This eight-digit OMB approval number, 0607-1029, confirms this approval and expires on 7/31/2027. If this number were not displayed, we could not conduct this survey.
To learn more about this survey go to: https://www.census.gov/programs-surveys/htops.html
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Alternative:
You are accessing a United States Government computer network. Use of this system indicates your consent to collection, monitoring, recording, and use of the information that you provide for any lawful government purpose. So that our website remains safe and available for its intended use, network traffic is monitored to identify unauthorized attempts to access, upload, change information, or otherwise cause damage to the web service. Use of the government computer network for unauthorized purposes is a violation of Federal law and can be punished with fines or imprisonment (PUBLIC LAW 99-474). If you want to know more about the use of this system, and how your privacy is protected, visit our online privacy webpage at
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Q1 Our records have your name as {fill NAME}. Is this correct?
Yes (1)
Yes, but name has legally changed or is misspelled (2)
No (3)
NAME_CORR What is your name?
First Name (1) __________________________________________________
Last Name (2) __________________________________________________
GET_NAME Our records have {fill NAME} as the primary respondent for your household. Please either ask {fill NAME} to complete the survey now or share the link you used to access the survey with them.
Continue survey now (1)
End survey (2)
END Please close your browser window now. The survey can be continued at a later time using the same link.
R2a You are not eligible to complete this survey. Thank you for your time.
[TOPICAL SURVEY QUESTIONNAIRES HERE]
Back End of Instrument
POC_display Please review the contact information we have for you and indicate whether the information is correct or needs to be updated.
Q3
Our records have your phone number as {fill
PHONE}. Is this correct?
Yes (1)
No (2)
Q6 What is a good phone number to reach you?
________________________________________________________________
Q7
Is this number a cell phone or land line?
Cell phone (1)
Land line (2)
Neither (3)
Q8 We send survey invitations via text message. Message and data rates may apply, depending on your mobile phone service plan. Message frequency varies. You can opt out of these messages at any time by replying STOP or reply HELP for more assistance. Would you like us to contact you by text message?
Yes (1)
No (2)
Q9 We usually send updates, notifications, and survey links via email. Our records have your email address as {fill EMAIL}. Is this correct?
Yes (1)
No (2)
Q9a What is the best email address for us to reach you?
________________________________________________________________
Q10a This month we will deliver your $5 incentive through email. Should we should send your payment to {fill EMAIL or Q9b email}?
Yes (1)
No (2)
Q10 What is the email address where we should send your incentive?
________________________________________________________________
Only ask this question if there is no email provided:
Q11_a
Our records have the following address as your home address where we
will mail the incentive for this survey. Is this correct?
{fill ADDRESS}
Yes (1)
No (2)
Only ask this question if there is no email provided:
Q12 Please enter your home address.
Address 1 (2) __________________________________________________
Address 2 (3) __________________________________________________
City (4) __________________________________________________
State (5) __________________________________________________
ZIP Code (6) __________________________________________________
RIP. We may recontact this household in the future to update information. We would like to use some of the information you have provided today to make that interview shorter and more efficient. When we speak to you or to someone else you are living with, is it OK if we use some of your answers as a starting point?
Yes (1)
No (2)
Submit_Page That concludes the survey. Please click on the “Submit” button when you are finished. Thank you for participating in the Household Trends and Outlook Pulse Survey.
June 2025 Topical Questionnaire
Household Pulse Survey
Start of Block: Demographics
D11 How many people under 18 years-old currently live in your household? Please enter a number.
________________________________________________________________
Display This Question:
If If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
D12 In your household, are there… Select all that apply.
Children under 1 year old? (1)
Children 1 through 4 years old? (2)
Children 5 through 11 years old? (3)
Children 12 through 17 years old? (4)
Display This Question:
If If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
EMP7
Next, we are going to ask about the childcare arrangements for
children in the household.
At any time in the last
4 weeks, were any children in the household unable to attend
daycare or another childcare arrangement as a result of child care
being closed, unavailable, unaffordable, or because you are concerned
about your child’s safety in care? Please include before
school care, after school care, and all other forms of childcare that
were unavailable. Select only one answer.
Yes (1)
No (2)
Not applicable (3)
Display This Question:
If EMP7 = Yes
EMP8 Which if any of the following occurred in the last 4 weeks as a result of childcare being closed, unavailable, unaffordable, or because you are concerned about your child’s safety in care? Select all that apply.
You (or another adult) took unpaid leave to care for the children (1)
You (or another adult) used vacation, or sick days, or other paid leave in order to care for the children (2)
You (or another adult) cut your work hours in order to care for the children (3)
You (or another adult) left a job in order to care for the children (4)
You (or another adult) lost a job because of time away to care for the children (5)
You (or another adult) did not look for a job in order to care for the children (6)
You (or another adult) supervised one or more children while working (7)
Other (specify) (8) _________________________________________
None of the above (9)
Start of Block: Employment
EMP_Intro Now we are going to ask about your employment.
EMP1 Have you, or has anyone in your household experienced a loss of employment income in the last 4 weeks? Select only one answer.
Yes (1)
No (2)
EMP2
In the last 7 days, did you do ANY work for
either pay or profit? Select only one answer.
Yes (1)
No (2)
Display This Question:
If EMP2 = Yes
EMP3 Are you employed by the government, by a private company, a nonprofit organization or are you self-employed or working in a family business? Select only one answer.
Government (1)
Private company (2)
Non-profit organization including tax exempt and charitable organizations (3)
Self-employed (4)
Working in a family business (5)
Display This Question:
If EMP2 = No
EMP4 What is your main reason for not working for pay or profit? Select only one answer. I did not work because:
I did not want to be employed at this time (1)
I am/was caring for children not in school or daycare (2)
I am/was caring for an elderly person (3)
I am/was sick or disabled (4)
I am retired (5)
I am/was laid off or furloughed (6)
My employer closed temporarily or went out of business (7)
I do/did not have transportation to work (8)
Other reason, please specify (9) __________________________________________________
Display This Question:
If EMP2 = Yes
SPN5_DAYSTW_2 In the last 7 days, have you teleworked or worked from home?
