The Survery of the Health of Wisconsin (SHOW) gathers data on health and a wide range of health determinants including social and economic factors, health care access, mental health, quality of life, discrimination and neighborhood perceptions.

Questionnaire topics

Below is an expanded summary of data SHOW collects and tests administered for each topic.

Demographics

Demographics data include, for example, age, sex, education, racial and ethnic ancestry as well as individual and household reported income and number of individuals in the household. Poverty levels are determined using U.S. Department of Health and Human Services poverty guidelines. See economic hardship.

Health and health history

Health questions include respondent’s diagnosed health conditions, including chronic conditions and their medical treatment. Health history questions capture information on family history of certain conditions such as diabetes, Alzheimer’s disease, dementia, asthma, heart attack and stroke. We combine information from multiple questions or reformat responses in order to derive details for certain conditions, which are listed below.

Asthma

Variables on the diagnosis, awareness (undiagnosed asthma), treatment and control of asthma.

Cardiovascular health

The cardiovascular health index (2008-13, modified from Folsom AR et al 2011, see codebook) is based on meeting the American Heart Association's recommendation for seven components of a healthy lifestyle, which include:

  • smoking status
  • body mass index
  • physical activity
  • diet
  • total cholesterol
  • blood pressure
  • and hemoglobin A1c

Changes to the diet instrument in 2014 changed this derived variable.

Chronic health conditions

A derived variable depicts a history of one or more of the following health conditions:

  • coronary heart disease (angina or myocardial infarction)
  • stroke
  • diabetes
  • asthma
  • chronic obstructive pulmonary disease
  • chronic bronchitis
  • arthritis
  • cancer

Cognitive function

The first part of the cognitive instrument includes a common verbal category fluency test in which respondents are asked to name as many different animals as they can in one minute. Following this exercise, the Mini-Cog test is administered, a three-minute screening instrument for cognitive impairment.

The Mini-Cog uses a three-item recall test for memory and a simply scored clock-drawing test. The latter serves as an “informative distractor,” helping to clarify scores when the memory recall score is intermediate. In 2008-13, all adults received cognitive testing. From 2014-present, adults 60 and older were asked to complete testing.

Diabetes

Variables on the diagnosis, awareness (undiagnosed diabetes), treatment, and control of diabetes.

General health status

The SF-12v2 Health Survey Standard Version from Quality Metric Health Outcomes instrument captures an individual’s perceived health status, including the physical component summary and mental component summary scores.

Hypertension

Variables on the diagnosis, awareness (undiagnosed hypertension), treatment, and control of hypertension.

Reproductive health

Information on female reproductive health includes questions on hormone use, pregnancy and maternity. It also includes questions about common screening tests that have been recommended for women at different ages by a variety of health organizations.

Sleep

Questions on individuals’ sleep patterns, sleep duration, sleep quality and disorders related to sleep.

Mental health

Cognitive function

The first part of the cognitive instrument includes a common verbal category fluency test in which respondents are asked to name as many different animals as they can in one minute. Following this exercise, the Mini-Cog test is administered, a 3-minute screening instrument for cognitive impairment.

The Mini-Cog uses a three-item recall test for memory and a simply scored clock-drawing test. The latter serves as an “informative distractor,” helping to clarify scores when the memory recall score is intermediate. From 2008-13, all adults received cognitive testing. From 2014-present, adults 60 and older were asked to complete testing.

Depression

The Patient Health Questionnaire (PHQ-8) eight-item instrument provides a diagnostic and severity measure of depression. The PHQ-8 (administered from 2008-13) is based on DSM-IV diagnostic criteria for depression. The PHQ-2 screener for depression (2014-present) uses the first two items of the PHQ-8, (frequency of depressed mood and anhedonia over the past two weeks).

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) Checklist – Civilian Version for DSM-IV (PCL-C, administered 2008-2012) is a standardized self-report rating scale for PTSD comprised of 17 items that correspond to the key symptoms of PTSD, applied generally to any traumatic event. In 2014-present, the six-item abbreviated PTSD Checklist, a shortened version of the PCL-C (including items 1, 4, 7, 10, 14, and 15), as well as item 13 from the PCL-C was administered.

Stress

This instrument measures how often people have feelings and behaviors that might indicate stress, anxiety, and depression. The first part of the questionnaire is based on the Global Perceived Stress Scale, an eight-item self-report measure of perceived chronic stress, originally created for use in the Jackson Heart Study. The 21-item Depression, Anxiety and Stress Scale (DASS) was administered in 2008-2013 and the 7-item shortened version of the DASS in 2014-present.

Health care

Health insurance

The insurance, access, and utilization instrument includes questions on respondents’ health insurance status as well as their access to and use of the health care system.

Prescription medication

Prescription medications used in the last 30 days as well as select over the counter medications are captured.

Health-related behaviors

Alcohol

Respondents’ history of drinking alcoholic beverages. Heavy drinking is defined as consuming more than 14 drinks per week for men or more than seven drinks per week for women.

Contraception

Variables on contraceptive use, types of contraception used, and reasons for not using contraception.

Diet and food

A diet questionnaire that focuses on the frequency of certain types of foods in one's diet, frequency of eating home prepared food, restaurant and fast food. Participants are also asked about growing or producing their own food. See food frequency.

