Jessica Smith Dissertation

How old are you?

What is your gender?

Male

Female

Transgender

Other

What is your race? Please select all that apply.

Black/African American

American Indian or Alaska Native

White/Caucasian

Asian/Asian American

Native Hawaiian/Pacific Islander

Hispanic/Latino/Latina

Other

What is your current relationship status?

Single/divorced

Married/domestic partnership/living with a partner

Dating, not living together

Widowed/grieving the loss of a partner

Other

Where do you live?

What part of the country do you live in?

Northeast, New England

South, Southeast

Southwest, West

Plains, Midwest

Non-continental U.S., U.S. territories

Other

Do you have health insurance? Select all that apply:

Yes, through my employer

Yes, through my partner's employer

Yes, through my parents

Yes, through an individual policy that I purchase

Yes, through Medicare

Yes, through Medicare plus a Medicare supplement

Yes, though Medicaid

No, I do not have health insurance

What is the highest level of education that you have completed?

Junior high

High school

Some college, 1 or 2 year degree or certificate

College degree (Bachelors)

Some graduate school

Graduate degree (ex: MA, MS, PhD, PsyD, MD, etc)

What was your total 2013 household income, before taxes?

What is your current weight in pounds?