Yes, for 1-2 days (1)
Yes, for 3-4 days (2)
Yes, for 5 or more days (3)
No (4)
End of Block: Employment
HLTH8 Are you currently covered by any of the following types of health insurance or health coverage plans? Mark Yes or No for each.
|
Yes (1) |
No (2) |
Insurance through a current or former employer or union (through yourself or another family member) (1) |
|
|
Insurance purchased directly from an insurance company, including marketplace coverage (through yourself or another family member) (2) |
|
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Medicare, for people 65 and older, or people with certain disabilities (3) |
|
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Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability (4) |
|
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TRICARE or other military health care (5) |
|
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VA (including those who have ever used or enrolled for VA health care) (6) |
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Indian Health Service (7) |
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Other (8) |
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Start of Block: Food Security
FD1 Getting enough food can be a problem for some people. In the last 7 days, which of these statements best describes the food eaten in your household? Select only one answer.
Enough of the kinds of food (I/we) wanted to eat (1)
Enough, but not always the kinds of food (I/we) wanted to eat (2)
Sometimes not enough to eat (3)
Often not enough to eat (4)
Display This Question:
If FD1 = Enough, but not always the kinds of food (I/we) wanted to eat
Or FD1 = Sometimes not enough to eat
Or FD1 = Often not enough to eat
And If
If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
FD2
Please indicate whether the next statement was often true,
sometimes true, or never true in the last 7 days for the
children living in your household who are under 18 years old.
"The children were not eating enough because we just
couldn't afford enough food."
Often true (1)
Sometimes true (2)
Never true (3)
Display This Question:
If FD1 = Enough, but not always the kinds of food (I/we) wanted to eat
Or FD1 = Sometimes not enough to eat
Or FD1 = Often not enough to eat
FD3 Why did you not have enough to eat (or not what you wanted to eat)? Select all that apply.
Couldn’t afford to buy more food (1)
Couldn’t get to store to buy food (for example, didn’t have transportation, have mobility or health limitations that prevent you from getting out) (2)
Couldn’t go to store due to safety concerns (3)
None of the above (4)
FD4 During the last 7 days, did you or anyone in your household get free groceries from a food pantry, food bank, church, or other place that provides free food? Select only one answer.
Yes (1)
No (2)
FD6_rev Do you or does anyone in your household currently receive benefits from… Select all that apply.
Supplemental Nutrition Assistance Program (SNAP) or Food Stamp Program (1)
WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) (2)
Free or reduced-price meals at school through NSLP (National School Lunch Program) (3)
Pay
full-price meals at school through NSLP (National School Lunch
Program) (4)
None of these (5)
SPN4 In the last 2 months, how difficult has it been for your household to pay for usual household expenses, including but not limited to food, rent or mortgage, car payments, medical expenses, student loans, and so on? Select only one answer.
Not at all difficult (1)
A little difficult (2)
Somewhat difficult (3)
Very difficult (4)
INFLATE1 In the area where you live and shop, do you think prices in general have changed in the last 2 months? Select only one answer.
I think prices have increased (1)
I do not think prices have changed (2)
I think prices have decreased (3)
I do not know (4)
Display This Question:
If INFLATE1 = I think prices have increased
INFLATE2 How stressful, if at all, has the increase in prices in the last 2 months been for you? Select only one answer.
Very stressful (1)
Moderately stressful (2)
A little stressful (3)
Not at all stressful (4)
INFLATE4 In the area you live and shop, how concerned are you, if at all, that prices will increase in the next 6 months? Select only one answer.
Very concerned (1)
Somewhat concerned (2)
A little concerned (3)
Not at all concerned (4)
End of Block: Food Security
Start of Block: Housing
HSE1
The next questions ask about housing.
Is your house or
apartment…? Select only one answer.
Owned by you or someone in this household free and clear? (1)
Owned by you or someone in this household with a mortgage or loan (including home equity loans)? (2)
Rented? (3)
Occupied without payment of rent? (4)
Display This Question:
If HSE1 = Rented?
HSE3 Is this household currently caught up on rent payments? Select only one answer.
Yes (1)
No (2)
Display This Question:
If HSE1 = Owned by you or someone in this household with a mortgage or loan (including home equity loans)?
HSE4 Is this household currently caught up on mortgage payments? Select only one answer.
Yes (1)
No (2)
Display This Question:
If HSE3 = No
Or HSE4 = No
HSE6 How many months behind is this household in paying your rent or mortgage?
________________________________________________________________
Display This Question:
If HSE3 = No
HSE8 How likely is it that your household will have to leave this home or apartment within the next 2 months because of eviction? Select only one answer.
Very likely (1)
Somewhat likely (2)
Not very likely (3)
Not likely at all (4)
Display This Question:
If HSE4 = No
HSE9 How likely is it that your household will have to leave this home within the next 2 months because of foreclosure? Select only one answer.
Very likely (1)
Somewhat likely (2)
Not very likely (3)
Not likely at all (4)
NEWHSE10 (If either HSE8 or HSE9 = 1 or 2)
If you (and your household) did have to leave, where do you think you would go? Select only one answer.
Get a different place of your/their own to live in (1)
Move in with friends (2)
Move in with family (3)
Household would split up and go to different places (4)
Would probably Go to a homeless shelter (5)
Move into vehicle (6)
Live outside (7)
NEWHSE11: At any time in the last 12 months did you or a person that currently lives with you experience homelessness?
Yes (1)
No (2)
NEW
HSE12: (If either NEWHSE11 = 1): (If yes) Where did you or that
person live or stay when experiencing homelessness? Select all
that apply.
In a homeless shelter (1)
On the streets/tent/car/abandoned building (2)
Sleeping temporarily on someone’s couch (3)
Other (4)
Don’t know (5)
NEW
HSE13: (If either NEWHSE11 = 1): (If yes) Were you the person who
experienced homelessness? If not, how is that person related to you?
