Household Interview English -...

Questionnaire

Brazilian Longitudinal Study of Aging (ELSI-Brazil)

2

Enrollment section

BEGINNING SECTION - ENROLLMENT

Our interview begins with the Household Module. This section can be answered by any

household resident who is able to provide accurate information about the other

residents.

Now let's start the interview with general questions about the residents of this house.

iddom HOUSEHOLD ID |__|__|__|__|__|

________________________________________

region Region

(1) North

(2) Northeast

(3) Southeast

(4) South

(5) Center-West

zone Zone (1) Urban

(2) Rural

ar4

Date of interview:

___|___|___

Today!

ar5 Name of interviewer:

________________________________________

ar6

In total, how many people live in this

home?

Resident: is a person who has the

household as a usual place of

residence at the time of the interview.

Household: is a place that is

structurally separated and

independent, used as housing for one

or more people.

|__|__| residents

Resident ID |__|__|

ar7 Full name (do not abbreviate) of the

head of the household: |__|__|__|__|__|__|__|__|__|__|

ar8 What is the gender of Mr. /Mrs. (name

of the head of the household)?

(0) Female

(1) Male

ar9 What is the date of birth of Mr./Mrs.

(name of the head of the household)?

|__|__|/|__|__|__|/|__|__|__|__|

(99999999999) Didn’t know/didn’t answer

ar10

How old is Mr. /Mrs. (name of the

head of the household) at the date of

the interview?

|__|__| years

ar11_1 a

ar11_14

Full name (do not abbreviate) of the

other resident of the household: |__|__|__|__|__|__|__|__|__|__|

ar12_1 a

ar12_14

What is the gender of Mr. /Mrs. (name

of the other household resident)?

(0) Female

(1) Male

Questionnaire


3

ar13_1 a

ar13_14

What is the date of birth of Mr. /Mrs.

(name of the other household

resident)?

|__|__| /|__|__|__|/|__|__|__|__| (999) Didn’t know/didn’t answer

ar14_1 a

ar14_14

How old is Mr. /Mrs. (name of the

other household resident) at the date

of the interview?

|__|__| years


ar15_1 a

ar15_14

What is the relationship of Mr./Mrs.

(name of the other household

resident) with the head of the

household?

(1) Person in charge of or head of the

household (DISABLED OPTION for the other

residents)

(2) Spouse or partner (3) Child (4) Stepchild (5) Son or daughter-in-law (6) Grandchild (7) Great-grandchild (8) Parents/stepparents (9) Father or mother-in-law (10) Grandfather or grandmother (11) Siblings (12) Other relative (13) Aggregated (non-family member that

does not share expenses) (14) Cohabitant (non-family member that

shares expenses) (15) Boarder (non-family member that pays

for lodging)

(16) Others

(17) Aggregated/Cohabitant

Questionnaire


4

Section A: Household characteristics

Interviewer: the following questions should be answered according to your

observation.

a1 Interviewer: this property is: (1) House

(2) Apartment

a2

Is the access to the household made

through a staircase?

Consider the access from the street to

the household.

(0) No (GO TO a4)

(1) Yes

a3 How many steps does this staircase

have?

(1) Between 1 and 5 steps

(2) Between 6 and 15 steps

(3) 15 steps or more

a4 Is there a ramp to access the household? (0) No

(1) Yes

a5

The access to the apartment is made by:

Consider the access from the reception

or gate of the building to the apartment

door.

(0) Staircase

(1) Elevator (GO TO a7)

a6

How many stairwells leading to the

apartment?

Stairwell: gap between stair landings.

|__|__| stairwells (99) Didn’t know/didn’t answer

a7

The predominant material on the

outside walls of the household is:

Do not consider fences, railings etc.

(1) Masonry with coating (2) Masonry without coating (3) Others (wood, straw, uncoated clay

walls or other material)


a8

The street where the household is

located is asphalted or paved with stones

or other material?

