CDE Detailed Report

Disease: Sport Related Concussion
Subdomain Name: Social Status
CRF: Socioeconomic Status

Displaying 1 - 28 of 28
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C00004 Birth country ISO code BirthCntryISOCode Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born Code (ISO 3166-1 alpha-2 code) for country where the participant/subject was born Birth country name through corresponding ISO 3166 1 alpha 2 code AF;AX;AL;DZ;AS;AD;AO;AI;AQ;AG;AR;AM;AW;AU;AT;AZ;BS;BH;BD;BB;BY;BE;BZ;BJ;BM;BT;BO;BQ;BA;BW;BV;BR;IO;BN;BG;BF;BI;KH;CM;CA;CV;KY;CF;TD;CL;CN;CX;CC;CO;KM;CG;CD;CK;CR;CI;HR;CU;CW;CY;CZ;DK;DJ;DM;DO;EC;EG;SV;GQ;ER;EE;ET;FK;FO;FJ;FI;FR;GF;PF;TF;GA;GM;GE;DE;GH;GI;GR;GL;GD;GP;GU;GT;GG;GN;GW;GY;HT;HM;VA;HN;HK;HU;IS;IN;ID;IR;IQ;IE;IM;IL;IT;JM;JP;JE;JO;KZ;KE;KI;KP;KR;KW;KG;LA;LV;LB;LS;LR;LY;LI;LT;LU;MO;MK;MG;MW;MY;MV;ML;MT;MH;MQ;MR;MU;YT;MX;FM;MD;MC;MN;ME;MS;MA;MZ;MM;NA;NR;NP;NL;NC;NZ;NI;NE;NG;NU;NF;MP;NO;OM;PK;PW;PS;PA;PG;PY;PE;PH;PN;PL;PT;PR;QA;RE;RO;RU;RW;BL;SH;KN;LC;MF;PM;VC;WS;SM;ST;SA;SN;RS;SC;SL;SG;SX;SK;SI;SB;SO;ZA;GS;SS;ES;LK;SD;SR;SJ;SZ;SE;CH;SY;TW;TJ;TZ;TH;TL;TG;TK;TO;TT;TN;TR;TM;TC;TV;UG;UA;AE;GB;US;UM;UY;UZ;VU;VE;VN;VG;VI;WF;EH;YE;ZM;ZW AFGHANISTAN;ALAND ISLANDS;ALBANIA;ALGERIA;AMERICAN SAMOA;ANDORRA;ANGOLA;ANGUILLA;ANTARCTICA;ANTIGUA AND BARBUDA;ARGENTINA;ARMENIA;ARUBA;AUSTRALIA;AUSTRIA;AZERBAIJAN;BAHAMAS;BAHRAIN;BANGLADESH;BARBADOS;BELARUS;BELGIUM;BELIZE;BENIN;BERMUDA;BHUTAN;BOLIVIA, PLURINATIONAL STATE OF;BONAIRE, SINT EUSTATIUS AND SABA;BOSNIA AND HERZEGOVINA;BOTSWANA;BOUVET ISLAND;BRAZIL;BRITISH INDIAN OCEAN TERRITORY;BRUNEI DARUSSALAM;BULGARIA;BURKINA FASO;BURUNDI;CAMBODIA;CAMEROON;CANADA;CAPE VERDE;CAYMAN ISLANDS;CENTRAL AFRICAN REPUBLIC;CHAD;CHILE;CHINA;CHRISTMAS ISLAND;COCOS (KEELING) ISLANDS;COLOMBIA;COMOROS;CONGO;CONGO, THE DEMOCRATIC REPUBLIC OF THE;COOK ISLANDS;COSTA RICA;COTE D'IVOIRE;CROATIA;CUBA;CURACAO;CYPRUS;CZECH REPUBLIC;DENMARK;DJIBOUTI;DOMINICA;DOMINICAN REPUBLIC;ECUADOR;EGYPT;EL SALVADOR;EQUATORIAL GUINEA;ER;ESTONIA;ETHIOPIA;FALKLAND ISLANDS (MALVINAS);FAROE ISLANDS;FIJI;FINLAND;FRANCE;FRENCH GUIANA;FRENCH POLYNESIA;FRENCH SOUTHERN TERRITORIES;GABON;GAMBIA;GEORGIA;GERMANY;GHANA;GIBRALTAR;GREECE;GREENLAND;GRENADA;GUADELOUPE;GUAM;GUATEMALA;GUERNSEY;GUINEA;GUINEA-BISSAU;GUYANA;HAITI;HEARD ISLAND AND MCDONALD ISLANDS;HOLY SEE (VATICAN CITY STATE);HONDURAS;HONG KONG;HUNGARY;ICELAND;INDIA;INDONESIA;IRAN, ISLAMIC REPUBLIC OF;IRAQ;IRELAND;ISLE OF