Select all that apply.
It was me (1)
My spouse/partner (2)
My child 18 or older (3)
My child under age 18 (4)
Parent (5)
Sibling (6)
Other family member (7)
Unrelated person (8)
HSE14 In the last 2 months, Did your household reduce or forego expenses for basic household necessities, such as medicine or food, in order to pay an energy bill?
Yes (1)
No (2)
HSE15 In the last 2 months, did your household keep your home at a temperature that you felt was unsafe or unhealthy?
Yes (1)
No (2)
HSE16 In the last 2 months, was your household unable to pay an energy bill or unable to pay the full bill amount?
Yes (1)
No (2)
TRANS1 Currently, which of the following transportation options do you have access to: Select all that apply.
Walk (1)
Bike or e-scooter (2)
Motorcycle or moped (3)
Your own personal vehicle (e.g., car, truck, SUV) (4)
A personal vehicle borrowed from a friend, family member, neighbor, coworker, or acquaintance (including carpooling) (5)
Rental car or carsharing service (e.g., Zipcar) (6)
Taxi service or rideshare (e.g., Uber, Lyft) (7)
Bus (8)
Rail transit (subway, light rail, streetcar, commuter rail) (9)
Ferryboat (10)
Paratransit (that is, specialized, door-to-door transport service for people with disabilities) (11)
Other methods, please specify (12) ______________________________________
TRANS2 Which one of the following statements best describes your access to transportation in the last 4 weeks:
Enough transportation to meet your needs (1)
Enough transportation, but not always the kinds you want to use (2)
Sometimes not enough transportation to meet your needs (3)
Often not enough transportation to meet your needs (4)
Always not enough transportation to meet your needs (5)
Display This Question:
If TRANS2 = Sometimes not enough transportation to meet your needs
Or TRANS2 = Often not enough transportation to meet your needs
Or TRANS2 = Always not enough transportation to meet your needs
TRANS3 If you do not have enough transportation to meet your needs, which of the following reasons explain why (select all that apply):
My transportation options are not available when I need them (1)
My transportation options require more travel time than I have available (2)
My transportation options are unpredictable (travel time, availability) (3)
My transportation options cost more than I can afford (4)
My transportation options feel unsafe (5)
I have a disability that limits my travel options or makes travel challenging (6)
None of the above (7)
End of Block: Housing
Start of Block: Trust
Trust1 The population count, the crime rate, and the unemployment rate are examples of statistics produced by the federal government. Personally, how much trust do you have in federal statistics in the United States? Would you say that you tend to trust federal statistics or you tend not to trust them?
Tend to trust federal statistics (1)
Tend not to trust federal statistics (2)
Trust2 Below is a list of institutions in American society. Please indicate how much confidence you, yourself, have in each one.
|
A great deal (1) |
Quite a lot (2) |
Some (3) |
Very little (4) |
The military (1) |
|
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|
The police (4) |
|
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|
|
The U.S. Supreme Court (5) |
|
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The presidency (6) |
|
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|
|
Public schools (7) |
|
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The criminal justice system (8) |
|
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Congress (9) |
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U.S. Census Bureau (10) |
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U.S. statistical agencies (11) |
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Trust3 To what extent do you agree or disagree with the following statement? Policy makers need federal statistics to make good decisions about things like federal funding.
Strongly agree (1)
Somewhat agree (2)
Neither agree nor disagree (3)
Somewhat disagree (4)
Strongly disagree (5)
End of Block: Trust
AI1 Artificial Intelligence (AI) refers to computer systems that perform tasks requiring human intelligence, such as decision-making, language processing, and image recognition. Examples include virtual assistants, online translation tools, and generative AI (e.g., ChatGPT, Gemini, or Claude), which can create text or images.
In the last 2 months, have you or anyone in your household used an AI tool for any of the following? (Select all that apply)
☐ Finding
factual information
☐
Assisting with schoolwork
☐
Assisting with work projects
☐
Performing a task you would have otherwise hired someone to do
☐
Assisting with creative tasks (e.g., writing, drawing)
☐
Brainstorming or idea generation
☐
Integrated into another product you use (e.g., search engine, app)
☐
No one in my household has used an AI tool in the last three months
☐
Other (please specify) ___________
AI2(If selected any AI usage above)
Please indicate which of the following you agree with:
☐ AI
tools make me more productive.
☐
I control when I use AI.
☐
I control how my data is used by AI.
☐
AI has changed my field of work.
☐
I trust information from AI systems.
☐
I feel prepared to use AI at work.
☐
I feel prepared to use AI in daily life.
☐
I am worried about AI’s impact on my career.
AI3. In the last 2 months, have you actively opted out of using an AI system? (e.g., disabling facial recognition, turning off a virtual assistant, stopping use of an AI-driven app)
☐ Yes
☐
No
☐ Not sure
AI4. A search engine is a website that returns results based on a query, sometimes with AI-generated summaries (e.g., Google, Bing, DuckDuckGo).
In the last 2 months, have you or anyone in your household searched online for:
☐ Housing
opportunities
☐
Job opportunities
☐
Schools or educational programs
☐
Food sources nearby
☐
Medical assistance nearby
☐
Public services or benefits
☐
Health insurance
☐
Credit cards or loans
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Either the A or B version of the following items will be displayed.
Retirement accounts
RETIRE
“A” Treatment
The next set of questions will ask about last year, 2024.
At any time during 2024, did ^NAMEANYONE_ALL have any of the following retirement accounts specifically for retirement savings?
Select yes or no for each item.
401(k) |
Yes No |
403(b) |
Yes No |
Roth IRA |
Yes No |
Traditional IRA |
Yes No |
KEOGH plan |
Yes No |
SEP (Simplified Employee Pension) plan |
Yes No |
Other type of retirement account |
Yes No |
“B” Treatment
The next set of questions will ask about last year, 2024.
