Health + Well Being Survey 2024 Question Title * 1. Which gender do you identify with? Male Female Transgender Do not identify as female, male, or transgender Question Title * 2. Select your age range. Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 3. Over the last 12 months would you say your overall health and well being has been: Very good Fairly good Not very good Not good at all Question Title * 4. Overall, 0 Not at all 1 2 3 4 5 Completely How satisfied are you with your Physical well-being? How satisfied are you with your Physical well-being? 0 Not at all How satisfied are you with your Physical well-being? 1 How satisfied are you with your Physical well-being? 2 How satisfied are you with your Physical well-being? 3 How satisfied are you with your Physical well-being? 4 How satisfied are you with your Physical well-being? 5 Completely How optimistic do you feel about your Physical health in the next 12 months? How optimistic do you feel about your Physical health in the next 12 months? 0 Not at all How optimistic do you feel about your Physical health in the next 12 months? 1 How optimistic do you feel about your Physical health in the next 12 months? 2 How optimistic do you feel about your Physical health in the next 12 months? 3 How optimistic do you feel about your Physical health in the next 12 months? 4 How optimistic do you feel about your Physical health in the next 12 months? 5 Completely Question Title * 5. Overall, 0 Not at all 1 2 3 4 5 Completely How satisfied are you with your Emotional well-being? How satisfied are you with your Emotional well-being? 0 Not at all How satisfied are you with your Emotional well-being? 1 How satisfied are you with your Emotional well-being? 2 How satisfied are you with your Emotional well-being? 3 How satisfied are you with your Emotional well-being? 4 How satisfied are you with your Emotional well-being? 5 Completely How optimistic do you feel about your Emotional health in the next 12 months? How optimistic do you feel about your Emotional health in the next 12 months? 0 Not at all How optimistic do you feel about your Emotional health in the next 12 months? 1 How optimistic do you feel about your Emotional health in the next 12 months? 2 How optimistic do you feel about your Emotional health in the next 12 months? 3 How optimistic do you feel about your Emotional health in the next 12 months? 4 How optimistic do you feel about your Emotional health in the next 12 months? 5 Completely Question Title * 6. Overall, 0 Not at all 1 2 3 4 5 Completely How satisfied are you with your Spiritual well-being? How satisfied are you with your Spiritual well-being? 0 Not at all How satisfied are you with your Spiritual well-being? 1 How satisfied are you with your Spiritual well-being? 2 How satisfied are you with your Spiritual well-being? 3 How satisfied are you with your Spiritual well-being? 4 How satisfied are you with your Spiritual well-being? 5 Completely How optimistic do you feel about your Spiritual health in the next 12 months? How optimistic do you feel about your Spiritual health in the next 12 months? 0 Not at all How optimistic do you feel about your Spiritual health in the next 12 months? 1 How optimistic do you feel about your Spiritual health in the next 12 months? 2 How optimistic do you feel about your Spiritual health in the next 12 months? 3 How optimistic do you feel about your Spiritual health in the next 12 months? 4 How optimistic do you feel about your Spiritual health in the next 12 months? 5 Completely Question Title * 7. Over the past 12 months have you done any of the following in an attempt to keep fit and healthy? (Check all the apply.) Followed a fitness program (e.g. gym, sports training, etc.) Maintained a long term active lifestyle (e.g. playing sport, cycling, walking, etc.) Recently taken up a more active lifestyle Tried to eat a healthier diet (e.g. vegetarian, vegan, etc.) Gone on a diet to lose weight Tried to reduce stress levels (e.g. meditation, breathing, etc.) Tried to reduce or give up drinking alcohol Other (please specify) None of the above Question Title * 8. Have any of the following behaviors ever been part of your lifestyle? Never done this Used to but gave it up Have reduced doing this Still do this Smoking Smoking Never done this Smoking Used to but gave it up Smoking Have reduced doing this Smoking Still do this Drinking Drinking Never done this Drinking Used to but gave it up Drinking Have reduced doing this Drinking Still do this Using recreational drugs Using recreational drugs Never done this Using recreational drugs Used to but gave it up Using recreational drugs Have reduced doing this Using recreational drugs Still do this Being dependent upon prescription drugs Being dependent upon prescription drugs Never done this Being dependent upon prescription drugs Used to but gave it up Being dependent upon prescription drugs Have reduced doing this Being dependent upon prescription drugs Still do this Eating excessively Eating excessively Never done this Eating excessively Used to but gave it up Eating excessively Have reduced doing this Eating excessively Still do this Sedentary lifestyle Sedentary lifestyle Never done this Sedentary lifestyle Used to but gave it up Sedentary lifestyle Have reduced doing this Sedentary lifestyle Still do this Eating too much sugar Eating too much sugar Never done this Eating too much sugar Used to but gave it up Eating too much sugar Have reduced doing this Eating too much sugar Still do this Question Title * 9. When I become anxious or feel like I have too much to do in too little time, I...(Check all that apply.) Keep doing what I am doing and plow through Take a break Exercise Meditate Eat Take medication Go outside Other (please specify) Question Title * 10. I regularly spend time in solitude and silence to connect with my spirituality. This enables me to be still and undistracted in nature. Very true Sometimes true Mostly true Not very true Done