MAN;ISRAEL;ITALY;JAMAICA;JAPAN;JERSEY;JORDAN;KAZAKHSTAN;KENYA;KIRIBATI;KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF;KOREA, REPUBLIC OF;KUWAIT;KYRGYZSTAN;LAO PEOPLE'S DEMOCRATIC REPUBLIC;LATVIA;LEBANON;LESOTHO;LIBERIA;LIBYA;LIECHTENSTEIN;LITHUANIA;LUXEMBOURG;MACAO;MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF;MADAGASCAR;MALAWI;MALAYSIA;MALDIVES;MALI;MALTA;MARSHALL ISLANDS;MARTINIQUE;MAURITANIA;MAURITIUS;MAYOTTE;MEXICO;MICRONESIA, FEDERATED STATES OF;MOLDOVA, REPUBLIC OF;MONACO;MONGOLIA;MONTENEGRO;MONTSERRAT;MOROCCO;MOZAMBIQUE;MYANMAR;NAMIBIA;NAURU;NEPAL;NETHERLANDS;NEW CALEDONIA;NEW ZEALAND;NICARAGUA;NIGER;NIGERIA;NIUE;NORFOLK ISLAND;NORTHERN MARIANA ISLANDS;NORWAY;OMAN;PAKISTAN;PALAU;PALESTINIAN TERRITORY, OCCUPIED;PANAMA;PAPUA NEW GUINEA;PARAGUAY;PERU;PHILIPPINES;PITCAIRN;POLAND;PORTUGAL;PUERTO RICO;QATAR;REUNION;ROMANIA;RUSSIAN FEDERATION;RWANDA;SAINT BARTHELEMY;SAINT HELENA, ASCENSION AND TRISTAN DA CUNHA;SAINT KITTS AND NEVIS;SAINT LUCIA;SAINT MARTIN (FRENCH PART);SAINT PIERRE AND MIQUELON;SAINT VINCENT AND THE GRENADINES;SAMOA;SAN MARINO;SAO TOME AND PRINCIPE;SAUDI ARABIA;SENEGAL;SERBIA;SEYCHELLES;SIERRA LEONE;SINGAPORE;SINT MAARTEN (DUTCH PART);SLOVAKIA;SLOVENIA;SOLOMON ISLANDS;SOMALIA;SOUTH AFRICA;SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS;SOUTH SUDAN;SPAIN;SRI LANKA;SUDAN;SURINAME;SVALBARD AND JAN MAYEN;SWAZILAND;SWEDEN;SWITZERLAND;SYRIAN ARAB REPUBLIC;TAIWAN, PROVINCE OF CHINA;TAJIKISTAN;TANZANIA, UNITED REPUBLIC OF;THAILAND;TIMOR-LESTE;TOGO;TOKELAU;TONGA;TRINIDAD AND TOBAGO;TUNISIA;TURKEY;TURKMENISTAN;TURKS AND CAICOS ISLANDS;TUVALU;UGANDA;UKRAINE;UNITED ARAB EMIRATES;UNITED KINGDOM;UNITED STATES;UNITED STATES MINOR OUTLYING ISLANDS;URUGUAY;UZBEKISTAN;VANUATU;VENEZUELA, BOLIVARIAN REPUBLIC OF;VIET NAM;VIRGIN ISLANDS, BRITISH;VIRGIN ISLANDS, U.S.;WALLIS AND FUTUNA;WESTERN SAHARA;YEMEN;ZAMBIA;ZIMBABWE Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C12605 Caregiver primary type CaregvrPrimryType Type of relationship that the person who serves as the participant/subject's primary caregiver has with the participant/subject Type of relationship that the person who serves as the participant/subject's primary caregiver has with ther participant/subject Primary caregiver for the participant/ subject: Self;Sibling;Spouse or partner;Home aide;Parent or legal guardian;Long-term care/nursing facility staff;Child;Other, specify Self;Sibling;Spouse or partner;Home aide;Parent or legal guardian;Long-term care/nursing facility staff;Child;Other, specify Alphanumeric