At any time during 2024, which of the following retirement accounts specifically for retirement savings did ^NAMEANYONE_ALL have?
Select all that apply.
401(k)
403(b)
Roth IRA
Traditional IRA
KEOGH plan
SEP (Simplified Employee Pension) plan
Other type of retirement account
None of the above
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE(401(k))=1
and Number of People in HHLD >1
RET401k_HAV
“A” Treatment
At any time during 2024, did any of the following household members have a 401(k)?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had a 401(k)?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE_403(b)=1
and Number of People in HHLD >1
RET403b_HAV
“A” Treatment
At any time during 2024, did any of the following household members have a 403(b)?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had a 403(b)?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE_Roth IRA = 1
and Number of People in HHLD >1
ROTHIRA_HAV
“A” Treatment
At any time during 2024, did any of the following household members have a Roth IRA?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had a Roth IRA?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE_Traditional IRA=1
and Number of People in HHLD >1
TRADIRA_HAV
“A” Treatment
At any time during 2024, did any of the following household members have a Traditional IRA?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had a Traditional IRA?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE_KEOGH = 1
and Number of People in HHLD >1
KEOGH_HAV
“A” Treatment
At any time during 2024, did any of the following household members have a KEOGH plan?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had a KEOGH plan?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE_SEP = 1
and Number of People in HHLD >1
SEP_HAV
“A” Treatment
At any time during 2024, did any of the following household members have a SEP (Simplified Employee Pension) plan?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had a SEP (Simplified Employee Pension) plan?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If RETIRE_Other = 1
and Number of People in HHLD >1
RETOTH_HAV
“A” Treatment
At any time during 2024, did any of the following household members have another type of retirement account you haven’t told us about?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had another type of retirement you haven’t told us about?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Veterans Payments
VA_PAYMENTS
“A” Treatment
At any time during 2024, did ^NAMEANYONE_ALL receive any of the following types of Veteran Affairs (VA) payments?
Include assistance received by children of veterans.
Do not include anything you have already reported.
Select yes or no for each item.
Service-connected disability compensation
|
Yes No |
VA survivor benefits
|
Yes No |
Veterans’ Pension (a specific program for lower income veterans; different from a military pension)
|
Yes No |
VA educational assistance (including assistance received by children of veterans)
|
Yes No |
Other Veterans’ payments |
Yes No |
“B” Treatment
At any time during 2024, which of the following types of Veteran Affairs (VA) payments did ^NAMEANYONE_ALL receive?
Include assistance received by children of veterans.
Do not include anything you have already reported.
Select all that apply.
Service-connected disability compensation
VA survivor benefits
Veterans’ Pension (a specific program for lower income veterans; different from a military pension)
VA educational assistance (including assistance received by children of veterans)
Other Veterans’ payments
None of the above
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If VAPAYMENTS_Service-connected = 1
and Number of People in HHLD >1
and Number of People Ages 15+ > 0
VETSERV_HAV
“A” Treatment
At any time during 2024, did any of the following household members receive service-connected disability compensation either for themselves or as combined payments with other family members?
Select Yes or No for each person.
[List of hh members aged 15 and over] |
Yes No |
“B” Treatment
At any time during 2024, which household members received service-connected disability compensation either for themselves or as combined payments with other family members?
Select all that apply.
[List of hh members aged 15 and over]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If VAPAYMENTS_SurvivorBenefits = 1
and Number of People in HHLD >1
and Number of People Ages 15+ > 0
VETSURV_HAV
“A” Treatment
At any time during 2024, did any of the following household members receive survivor benefits either for themselves or as combined payments with other family members?
Select Yes or No for each person.
[List of hh members aged 15 and over] |
Yes No |
“B” Treatment
At any time during 2024, which household members received survivor benefits either for themselves or as combined payments with other family members?
Select all that apply.
[List of hh members aged 15 and over]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If VAPAYMENTS_VetPension = 1
and Number of People in HHLD >1
and Number of People Ages 15+ > 0
VETPEN_HAV
“A” Treatment
At any time during 2024, did any of the following household members receive Veterans Pension either for themselves or as combined payments with other family members?
Select Yes or No for each person.
[List of hh members aged 15 and over] |
Yes No |
“B” Treatment
At any time during 2024, which household members received Veterans Pension either for themselves or as combined payments with other family members?
Select all that apply.
[List of hh members aged 15 and over]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If VAPAYMENTS_EducationAsst = 1
and Number of People in HHLD >1
and Number of People Ages 15+ > 0
VETEDUC_HAV
“A” Treatment
At any time during 2024, did any of the following household members receive VA educational assistance (including assistance received by children of veterans) either for themselves or as combined payments with other family members?
Select Yes or No for each person.
[List of hh members aged 15 and over] |
Yes No |
“B” Treatment
At any time during 2024, which household members received VA educational assistance (including assistance received by children of veterans) either for themselves or as combined payments with other family members?
Select all that apply.
[List of hh members aged 15 and over]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If VAPAYMENTS_OtherBenefits = 1
and Number of People in HHLD >1
and Number of People Ages 15+ > 0
VETOTH_HAV
“A” Treatment
At any time during 2024, did any of the following household members receive other Veterans’ payments either for themselves or as combined payments with other family members?
Select Yes or No for each person.
[List of hh members aged 15 and over] |
Yes No |
“B” Treatment
At any time during 2024, which household members received other Veterans’ payments either for themselves or as combined payments with other family members?
Select all that apply.
[List of hh members aged 15 and over]
None of the above (mutually exclusive)
|----------------------------------------------------------PAGE BREAK-------------------------------------------------|
LFSB asset questions
GOVTSEC
At any time during 2024, did ^NAMEANYONE_ALL have any government securities (such as treasury bills), municipal bonds, or corporate bonds?
Exclude any government securities and bonds held in the retirement accounts.
