How Healthy Is The Capital District? A Community Survey

1. Survey Questions

 
Thank you for taking the time to complete the 21 question survey below.

Your input is valuable and all responses are confidential.


1. Where do you currently reside?
2. What ZIP CODE do you live in?
3. What best describes you?
4. Which of the following best describes you?
5. Do you have health insurance?
6. If you do not have health care coverage, what is the main reason you don't?
7. When was your last physical?
8. Where do you go to get most of your health care services?
9. What typically prevents you from seeking health care when you need it (select all items that apply)?
10. What needed health services are not available in your community?
11. Is there a group of people in your community (gender, age, race, neighborhood) experiencing a particular health problem that is not being adequately addressed by the health care system? If yes, please identify this group and the problem?
12. How many times have you visited the hospital emergency room during the past 2 years?
13. Sometimes people use the hospital emergency room for care when they don't have a health emergency. If you have utilized an emergency room within the past 2 years, please identify the reasons below?
14. Do you or someone in your household have a chronic illness? If yes, please check all that apply?
15. Do you or someone in your household with a chronic illness, identified above, have problems accessing health care services to address the illness? If so, please identify the problem?
16. How satisfied are you with the quality of health promotion and preventive care information and support you regularly receive from your primary health care provider?
17. I would be healthier if
18. The partners of HCDI selected our top health priorities based upon the following criteria:number of people impacted, severity of illness, how preventable it is, whether it is a root cause of other illnesses,and cost to the health care system. Do you agree that the following are the top two health priorities for the Capital Region.
(a.)Access to Health Care-Having Health Insurance, Having A Regular Health Care Provider, Access to Specialists, Access to Dental Care

(b.)Chronic Diseases-Diabetes, Stroke, Diseases of the Heart, Cancer
19. Please identify any other health issues that you feel should be a priority focus area in future community health planning initiatives?
20. How satisfied are you with the quality of health promotion and preventive care information and support you regularly receive from your health care insurer?
21. How Familiar Are You With The Healthy Capital District Initiative?
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