Choose all that apply

Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Socioeconomic Status Social Status Participant Characteristics

Multiple Pre-Defined Values Selected

C21660 Caregiver marital or partner status CargvrMartlPartnerStatus Status of participant/subject's caregiver's current domestic relationship, whether marital or partnered Status of participant/subject's caregiver's current domestic relationship, whether marital or partnered Caregiver marital/partner status Never married;Married;Domestic partnership;Divorced;Separated;Widowed Never married;Married;Domestic partnership;Divorced;Separated;Widowed Alphanumeric

Choose one

Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00005 Birth country name BirthCntryName Name for country where the participant/subject was born Name for country where the participant/subject was born Birth country name Alphanumeric

Choose one. It may be easier to record the full name of the country and code the data later using the ISO 3166-1 alpha-2 codes.

ISO 3166-1 alpha-2 codes (http://www.iso.org/iso/iso_3166_code_lists) Adult;Pediatric Supplemental 3.00 2013-07-24 21:00:23.88 Socioeconomic Status Social Status Participant Characteristics 255

Free-Form Entry

C12606 Health insurance private group type HlthInsPrivatGrpTyp Type of private or group health insurance, if any, in which the participant/subject is currently enrolled Type of private or group health insurance, if any, in which the participant/subject is currently enrolled Health insurance private or group type (U.S. Specific): Traditional indemnity plan, often called fee-for-service plan;Health Maintenance Organization;Individual Practice Association;Preferred Provider Organization;Point-of-Service;Other, specify Traditional indemnity plan, often called fee-for-service plan;Health Maintenance Organization (HMO);Individual Practice Association (IPA);Preferred Provider Organization (PPO);Point-of-Service (POS);Other, specify Alphanumeric

Choose all that apply

Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C55459 Repeated grade indicator RepeatedGradeInd Indicator that the child has repeated any grades Indicator that the child has repeated any grade Has participant repeated a grade in the past (choose one)? No;Yes;Unknown No;Yes;Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-05 13:55:50.0 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00012 Education level USA type EduLvlUSATyp Highest grade or level of school participant/subject has completed or the highest degree received Highest grade or level of school participant/subject has completed or the highest degree received Education level: (select the highest level attained) Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational/technical/vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

3134878
C12819 Disability benefit indicator DisabltyBenefitInd Indicator of whether participant/subject receives disability benefit payments Indicator of whether participant/subject receives disability benefit payments Disability benefits: Yes;No;Unknown;Not applicable Yes;No;Unknown;Not applicable Alphanumeric

Choose one

No references available Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C55460 Education level parent 1 type EduLvlPrnt1USATyp Highest grade or level of school the participant's/subject's parent has completed or the highest degree he/she has received Highest grade or level of school the participant's/subject's parent has completed or the highest degree he/she has received Parent 1 education level: (select the highest level attained) Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric (NHANES); National Health Interview Survey (NHIS); PhenX Toolkit (https://www.phenxtoolkit.org) Current Educational Attainment #011001 Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00013 Education level primary caregiver USA type EduLvlPrimCaregiverUSATyp Highest grade or level of school the participant's/subject's primary caregiver has completed or the highest degree he/she has received Highest grade or level of school the participant's/subject's primary caregiver has completed or the highest degree he/she has received What is the highest grade or level of school the participant's/subject's primary caregiver has completed or the highest degree obtained? (Choose one): Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric

Choose the highest level attained by the participant/subject's primary caregiver. This element is recommended for Pediatric stroke studies. Choose highest level attained.

National Health and Nutrition Examination Survey (NHANES); National Health Interview Survey (NHIS); PhenX Toolkit (https://www.phenxtoolkit.org) Current Educational Attainment #011001 Adult;Pediatric Core 3.00 2013-07-20 10:21:25.65 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C17402 Site name SiteName The name of the site for the study The name of the site for the study Site Name: Alphanumeric Adult;Pediatric Supplemental 3.00 2013-06-21 00:00:00.0 Socioeconomic Status Social Status Participant Characteristics 255