Yes
No
|-----------------------------------------------------PAGE BREAK-----------------------------------------------|
Display This Question:
If GOVTSEC = 1
and Number of People in HHLD >1
GOVTSEC_HAV
“A” Treatment
At any time during 2024, did any of the following household members have government securities (such as treasury bills), municipal bonds, or corporate bonds?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had government securities (such as treasury bills), municipal bonds, or corporate bonds?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|-------------------------------------------------------PAGE BREAK---------------------------------------------------|
CRYPTO At any time during 2024, did ^NAMEANYONE_ALL have any cryptocurrencies (such as Bitcoin, Ethereum, or Tether) or Non-Fungible Tokens (NFTs)?
Yes
No
|--------------------------------------------------PAGE BREAK-------------------------------------------------|
Display This Question:
If CRYPTO = 1
and Number of People in HHLD >1
CRYPTO_HAV
“A” Treatment
At any time during 2024, did any of the following household members have cryptocurrencies (such as Bitcoin, Ethereum, or Tether) or Non-Fungible Tokens (NFTs)?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members had cryptocurrencies (such as Bitcoin, Ethereum, or Tether) or Non-Fungible Tokens (NFTs)?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|---------------------------------------------------------PAGE BREAK--------------------------------------------------|
CC_DEBT At any time during 2024, did ^NAMEANYONE_ALL carry a balance from one month to another for any store or credit card bills?
Yes
No
|-------------------------------------------------------PAGE BREAK----------------------------------------------------|
Display This Question:
If CC_DEBT = 1
and Number of People in HHLD >1
CC_DEBT_HAV
“A” Treatment
At any time during 2024, did any of the following household members carry a balance from one month to another for store or credit card bills?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
At any time during 2024, which household members carried a balance from one month to another for store or credit card bills?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------------PAGE BREAK--------------------------------------------|
SNAP, WIC, Food Assistance, School Meals
The next section has questions similar to ones you have already answered. Please answer them again to help us improve our questionnaires for the future.
FOOD_ASST Do you or does anyone in your household currently receive benefits from…?
Select Yes or No for each item.
Supplemental Nutrition Assistance Program (SNAP) or Food Stamp Program |
Yes No |
WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) |
Yes No |
Free or reduced-price meals at school through NSLP (National School Lunch Program) |
Yes No |
Summer EBT (Electronic Benefits Transfer) or SUN Bucks |
Yes No |
|--------------------------------------------------------------PAGE BREAK--------------------------------------------|
Display This Question:
If FOOD_ASST_SNAP= 1
and Number of People in HHLD >1
SNAP_COV
“A” Treatment
Are any of the following household members currently covered by SNAP benefits or the Food Stamp Program?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Which household members are currently covered by SNAP benefits or the Food Stamp Program?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|-------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If FOOD_ASST_WIC = 1
and Number of People in HHLD >1
WIC_COV
“A” Treatment
Are any of the following household members currently covered by WIC benefits?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Which household members are currently covered by WIC benefits?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK--------------------------------------------------|
Display This Question:
If FOOD_ASST_NSLP= 1
and Number of People in HHLD >1
and Number of People Ages 5-18 years old > 0
NSLP_COV
“A” Treatment
Do any of the following household members currently receive free or reduced-price meals at school through NSLP (National School Lunch Program)?
Select Yes or No for each person.
[List of hh members aged 5-18] |
Yes No |
“B” Treatment
Which household members currently receive free or reduced-price meals at school through NSLP (National School Lunch Program)?
Select all that apply.
[List of hh members 5-18]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK--------------------------------------------------|
Display This Question:
If FOOD_ASST_EBT= 1
and Number of People in HHLD >1
and Number of People Ages 5-18 years old > 0
SEBT_COV
“A” Treatment
Do any of the following household members currently receive Summer EBT (Electronic Benefits Transfer) or SUN Bucks)?
Select Yes or No for each person.
[List of hh members aged 5-18] |
Yes No |
“B” Treatment
Which household members currently receive Summer EBT (Electronic Benefits Transfer) or SUN Bucks?
Select all that apply.
[List of hh members 5-18]
None of the above (mutually exclusive)
|-------------------------------------------------------PAGE BREAK---------------------------------------------------|
HEALTH Which of the following health insurance or health coverage plans is ^NAMEANYONE_ALL currently covered by?
Select all that apply.
Insurance through a current or former employer or union (through yourself or another family member)
Insurance purchased directly from an insurance company, including marketplace coverage (through yourself or another family member)
Medicare, for people 65 and older, or people with certain disabilities
Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability
TRICARE or other military health care
VA (including those who have ever used or enrolled for VA health care)
Indian Health Service
Other
No one in this household had health insurance or a health coverage plan
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_Employer= 1
and Number of People in HHLD >1
EMP_COV
“A” Treatment
Are any of the following household members currently covered by…
Insurance through a current or former employer or union (through yourself or another family member)?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Which household members are currently covered by…
Insurance through a current or former employer or union (through yourself or another family member)?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_Marketplace= 1
and Number of People in HHLD >1
MKT_COV
“A” Treatment
Are any of the following household members currently covered by…
Insurance purchased directly from an insurance company, including marketplace coverage (through yourself or another family member)?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Which household members are currently covered by…
Insurance purchased directly from an insurance company, including marketplace coverage (through yourself or another family member)?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_Medicare= 1
and Number of People in HHLD >1
MEDICARE_COV
“A” Treatment
Are any of the following household members currently covered by…
Medicare, for people 65 and older, or people with certain disabilities?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Which household members are currently covered by…
Medicare, for people 65 and older, or people with certain disabilities?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_Medicaid= 1
and Number of People in HHLD >1
MEDICAID_COV
“A” Treatment
Are any of the following household members currently covered by…
Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Are any of the following household members currently covered by…
Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_TRICARE= 1
and Number of People in HHLD >1
TRICARE_COV
“A” Treatment
Are any of the following household members currently covered by…
TRICARE or other military health care?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Are any of the following household members currently covered by…
TRICARE or other military health care?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_VA= 1
and Number of People in HHLD >1
VACARE_COV
“A” Treatment
Are any of the following household members currently covered by…
VA (including those who have ever used or enrolled for VA health care)?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Are any of the following household members currently covered by…
VA (including those who have ever used or enrolled for VA health care)?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_INDIAN= 1
and Number of People in HHLD >1
INDIAN_COV
“A” Treatment
Are any of the following household members currently covered by…
Indian Health Service?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Are any of the following household members currently covered by…
Indian Health Service?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
|--------------------------------------------------------PAGE BREAK---------------------------------------------------|
Display This Question:
If HEALTH_Other= 1
and Number of People in HHLD >1
ANOTHER_COV_A
“A” Treatment
Are any of the following household members currently covered by…
Another type of health insurance?
