PhenX Toolkit:



Race/Ethnicity Census 2020 & All of Us MappingCensus 2020 Items & Response choices in BlackAll of Us response options in redReminder - All of Us question: “Which categories describe you? Select all that apply. Note, you may select more than one group.”8. Is Person 1 of Hispanic, Latino, or Spanish origin?No, not of Hispanic, Latino, or Spanish originYes, Mexican, Mexican Am., ChicanoYes, Puerto RicanYes, CubanYes, another Hispanic, Latino, or Spanish origin – Print, for example, Salvadoran, Dominican, Colombian, Guatemalan, Spaniard, Ecuadorian, etc. ________________[ ] Hispanic, Latino, or Spanish (For example: Colombian, Cuban, Dominican, Mexican or Mexican American, Puerto Rican, Salvadoran, etc.) Branching Logic if ‘Hispanic, Latino, or Spanish’ selected: [ ] Colombian[ ] Cuban[ ] Dominican[ ] Ecuadorian[ ] Honduran [ ] Mexican or Mexican American [ ] Puerto Rican [ ] Salvadoran [ ] Spanish [ ] None of these fully describe me _________________________9. What is Person 1’s race? Mark one or more boxes AND print origins.White – Print, for example, German, Irish, English, Italian, Lebanese, Egyptian, etc. _____________[ ] White (For example: English, European, French, German, Irish, Italian, Polish, etc.) Branching Logic if ‘White’ selected: [ ] Dutch [ ] English [ ] European [ ] French [ ] German [ ] Irish [ ] Italian [ ] Norwegian [ ] Polish [ ] Scottish [ ] Spanish [ ] Middle Eastern or North African (For example: Algerian, Egyptian, Iranian, Lebanese, Moroccan, Syrian, etc.) Branching Logic if ‘Middle Eastern or North African’ selected: [ ] Afghan [ ] Algerian [ ] Egyptian [ ] Iranian [ ] Iraqi [ ] Israeli [ ] Lebanese [ ] Moroccan [ ] Syrian [ ] Tunisian [ ] None of these fully describe me __________________________Black or African Am. – Print, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc. _______________[ ] Black, African American, or African (For example: African American, Ethiopian, Haitian, Jamaican, Nigerian, Somali, etc.) Branching Logic if ‘Black, African American, or African’ selected: [ ] African American[ ] Barbadian [ ] Caribbean [ ] Ethiopian [ ] Ghanaian [ ] Haitian [ ] Jamaican [ ] Liberian [ ] Nigerian [ ] Somali [ ] South African [ ] None of these fully describe me____________________________American Indian or Alaska Native – Print name of enrolled or principal tribe(s), for example, Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc. _____________[ ] American Indian or Alaska Native (For example: Aztec, Blackfeet Tribe, Mayan, Navajo Nation, Native Village of Barrow (Utqiagvik) Inupiat Traditional Government, Nome Eskimo Community, etc.) Branching Logic if ‘American Indian or Alaska Native’ selected: [ ] American Indian [ ] Alaska Native [ ] Central or South American Indian [ ] None of these fully describe me_____________________________ ? Branching Logic if ‘American Indian,’ ‘Alaska Native,’ OR ‘Central or South American Indian’ selected: Provide the name of the tribe in which you are enrolled or affiliated or your tribal descent (For example: Aztec, Blackfeet Tribe, Mayan, Navajo Nation, Native Village of Barrow (Utqiagvik) Inupiat Traditional Government, Nome Eskimo Community, etc.) _____________________________ChineseFilipinoAsian IndianVietnameseKoreanJapaneseOther Asian –Print, for example, Pakistani, Cambodian, Hmong, etc. _____________[ ] Asian (For example: Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, etc.) Branching Logic if ‘Asian’ selected: [ ] Asian Indian [ ] Cambodian [ ] Chinese [ ] Filipino [ ] Hmong [ ] Japanese[ ] Korean [ ] Pakistani [ ] Vietnamese [ ] None of these fully describe me_______________________________Native HawaiianSamoanChamorroOther Pacific Islander –Print, for example, Tongan, Fijian, Marshallese, etc. ______________[ ] Native Hawaiian or other Pacific Islander (For example: Chamorro, Fijian, Marshallese, Native Hawaiian, Tongan, etc.) Branching Logic if ‘Native Hawaiian or other Pacific Islander’ selected: [ ] Chamorro [ ] Chuukese [ ] Fijian [ ] Marshallese [ ] Native Hawaiian [ ] Palauan [ ] Samoan [ ] Tahitian [ ] Tongan [ ] None of these fully describe me ____________________________Some other race – Print race or origin. ______________ ................
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