Macoupin & Montgomery County Community Health Needs Assessment 2024

This survey will take less than five minutes. Thank you for helping us find ways to create a healthier community.

This survey is being conducted by HSHS St. Francis Hospital in Litchfield.

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* 1. In what year were you born? (enter 4-digit birth year; for example, 1976)

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* 2. What is your gender?

Male

Female

Prefer not to say

Other (please specify)

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

Less than high school

Some high school

High school diploma or equivalent

Trade or technical school beyond high school

Some college

Four-year college degree

More than four-year college degree

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* 4. What is your approximate average household income?

Less than $20,000

$20,001 - $40,000

$40,001 - $60,000

$60,001 - $80,000

$80,001 - $100,000

$100,000+

Retired

Prefer not to answer

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* 5. Select the option(s) that best describe your race/ethnicity:

American Indian or Alaska Native

Asian

Black or African American

Hispanic, Latino, or Spanish Origin

Native Hawaiian or Other Pacific Islander

White

Other race or ethnicity

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* 6. What is your zip code?

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* 7. What is your disability status?

Do not have a disability

Have a disability

Prefer not to say

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* 8. Rank the following health concerns in order from 1 (most important health concern) to 6 (least important health concern) by dragging your choices up or down.

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* 9. How would you rate YOUR overall health?

Very healthy

Healthy

Somewhat healthy

Not very healthy

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* 10. How would you rate the health of Macoupin County?

Very healthy

Healthy

Somewhat healthy

Not very healthy

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* 11. How would you rate the health of Montgomery County?

Very healthy

Healthy

Somewhat healthy

Not very healthy

Macoupin & Montgomery County Community Health Needs Assessment 2024

Question Title

* 1. In what year were you born? (enter 4-digit birth year; for example, 1976)

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* 2. What is your gender?

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

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* 4. What is your approximate average household income?

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* 5. Select the option(s) that best describe your race/ethnicity:

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* 6. What is your zip code?

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* 7. What is your disability status?

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* 8. Rank the following health concerns in order from 1 (most important health concern) to 6 (least important health concern) by dragging your choices up or down.

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* 9. How would you rate YOUR overall health?

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* 10. How would you rate the health of Macoupin County?

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* 11. How would you rate the health of Montgomery County?

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* 12. What do you think is/are the biggest health problems facing Macoupin and Montgomery counties?

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* 13. What is the one thing you would do to make the health of Macoupin and Montgomery counties better?