Select Yes or No for each person.
[List of hh members] |
Yes No |
“B” Treatment
Which household members are currently covered by…
Another type of health insurance?
Select all that apply.
[List of hh members]
None of the above (mutually exclusive)
August 2025 Topical Questionnaire
Household Pulse Survey
Start of Block: Demographics
D11 How many people under 18 years-old currently live in your household? Please enter a number.
________________________________________________________________
Display This Question:
If If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
D12 In your household, are there… Select all that apply.
Children under 1 year old? (1)
Children 1 through 4 years old? (2)
Children 5 through 11 years old? (3)
Children 12 through 17 years old? (4)
Display This Question:
If D12 = Children 5 through 11 years old?
Or D12 = Children 12 through 17 years old?
D13 During the school year that began in the Summer / Fall of 2025, how many children in this household are enrolled in Kindergarten through 12th grade or grade equivalent? Enter whole numbers for all that apply.
Number enrolled in a public school (1) _______________________________
Number enrolled in a private school (2) _______________________________
Number homeschooled, that is not enrolled in public or private school (3) __________________________________________________
None (4)
Display This Question:
If If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
EMP7
Next, we are going to ask about the childcare arrangements for
children in the household.
At any time in the last
4 weeks, were any children in the household unable to attend
daycare or another childcare arrangement as a result of child care
being closed, unavailable, unaffordable, or because you are concerned
about your child’s safety in care? Please include before
school care, after school care, and all other forms of childcare that
were unavailable. Select only one answer.
Yes (1)
No (2)
Not applicable (3)
Display This Question:
If EMP7 = Yes
EMP8 Which if any of the following occurred in the last 4 weeks as a result of childcare being closed, unavailable, unaffordable, or because you are concerned about your child’s safety in care? Select all that apply.
You (or another adult) took unpaid leave to care for the children (1)
You (or another adult) used vacation, or sick days, or other paid leave in order to care for the children (2)
You (or another adult) cut your work hours in order to care for the children (3)
You (or another adult) left a job in order to care for the children (4)
You (or another adult) lost a job because of time away to care for the children (5)
You (or another adult) did not look for a job in order to care for the children (6)
You (or another adult) supervised one or more children while working (7)
Other (specify) (8) _________________________________________
None of the above (9)
Display This Question:
If D12 = Children under 1 year old?
|
INF2 How many months old is the baby or infant in your household? If there is more than one, please report the age of the youngest.
Under 6 months (1)
Between 6 months and 9 months (2)
Between 9 months and 12 months (3)
Display This Question:
If D12 = Children under 1 year old?
INF5 How is the baby in your household fed (in addition to any solid foods the baby may be consuming)? If there is more than one baby, please report on the youngest.
Breastfeeding (or pumped breastmilk) only (1)
Sometimes breastfeeding (or pumped breastmilk) and sometimes infant formula (2)
Infant formula only (3)
Baby isn’t fed breastmilk OR infant formula (4)
Display This Question:
If INF5 = Sometimes breastfeeding (or pumped breastmilk) and sometimes infant formula
Or INF5 = Infant formula only
INF6 In the last 4 weeks, did you have difficulty getting infant formula?
Yes, in the last 7 days (1)
Yes, more than 7 days ago but within the last 4 weeks (2)
No, did not have trouble getting infant formula in the last 4 weeks (3)
End of Block: Demographics
Start of Block: Employment
EMP_Intro Now we are going to ask about your employment.
EMP1 Have you, or has anyone in your household experienced a loss of employment income in the last 4 weeks? Select only one answer.
Yes (1)
No (2)
EMP2
In the last 7 days, did you do ANY work for
either pay or profit? Select only one answer.
Yes (1)
No (2)
Display This Question:
If EMP2 = Yes
EMP3 Are you employed by the government, by a private company, a nonprofit organization or are you self-employed or working in a family business? Select only one answer.
Government (1)
Private company (2)
Non-profit organization including tax exempt and charitable organizations (3)
Self-employed (4)
Working in a family business (5)
Display This Question:
If EMP2 = No
EMP4 What is your main reason for not working for pay or profit? Select only one answer. I did not work because:
I did not want to be employed at this time (1)
I am/was caring for children not in school or daycare (2)
I am/was caring for an elderly person (3)
I am/was sick or disabled (4)
I am retired (5)
I am/was laid off or furloughed (6)
My employer closed temporarily or went out of business (7)
I do/did not have transportation to work (8)
Other reason, please specify (9) __________________________________________________
Display This Question:
If EMP2 = Yes
SPN5_DAYSTW_2 In the last 7 days, have you teleworked or worked from home?
Yes, for 1-2 days (1)
Yes, for 3-4 days (2)
Yes, for 5 or more days (3)
No (4)
End of Block: Employment
Start of Block: Mental Health and Health Status
display_HLTH Next, we will ask about health.
DIS1 Do you have difficulty seeing, even when wearing glasses? Select only one answer.
No - no difficulty (1)
Yes - some difficulty (2)
Yes - a lot of difficulty (3)
Cannot do at all (4)
DIS2 Do you have difficulty hearing, even when using a hearing aid? Select only one answer.
No - no difficulty (1)
Yes - some difficulty (2)
Yes - a lot of difficulty (3)
Cannot do at all (4)
DIS4 Do you have difficulty walking or climbing stairs? Select only one answer.