(0) No

(1) Yes

The following questions should be answered by any resident of the household,

preferably by someone who could better inform the expenses and income of the other

residents.

Questionnaire


5

a9

How many rooms are there in this

house, including living rooms,

bathrooms etc.?

Room: each compartment of the

household covered by a ceiling and

separated by walls, including bathroom

and kitchen.

Do not consider as a room: corridors,

open porches, garage and other spaces

for non-residential purposes.

|__|__| rooms


a10

How many rooms are permanently

serving as dormitory for the residents of

this house?

|__|__| rooms


a11 Is there running water (piped) in this

house in at least one room?

(0) No

(1) Yes, from the general water distribution

system

(2) Yes, from the well or spring on the

property

(3) Yes, from the well or spring outside of

the property

(4) Yes, from another source


a12

How many bathrooms or toilets are

there in this house?

Bathroom: room intended to bathe,

that also has a toilet bowl or a hole for

excrements.

Restroom: room or spot constrained by

walls of any material, covered or not

with a ceiling, which has a toilet bowl

or a hole for excrements.

Consider all bathrooms exclusively used

by the residents of the household,

including the ones on the service area

and outside of the house. Shared

bathrooms - serving more than one

dwelling – should not be considered

|__|__| bathrooms/toilets


a13

Are there adaptations in this house for

people with limited mobility, such as

handrails in the bathroom, kitchen or

stairs, widened doors or ramps?

Read the alternatives to the respondent.

(0) No (GO TO a15)

(1) Yes

Questionnaire


6

Next, I’ll list some adaptations for people with limited mobility. I’ll ask you to tell me if

they exist or not in this house.

a14_1 Are there handrails or adaptations on

the bathrooms in this house?

(0) No

(1) Yes

a14_2

Are there handrails or adaptations on

other rooms or in the areas of

circulation in this house?

(0) No

(1) Yes

a14_3

Are there handrails or adaptations on

the staircases located inside or outside

this house?

(0) No

(1) Yes

a14_4 Are there other adaptations in this

house not mentioned before?

(0) No

(1) Yes

a15

Is this household registered with the

Family Health Program / Strategy / Unit?

(0) No (GO TO a17)

(1) Yes


(GO TO a17)

a16 When did this household get registered?

(1) Less than 2 months

(2) Between 2 and less than 6 months

(3) Between 6 months and less than a year

(4) One year or more


a17

In the last 12 months, how often was

this household visited by a Community

Health Agent or by any other member of

the Family Health Team?

Community Health Agents:

professionals that work in the Basic

Healthcare Unit with the purpose of

enrolling all residents within their area

of operation; periodically visit families

and individuals under their

responsibility; develop individual and

collective educational activities in the

households and in the community; and

provide guidance to the families on the

use of available health services.

(1) Monthly

(2) Every other month

(3) Between 2 and 4 times a year

(4) Once

(5) Was never visited


Questionnaire


7

Section B: Assets (possessions)

Next, I’ll ask questions about this household and other assets and properties. This

information is confidential and will be exclusively used for the purposes of this study.

This information is of interest of the Ministry of Health.

b1

This house/property is:

(0) Owned and paid off

(1) Owned but not yet paid off

(2) Rented (GO TO b5)

(3) Made available by a family member

(GO TO b7)

(4) Made available by an employer

(GO TO b7)

(5) Other condition (GO TO b7)

b2

Who is the main owner of this

house/property?

Resident |__|__|__|__|__|


A list with the names of all residents

identified in the Enrollment Section will

appear on the screen.

b3

Considering the LAST 3 MONTHS, what

was the amount spent with the last

monthly mortgage payment of this

house/property?

