Exit this survey 2015 Columbus County NC Community Health Assessment Question Title * 1. In your opinion, what do most people die from in your community? (Check only one) Asthma/Lung Disease Cancer Diabetes Suicide HIV/AIDS Heart Disease Stroke/Cerebrovascular Disease Homicide/Violence Motor Vehicle Deaths Other (please specify) Question Title * 2. In your opinion what is the biggest health issue of concern in your community? Asthma/Lung disease Chronic disease(cancer, diabetes, heart disease, stroke) Child abuse Dental health Drug/Alcohol abuse Gangs/Violence Mental health Obesity Teen pregnancy Tobacco use Vehicle crashes Other (please specify) Question Title * 3. In your opinion, what do you think is the main reason that keeps people in your community from seeking medical treatment? Cultural/health beliefs Fear(not ready to face health problem) Health services too far away Lack of insurance/unable to pay for doctor's visit Lack of knowledge/understanding of the need None/no barriers Not important Transportation No appointments available at doctor when needed/have to wait too long at doctor's office Other (please specify) Question Title * 4. Which factor do you feel most affects the quality of health care you or people in your community receive? Ability to read and write/education Age Economic(low income, no insurance) Language barrier/Interpreter/Translator Race Sex/gender Other (please specify) Question Title * 5. In your opinion, do you feel people in your community lack the funds for any of the following? Food Health insurance Home/shelter Utilities(electricity, fuel, water) Medicine Transportation Other (please specify) Question Title * 6. How do you rate your own health? Excellent Very good Good Fair Poor Don't know/not sure Next