Richland County Community Member Survey

Welcome!

Richland County Public Health & Avita Health System are conducting a Community Health Needs Assessment (CHNA) to identify and assess the health needs of the community. We are asking community members (those who live and/or work in Richland County) to complete this short, 15 minute survey. This information will help guide us as we consider services and programs that will benefit the community. 
 
Be assured that this process is completely anonymous - we cannot access your name and your responses will be kept confidential. Your participation in this survey is entirely voluntary and you are free to leave questions unanswered. Thank you for helping us to better serve our community!
1.Where do you live or reside in Richland County? (choose one)
2.Where do you work? (choose one)
3.Which of the following best describes your age?
4.What is your gender identity?
5.What is your sexual orientation?
6.What is your race and/or ethnicity? (Select all that apply)
7.What is your primary language spoken at home?
8.How many children, ages 0-18, live in your household?
9.What is the highest level of education you have completed?
10.Are you currently employed?
11.If you are currently employed, which of the following best describes your occupational category?
12.What is your annual household income?
13.Do you identify as having a disability?
14.What is your current living situation?
15.Have you experienced any of the following types of abuse in the past year? (Select all that apply)
16.While it can be hard to choose, do your best to select what you feel are the TOP 5 CONCERNS OF YOUR COMMUNITY? (please check your top 5)(Required.)
17.Indicate the level of IMPORTANCE that Richland County health partners should place on addressing these needs IN YOUR COMMUNITY - from not important to very important.
NOT IMPORTANT
SOMEWHAT IMPORTANT
IMPORTANT
VERY IMPORTANT
DON'T KNOW
Access to childcare
Access to healthy foods
Air and water quality
Access to primary healthcare (regular health check-ups, family doctor, etc.)
Access to dental/oral care
Access to vision healthcare
Access to mental healthcare 
Asthma and COPD
Cancer
Child abuse
Crime and violence
Diabetes
Disabilities
Early education/preschool
Employment
Food insecurity (not having enough food to eat) 
HIV/AIDS and STIs
Heart disease and stroke
Maternal and child/infant health
Mental health
Nutrition and physical activity 
Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.)
Substance use
Tobacco and nicotine use
Tuberculosis
Wifi/internet access
18.If you do NOT currently have healthcare coverage or insurance, what are the main reasons why? (Select all that apply)
19.During the most recent time you or a member of your household delayed or went without needed healthcare, what were the main reasons? (Select all that apply)
20.Where do you and your family members go most often to receive routine healthcare services (physical exams, check-ups, immunizations, treatment for chronic diseases)? (Select all that apply)
21.How long has it been since you have been to the doctor to get a checkup when you were well (not because you were already sick)?
22.If you were sick, where would you go first for treatment? Assume that this is not an emergency situation.
23.How would you rate your current access to mental or behavioral health services?
24.What, if any, are your main barriers to accessing mental or behavioral health services, if needed? (Select all that apply)
25.If you do want to get healthier and in better shape; what if anything, do you feel is holding you back? (Select all that apply)
26.In the last year, was there a time when you needed prescription medicine but were not able to get it? 
27.About how long has it been since you have been to the dentist to get a checkup (not for an emergency)?
28.In the last year, was there a time when you needed dental care but could not get it?
29.In the last year, was there a time when you needed mental health counseling but could not get it?
30.Do you have a personal physician?
31.How long has it been since you have had a flu shot?
32.Overall, my physical health is:
33.Overall, my mental health is:
34.In the past 12 months, has lack of reliable transportation kept you from going to (select all that apply):
35.What resources are lacking within your community? (Select all that apply)
36.How many times did you volunteer in your community in the past year? (This could include helping out with local charities, helping at your kids’ school, serving on a board, at your church, or another local organization, reading at your local library, helping at a food bank, spending time with local senior citizens, etc.)
37.Do you have any other feedback or comments to share with us?
Thank you! Please send this survey to anyone you know who lives and/or works in Richland County.