ONLY IF b1=(1)

(0) No expenditure on this item

(1) Less than R$50 (2) Between R$50 and R$99 (3) Between R$100 and R$199 (4) Between R$200 and R$299 (5) Between R$300 and R$399 (6) Between R$400 and R$499 (7) Between R$500 and R$599 (8) Between R$600 and R$699 (9) Between R$700 and R$799 (10) Between R$800 and R$899 (11) Between R$900 and R$999 (12) Between R$1,000 and R$1,499 (13) Between R$1,500 and R$1,999 (14) Between R$2,000 and R$2,999 (15) Between R$3,000 and R$3,999 (16) Between R$4,000 and R$4,999 (17) Between R$5,000 and R$9,999 (18) R$10,000 and up (99) Didn’t know/didn’t answer

b4

How much is still remaining for you to

pay this house/property off (i.e. how

much is the outstanding mortgage)?

ONLY IF b1=(1)

(1) Less than R$ 10,000

(2) Between R$ 10,000 and R$ 49,999

(3) Between R$ 50,000 and R$ 99,999

(4) Between R$ 100,000 and R$ 199,999

(5) R$ 200,000 and up


Questionnaire


8

b5

Considering the LAST 3 MONTHS, what

was the amount spent with the last

rental payment of this house/property?

ONLY IF b1=(2)



(GO TO b7)

b6

In your opinion, how much would this

house/property be worth if it was sold

now?

ONLY IF b1=(0) OR b1=(1)

(1) Less than R$50,000

(2) Between R$50,000 and R$99,999

(3) Between R$100,000 and R$199,999

(4) Between R$200,000 and R$299,999

(5) Between R$300,000 and R$399,999

(6) Between R$400,000 and R$499,999

(7) Between R$500,000 and R$599,999

(8) Between R$600,000 and R$999,999

(9) Between R$1 million and R$1,499,999

million

(10) Between R$1,5 million and

R$1,999,999 million

(11) Two million and up


b7

Excluding this house/property, do you

or any other member of this household

own another house, flat, land or farm?

(0) No (GO TO b9)

(1) Yes

Questionnaire


9

b8

Apart from this house, how much all

these properties would be worth, if

they were sold now?


(2) Between R$50,000 and R$99,999

(3) Between R$100,000 and R$199,999

(4) Between R$200,000 and R$299,999

(5) Between R$300,000 and R$399,999

(6) Between R$400,000 and R$499,999

(7) Between R$500,000 and R$599,999

(8) Between R$600,000 and R$999,999

(9) Between R$1 million and R$1,499,999

million

(10) Between R$1,5 million and

R$1,999,999 million

(11) Two million and up


Next, I’ll list a number of appliances. I’ll ask you to tell me how many of them are

present in this house. I’ll also request information regarding vehicles and services

available here.

b9 Refrigerator

(0) None (GO TO b11)

(1) Yes

(99) Didn’t know/didn’t answer(GO TO b11)

b10 How many? |__|__|

b11

Washing machine

Do not consider the semiautomatic

ones - “tanquinho”.


(1) Yes

(99) Didn’t know/didn’t answer (GO TO b13)

b12 How many? |__|__|

b13 Dryer (attached or not to the washing

machine)


(1) Yes


b14 How many? |__|__|

b15 Dishwasher


(1) Yes


b16 How many? |__|__|

b17 Microwave


(1) Yes


b18 How many? |__|__|

b19 Color TV


(1) Yes


b20 How many? |__|__|

Questionnaire


10

b21

VCR and/or DVD and/or equivalent

DVD (Digital Video Disc or Digital

Versatile Disc): household device

capable of playing media in DVD

format or other more updated

formats, including videogames,

computers, and notebooks.

Consider portable devices and the

ones coupled in microcomputers. Do

not consider automobile DVD.


(1) Yes


b22 How many? |__|__|

b23

Landline

Consider all landline accounts.


(1) Yes


b24 How many? |__|__|

b25

Cellular phone

Consider all cellular accounts.


(1) Yes


b26 How many? |__|__|

b27 Air conditioner


(1) Yes


b28 How many? |__|__|

b29

Computer

Consider: desktop computers, lap tops,

notebooks and net books.