Food frequency

Modified version of the Block Dietary Data Systems (BDDS) questionnaire created by NutritionQuest, a food frequency screener on fat, sugar, fruit and vegetable intake, administered in 2008-13. Beginning in 2014, the modified from NHANES' 26-item Dietary Screener Questionnaire (DSQ) was used, which asks about the frequency of consumption in the past month of selected foods and drinks. This instrument captures intakes of fruits and vegetables, dairy/calcium, added sugars, whole grains/fiber, red meat, and processed meat.

Physical activity

Physical activity and physical fitness questions on activities done over a typical week or typical day. The first series of questions are related to work, then transportation, followed by questions regarding physical activities during recreational time. A modified version of the NHANES physical activity questionnaire was administered in 2008-13. The Global Physical Activity Questionnaire (GPAQ) was administered in 2014-present. The last series of questions of the GPAQ are related to activities that involve sitting.

Screening, prevention and safety habits

Questions on common screening tests and vaccinations that have been recommended for different age groups by different health organizations as well as information relating to an individual's prevention and safety habits.

Smoking history and exposure to smoke

Respondent's smoking history, age when smoking started/ended, and the exposure to second-hand smoking.

Sexual behavior and identity

A sexual behavior module provided information on sexual history and behaviors in 2008-13. Beginning in 2014, to present, the module asks about sexual identity.

Weight history

Weight history provides specific information relating to the actual and perceived weight of the respondent over his/her lifetime. Methods used to lose or maintain weight are also ascertained.

Physical and built environment

Geography

Geography data includes U.S. Census geography at the block group level or higher, as well as RUCA, Six State, and Census urban rural classifications for each respondent's residence. Data linkages between external data and SHOW data by census block group can be completed in the SHOW offices.

Housing characteristics

A housing characteristics questionnaire provides specific information relating to the physical home environment.

Neighborhood

The Characteristics of your Neighborhood questionnaire provides specific information on walking distances to destinations and subjective evaluations of the neighborhood. Destinations include park, trail, pool, fitness center, grocery store, library, school, restaurants and fast food, pharmacy, salon, church, and others.

Walk Score

Walk Score, Bike Score, and Transit Score results were calculated by and obtained from the Walk Score website based on respondent addresses. This codebook includes scores for adults and minors.

Wisconsin Assessment of the Social and Built Environment (WASABE) (2009-10)

For select 2009 and 2010 households, an objective audit of the 400-meter street network buffer surrounding SHOW households was completed to assess the social and built environment.

Social and economic determinants

Caregiving

A module on caregiving was administered in 2008-13 for specific information regarding current or past unpaid regular care provided to a friend or family member made necessary due to disability or illness. Beginning in 2014, questions were abbreviated to only inquire on current or in past 12 months provision of unpaid regular care.

Discrimination

A module on discrimination asks questions on how the respondent has been treated during his/her life. Answers to questions regarding unfair treatment related to race, age, gender, culture, religion, physical appearance, and sexual orientation are recorded.

Economic hardship

The Economic Hardship Index is calculated based on unemployment rate, proportion dependent population, education, income level, proportion in crowded housing, and proportion in poverty at the census block group, census tract, and county levels. Values are scaled to zero to 100 for each dimension using the minimum and maximum values within the state at each geographic level. A composite score is calculated using the scaled values from each dimension with equal weighting, then ranked within each geographic level. A lower rank indicates less economic hardship.

Food security

A module on food security includes questions on concerns about having enough food or about the costs of food for the respondent or his/her family.

Health literacy

The Short Test of Functional Health Literacy in Adults was administered in 2008-13. In 2014-present, literacy has been assessed using the Rapid Estimate of Adult Literacy in Medicine short form. Participants are also asked whether they need help with written health materials.

Military experience

Military service in the United States Armed Forces, either in the regular military or in the National Guard or reserve unit, is recorded. In 2014-present, questions on military experience are asked in the Demographics instrument.

Occupation

Questions on respondent’s work experience with details on the type of work done and duties performed so that this information can be accurately categorized into an industry and an occupation code from the Census 2000 Industry and Occupation Index.

Quality of life (2008-13)

The EQ-5D is a standardized instrument for use as a measure of health outcome, providing a simple descriptive profile and a single index value for health status. EQ-5D is produced and maintained by the EuroQol Group.

Sense of community (2014-present)

This questionnaire includes measures of sociopolitical control, sense of community and community participation.

Stress

This instrument measures how often people have feelings and behaviors that might indicate stress, anxiety, and depression. The first part of the questionnaire is based on the Global Perceived Stress Scale, an 8-item self-report measure of perceived chronic stress, originally created for use in the Jackson Heart Study. The 21-item Depression, Anxiety and Stress Scale (DASS) was administered in 2008-2013 and the 7-item shortened version of the DASS in 2014-present.

Life events

The Life Events questionnaire is a 42-item instrument for capturing an individual’s major life events linked to stress, scored as the social readjustment rating scale. This section is based on the premise that good and bad events in one's life can increase stress levels and make one more susceptible to illness and mental health problems (Holmes & Rahe, 1967; see codebooks).