Living Standards Research Programme

Ministry of Social Development

Living Standards Research Programme

Questionnaire for single people

Ministry of Social Development
Living Standards
1301466 / Questionnaire ID number:
Week No: / SINGLE QUESTIONNAIRE / Started:
Time Finished:
Interview Duration:
(MINS)
AREA:
Map Number:
Number of Calls(CIRCLE)
OneTwoThree
FourFiveSix
Seven / Respondent’s Name______
Respondent’s Phone No: ( )______
City:______Date: ____/____/2004
Interviewer:______Employ No:______
Supervisor Checked:______Audit:______Coded:______

AREA (CIRCLE)

Whangerei / 01
Auckland / 02
Hamilton / 03
Tauranga / 04
Rotorua / 05
New Plymouth / 06
Wanganui / 07
Palmerston North / 08
Napier / 09
Hastings / 10
Gisborne / 11
Wellington / 12
Nelson / 13
Christchurch / 14
Dunedin / 15
Invercargill / 16
MAP NUMBER
______/ INTERVIEWER RECORD:
Consent given to use data for other purpose?
Yes / 1
No / 2
/ INTERVIEWER ASK:
May we recontact you if we have any queries with this survey you have just completed?
Yes / 1
No / 2
RESPONDENT SIGNATURE:
I have received the Voucher:
CIRCLE
Yes
No
Signature: ------
I hereby certify that this is an accurate and complete interview, taken in accordance with my instructions and the ICC/ESOMAR International Code.
______
SignatureDate

I am going to ask you a series of questions about the people living in your household. This is to establish the people in your Family Group.

Identify the REspondents’ family group by asking the following Questions and filling ouT TABLEs 1 and 2.

A Family Group is the respondent plus their partner or spouse (if any) plus their children under the age of 18 (if any), unless the children have their own partner or children living in the household. if children are working full time they are considered financially independent and therefore a separate family group. single people are their own family group.

Q2Can you please tell me the names of everyone in this household who is aged 18 years or older, beginning with yourself?

IF YES: Write names in Table 1.

Q3Now can you tell me the names of all people aged 17 or under who usually live in the household?

IF YES: Write names in Table 2.

Q4What is the relationship of each household member to you, starting with

READ OUT ALL NAMES IN TABLES 1 AND 2 (NOT INCLUDING RESPONDENT)

SHOWCARD 1.

SELECT only one relationship.

record double digit code in table.

IF NO ONE AGED UNDER 18 YEARS IN THE HOUSEHOLD SKIP TO Q9

IF RESPONDENT HAS CHILDREN LIVING IN THE HOUSEHOLD CONTINUE IF NOT GO TO Q9

Q5Are you the parent or primary care-giver/ legal guardian of any of those aged 17 years or underin the household?

IF LEGAL GUARDIAN ENSURE THAT THEY ARE THE PRIMARY CARE GIVER

Yes / 1
No / 2

IF YES: ASK Q6

IF NO:GO TO Q9

Q6Are they all financially dependent on you?

Yes / 1
No / 2

IF NO: IDENTIFY CHILD AND CIRCLE NO IN FAMILY GROUP ONE COLUMN

Q7Do any of your(dependent) children have a partner or spouse living in this house?

IF YES: Identify child and CIRCLE NO IN FAMILY GROUP 1 COLUMN

Q8Do any of these (dependent) children (or does this child) have a child (or children) of their own living in this house?

IF YES: IDENTIFY CHILD AND CIRCLE NO IN FAMILY GROUP 1 COLUMN

IF NO: Identify child and CIRCLE YES IN FAMILY GROUP 1 COLUMN

CHECK ALL CHILDREN HAVE BEEN CIRCLED AS YES OR NO IN FAMILY GROUP

Q9What is the gender of all household members starting with

READ OUT SECOND NAME IN GRIDAND CONTINUE

Q10What is the age, to the nearest year, of each household member, starting with yourself… Please estimate if you don’t know the exact year.