Do not consider: calculators, electronic

organizers, tablets, palmtops, smart

phones and other devices.


(1) Yes


b30 How many? |__|__|

b31

Access to the Internet in this household

Consider access to the Internet when it

is done through a desktop computer or

a portable computer (laptop, notebook

or netbook).

Do not consider when the access is

through a cellular phone on the

household.

(0) None

(1) Yes


Questionnaire


11

b32 Cable or satellite TV (Net, Sky, Direct

TV etc)?

(0) None

(1) Yes


b33

Motorcycles or other motor two-

wheelers combustion vehicles

Consider a motorcycle lent by an

employer when the resident has that

vehicle available for his/her personal

use, including during the weekends.

Do not consider a motorcycle lent by

an employer when this vehicle is only

available to the resident for the daily

work commute.


(1) Yes


b34 How many? |__|__|

b35

Automobiles

Include: automobiles, SUVs (Sport

Utility Vehicle), trucks with open or

closed body, pick-ups, Kombis, station

wagons, vans, among others.

Consider the car lent by the employer

when the resident has that vehicle

available for his/her personal use,

including during the weekends. Do not

consider the car when this vehicle is

only available to the resident for the

daily work commute.


(1) Yes

(99) Didn’t know/didn’t answer (GO TO b38)

b36 How many? |__|__|


Questionnaire


12

b37

If all these vehicles were sold today,

how much would they be worth?

If more than one vehicle, consider the

sum of all values.

(1) Less than R$ 10.000

(2) Between R$ 10,000 and R$ 14,999

(3) Between R$ 15,000 and R$ 19,999

(4) Between R$ 20,000 and R$ 24,999

(5) Between R$ 25,000 and R$ 29,999

(6) Between R$ 30,000 and R$ 34,999

(7) Between R$ 35,000 and R$ 39,999

(8) Between R$ 40,000 and R$ 44,999

(9) Between R$ 45,000 and R$ 49,999

(10) Between R$ 50,000 and R$ 54,999

(11) Between R$ 55,000 and R$ 59,999

(12) Between R$ 60,000 and R$ 64,999

(13) Between R$ 65,000 and R$ 69,999

(14) Between R$ 70,000 and R$ 74,999

(15) Between R$ 75,000 and R$ 79,999

(16) Between R$ 80,000 and R$ 84,999

(17) Between R$ 85,000 and R$ 89,999

(18) Between R$ 90,000 and R$ 94,999

(19) Between R$ 95,000 and R$ 99,999

(20) R$ 100,000 and up


b38

Are there any domestic employees

working at this household, such as

cleaning personnel, cooks,

housekeepers or gardeners (among

others)?

Do not consider caregiver(s) or health

professionals.

(0) No (GO TO b40)

(1) Yes

Questionnaire


13

b39

In the PAST MONTH, what was the total

spent by this household with all

domestic employees?

Consider: salaries, payments to daily

domestic employees, Social Security

payments and others. Do not consider

food.

Mark down the value that best

represents the total amount spent and

remember that (SM) MW=Minimum

Wage.

(1) Less than R$788 (less than 1 MW)

(2) Between R$788 and R$1,575 (1 to 1,99

MW)

(3) Between R$1,576 and R$ 2,363 (2 to

2,99 MW)

(4) Between R$2,364 and R$3,151 (3 to 3,99

MW)

(5) Between R$3,152 and R$3,939 (4 to 4,99

MW)

(6) Between R$3,940 and R$4,727 (5 to 5,99

MW)

(7) Between R$4,728 and R$5,515 (6 to 6,99

MW)

(8) Between R$5,516 and R$6,303 (7 to 7,99

MW)

(9) Between R$6,304 and R$7,091 (8 to 8,99

MW)

(10) Between R$7,092 and R$7,879 (9 to

9,99 MW)

(11) R$7,880 and up (10 MW or more)


Questionnaire


14

Section C: Household expenses

The following questions are related to the expenses of this household residents.

c1 In the LAST WEEK, in a normal day, how

many people had meals in this house?

|__|__| person(s) (99) Didn’t know/didn’t answer

c2

In the PAST MONTH, how much was

spent, on average, with grocery

shopping, butchers, street markets?

