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!

Question Title

1. Where do you live or reside in Richland County? (choose one)

44805 (Ashland)

44813 (Belville)

44822 (Butler)

44827 (Crestline)

43019 (Fredericktown)

44833 (Gallion)

44837 (Greenwich)

44843 (Lucas)

44901 (Mansfield)

44902 (Mansfield)

44903 (Mansfield)

44904 (Mansfield)

44905 (Mansfield)

44906 (Mansfield)

44907 (Mansfield)

44862 (Ontario)

44864 (Perrysville)

44865 (Plymouth)

44875 (Shelby)

44878 (Shiloh)

None of the above, I live primarily at the following ZIP code:

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2. Where do you work? (choose one)

44805 (Ashland)

44813 (Belville)

44822 (Butler)

44827 (Crestline)

43019 (Fredericktown)

44833 (Gallion)

44837 (Greenwich)

44843 (Lucas)

44901 (Mansfield)

44902 (Mansfield)

44903 (Mansfield)

44904 (Mansfield)

44905 (Mansfield)

44906 (Mansfield)

44907 (Mansfield)

44862 (Ontario)

44864 (Perrysville)

44865 (Plymouth)

44875 (Shelby)

44878 (Shiloh)

I am not currently employed

None of the above, I work primarily at the following ZIP code:

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3. Which of the following best describes your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Prefer not to answer

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4. What is your gender identity?

Male

Female

Transgender

Non-binary

Prefer not to answer

Other

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5. What is your sexual orientation?

Heterosexual or Straight

Gay

Lesbian

Bisexual

Asexual

Prefer not to answer

Other (please specify)

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6. What is your race and/or ethnicity? (Select all that apply)

Asian

Black or African American

Hispanic/Latino/a

White/Caucasian

Multiracial/More than one race

Native American/Alaska Native

Native Hawaiian/Pacific Islander

Other (please specify)

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7. What is your primary language spoken at home?

English

Spanish

Other (please specify)

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8. How many children, ages 0-18, live in your household?

Other (please specify)

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9. What is the highest level of education you have completed?

Less than a High School diploma

High School degree or equivalent

Some college but no degree

Associate's degree (e.g. AA, AS)

Bachelor's degree (e.g. BA, BS)

Graduate degree (e.g. MA, MS, PhD, EdD, MD)

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10. Are you currently employed?

Yes, full-time (30 hours per week or more)

Yes, part-time (less than 30 hours per week)

Not employed - but looking for work

Not employed - not actively looking for work

Student

Retired

Disabled

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11. If you are currently employed, which of the following best describes your occupational category?

Art, culture, recreation, tourism and sport

Business, finance and administration

Education, law and social, community and government services

Health

Management

Manufacturing and utilities

Military

Natural and applied sciences and related occupations

Natural resources, agriculture and related production

Sales and service

Trades, transport and equipment operators and related occupations

Other (please specify)

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12. What is your annual household income?

Less than $20,000

$20,000-$34,999

$35,000-$49,999

$50,000-$74,999

$75,000-$99,999

Over $100,000

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13. Do you identify as having a disability?

Yes

Prefer not to answer

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14. What is your current living situation?

I have a steady place to live

I have a place to live today, but I am worried about losing it in the future

I do not have a steady place to live (I am temporarily staying with others)

I am staying in a shelter

I am living outside

I am living in a car

I am living elsewhere

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15. Have you experienced any of the following types of abuse in the past year? (Select all that apply)

Physical violence (punching, hitting, slapping, kicking, strangling, or physically restraining someone against their will, use of weapons, etc.)

Sexual (rape or other forced sexual acts, unwanted touching, etc.)

Verbal/Emotional (hurtful words, insults, etc.)

Mental/Psychological (negatively affecting someone's mental health, manipulation, etc.)

Financial/Economic (using money/finances to control someone)

Elder (an intentional act or failure to act that causes or creates a risk of harm to an older adult)

Cultural/Identity (discrimination based on race, culture, religion, sexual orientation, gender identity, disability, class, age, etc.)

Other (please specify)

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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)

Access to healthcare (e.g. doctors, hospitals, specialists, medical appointments, etc.)