COMPLETE TABLE 1 and table 2 with respondent

CIRCLE YES OR NO in family group 1 column for each PERSON IN EACH table

TABLE 1: Adults (all household members aged 18 years or over)

Q2 Name / Family Group 1 / Q4
Relationship to respondent / Q9
Gender / Q10
Age (Years)
Yes / No / M / F
1 / 1 / 2 / RESPONDENT / 1 / 2
2 / 1 / 2 / 1 / 2
3 / 1 / 2 / 1 / 2
4 / 1 / 2 / 1 / 2
5 / 1 / 2 / 1 / 2
6 / 1 / 2 / 1 / 2
7 / 1 / 2 / 1 / 2
8 / 1 / 2 / 1 / 2
9 / 1 / 2 / 1 / 2
10 / 1 / 2 / 1 / 2

TABLE 2: Children (all household members aged 17 years or younger).

Q3 Name / Family Group 1 / Q4
Relationship to respondent / Q9
Gender / Q10
Age (Years)
Yes / No / M / F
1 / 1 / 2 / 1 / 2
2 / 1 / 2 / 1 / 2
3 / 1 / 2 / 1 / 2
4 / 1 / 2 / 1 / 2
5 / 1 / 2 / 1 / 2
6 / 1 / 2 / 1 / 2
7 / 1 / 2 / 1 / 2
8 / 1 / 2 / 1 / 2
9 / 1 / 2 / 1 / 2
10 / 1 / 2 / 1 / 2
11 / 1 / 2 / 1 / 2
12 / 1 / 2 / 1 / 2

INTERVIEWER: IF RESPONDENT REFUSES TO ANSWER (E.G. AGE OR GENDER) PUT CODE 97 IN TABLE AS APPROPRIATE

If there ISMORE THAN ONE ADULT in Table 1 not in FAMILY GROUP 1 ask Q11

IF THERE IS ONE ADULTin Table 1 not in FAMILY GROUP 1 ASK Q12

if no other adults in Table 1 not in FAMILY GROUP 1 go to Q13

Q11How many couples live in this household?

Number
Don’t know / 99
Refused / 97

Q12Are any of the adults living with you in this household dependent on you financially or for physical care?

Yes / 1
No / 2
Don’t know / 9
Refused / 7

FILL IN SEParate family group card FOR ALL THOSE WHO ARE IN FAMILY GROUP 1 now. keep this card in front of you throughout the interview

see Family Group card: Ifrespondent has children, ask Q15, otherwise GO TO Q16

Q15Do any of these children regularly live some of the time in another household; for example shared custody arrangements?

SHOW FAMILY GROUP CARD

Child’s living arrangements / Child 1 / Child 2 / Child 3 / Child 4 / Child 5 / Child 6 / Child 7 / Child 8 / Child 9 / Child 10 / Child 11 / Child 12
Child always lives in this household / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1 / 1
Child regularly lives some of the time in another household / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2 / 2
Don’t know / 9 / 9 / 9 / 9 / 9 / 9 / 9 / 9 / 9 / 9 / 9 / 9
Refused / 7 / 7 / 7 / 7 / 7 / 7 / 7 / 7 / 7 / 7 / 7 / 7
FAMILY GROUP ONE

Ask the following questions for members of Family Group ONE only.

Q16Please tell me the ethnicity of each person in this family group. You may choose up to three ethnic groups for each person.