Includes purchases of food, personal

hygiene products, and cleaning supplies.

Also includes home delivered meals. It does not include meals away from

home.

(SHOW CARD 1)



c3

Do you or anyone else who lives in this

house eat legumes/vegetables, fruits or

meat that are farmed, produced, caught

or harvested by yourselves?

(0) No (GO TO c5) (1) Yes

Questionnaire


15

c4

In the PAST MONTH, what was the worth

of the food produced at home that you

and the other residents of this household

consumed? In other words, how much

would you have to pay for this food if

you had to buy it?

(SHOW CARD 1)


(1) Less than R$50

(2) Between R$50 and R$99










(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


c5

In the PAST MONTH, how much did your

household spend on eating out?

(SHOW CARD 1)



Questionnaire


16

c6


spent by this household with electricity,

water, and cooking gas?

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


c7


spent, approximately, with the payment

of condo fees of this property?

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


Questionnaire


17

c8


spent by this household on local

transportation (to go to work, school,

leisure etc.)?

Includes: bus, train, taxi, underground

train, and parking. Includes transport

ticket scheme. It does not include fuel

expenses.

(SHOW CARD 1)



c9


spent by this household on fuel

(gasoline, ethanol or diesel) and

maintenance or repair of vehicles?

(SHOW CARD 1)



Questionnaire


18

c10


spent by this household with telephone

bills (landline and mobile), cable/satellite

TV and Internet?

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


c11


spent by this household on

entertainment?

Includes: fees to buy books, newspapers

and/or magazines; going to the cinema,

theatre and/or shows; going to bars etc.

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


Questionnaire


19

c12

In the LAST YEAR, how much did you or

the other residents of this house spend

with the payment of the LAST PROPERTY

TAX BILL (IPTU)?

In case of a country estate, consider the

Rural Property Tax (ITR)

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


c13

In the LAST YEAR, how much was spent

by this household with the latest

Automotive Ownership Tax (IPVA)?

Consider all vehicles, including

motorcycles.

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


Questionnaire


20

c14

In the LAST YEAR, how much did you or

the other residents in this house spend

on the purchase of motor vehicles?

Includes automobiles, SUVs (Sport

Utility Vehicle), trucks with open or

closed body, pick-ups, Kombis, station

wagons, vans, motorcycles, among

others.



(2) Between R$5,000 and R$9,999

(3) Between R$10,000 and R$14,999

(4) Between R$15,000 and R$19,999

(5) Between R$20,000 and R$24,999

(6) Between R$25,000 and R$29,999

(7) Between R$30,000 and R$34,999

(8) Between R$35,000 and R$39,999

(9) Between R$40,000 and R$44,999

(10) Between R$45,000 and R$49,999

(11) Between R$50,000 and R$99,999

(12) R$100,000 and up


c15

In the PAST 12 MONTHS, how much did

you or other residents of this house

spend with education/school?

Includes: day care and/or school fees,

school transportation, tuition fees,

books, school supplies, school uniforms,

tutoring, language courses and music

classes, computer classes, swimming,

gymnastics, ballet, among others.

(SHOW CARD 1)


(1) Less than R$50











(12) Between R$1,000 and R$1,499

(13) Between R$1,500 and R$1,999

(14) Between R$2,000 and R$2,999

(15) Between R$3,000 and R$3,999

(16) Between R$4,000 and R$4,999

(17) Between R$5,000 and R$9,999

(18) R$10,000 and up


c16

Do you or other members of this

household have private health

insurance?

(0) No (GO TO c18)

(1) Yes

Questionnaire


21

c17


spent by this household on private

health insurance monthly fees?

