e. c. 0 66 s~io-economic and Cuttural Characteristics 1 lncomc a1,d E,c~nses a. occupation. place or work and incorne or each working member b. Adequacy to meet basic ncccssitfcs (food, clothh,g, shelter) c. Who mal<e~ decision~ ;,boul money ;ind how 1t Is spent Educatiotii!I analnment ol each mcmt,er Ethnc: background and religious o1fflliation family Traditions. event~ or practices affec;ting members' he. a Ith or family 4. s. 6. rvnction,ng s,gnifiunt Other$-role(sl they play in family's life Relationship of the family to larger community-Nature and extent of particip. itton of th famiiy in comm~in lty activities t{orne and Environment 1. 2 3. 4. Hcusing a. /ldt!quacy of living s~ace LI. Sleepn!! arra1. !;Ernent c. Pre!enc,; of brceamg or resting sites of vectors or diseases (e. g. rnosoulcoes. roaches, mes, rodents, etc. ) d. Pte~ence of ac Ctccnt and fire hazards Food storafie-and cool,ing racillties W. Jter ~upply-~our<;e, ownership. potability Toilet !ac,lol y-t,·pe. ownersh, p, sanitary condition Garbase/ref,Jse dispo,al-type, sanitary condition Drainage sv~lem-type, san1ta,ry rondltion Kind of ne1ghoochood, e. g. congested, slum, etc. sooal and health facilities avallable commun icacion and transport anon facilities available Health Statt. J$ of each Famfly Member 1. Med,cal and nursing h,story indicating current or past slsnificanl Hlnesses or beliefs and pracoces conducive to health and illness 2. NLttr>t1cnal a H<:s~ment {specially for vulnerable or at-risk members) a. /. nthropornetrlc data· Measures of nutri Honal status of children-weight, he1~t m111-upper arm circumference: Risk assessment measures for Obe~1ty body ma~s index (81-. 111: wel5ht in legs. div,decf by height ,n /T\Ftersl ), wa1~r circumference (\,VC; greater than 90 crn. in men and oreater th;;" 80 cm 1n women ). waist hip ratio (WHR = waist ci1<. 1.,n1forence 1n cm d1v1ded by hip circumference in cm Central Obesity: Wf1R Pquar !I) or gre111er than 1. 0 cm. in men and 0. 85 in women). b, D'eta1y n,sro,y specify,ng qual,ry and quantity of food/nutrient intake per day c.. Eating/fc~'1,ng hal:>its/pr;icnce\ 3. Developmt'r. tal dv,ei. sm.. nt of infants, toddler~. and preschoolers-e. 9., Metro Mantia 0e,,elcpmemal Screening it"St (MMDSn. · Risk fano, as:essrnent ind t. 1nng p1'esenc. c of major and contributing modift. Jl::le risk factors tor specific l,f~sty Je diseases-e. g. hypertension, phy~ic. tl,n. act1v1ly, se-de11tary Jrfestyte, ci;garette/toba~c. o smoking. elcvaled blood lipids/cho!o1. erot, obesil-y, dtabe~es mellirus, Inadequate Hber rnt. :ike, Streu, a!cohol dr1n1'. ir-,a and ~Mer subst... mce ~buw 