Access to childcare

Adverse childhood experiences (e.g. child abuse, mental health, family issues, trauma)

Chronic diseases (e.g. heart disease, diabetes, cancer, asthma)

Crime and violence

Education (e.g. early childhood education, elementary school, post-secondary education)

Employment

Environmental conditions (e.g. air and water quality)

Food insecurity (e.g. not being able to access and/or afford healthy food)

HIV/AIDS and Sexually Transmitted Infections (STIs)

Housing and homelessness

Income/poverty

Internet/wifi access

Maternal, infant and child health (e.g. pre-term births, infant mortality, maternal mortality)

Mental health and access to mental healthcare

Nutrition and physical health/exercise

Preventive care and practices (e.g. mammograms, vaccinations)

Substance/drug use

Tobacco and nicotine use/smoking

Transportation (e.g. public transit, cars, cycling, walking)

Question Title

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 childcare NOT IMPORTANT	Access to childcare SOMEWHAT IMPORTANT	Access to childcare IMPORTANT	Access to childcare VERY IMPORTANT	Access to childcare DON'T KNOW
Access to healthy foods	Access to healthy foods NOT IMPORTANT	Access to healthy foods SOMEWHAT IMPORTANT	Access to healthy foods IMPORTANT	Access to healthy foods VERY IMPORTANT	Access to healthy foods DON'T KNOW
Air and water quality	Air and water quality NOT IMPORTANT	Air and water quality SOMEWHAT IMPORTANT	Air and water quality IMPORTANT	Air and water quality VERY IMPORTANT	Air and water quality DON'T KNOW
Access to primary healthcare (regular health check-ups, family doctor, etc.)	Access to primary healthcare (regular health check-ups, family doctor, etc.) NOT IMPORTANT	Access to primary healthcare (regular health check-ups, family doctor, etc.) SOMEWHAT IMPORTANT	Access to primary healthcare (regular health check-ups, family doctor, etc.) IMPORTANT	Access to primary healthcare (regular health check-ups, family doctor, etc.) VERY IMPORTANT	Access to primary healthcare (regular health check-ups, family doctor, etc.) DON'T KNOW
Access to dental/oral care	Access to dental/oral care NOT IMPORTANT	Access to dental/oral care SOMEWHAT IMPORTANT	Access to dental/oral care IMPORTANT	Access to dental/oral care VERY IMPORTANT	Access to dental/oral care DON'T KNOW
Access to vision healthcare	Access to vision healthcare NOT IMPORTANT	Access to vision healthcare SOMEWHAT IMPORTANT	Access to vision healthcare IMPORTANT	Access to vision healthcare VERY IMPORTANT	Access to vision healthcare DON'T KNOW
Access to mental healthcare	Access to mental healthcare NOT IMPORTANT	Access to mental healthcare SOMEWHAT IMPORTANT	Access to mental healthcare IMPORTANT	Access to mental healthcare VERY IMPORTANT	Access to mental healthcare DON'T KNOW
Asthma and COPD	Asthma and COPD NOT IMPORTANT	Asthma and COPD SOMEWHAT IMPORTANT	Asthma and COPD IMPORTANT	Asthma and COPD VERY IMPORTANT	Asthma and COPD DON'T KNOW
Cancer	Cancer NOT IMPORTANT	Cancer SOMEWHAT IMPORTANT	Cancer IMPORTANT	Cancer VERY IMPORTANT	Cancer DON'T KNOW
Child abuse	Child abuse NOT IMPORTANT	Child abuse SOMEWHAT IMPORTANT	Child abuse IMPORTANT	Child abuse VERY IMPORTANT	Child abuse DON'T KNOW
Crime and violence	Crime and violence NOT IMPORTANT	Crime and violence SOMEWHAT IMPORTANT	Crime and violence IMPORTANT	Crime and violence VERY IMPORTANT	Crime and violence DON'T KNOW
Diabetes	Diabetes NOT IMPORTANT	Diabetes SOMEWHAT IMPORTANT	Diabetes IMPORTANT	Diabetes VERY IMPORTANT	Diabetes DON'T KNOW
Disabilities	Disabilities NOT IMPORTANT	Disabilities SOMEWHAT IMPORTANT	Disabilities IMPORTANT	Disabilities VERY IMPORTANT	Disabilities DON'T KNOW
Early education/preschool	Early education/preschool NOT IMPORTANT	Early education/preschool SOMEWHAT IMPORTANT	Early education/preschool IMPORTANT	Early education/preschool VERY IMPORTANT	Early education/preschool DON'T KNOW
Employment	Employment NOT IMPORTANT	Employment SOMEWHAT IMPORTANT	Employment IMPORTANT	Employment VERY IMPORTANT	Employment DON'T KNOW