(SHOW CARD 1)

(0) No expenditure on this item (1) Less than R$50 (2) Between R$50 and R$99 (3) Between R$100 and R$199 (4) Between R$200 and R$299 (5) Between R$300 and R$399 (6) Between R$400 and R$499 (7) Between R$500 and R$599 (8) Between R$600 and R$699 (9) Between R$700 and R$799 (10) Between R$800 and R$899 (11) Between R$900 and R$999 (12) Between R$1,000 and R$1,499 (13) Between R$1,500 and R$1,999 (14) Between R$2,000 and R$2,999 (15) Between R$3,000 and R$3,999 (16) Between R$4,000 and R$4,999 (17) Between R$5,000 and R$9,999 (18) R$10,000 and up (99) Didn’t know/didn’t answer

c18

In the LAST 12 MONTHS, how much did

you or other residents of this house

spend with other expenses not

mentioned in the previous questions,

including purchase of clothing, bed linen

and bedroom, pantry and kitchen

accessories, decorative items and

appliances?

(SHOW CARD 1)

(0) No expenditure on this item (1) Less than R$50 (2) Between R$50 and R$99 (3) Between R$100 and R$199 (4) Between R$200 and R$299 (5) Between R$300 and R$399 (6) Between R$400 and R$499 (7) Between R$500 and R$599 (8) Between R$600 and R$699 (9) Between R$700 and R$799 (10) Between R$800 and R$899 (11) Between R$900 and R$999 (12) Between R$1,000 and R$1,499 (13) Between R$1,500 and R$1,999 (14) Between R$2,000 and R$2,999 (15) Between R$3,000 and R$3,999 (16) Between R$4,000 and R$4,999 (17) Between R$5,000 and R$9,999 (18) R$10,000 and up (99) Didn’t know/didn’t answer

Questionnaire


22

Section D: Residents income

Now let’s talk about Mr./Mrs. (name of the eligible resident), resident who is not

the householder, aged 50 years or older.

d1_1 a

d1_14

In the LAST 30 DAYS, have Mr./Mrs.

(name of the eligible resident) had

any income from salaries or from

independent activities (self-

employed)?

Consider the usual gross earnings.

Do not include: retirement benefit,

death benefit, alimony, Continuous

Cash Benefit, Conditional Cash

Transfer (Bolsa Família), cash

donations or any income from rents,

leases, financial investments or other

sources.

(0) No (GO TO d4)

(1) Yes

(99) Didn’t know/didn’t answer (GO TO d4)

d2_1 a

d2_14 What is the amount of this income?

R$ |__|__|__|__|__|.00


If the amount was informed, the following

question will be automatically filled with the

range that best represents the reported

amount and it won’t be necessary to ask the

respondent.

d3_1 a

d3_14

What is the range that best represents

the total of this gain?

(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW)

(13) R$9,456 to R$10,243 (12 to 12,99 MW)

(14) R$10,244 to R$11,031 (13 to 13,99 MW)

(15) R$11,032 to R$11,819 (14 to 14,99 MW)

(16) R$11,820 to R$15,759 (15 to 19,99 MW)

(17) R$15,760 and up (20 MW or more)


Questionnaire


23

d4_1 a

d4_14

In the PAST 30 DAYS, have Mr./Mrs.

(name of the eligible resident)

received any income from retirement

benefits or death pension?

Includes: social security benefit – INSS

– as well as benefits from the private

pension system or the public

municipal/state/federal system. Do

not include alimony/spousal support.

(0) No (GO TO d7) (1) Yes (99) Didn’t know/didn’t answer (GO TO d7)

d5_1 a


R$ |__|__|__|__|__|.00 (9999999) Didn’t know/didn’t answer


question will be automatically filled with

the range that best represents the reported


respondent.

d6_1 a

d6_14



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW) (13) R$9,456 to R$10,243 (12 to 12,99 MW) (14) R$10,244 to R$11,031 (13 to 13,99 MW)

(15) R$11,032 to R$11,819 (14 to 14,99 MW) (16) R$11,820 to R$15,759 (15 to 19,99 MW) (17) R$15,760 and up (20 MW or more) (99) Didn’t know/didn’t answer

Questionnaire


24

d7_1 a

d7_14



received the Continuous Cash Benefit

(BPC-LOAS), Conditional Cash Transfer

Program (Bolsa Família) or any

monetary donation from someone

who is not a resident in this

household?

