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Sociodemographic Questionnaire

The MacArthur Network on SES and Health has developed a sociodemographic questionnaire which is currently being used in a number of network sponsored projects. The instrument begins with subjective social status questions developed by the network; (see MacArthur Subjective Social Status Scale in the Psychosocial Notebook). The remaining questions assess educational attainment, occupational status, income and assets. Ideally, all questions would be used; if a subset must be selected, items 1, 2, 3, 4, 6b and 6c, 7 and 9 are recommended.

Question 1.

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Question 2.

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Question 3. What is the highest grade (or year) of regular school you have completed? (Check one.)

Elementary School	High School	College	Graduate School
01____	09____	13_____	17_____
02____	10____	14_____	18_____
03____	11____	15_____	19_____
04____	12____	16_____	20+____
05____
06____
07____
08____

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Question 4. What is the highest degree you earned?

_____High school diploma or equivalency (GED)
_____Associate degree (junior college)
_____Bachelor's degree
_____Master's degree
_____Doctorate
_____Professional (MD, JD, DDS, etc.)
_____Other specify
_____None of the above (less than high school)

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Question 5. Which of the following best describes your current main daily activities and/or responsibilities?

_____Working full time
_____Working part-time
_____Unemployed or laid off
_____Looking for work
_____Keeping house or raising children full-time
_____Retired

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Question 6. With regard to your current or most recent job activity:

a. In what kind of business or industry do (did) you work?

__________________________________________________________
(For example: hospital, newpaper publishing, mail order house, auto engine manufacturing, breakfast cereal manufacturing.)

b. What kind of work do (did) you do? (Job Title)

__________________________________________________________
(For example: registered nurse, personnel manager, supervisior of order department, gasoline engine assembler, grinder operator.)

c. How much did you earn, before taxes and other deductions, during the past 12 months?
_____Less than $5,000
_____$5,000 through $11,999
_____$12,000 through $15,999
_____$16,000 through $24,999
_____$25,000 through $34,999
_____$35,000 through $49,999
_____$50,000 through $74,999
_____$75,000 through $99,999
_____$100,000 and greater
_____Don't know
_____No response

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Question 7. How many people are currently living in your household, including yourself?

_____Number of people
_____Of these people, how many are children?
_____Of these people, how many are adults?
_____Of the adults, how many bring income into the household?

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Question 8. Is the home where you live:

_____Owned or being bought by you (or someone in the household)?
_____Rented for money?
_____Occupied without payment of money or rent?
_____Other (specify)____________________________________

[Some might try to get a "market value" estimate of the value of owned homes and an estimate of how much principal was outstanding on the mortgage.]

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Question 9. Which of these categories best describes your total combined family income for the past 12 months?
This should include income (before taxes) from all sources, wages, rent from properties, social security, disability and/or veteran's benefits, unemployment benefits, workman's compensation, help from relatives (including child payments and alimony), and so on.

_____Less than $5,000
_____$5,000 through $11,999
_____$12,000 through $15,999
_____$16,000 through $24,999
_____$25,000 through $34,999
_____$35,000 through $49,999
_____$50,000 through $74,999
_____$75,000 through $99,999
_____$100,000 and greater
_____Don't know
_____No response

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Question 10. If you lost all your current source(s) of household income (your paycheck, public assistance, or other forms of income), how long could you continue to live at your current address and standard of living?

______ Less than 1 month
______ 1 to 2 months
______ 3 to 6 months
______ 7 to 12 months
______ More than 1 year

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Question 11. Suppose you needed money quickly, and you cashed in all of your (and your spouse's) checking and savings accounts, and any stocks and bonds. If you added up what you would get, about how much would this amount to?

______Less than $500
______$500 to $4,999
______$5,000 to $9,999
______$10,000 to $19,999
______$20,000 to $49,999
______$50,000 to $99,999
______$100,000 to $199,999
______$200,000 to $499,999
______$500,000 and greater
______Don't know
______No response

If you now subtracted out any debt that you have (credit card debt, unpaid loans including car loans, home mortgage), about how much would you have left?

______Less than $500
______$500 to $4,999
______$5,000 to $9,999
______$10,000 to $19,999
______$20,000 to $49,999
______$50,000 to $99,999
______$100,000 to $199,999
______$200,000 to $499,999
______$500,000 and greater
______Don't know
______No response

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