Please take a moment to complete the survey below. The purpose of this survey is to get your opinions about the health status and quality of life in Oklahoma City and County. The survey results will contribute to the Oklahoma City-County Wellness Score and Community Context Assessment. Your responses are very important and are completely voluntary. All information you provide will be kept confidential. Thank you for sharing your opinions. If you wish to contact the Oklahoma City-County Health Department Wellness Score committee for any reason, the contact information is at the end of the survey.

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* 1. In order for the Wellness Score committee to sort responses, please provide the zip code where you live:

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* 2. What skills and strengths do you have that you are proud of? 

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* 3. What are the primary assets or resources that make your community unique or stand out? What makes your neighborhood great? 

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* 4. What else would you like to see in your neighborhood? 

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* 5. When was a time you felt really connected to your community? What made that feeling of connection happen?

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* 6. What aspects of your community do you believe contribute to the overall well-being and quality of life for its residents? 

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* 7. What is a key health issue that you or your community have experienced?

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* 8. How can the skills and resources you named earlier be used to improve this health issue? 

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* 9. Please indicate how your community rates as a place to raise children.
(Consider school quality, daycare, after-school programs, recreation, etc.)

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* 10. Please indicate how your community rates as a place to grow old.
(Consider elder-friendly housing, transportation to medical services, churches, shopping, elder daycare, social support for elderly living alone, meals on wheels)

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* 11. Please indicate how your community rates as a safe community. 
(Consider safety in the home, the workplace, school playgrounds, parks, the mall, and gathering places)

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* 12. What are the things that make your neighborhood feel unsafe, unwelcoming, or inaccessible? 

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* 13. Would you say the overall quality of transportation available in Oklahoma County is:

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* 14. Have you experienced any difficulties in accessing healthcare services in the past year? 

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* 15. If yes, what barriers have you faced? (select all that apply)

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* 16. If you could change one thing about your neighborhood tomorrow, what would you change? 

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* 17. On average, how many hours of sleep do you get per night?

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* 18. Do you smoke cigarettes or use any other tobacco products such as vapes, e-cigarettes, chewing tobacco, snus, snuff, cigars, cigarillos? 

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* 19. How often do you engage in activities that promote mental well-being, such as hobbies, socializing, or spending time in nature? 

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* 20. In your community, are there things outdoors for a range of ages (e.g., playground, basketball court, benches, and space for physical activity for seniors)?

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* 21. Do you regularly schedule and attend preventive health checkups, such as annual physical exams and screenings? 

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* 22. Age:

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* 23. Marital status: 

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* 24. Are you Hispanic or Latino?

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* 25. How would you describe yourself? 

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* 26. Education:

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* 27. How do you pay for your health care? 
(Check all that apply)

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* 28. What is your employment status? 

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* 29. What is your approximate annual household income?
(Please select the option that best corresponds to your situation)

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