Consider alimony received

spontaneously or resulting from

lawsuit and also donation or

allowance received without any

services provided, from non-

resident(s) of the household.


d8_1 a







respondent.

d9_1 a

d9_14



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW) (13) R$9,456 to R$10,243 (12 to 12,99 MW) (14) R$10,244 to R$11,031 (13 to 13,99 MW) (15) R$11,032 to R$11,819 (14 to 14,99 MW) (16) R$11,820 to R$15,759 (15 to 19,99 MW) (17) R$15,760 and up (20 MW or more) (99) Didn’t know/didn’t answer

Questionnaire


25

d16_1 a

d16_14



received any income from rentals or

leases?

Consider income from rentals,

subletting and leasing of properties,

furniture, machinery, equipment,

animals, among others.

(0) No (GO TO d22) (1) Yes (99) Didn’t know/didn’t answer

(GO TO d22)

d17_1 a







respondent.

d18_1 a

d18_14



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)


d22_1 a

d22_14



received any interest from any source

other than the ones previously

mentioned?


d23_1 a







respondent.

Questionnaire


26

d24_1 a

d24_14



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)


Now let’s talk about Mr./Mrs. (name of the eligible resident), resident who is

householder, aged 50 years or older.

dr1


(name of the eligible resident) had

any income from salaries or from

independent activities (self-

employed)?

Consider the usual gross earnings.

Do not include: retirement benefit,

death benefit, alimony, Continuous

Cash Benefit, Conditional Cash

Transfer (Bolsa Família), cash

donations or any income from rents,

leases, financial investments or other

sources.

(0) No (GO TO dr4) (1) Yes (99) Didn’t know/didn’t answer (GO TO dr4)

dr2 What is the amount of this income?






respondent.

Questionnaire


27

dr3



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)


dr4



received any income from retirement

benefits or death pension?

Includes: social security benefit – INSS

– as well as benefits from the private

pension system or the public

municipal/state/federal system. Do

not include alimony/spousal support.








respondent.

Questionnaire


28

dr6



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW) (13) R$9,456 to R$10,243 (12 to 12,99 MW) (14) R$10,244 to R$11,031 (13 to 13,99MW)

(15) R$11,032 to R$11,819 (14 to 14,99 MW) (16) R$11,820 to R$15,759 (15 to 19,99 MW) (17) R$15,760 and up (20 MW or more) (99) Didn’t know/didn’t answer

dr7



received the Continuous Cash Benefit

(BPC-LOAS), Conditional Cash Transfer

Program (Bolsa Família) or any

monetary donation from someone

who is not a resident in this

household?

Consider alimony received

spontaneously or resulting from

lawsuit and also donation or

allowance received without any

services provided, from non-

resident(s) of the household.








respondent.

Questionnaire


29

dr9



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW)

(13) R$9,456 to R$10,243 (12 to 12,99 MW)

(14) R$10,244 to R$11,031 (13 to 13,99 MW)

(15) R$11,032 to R$11,819 (14 to 14,99 MW)

(16) R$11,820 to R$15,759 (15 to 19,99 MW)

(17) R$15,760 and up (20 MW or more)


dr16



received any income from rentals or

leases?

Consider income from rentals,

subletting and leasing of properties,

furniture, machinery, equipment,

animals, among others.

(0) No (GO TO dr22)

(1) Yes

(99) Didn’t know/didn’t answer (GO TO dr22)


R$ |__|__|__|__|__|.00






respondent.