No - no difficulty (1)
Yes - some difficulty (2)
Yes - a lot of difficulty (3)
Cannot do at all (4)
DIS3 Do you have difficulty remembering or concentrating? Select only one answer.
No - no difficulty (1)
Yes - some difficulty (2)
Yes - a lot of difficulty (3)
Cannot do at all (4)
DIS5 Do you have difficulty with self-care, such as washing all over or dressing? Select only one answer.
No - no difficulty (1)
Yes - some difficulty (2)
Yes - a lot of difficulty (3)
Cannot do at all (4)
DIS6 Using your usual language, do you have difficulty communicating, for example understanding or being understood? Select only one answer.
No - no difficulty (1)
Yes - some difficulty (2)
Yes - a lot of difficulty (3)
Cannot do at all (4)
HLTH_intro Over the last 2 weeks, how often have you been bothered by...
HLTH1 Feeling nervous, anxious, or on edge? Select only one answer.
Not at all (1)
Several days (2)
More than half the days (3)
Nearly every day (4)
HLTH2 Not being able to stop or control worrying? Select only one answer.
Not at all (1)
Several days (2)
More than half the days (3)
Nearly every day (4)
HLTH3 Having little interest or pleasure in doing things? Select only one answer.
Not at all (1)
Several days (2)
More than half the days (3)
Nearly every day (4)
HLTH4 Feeling down, depressed, or hopeless? Select only one answer.
Not at all (1)
Several days (2)
More than half the days (3)
Nearly every day (4)
Display This Question:
If If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
MH1 During the last 4 weeks, did any children in your household need mental health treatment? Mental health treatment includes health services like counseling or medication.
Yes, all children needed mental health treatment (1)
Yes, some but not all children needed mental health treatment (2)
No, none of the children needed mental health treatment (3)
Display This Question:
If MH1 = Yes, all children needed mental health treatment
Or MH1 = Yes, some but not all children needed mental health treatment
MH2 Did the children who needed mental health treatment receive it?
Yes, all children who needed treatment received it (1)
Yes, but only some children who needed treatment received it (2)
No, none of the children who needed treatment received it (3)
Display This Question:
If MH2 = Yes, all children who needed treatment received it
Or MH2 = Yes, but only some children who needed treatment received it
MH3 Were you satisfied with the type, quality, and quantity of mental health treatment the children received?
Satisfied with all of the mental health treatment the children received (1)
Satisfied with some but not all of the mental health treatment the children received (2)
Not satisfied with the mental health treatment the children received (3)
Display This Question:
If MH1 = Yes, all children needed mental health treatment
Or MH1 = Yes, some but not all children needed mental health treatment
MH4 How difficult was it to get mental health treatment for the children?
Not difficult (1)
Somewhat difficult (2)
Very difficult (3)
Unable to get treatment due to difficulty (4)
Did not try to get treatment (5)
HLTH8 Are you currently covered by any of the following types of health insurance or health coverage plans? Mark Yes or No for each.
|
Yes (1) |
No (2) |
Insurance through a current or former employer or union (through yourself or another family member) (1) |
|
|
Insurance purchased directly from an insurance company, including marketplace coverage (through yourself or another family member) (2) |
|
|
Medicare, for people 65 and older, or people with certain disabilities (3) |
|
|
Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability (4) |
|
|
TRICARE or other military health care (5) |
|
|
VA (including those who have ever used or enrolled for VA health care) (6) |
|
|
Indian Health Service (7) |
|
|
Other (8) |
|
|
End of Block: Mental Health and Health Status
Start of Block: Socialization
SOC2_first How often do you feel lonely?
Always (1)
Usually (2)
Sometimes (3)
Rarely (4)
Never (5)
SOC1_first How often do you get the social and emotional support you need?
Always (1)
Usually (2)
Sometimes (3)
Rarely (4)
Never (5)
SOC3. In a typical week, and not including people you live with, how many times do you get together with people that you care about and feel close to?
Never or less than once a week (1)
1 to 2 times (2)
3 to 4 times (3)
5 or more times a week (4)
SOC4. In a typical week, and not including people you live with, how many times do you talk on the telephone or by video with the people that you care about and feel close to?
Never or less than once a week (1)
1 to 2 times (2)
3 to 4 times (3)
5 or more times (4)
SOC5. During the past 12 months, how many times did you attend religious services?
Do not include special occasions such as weddings, funerals, or other special events.
Zero (1)
1 to 3 times (2)
4 to 11 times (3)
12 or more times (4)
SOC 6. During the past 12 months, how many times did you attend meetings of clubs or organizations you belong to? Examples include community groups, unions, athletic groups, or school groups
Zero/do not belong to a group (1)
1 to 3 (2)
4 to 11 (3)
12 or more (4)
End of Block: Socialization
Start of Block: Food Security
FD1 Getting enough food can be a problem for some people. In the last 7 days, which of these statements best describes the food eaten in your household? Select only one answer.
Enough of the kinds of food (I/we) wanted to eat (1)
Enough, but not always the kinds of food (I/we) wanted to eat (2)
Sometimes not enough to eat (3)
Often not enough to eat (4)
Display This Question:
If FD1 = Enough, but not always the kinds of food (I/we) wanted to eat
Or FD1 = Sometimes not enough to eat
Or FD1 = Often not enough to eat
And If
If How many people under 18 years-old currently live in your household? Please enter a number. Text Response Is Greater Than 0
FD2
Please indicate whether the next statement was often true,
sometimes true, or never true in the last 7 days for the
children living in your household who are under 18 years old.
"The children were not eating enough because we just
couldn't afford enough food."
Often true (1)
Sometimes true (2)
Never true (3)
Display This Question:
If FD1 = Enough, but not always the kinds of food (I/we) wanted to eat
Or FD1 = Sometimes not enough to eat
Or FD1 = Often not enough to eat
FD3 Why did you not have enough to eat (or not what you wanted to eat)? Select all that apply.