SHOWCARD 2

Ethnicity / Respo-ndent / Child 1 / Child 2 / Child 3 / Child 4 / Child 5 / Child 6 / Child 7 / Child 8 / Child 9 / Child 10 / Child 11 / Child 12
NZ European or Pakeha / 11 / 11 / 11 / 11 / 11 / 11 / 11 / 11 / 11 / 11 / 11 / 11 / 11
Other European / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12
NZ Māori / 13 / 13 / 13 / 13 / 13 / 13 / 13 / 13 / 13 / 13 / 13 / 13 / 13
Samoan / 14 / 14 / 14 / 14 / 14 / 14 / 14 / 14 / 14 / 14 / 14 / 14 / 14
CookIsland Maori / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15 / 15
Tongan / 16 / 16 / 16 / 16 / 16 / 16 / 16 / 16 / 16 / 16 / 16 / 16 / 16
Niuean / 17 / 17 / 17 / 17 / 17 / 17 / 17 / 17 / 17 / 17 / 17 / 17 / 17
Other Pacific / 18 / 18 / 18 / 18 / 18 / 18 / 18 / 18 / 18 / 18 / 18 / 18 / 18
Chinese / 19 / 19 / 19 / 19 / 19 / 19 / 19 / 19 / 19 / 19 / 19 / 19 / 19
Indian / 20 / 20 / 20 / 20 / 20 / 20 / 20 / 20 / 20 / 20 / 20 / 20 / 20
Fijian / 21 / 21 / 21 / 21 / 21 / 21 / 21 / 21 / 21 / 21 / 21 / 21 / 21
Other Asian / 22 / 22 / 22 / 22 / 22 / 22 / 22 / 22 / 22 / 22 / 22 / 22 / 22
Other / 23 / 23 / 23 / 23 / 23 / 23 / 23 / 23 / 23 / 23 / 23 / 23 / 23
Don’t know / 99 / 99 / 99 / 99 / 99 / 99 / 99 / 99 / 99 / 99 / 99 / 99 / 99
Refused / 97 / 97 / 97 / 97 / 97 / 97 / 97 / 97 / 97 / 97 / 97 / 97 / 97

Q17What was your country of birth?

SHOWCARD 3

Country of Birth / Respondent
New Zealand / 01 / GO TO Q19
Australia / 02 / CONTINUE
Samoa / 03
Tonga / 04
Cook Islands / 05
Niue / 06
Fiji / 07
Other Pacific / 08
South Korea / 09
China / 10
India / 11
Other Asian / 12
United Kingdom / 13
Other European / 14
South African / 15
Other African / 16
Other / 17
Don’t know / 99 / GO TO Q19
Refused / 97

Q18How many years have you livedin New Zealand?

Number of years / Respondent
Less than 1 year / 1
Between 1 and 2 years / 2
Between 2 and 5 years / 3
Between 5 and 10 years / 4
More than 10 years / 5
Don’t know / 9
Refused / 7

Q19Please tell me what your highest qualification is?

Highest Qualifications / Respondent
No qualification / 01
School qualification / 02
Trade certificate, advanced trade certificate, NZ certificate or diploma, technicians certificate, local polytechnic certificate or diploma / 03
Nursing certificate or diploma / 04
Teachers certificate or diploma / 05
University certificate, diploma, bachelors degree or post grad degree, cert, or diplomaUndergraduate university qualification (e.g. certificate, diploma, bachelors) / 06
Postgraduate university qualification (e.g. masters, doctorate) / 07
Other qualification / 087
Don’t Know / 99
Refused / 97
Economic Standard of Living

Now I have some questions about you and your family group.

INTERVIEWER: Shuffle blue cards

Q20 I am now going to show you some cards naming some different items. Can you please sort these cards into two piles? In one pile I’d like you to put the things that you have, and in the other pile I’d like you to put the things that you don’t have. By have, I mean have access to in your household.

record ‘don’t have’ pile first then ‘have’ pile. Record in column Q20.

IF RESPONDENT HAS ALL ITEMS GO TO Q23.

see Family Group card: If respondent has children, ask Q23 – Q25, otherwise GO TO Q26

Give respondent pile of ‘don’t have’ items and ask Q21for each item

Q21For each of these items that you don’t have, can you tell me if you would like to have one?If necessary:If someone gave it to you

Record in column Q21

For each item that the respondent would like to have, ask Q22.

IF RESPONDENT WOULD NOT LIKE TO HAVE ANY ITEMS GO TO Q23.

see Family Group card:If respondent has children, ask Q23 – Q25, otherwise GO TO Q26.

Q22Is the reason that you don’t have that item because of the cost, or some other reason?