Food insecurity (not having enough food to eat)	Food insecurity (not having enough food to eat) NOT IMPORTANT	Food insecurity (not having enough food to eat) SOMEWHAT IMPORTANT	Food insecurity (not having enough food to eat) IMPORTANT	Food insecurity (not having enough food to eat) VERY IMPORTANT	Food insecurity (not having enough food to eat) DON'T KNOW
HIV/AIDS and STIs	HIV/AIDS and STIs NOT IMPORTANT	HIV/AIDS and STIs SOMEWHAT IMPORTANT	HIV/AIDS and STIs IMPORTANT	HIV/AIDS and STIs VERY IMPORTANT	HIV/AIDS and STIs DON'T KNOW
Heart disease and stroke	Heart disease and stroke NOT IMPORTANT	Heart disease and stroke SOMEWHAT IMPORTANT	Heart disease and stroke IMPORTANT	Heart disease and stroke VERY IMPORTANT	Heart disease and stroke DON'T KNOW
Maternal and child/infant health	Maternal and child/infant health NOT IMPORTANT	Maternal and child/infant health SOMEWHAT IMPORTANT	Maternal and child/infant health IMPORTANT	Maternal and child/infant health VERY IMPORTANT	Maternal and child/infant health DON'T KNOW
Mental health	Mental health NOT IMPORTANT	Mental health SOMEWHAT IMPORTANT	Mental health IMPORTANT	Mental health VERY IMPORTANT	Mental health DON'T KNOW
Nutrition and physical activity	Nutrition and physical activity NOT IMPORTANT	Nutrition and physical activity SOMEWHAT IMPORTANT	Nutrition and physical activity IMPORTANT	Nutrition and physical activity VERY IMPORTANT	Nutrition and physical activity DON'T KNOW
Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.)	Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.) NOT IMPORTANT	Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.) SOMEWHAT IMPORTANT	Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.) IMPORTANT	Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.) VERY IMPORTANT	Preventive practices (mammograms, vaccines/immunizations, health screenings, etc.) DON'T KNOW
Substance use	Substance use NOT IMPORTANT	Substance use SOMEWHAT IMPORTANT	Substance use IMPORTANT	Substance use VERY IMPORTANT	Substance use DON'T KNOW
Tobacco and nicotine use	Tobacco and nicotine use NOT IMPORTANT	Tobacco and nicotine use SOMEWHAT IMPORTANT	Tobacco and nicotine use IMPORTANT	Tobacco and nicotine use VERY IMPORTANT	Tobacco and nicotine use DON'T KNOW
Tuberculosis	Tuberculosis NOT IMPORTANT	Tuberculosis SOMEWHAT IMPORTANT	Tuberculosis IMPORTANT	Tuberculosis VERY IMPORTANT	Tuberculosis DON'T KNOW
Wifi/internet access	Wifi/internet access NOT IMPORTANT	Wifi/internet access SOMEWHAT IMPORTANT	Wifi/internet access IMPORTANT	Wifi/internet access VERY IMPORTANT	Wifi/internet access DON'T KNOW

Question Title

18. If you do NOT currently have healthcare coverage or insurance, what are the main reasons why? (Select all that apply)

I am waiting to get coverage through my job

I don't think I need health insurance

I haven't had time to deal with it

It costs too much

I am not eligible or do not qualify

It is too confusing to sign up

Does not apply - I have health coverage/insurance

Other (please specify)

Question Title

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)

Could not get an appointment quickly enough/too long of a wait for an appointment

Could not get an appointment that was convenient with my work hours or child's school schedule

Distrust/fear of discrimination

Lack of provider awareness and/or education about my health condition

Language barriers

No insurance and could not afford care

Insurance did not cover the cost of the procedure or care

Not knowing where to go or how to find a doctor

Technology barriers with virtual visits/telehealth services

Not having a provider who understands and/or respects my cultural or religious beliefs

Lack of transportation to the appointment

The appointment was too far away and/or outside of Richland County

Distrust/fear of discrimination

No barriers and did not delay health care - received all the care that was needed

Other (please specify)

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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)

Doctor's office (primary care physician, family physician, internist, pediatrician, etc.)