Free-Form Entry

C55461 Education Level parent 2 type EduLvlPrnt2USATyp Highest grade or level of school the participant's/subject's parent has completed or the highest degree he/she has received Highest grade or level of school the participant's/subject's parent has completed or the highest degree he/she has received Parent 2 education level: (select the highest level attained) Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Never attended/Kindergarten only;1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;GED or equivalent;Some college, no degree;Associate degree: occupational, technical, or vocational program;Associate degree: academic program;Bachelor's degree (e.g., BA, AB, BS, BBA);Master's degree (e.g., MA, MS, MEng, MEd, MBA);Professional school degree (e.g., MD, DDS, DVM, JD);Doctoral degree (e.g., PhD, EdD);Unknown Alphanumeric (NHANES); National Health Interview Survey (NHIS); PhenX Toolkit (https://www.phenxtoolkit.org) Current Educational Attainment #011001 Adult;Pediatric Supplemental 3.00 2013-07-20 10:21:25.65 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00202 Education school participation status EduSchoolParticipStatus Status of participant/subject's current attendance at school Status of participant/subject's current attendance at school School status Going to school;On vacation from school (between grades);Neither;Unknown Going to school;On vacation from school (between grades);Neither;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C17499 Special education indicator SpecialEduInd Indicator as to whether the participant/subject has or had special education Indicator as to whether the participant/subject has or had special education Has participant had special education services? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-15 16:08:48.687 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C55466 Housing type HousingTyp Type of housing where the participant/subject is currently living Type of housing where the participant/subject is currently living Type of housing (choose one): Apartment;Single family house;Homeless;Shelter;Dormitory;Multifamily house Apartment;Single family house;Homeless;Shelter;Dormitory;Multifamily house Alphanumeric

Choose one

Adult;Pediatric Supplemental 1.00 2017-05-11 13:16:17.0 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00205 Family income range FmlyIncRng Range, in U.S. dollars, of the annual pre-tax, pre-deduction total income, of the household of which the participant/subject is a member Range, in U.S. dollars, of the annual pre-tax, pre-deduction total income, of the household of which the participant/subject is a member Total annual gross income of a household including the participant/ subject. $15,000 to $24,999;$25,000 to $34,999;$35,000 to $49,999;$50,000 to $74,999;$75,000 to $99,999;$100,000 and over;Refused;Unknown;Under $15,000 $15,000 to $24,999;$25,000 to $34,999;$35,000 to $49,999;$50,000 to $74,999;$75,000 to $99,999;$100,000 and over;Refused;Unknown;Under $15,000 Alphanumeric

Choose one. This includes pre-tax cash income earned by persons, money wages and salaries, self-employment income, property income (dividends, interest and rents), money transfer payments from a variety of government and private welfare and social insurance schemes (such as social security, unemployment and workers' compensation, and public assistance), private and government retirement income, interpersonal transfers (such as alimony and child support) and other periodic income. This excludes certain lump sum payments and capital gains. Add date stamp for when assessed. Recommend collection at least on date of TBI and perhaps after all initial medical treatment.

Women's Health Initiative American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau. http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C18684 Health insurance other text HlthInsOTH The free-text field related to 'Health insurance type' specifying other text. Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care The free-text field related to 'Health insurance type' specifying other text. Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care Other, specify Alphanumeric Adult;Pediatric Supplemental 1.00 2014-05-27 13:34:46.0 Socioeconomic Status Social Status Participant Characteristics 4000

Free-Form Entry

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C55471 Participant head of household status HeadHouseParticpStatus Status of participant/subject's household Status of participant/subject's household Participant Household Status (From Head to Head study) Head of Household;Not Head of Household Head of Household;Not Head of Household Alphanumeric Adult;Pediatric Supplemental 1.00 2017-05-11 13:45:24.0 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00206 Family income supported persons count FamilyIncmeSupprtPersCt Count of all people, including the participant/subject, who are supported by the household gross annual income reported Count of all people, including the participant/subject, who are supported by the household gross annual income reported Number of people supported by this income, including you: Numeric Values American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau. http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Free-Form Entry

1 99
C18861 Health insurance private group other text HlthInsPrivatGrpOTH The free-text field related to 'Health insurance private group type' specifying other text. Type of private or group health insurance, if any, in which the participant/subject is currently enrolled The free-text field related to 'Health insurance private group type' specifying other text. Type of private or group health insurance, if any, in which the participant/subject is currently enrolled Other, specify: Alphanumeric Adult;Pediatric Supplemental 3.00 2013-07-24 11:38:01.2 Socioeconomic Status Social Status Participant Characteristics 4000

Free-Form Entry

C00207 Marital or partner status MartlPartnerStatus Status of participant/subject's current domestic relationship, whether marital or partnered Status of participant/subject's current domestic relationship, whether marital or partnered Marital/partner status (choose one): Never married;Married;Domestic partnership;Divorced;Separated;Widowed Never married;Married;Domestic partnership;Divorced;Separated;Widowed Alphanumeric

Choose the current marital status of the participant/subject

Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: the national longitudinal mortality study. Ann Epidemiol. 2000;10: 224-238. Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

2188083
C19247 Subject ID SubIDNam Subject identification ID Subject identification ID Subject ID: Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 13:10:49.0 Socioeconomic Status Social Status Participant Characteristics 255

Free-Form Entry

C00214 Living with persons count PrsnCohabitCt Count of other people with whom the participant/subject currently lives, cohabits, or stays Count of other people with whom the participant/subject currently lives, cohabits, or stays Number of people the participant/subject lives or stays with: Numeric Values

Include everyone who is living or staying here for more than 2 months. Include anyone else staying here who does not have another place to stay even if they are here for 2 months or less. Do not include anyone who is living somewhere else for more than 2 months, such as college student living away or someone in the Armed Forces on deployment.