Couldn’t afford to buy more food (1)
Couldn’t get to store to buy food (for example, didn’t have transportation, have mobility or health limitations that prevent you from getting out) (2)
Couldn’t go to store due to safety concerns (3)
None of the above (4)
FD4 During the last 7 days, did you or anyone in your household get free groceries from a food pantry, food bank, church, or other place that provides free food? Select only one answer.
Yes (1)
No (2)
FD6_rev Do you or does anyone in your household currently receive benefits from… Select all that apply.
Supplemental Nutrition Assistance Program (SNAP) or Food Stamp Program (1)
WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) (2)
Free or reduced-price meals at school through NSLP (National School Lunch Program) (3)
Summer EBT (Electronic Benefits Transfer) or SUN Bucks (6)
None of these (5)
Start of Block: Housing
HSE1
The next questions ask about housing.
Is your house or
apartment…? Select only one answer.
Owned by you or someone in this household free and clear? (1)
Owned by you or someone in this household with a mortgage or loan (including home equity loans)? (2)
Rented? (3)
Occupied without payment of rent? (4)
Display This Question:
If HSE1 = Rented?
HSE3 Is this household currently caught up on rent payments? Select only one answer.
Yes (1)
No (2)
Display This Question:
If HSE1 = Owned by you or someone in this household with a mortgage or loan (including home equity loans)?
HSE4 Is this household currently caught up on mortgage payments? Select only one answer.
Yes (1)
No (2)
Display This Question:
If HSE3 = No
Or HSE4 = No
HSE6 How many months behind is this household in paying your rent or mortgage?
________________________________________________________________
Display This Question:
If HSE3 = No
HSE8 How likely is it that your household will have to leave this home or apartment within the next 2 months because of eviction? Select only one answer.
Very likely (1)
Somewhat likely (2)
Not very likely (3)
Not likely at all (4)
Display This Question:
If HSE4 = No
HSE9 How likely is it that your household will have to leave this home within the next 2 months because of foreclosure? Select only one answer.
Very likely (1)
Somewhat likely (2)
Not very likely (3)
Not likely at all (4)
HSE14 In the last 2 months, Did your household reduce or forego expenses for basic household necessities, such as medicine or food, in order to pay an energy bill?
Yes (1)
No (2)
HSE15 In the last 2 months, did your household keep your home at a temperature that you felt was unsafe or unhealthy?
Yes (1)
No (2)
HSE16 In the last 2 months, was your household unable to pay an energy bill or unable to pay the full bill amount?
Yes (1)
No (2)
HEAT1. Which of the following cooling devices do you have in your home? (mark all the apply)
Central Air Conditioning
Window Air Conditioning units
Fans
Evaporative Coolers (swamp coolers)
Other cooling devices
HEAT2. This summer, have you been able to keep your home at a safe and healthy temperature on hot days? (Pick one)
Yes
Sometimes
No
HEAT3. [If HEAT1==1 or HEAT1==2) and (HEAT2=2 or HEAT2=3) What prevents you from keeping your home safe and healthy temperature? (select all that apply)
My air conditioning is not strong enough to keep my home cool.
My air conditioning is not working.
I cannot afford to run my air conditioning at all.
I cannot afford to run my air conditioning as much needed to keep my home cool enough.
The power frequently goes out.
Other
HEAT4. [If HEAT1 ne 1 and HEAT1 ne 2) and (HEAT2=2 or HEAT2=3) What prevents you from keeping your home safe and healthy temperature? (select all that apply)
My cooling devices are not strong enough to keep my home cool.
My cooling devices are not working.
I cannot afford to run my cooling devices at all.
I cannot afford to run my cooling devices as much needed to keep my home cool enough.
The power frequently goes out.
I don’t have air conditioning.
HEAT5. A cooling shelter is an air-conditioned or cooled location that has been designated as a place to go to cool off in extreme heat. Do you or members of your household ever go to a cooling shelter on hot days? (Pick one)
Yes
No
We don’t need to go to a cooling shelter
HEAT6. [If HEAT5==1] Do you face any of these issues with the cooling shelter? (Select all that apply)
The cooling shelter is too crowded
The cooling shelter is not open when I/we want to go
The nearest cooling shelter is far away or difficult to reach
Someone in my household needs medical or mobility support that is not available at the cooling shelter
I don’t feel safe at the cooling shelter
The cooling shelter does not allow pets
Other issues
N/A. No issues with the cooling shelter
HEAT7. [If Q5==2] Why don’t you go to a cooling shelter on hot days? (Select all that apply)
The cooling shelter is too crowded
The cooling shelter is not open when I/we want to go
The nearest cooling shelter is far away or difficult to reach
Someone in my household needs medical or mobility support that is not available at the cooling shelter
I don’t feel safe at the cooling shelter
The cooling shelter does not allow pets
I don’t know where to find a cooling shelter
I don’t need a cooling shelter
Other issues
Start of Block: Trust
Trust1 The population count, the crime rate, and the unemployment rate are examples of statistics produced by the federal government. Personally, how much trust do you have in federal statistics in the United States? Would you say that you tend to trust federal statistics or you tend not to trust them?
Tend to trust federal statistics (1)
Tend not to trust federal statistics (2)
Trust2 Below is a list of institutions in American society. Please indicate how much confidence you, yourself, have in each one.
|
A great deal (1) |
Quite a lot (2) |
Some (3) |
Very little (4) |
The military (1) |
|
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The police (4) |
|
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|
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The U.S. Supreme Court (5) |
|
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The presidency (6) |
|
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Public schools (7) |
|
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The criminal justice system (8) |
|
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Congress (9) |
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U.S. Census Bureau (10) |
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U.S. statistical agencies (11) |
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Trust3 To what extent do you agree or disagree with the following statement? Policy makers need federal statistics to make good decisions about things like federal funding.
Strongly agree (1)
Somewhat agree (2)
Neither agree nor disagree (3)
Somewhat disagree (4)
Strongly disagree (5)
End of Block: Trust
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |