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Participation in this survey is voluntary and anonymous. Responses will be aggregated, shared only in summary format, and used as one tool to inform the Essex County Community Health Assessment and Improvement Plan.

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* 1. When you imagine a strong, vibrant, healthy community, what are the most important features that come to mind? Choose up to 5.

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* 2. What are the main health concerns in the community where you live? Choose up to 5.

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* 3. How do you think your community will be doing in 5 years?

  Better About same Worse Unsure Prefer not to respond
Access to transportation
Affordable housing
Employment opportunities
Access to healthy food
Access to childcare
Safety

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* 4. What would help most in the community where you live? Choose up to 5.

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* 5. How would you rate the following statements?

  Strongly agree Agree Disagree Strongly disagree Prefer not to respond
During difficult times, I have "a village" I can call on for support.
I feel a sense of belonging to the community where I live.
Being a resident of my community is an important part of how I see myself.
I am a member of community social/religious/other groups and/or I participate in community events.

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* 6. If there was a time in the past year that you or a family member needed medical care but could not get it, why did you not get care? Select all that apply.

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* 7. In the last year, have you had trouble meeting your needs or the needs of those in your household in any of the following areas? Check all that apply.

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* 8. What are the trusted sources of health information for you and your family? Please check all that apply.

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* 9. Which of the following social media platforms/pages do you use to learn about local health or community-related events and programs? Check all that apply.

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* 10. In the last year, in an average week, how often did you (please check one response per row):

  0 days 1-3 days 4-6 days 7 days Unsure Prefer not to respond
Eat a balanced, healthy diet
Get 30 min (or more) of physical activity
Get 7-9 hours of sleep
Have quality encounters with friends, family, or community members
Feel stressed

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* 11. How would you rate your health in each area below? Please check one response per row.

  Poor Fair Good Excellent Unsure Prefer not to respond
Physical health
Dental health
Mental health

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* 12. Are there children under the age of 18 living in your household?

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* 13. If you answered yes to question #12, how would you rate the health of the children in your household (please check one response per row):

  Poor Fair Good Excellent Unsure Prefer not to respond
Physical health
Dental health
Mental health

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* 14. If you answered yes to question #12, what are the biggest concerns for the children in your household? Please check up to 3 major categories.

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* 15. What gender do you identify with?

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* 16. What is your age?

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* 17. In which town of Essex County do you reside? Select only one based on your primary residence

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* 18. What is the primary language spoken in your household?

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* 19. What is your race/ethnicity?

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* 20. What is your highest level of education?

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* 21. What is your current employment status?

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* 22. What is your annual household income?

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* 23. Do you or does anyone in your household have a disability?

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* 24. What type of health insurance do you currently have?

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* 25. Do you have reliable access to the internet in your home?

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