Record response in column Q22 for each item

Item No. / Q20 / Q21 / Q22
Have / Don’t have / Like / Wouldn’t like / Cost / Other reason
1 / 1 / 2 / 1 / 2 / 1 / 2
2 / 1 / 2 / 1 / 2 / 1 / 2
3 / 1 / 2 / 1 / 2 / 1 / 2
4 / 1 / 2 / 1 / 2 / 1 / 2
5 / 1 / 2 / 1 / 2 / 1 / 2
6 / 1 / 2 / 1 / 2 / 1 / 2
7 / 1 / 2 / 1 / 2 / 1 / 2
8 / 1 / 2 / 1 / 2 / 1 / 2
9 / 1 / 2 / 1 / 2 / 1 / 2
10 / 1 / 2 / 1 / 2 / 1 / 2
11 / 1 / 2 / 1 / 2 / 1 / 2
12 / 1 / 2 / 1 / 2 / 1 / 2
13 / 1 / 2 / 1 / 2 / 1 / 2
14 / 1 / 2 / 1 / 2 / 1 / 2

see Family Group card:If respondent has children, ask Q23 – Q25, otherwise GO TO Q26

Shuffle green cards

Q23Can you please sort these cards into two piles as before? In one pile put the things that you have and in the other pile can you put the things that you don’t have.

If necessary: By have, I mean have access to in your household.

record ‘don’t HAVE’ pile first then ‘HAVE’ pile. Record in column Q23.

IF RESPONDENT HAS ALL ITEMS GO TO Q26.

Give respondent pile of ‘don’t HAVE’ items and ask Q24 for each item

Q24For each of these items that you don’t have, can you tell me if you would like to have one?

If necessary:If someone gave it to you

Record in column Q24.

For each item that the respondent would like to have ask Q25.

IF RESPONDENT WOULD NOT LIKE TO HAVE ANY ITEM GO TO Q26.

Q25Is the reason that you don’t have that item because of the cost, or some other reason?

Record response in column Q25

Item number / Q23 / Q24 / Q25
Have / Don’t have / Like / Wouldn’t like / Cost / Other reason
15 / 1 / 2 / 1 / 2 / 1 / 2
16 / 1 / 2 / 1 / 2 / 1 / 2
17 / 1 / 2 / 1 / 2 / 1 / 2
18 / 1 / 2 / 1 / 2 / 1 / 2

Shuffle yellow cards

Q26I am now going to show you some cards naming different things to do. Can you please sort these cards into two piles? In one pile I’d like you to put the things that you do, and in the other pile I’d like you to put the things that you don’t do.

record ‘don’t Do’ pile first then ‘Do’ pile. Record in column Q26.

IF RESPONDENT DoeS ALL ITEMS GO TO Q29.

see Family Group card: If respondent has children, ask Q29 – Q31, otherwise GO TO Q32

Give respondent pile of ‘don’t do’ items and ask Q27 for each item

Q27For each of these things that you don’t do, can you tell me if you would like to do them?

If necessary:Not thinking about the cost

Record in column Q27

For each item that the respondent would like to do, ask Q28. IF RESPONDENT WOULD NOT LIKE TO DO ANY OF THEM GO TO Q29.

see Family Group card: If respondent has children, ask Q29-Q31; otherwise go to Q32.

Q28Is the reason that you don’t do this thing because of cost, or some other reason?

Record response in column Q28 for each item

Item number / Q26 / Q27 / Q28
Do / Don’t do / Like / Wouldn’t like / Cost / Other reason
19 / 1 / 2 / 1 / 2 / 1 / 2
20 / 1 / 2 / 1 / 2 / 1 / 2
21 / 1 / 2 / 1 / 2 / 1 / 2
22 / 1 / 2 / 1 / 2 / 1 / 2
23 / 1 / 2 / 1 / 2 / 1 / 2
24 / 1 / 2 / 1 / 2 / 1 / 2
25 / 1 / 2 / 1 / 2 / 1 / 2

see Family Group card:If respondent has children, ask Q29-Q31; otherwise go to Q32

Shuffle pink cards

Q29Can you please sort these items into two piles as before? In one pile I’d like you to put the things that you do, and in the other pile I’d like you to put the things that you don’t do.

record ‘don’t Do’ pile first then ‘Do’ pile. Record in column Q29.

IF RESPONDENT DoeS ALL ITEMS GO TO Q32.

Give respondent pile of ‘don’t do’ items and ask Q30for each item.

Q30For each of these things that you don’t do, can you tell me if you would like to do them?