Emergency room department at the hospital

Urgent care clinic

I wouldn't go to a doctor unless it was an emergency

Not sure

None of the above

Other (please specify)

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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)?

Within the last year

1-2 years ago

3-5 years ago

More than 5 years ago

I have never been to a doctor for a checkup

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22. If you were sick, where would you go first for treatment? Assume that this is not an emergency situation.

Doctor's office (primary care physician, family physician, internist, pediatrician, etc.)

Specialist's office (cardiologist, pulmonologist, endocrinologist, etc.)

Emergency room department at hospital

Urgent care clinic

I wouldn't go to a doctor unless it was an emergency

Not sure

None of the above

Other (please specify):

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23. How would you rate your current access to mental or behavioral health services?

Very high access

High access

Neutral

Low access

Very low access

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24. What, if any, are your main barriers to accessing mental or behavioral health services, if needed? (Select all that apply)

Could not get an appointment quickly enough/too long of a wait for an appointment

No insurance and it costs too much

I have insurance but it did not cover the cost of the services

Not knowing where to go or how to find behavioral or mental health providers

COVID-19 appointment cancellation, concern of infection, or other health related concern

Distrust/fear of discrimination

Uncomfortable with mental or behavioral health provider

Office hours of provider don't work with my schedule

Stigma of mental or behavioral health/nervous about admitting that I have a mental or behavioral health concern

Language barriers

Lack of provider awareness and/or education about my health condition

Technology barriers with virtual visits/telehealth services

Not having a provider who understands and/or respects my cultural or religious beliefs

Lacked transportation to the appointment

Do not need behavioral or mental health care

No barriers - received all the behavioral and mental health care that was needed

Other (please specify)

Question Title

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)

Stress

Lack of energy

My busy schedule (I don't have time to cook or exercise)

Lack of support from friends

Lack of support from family

I feel intimidated or awkward going to a gym or fitness center

Money (gyms and healthy foods are too expensive)

Lack of gyms or fitness centers to go to near me

Food and fitness is too confusing

Convenience (eating out is easier)

I don't like to cook

I don't like to exercise

I don't feel motivated to be healthier

None of the above. (I'm in good shape or don't want to be in better shape)

Other (please specify)

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26. In the last year, was there a time when you needed prescription medicine but were not able to get it?

Yes

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27. About how long has it been since you have been to the dentist to get a checkup (not for an emergency)?

Within the last year

1-2 years ago

3-5 years ago

More than 5 years ago

I have never been to the dentist for a checkup

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28. In the last year, was there a time when you needed dental care but could not get it?

Yes

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29. In the last year, was there a time when you needed mental health counseling but could not get it?

Yes

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30. Do you have a personal physician?

Yes

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31. How long has it been since you have had a flu shot?

Within the last year

1-2 years

3-5 years

5 or more years ago

I have never had a flu shot

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32. Overall, my physical health is:

Excellent

Good

Average

Poor

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33. Overall, my mental health is:

Excellent

Good

Average

Poor

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34. In the past 12 months, has lack of reliable transportation kept you from going to (select all that apply):

Medical appointments (for yourself or another member of your family)

Work/meetings

School (for yourself or another member of your family)

Childcare

Buying food/groceries

Physical activity opportunities/the gym

Getting other things for daily living

Other (please specify)

Not applicable

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35. What resources are lacking within your community? (Select all that apply)

Affordable food

Affordable housing

Recreational spaces

Primary healthcare access

Dental/Oral healthcare access

Vision healthcare access

Mental healthcare access

Transportation

There is no lack of resources in my community

I don't know what resources are lacking in my community

Other (please specify)

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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.)

I didn’t volunteer

1 time

2-3 times

4-5 times

6-7 times

8-9 times

10 or more times

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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.