Questionnaire


30

dr18



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)


dr22



received any interest from any source

other than the ones previously

mentioned?








respondent.

dr24



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)


Questionnaire


31

Now let’s talk about Mr./Mrs. (name of the eligible resident), resident who is not

householder, aged between 17 and 49 years old.

d25_1 a

d25_14

In the LAST 30 DAYS, have (name of

the resident aged between 17 and 49

years old) had any income from any of

the sources I`ll mention next?

Salary, self-employment, retirement

or death benefit, Continuous Cash

Benefit, Conditional Cash Transfer

(Bolsa Família), alimony, cash

donations by people who does not

live in the household, income from

rentals or leases, profit from savings

or other financial investments, or

earnings of any other source.


d26_1 a







respondent.

d27_1 a

d27_14



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)


Questionnaire


32

Now let’s talk about Mr./Mrs. (name of the eligible resident), resident who is

householder, aged between 17 and 49 years old.

dr25

In the LAST 30 DAYS, have (name of

the resident aged between 17 and 49

years old) had any income from any of

the sources I`ll mention next?

Salary, self-employment, retirement

or death benefit, Continuous Cash

Benefit, Conditional Cash Transfer

(Bolsa Família), alimony, cash

donations by people who does not

live in the household, income from

rentals or leases, profit from savings

or other financial investments, or

earnings of any other source.








respondent.

dr27



(SHOW CARD 2)


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW)

(13) R$9,456 to R$10,243 (12 to 12,99 MW)

(14) R$10,244 to R$11,031 (13 to 13,99 MW)

(15) R$11,032 to R$11,819 (14 to 14,99 MW)

(16) R$11,820 to R$15,759 (15 to 19,99 MW)

(17) R$15,760 and up (20 MW or more)


Questionnaire


33

d28

Adding ALL sources of monthly income

from ALL residents from this

household, which of the options best

describe the TOTAL INCOME OF THIS

HOUSELHOLD?

(SHOW CARD 2)

(0) No income


(2) R$788 to R$1,575 (1 to 1,99 MW)

(3) R$1,576 to R$ 2,363 (2 to 2,99 MW)

(4) R$2,364 to R$3,151 (3 to 3,99 MW)

(5) R$3,152 to R$3,939 (4 to 4,99 MW)

(6) R$3,940 to R$4,727 (5 to 5,99 MW)

(7) R$4,728 to R$5,515 (6 to 6,99 MW)

(8) R$5,516 to R$6,303 (7 to 7,99 MW)

(9) R$6,304 to R$7,091 (8 to 8,99 MW)

(10) R$7,092 to R$7,879 (9 to 9,99 MW)

(11) R$7,880 to R$8.667 (10 to 10,99 MW)

(12) R$8,668 to R$9,455 (11 to 11,99 MW)

(13) R$9,456 to R$10,243 (12 to 12,99 MW)

(14) R$10,244 to R$11,031 (13 to 13,99 MW)

(15) R$11,032 to R$11,819 (14 to 14,99 MW)

(16) R$11,820 to R$15,759 (15 to 19,99 MW)

(17) R$15,760 and up (20 MW or more)


d29

Within the alternatives I’ll mention

next, which one best describes the

income of all residents of the

household?

(1) It is always enough for all expenses

(2) It is sometimes enough for all expenses

(3) It is never enough for all expenses

d30

Who is the main informant of the

Household Module?

Consider the relationship between

the respondent and the head of

household.

(1) Person in charge of or head of the

household

(2) Spouse or partner

(3) Child

(4) Stepchild

(5) Son or daughter-in-law

(6) Grandchild

(7) Great-grandchild

(8) Parents/stepparents

(9) Father or mother-in-law

(10) Grandfather or grandmother

(11) Siblings

(12) Other relative

(13) Aggregated (non-family member that

does not share expenses)

(14) Cohabitant (non-family member that

shares expenses)

(15) Boarder (non-family member that pays

for lodging)

(16) Others

(17) Aggregated/cohabitant

Household Interview English -...

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