If necessary:Not thinking about the cost

Record in column Q30

For each item that the respondent would like to do, ask Q31. IF RESPONDENT WOULD NOT LIKE TO DO ANY GO TO Q32.

Q31Is the reason that you don’t do this thing because of the cost, or some other reason?

Record response in column Q31 for each item

Item number / Q29 / Q30 / Q31
Do / Don’t do / Like / Wouldn’t like / Cost / Other reason
26 / 1 / 2 / 1 / 2 / 1 / 2
27 / 1 / 2 / 1 / 2 / 1 / 2
28 / 1 / 2 / 1 / 2 / 1 / 2
29 / 1 / 2 / 1 / 2 / 1 / 2

Q32I am going to read out a list of things some people do to help keep down costs. In the last 12 months, have you done these things not at all, a little, or a lot?

Read out statements / Not at all / A little / A lot / Don’t Know / Refused
Bought cheaper cuts of meat or less meat than you would like to buy to help keep down costs? / 1 / 2 / 3 / 9 / 7
Gone without fresh fruit and vegetables to help keep down costs? / 1 / 2 / 3 / 9 / 7
Bought second-hand clothing instead of new to help keep down costs? / 1 / 2 / 3 / 9 / 7
Continued wearing clothing that was worn out because you couldn’t afford replacement? / 1 / 2 / 3 / 9 / 7
Put off buying clothes for as long as possible to help keep down costs? / 1 / 2 / 3 / 9 / 7
Relied on gifts of clothing to help keep down costs? / 1 / 2 / 3 / 9 / 7
Continued wearing shoes that were worn out because you couldn’t afford replacements? / 1 / 2 / 3 / 9 / 7
Put up with feeling cold to save heating costs? / 1 / 2 / 3 / 9 / 7
Stayed in bed longer to save heating costs? / 1 / 2 / 3 / 9 / 7
Postponed or put off visits to the doctor to help keep down costs? / 1 / 2 / 3 / 9 / 7
Gone without glasses you needed because you couldn’t afford them? / 1 / 2 / 3 / 9 / 7
NOT picked up a prescription to help keep down costs? / 1 / 2 / 3 / 9 / 7
Gone without or cut back on visits to family or friends to help keep down costs? / 1 / 2 / 3 / 9 / 7
Done without or cut back on trips to the shops or other local places to help keep down costs? / 1 / 2 / 3 / 9 / 7
Spent less time on hobbies than you would like, to help keep down costs? / 1 / 2 / 3 / 9 / 7
NOT gone to a funeral or tangi you would have liked to have gone to because of the cost? / 1 / 2 / 3 / 9 / 7

see Family Group card:If respondent has children, ask Q33; otherwise GO TO Q34

I am now going to read out another list of things some people do to help keep down costs.

Q33In the last 12 months, have you done these things not at all, a little, or a lot?

Read out statements / Not at all / A little / A lot / Don’tKnow / Refused
Postponed child’s visit to the doctor because of the cost? / 1 / 2 / 3 / 9 / 7
Postponed child’s visit to the dentist because of the cost? / 1 / 2 / 3 / 9 / 7
Child wore clothes or shoes too small or too large because of the cost? / 1 / 2 / 3 / 9 / 7
Made do with very limited space for the children to study or play because of the cost? / 1 / 2 / 3 / 9 / 7
Been unable to pay for your child to go on a school outing because of the cost? / 1 / 2 / 3 / 9 / 7
NOT bought school books or school supplies because of the cost? / 1 / 2 / 3 / 9 / 7
NOT bought children’s books for reading at home because of the cost? / 1 / 2 / 3 / 9 / 7
Child went without prescription glasses (or contact lenses) when they were needed? / 1 / 2 / 3 / 9 / 7
Child went without music, dance, art or other cultural lessons because of the cost? / 1 / 2 / 3 / 9 / 7
Had to limit your child’s involvement in sport because of the cost? / 1 / 2 / 3 / 9 / 7
Child shared a bed because of the cost? / 1 / 2 / 3 / 9 / 7

Q34How well does your total income meet your everyday needs for such things as accommodation, food, clothing and other necessities? Would you say that you have not enough money, just enough money, enough money, or more than enough money?

