2024 CAH&C Community Health Needs Assessment Survey
This survey is completely anonymous. All responses will be combined and reported to help assess the health needs of our community. Your participation is valuable and greatly appreciated
1.
How would you rate your current overall health?
Excellent
Good
Fair
Poor
Excellent
Good
Fair
Poor
2.
If you and/or members of your household have insurance coverage, how is it obtained? (check all that apply)
Medicaid
Traditional Medicare
Medicare Advantage Plan
Through Employer
Veterans Administration
Private Purchase
Uninsured
Other (please specify)
3.
What are the biggest barriers to accessing healthcare in your community? (Select all that apply)
Health services awareness
Insurance and coverage issues
Transportation and Distance
Cost and affordability
Technological barriers. Examples/ Cell Phone Applications, Computers, On-Line Services
Provider availability and shortages
Other (please specify)
4.
How often do you travel outside your community to receive healthcare services?
Always
Usually
Sometimes
Rarely
Never
5.
Do transportation issues prevent you from accessing healthcare?
Yes
No
6.
How far do you travel to reach your primary healthcare provider?
Less than 10 Miles
11- 30 Miles
31- 50 Miles
More than 50 Miles
7.
Would improved availability of public, private, or emergency transportation options make it easier for you to access healthcare services?
Yes
No
If Yes (please specify)
8.
In the event that you or someone you know needed Primary Care Services, do you believe that it could be accessed in Macoupin County?
Yes
No
9.
In the event that you or someone you know needed Specialty Care Services, do you believe that it could be accessed in Macoupin County?
Yes
No
10.
Are you a Veteran?
Yes
No
11.
Are you a Disabled Veteran?
Yes
No
12.
How would you describe the current level of healthcare access for veterans, including those with disabilities, in our community?
Excellent
Good
Fair
Poor
13.
Would you or someone you know be interested in pursuing a career in healthcare?
Yes
No
14.
Do you think there are enough resources (e.g., scholarships, career counseling) for individuals interested in healthcare careers in your community?
Yes
No
15.
How easy is it for you to access affordable, healthy food in your community?
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
16.
Have you experienced any health issues due to food insecurity? (e.g., diabetes, obesity, malnutrition)
Yes
No
If yes (please specify)
17.
What do you believe are the main barriers to accessing healthy food in your community?
18.
How would you rate your overall mental health?
Excellent
Good
Fair
Poor
19.
What barriers do you or someone you know face when trying to access mental health care? (Select all that apply)
Transportation Issues
Lack of Insurance/ Financial Resources
Cost
Stigma/ Privacy Concerns
Lack of Providers
Cultural or Language Barriers
Other (please specify)
20.
How knowledgeable do you feel about available mental health resources in your community?
Very Knowledgeable
Somewhat Knowledgeable
Not very Knowledgeable
Not at all Knowledgeable
21.
In your opinion, how can the community better support individuals with mental health issues?
22.
In the past 12 months, have you or someone you know personally experienced issues related to drug abuse or addiction?
Yes, I have experienced it personally
Yes, someone in my family or close circle has experienced it
No, neither I nor anyone close to me has experienced it
Not sure / Don’t know
23.
If you or someone you know were struggling with substance use or addiction, how easy would it be to find treatment or support in your community?
Very easy
Somewhat Easy
Somewhat Difficult
Very difficult
Not sure / Don't know
24.
Have you or someone you know been diagnosed with any chronic disease (such as diabetes, heart disease, arthritis, asthma, etc.) by a healthcare professional? (Please select all that apply)
Yes, diabetes
Yes, heart disease
Yes, arthritis
Yes, kidney disease
Yes, chronic pain or other musculoskeletal conditions
Yes, respiratory conditions (e.g., COPD, emphysema)
Yes, autoimmune disease (e.g., lupus, rheumatoid arthritis)
Yes, mental health disorder (e.g., depression, anxiety, schizophrenia)
No, I have not been diagnosed with any chronic disease
Prefer not to say
Other (please specify)
25.
In your opinion, how important is the expansion of specialty healthcare services (such as cardiology, oncology, mental health, orthopedics, etc.) in your community? Please rate the following statement:
"Expanding access to specialty healthcare services in my community is important."
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Don't know / Not sure
26.
If you feel that expanding specialty healthcare services is important, which specialties do you believe should be prioritized in your community? (Please select all that apply)
Oncology (cancer care)
Dialysis (kidney care)
Cardiology (heart care)
Pediatrics (children's health)
Orthopedics (bone and joint care)
Interventional Pain Management (non-opioid pain management)
Endocrinology (hormonal and metabolic disorders)
Mental Health (psychology, psychiatry, counseling)
Primary Care (adult health)
Physical Therapy
Radiology/Laboratory Services (x-rays, CT scans, MRI, and blood draws)
27.
In the past 12 months, have you or someone you know used any technology-based healthcare services, such as telehealth, remote online doctor visits, or other similar services?
Yes
No
Not sure / Don't know
28.
Would having more access to telehealth or remote online healthcare services improve your ability to receive care?
Yes, definitely
Yes, somewhat
No, not really
No, not at all
Not sure/ Don't know
29.
How would you describe your overall level of physical activity?
Very active (engage in physical activity or exercise most days of the week)
Moderately active (engage in physical activity a few times per week)
Occasionally active (engage in physical activity once a week or less)
Sedentary (little to no physical activity or exercise)
30.
What factors, if any, prevent you from being more physically active? (Select all that apply)
Lack of time
Lack of motivation
Health problems or chronic conditions
Lack of access to safe spaces for exercise (e.g., parks, gyms)
None / I am able to be as active as I want
Other (please specify)
31.
What is the zip code of your residence?
32.
What is your sex?
Male
Female
Prefer not to answer
33.
Please select your age group
Under 18
18-24
25-34
35-44
45-54
55-64
65+
34.
What is your highest level of education?
8th Grade
Some High School
High School
Some College
Associate's Degree
Bachelor's Degree
Master's Degree
Ph.D., J.D., or M.D.
Other (please specify)
35.
What is your employment status?
Employed Full-Time
Employed Part-Time
Unemployed, Seeking Opportunities
Unemployed, Not Seeking Opportunities
Retired
Disabled or Unable to work
Prefer not to say
Other (please specify)
36.
What is your household income level?
Under $15,000
Between $15,000 and $29,999
Between $30,000 and $49,999
Between $50,000 and $74,999
Between $75,000 and $99,999
Between $100,000 and $150,000
Over $150,000