American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau. http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Free-Form Entry

0 99
C19257 Residence area type ResidenceAreaTyp Type describing the participant's/subject's current location of residence Type describing the participant's/subject's current location of residence Area of residence: A big city (population >= 250,000) including suburbs/outskirts;A small town/ small city (population 500-10,000);Rural area (population =< 500);Unknown A big city (population >= 250,000) including suburbs/outskirts;A small town/ small city (population 500-10,000);Rural area (population =< 500);Unknown Alphanumeric Adult;Pediatric Supplemental 1.00 2014-06-05 17:27:45.0 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00215 Living with person relationship type LivPrsnRltnshpTyp Type(s) of relationship(s) between the participant/subject and all people with whom she or he currently lives, cohabits, or stays Type(s) of relationship(s) that obtain between the participant/subject and all people with whom she or he currently lives, cohabits, or stays Persons living with Husband or wife;Biological son or daughter;Adopted son or daughter;Stepson or stepdaughter;Brother or sister;Father or mother;Stepfather or stepmother;Grandchild;Grandparent;Parent-in-law;Son-in-law or daughter-in-law;Other relative;Roomer or boarder;Housemate or roommate;Unmarried partner;Foster child;Other nonrelative;Military unit member;N/A - Homeless;N/A - Alone;Personal care attendant;Other patient/ resident in care facility;Unknown Husband or wife;Biological son or daughter;Adopted son or daughter;Stepson or stepdaughter;Brother or sister;Father or mother;Stepfather or stepmother;Grandchild;Grandparent;Parent-in-law;Son-in-law or daughter-in-law;Other relative;Roomer or boarder;Housemate or roommate;Unmarried partner;Foster child;Other nonrelative;Military unit member;N/A - Homeless;N/A - Alone;Personal care attendant;Other patient/ resident in care facility;Unknown Alphanumeric

Choose all that apply

American Community Survey questionnaire. U.S. Department of Commerce, U.S. Census Bureau. http://www.census.gov/acs/www/Downloads/questionnaires/2012/Quest12.pdf Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Multiple Pre-Defined Values Selected

C19279 Citizen country indicator CitizenCountryInd The indicator for whether participant is a citizen of country The indicator for whether participant is a citizen of countr Are you a citizen of (country)? No;Yes;Unknown No;Yes;Unknown Alphanumeric

(country)

Adult;Pediatric Supplemental 1.00 2014-06-06 10:43:21.0 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

C00226 Health insurance type HlthInsTyp Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care Type of insurance that the participant/subject currently has providing coverage for medical, surgical or hospital care Type of health insurance: Medicaid;Medicare;Employer-sponsored disability insurance;Private or group health insurance;National Health Insurance;Veterans Affairs/Military;No Insurance/Self-pay;Unknown;Other, specify Medicaid;Medicare;Employer-sponsored disability insurance;Private or group health insurance;National Health Insurance;Veterans Affairs/Military;No Insurance/Self-pay;Unknown;Other, specify Alphanumeric

Choose all that apply

NHLBI CDE from https://cdebrowser.nci.nih.gov/CDEBrowser/ Adult;Pediatric Supplemental 3.00 2013-07-25 08:54:08.2 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

2953262
C19287 Income basic needs status IncomeBasicNeedsStatus The status of how the household currently manages to meet basic needs as defined by food, shelter and clothing The status of how the household currently manages to meet basic needs as defined by food, shelter and clothin How well do you manage with your current household income? Very well;Very poorly;Rather well;Rather poorly;Adequately (neither well nor poorly);Refused to answer;Unknown;Not applicable Very well;Very poorly;Rather well;Rather poorly;Adequately (neither well nor poorly);Refused to answer;Unknown;Not applicable Alphanumeric

Choose one. The status of how the household currently manages to meet basic needs as defined by food, shelter and clothing.

Adult;Pediatric Exploratory 1.00 2014-06-06 11:03:24.0 Socioeconomic Status Social Status Participant Characteristics

Single Pre-Defined Value Selected

CSV