Not enough / 1
Just enough / 2
Enough / 3
More than enough / 4
Don’t Know / 9
Refused / 7

Now I am going to ask you a couple of questions about your material standard of living – the things that money can buy. Your material standard of living does NOT include your capacity to enjoy life. You should NOT take your health into account.

Q35Generally, how would you rate your material standard of living?

High / 1
Fairly high / 2
Medium / 3
Fairly low / 4
Low / 5
Don’t Know / 9
Refused / 7

Q36Generally, how satisfied are you with your current material standard of living? Would you say you are very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied, very dissatisfied?

Very satisfied / 1
Satisfied / 2
Neither satisfied nor dissatisfied / 3
Dissatisfied / 4
Very dissatisfied / 5
Don’t Know / 9
Refused / 7

Q37How would you rate your material standard of living now compared to one year ago?

And how would you rate your material standard of living now compared to five years ago?

One year ago / Five years ago
Much better / 1 / Much better / 1
Better / 2 / Better / 2
About the same / 3 / About the same / 3
Worse / 4 / Worse / 4
Much worse / 5 / Much worse / 5
Don’t Know / 9 / Don’t Know / 9
Refused / 7 / Refused / 7
HEALTH

Now I am going to ask you about your health and the health of your family. I am going to begin with your health.

Q38Roughly on how many occasions in the past 12 months would you have consulted the following for your own health needs? (For you, not your children.)

Number / D/K / Refused
Doctor or general practitioner / 99 / 97
Accident and Emergency / 99 / 97
A medical specialist
IF NECESSARY:A Specialist is usually a doctor you are “referred to” by a GP or other doctor, for example: Cardiac surgeon; Ear, Nose and Throat specialist; Oncologist. / 99 / 97
Other mainstream health professionalsuch as dentists,opticians, physiotherapists, registered clinical psychologists etc
IF NECESSARY: people who are governed by a health registration process. / 99 / 97
Māori healer / 99 / 97
Alternative therapist (this includes therapists such as Chiropractors, Naturopaths, Homeopaths, Acupuncturists, Aromatherapists). / 99 / 97

Q39In the past 12 months, have you had any medical conditionsor injuriesthat have caused you serious health problems or disabilities? These could include physical problems (e.g.rheumatoid arthritis, partial deafness) or mental health problems (e.g. chronic depression, bipolar disorder).

N.B “serious” means something that affects your ability to do everyday things or means that you have substantial costs

Yes / 1 / CONTINUE
No / 2 / SKIP TO Q46
Don’t know / 9
Refused / 7

Q40And can you please tell me what those conditions were and how long you have had them?

Name of condition / D/K / Refused / How long you have had it? / D/K / Refused
Years / Months
1 / 99 / 97 / 99 / 97
2 / 99 / 97 / 99 / 97
3 / 99 / 97 / 99 / 97
4 / 99 / 97 / 99 / 97
5 / 99 / 97 / 99 / 97
6 / 99 / 97 / 99 / 97
7 / 99 / 97 / 99 / 97
8 / 99 / 97 / 99 / 97
9 / 99 / 97 / 99 / 97
10 / 99 / 97 / 99 / 97
1

IF MORE THAN 10 CONDITIONS PLEASE CIRCLE 1 IN BOX

Q41To what extent havetheseconditions restricted the following areas of your life in the last 12 months? Not at all, a little or a lot?

Not at all / A little / A lot / N/A / D/K / Refused
Employment / 1 / 2 / 3 / 6 / 9 / 7
Education or training / 1 / 2 / 3 / 6 / 9 / 7
Daily living (for example: personal care, transport, housework, gardening) / 1 / 2 / 3 / 6 / 9 / 7
Social activities / 1 / 2 / 3 / 6 / 9 / 7
Finances / 1 / 2 / 3 / 6 / 9 / 7

see Family Group Card: If respondent has children, ask Q46-Q49; otherwise GO TO Q50

Q46On roughly how many occasions would your children (as listed on the family group card) have been to the followingin the last 12 months?

Put total sum of visits for all children in household for each category as appropriate

PLEASE NOTE APPROXIMATIONS (BEST GUESS ESTIMATES) ARE FINE

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