Community Health Needs Survey 2025
This survey contains 43 questions relating to health in Dickinson County. With your feedback, community stakeholders will gain a better understanding of the areas that need improvement.
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1.
Where in Dickinson County do you live?
(Required.)
67410 - Abilene
67410 - Industry
67410 - Manchester
67431 - Chapman
67441 - Enterprise
67449 - Delavan
67449 - Herington
67451 - Navarre
67451 - Hope
67480 - Solomon
67482 - Talmage
67492 - Woodbine
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2.
What is your gender?
(Required.)
Male
Female
Other (please specify)
3.
What is your age range?
Under 20
21-30
31-40
41-50
51-60
61-70
71-80
81 or over
4.
What is your race? (check all that apply)
Asian (Indian, Japan, Chinese, Korean, Vietnamese, Filipino, etc.)
Black (African American)
Hispanic/Latino
Pacific Islander (Native Hawaiian, Samoan, Guamanian/Chamorro)
White/Caucasian
Other (please specify)
5.
What is your highest level of education?
Less than a high school diploma.
High school diploma, GED, or equivalent.
Some college, but no degree.
Associate’s Degree
Specialized Training or Certification
Bachelor’s Degree
Graduate or Professional Degree
Doctorate
Other (please specify)
6.
What was your total gross income last year? (before taxes)
Less than $20,000
$21,000 - $40,000
$40,001 - $60,000
$60,001 - $80,000
$80,001 - $100,000
$100,001 - $150,000
$150,001 - $200,000
Over $200,000
7.
What is your living arrangement?
Rent
Own
I am currently staying with friends or family.
Senior Living Establishment (does not include nursing homes or assisted living facilities)
I am homeless.
Other (please specify)
8.
Including yourself, how many people live in the same place with you?
9.
How many of the people living with you are under 18 years of age?
10.
What is your job status?
Full-time
Part-time
Unemployed – making no money
Unemployed – drawing unemployment benefits
Homemaker
Retired
Disabled
Student
Armed Forces
Other (please specify)
11.
Does your household have convenient access to a phone?
Yes
No
12.
Does your household have convenient access to the internet?
Yes
No
13.
Does your household have convenient access to transportation?
Yes
No
14.
What kind of insurance do you have? (check all that apply)
Employer Provided Insurance
Marketplace Provided Insurance
Medicaid/Kancare
Medicare (does not include Medicare Advantage plans)
Veterans Administration (VA)
I do not have insurance.
Other (please specify)
15.
How would you rate your health?
Excellent
Good
Fair
Poor
16.
Please identify the health issues that are directly affecting your household at the time you are completing this survey.
Aging Issues (Alzheimer’s Disease, hearing loss, memory loss, arthritis, depression, etc.)
Cancer
Chronic Pain (pain that lasts for long periods of time, or never truly goes away)
Diabetes (any type)
Heart Disease/Heart Attack/Stroke
HIV/AIDS
Infectious/Contagious Disease (flu, pneumonia, food poisoning, COVID)
Injuries (broken leg, severe wounds, etc.)
Lung Disease (asthma, COPD, etc.)
Mental Health Issues (ADHD, anxiety, bipolar, depression, OCD, PTSD, psychotic, etc.)
Issues with Weight (underweight, overweight, or obesity)
Sexually Transmitted Infections (Chlamydia, Gonorrhea, etc.)
Other (please specify)
17.
Please check which unhealthy behaviors YOU BELIEVE are affecting the community you live in.
Angry Behavior and/or Violence
Alcohol Abuse
Child Abuse
Drug Abuse
Domestic Violence
Elder Abuse
Lack of Exercise
Individuals and families are unable to get routine health check-ups.
Poor Eating Habits
Reckless Driving
Risky Sexual Behavior
Smoking/Vaping
Other (please specify)
18.
How would you rate each of the health care services in Dickinson County?
Excellent
Good
Poor
No Opinion
Ambulance Services
Excellent
Good
Poor
No Opinion
Chiropractors
Excellent
Good
Poor
No Opinion
Dentists
Excellent
Good
Poor
No Opinion
Emergency Room
Excellent
Good
Poor
No Opinion
Eye Doctor/Optometrist
Excellent
Good
Poor
No Opinion
County Health Department
Excellent
Good
Poor
No Opinion
Home Health
Excellent
Good
Poor
No Opinion
Hospice/Palliative Care
Excellent
Good
Poor
No Opinion
Inpatient Hospital Services
Excellent
Good
Poor
No Opinion
Mental Health Services
Excellent
Good
Poor
No Opinion
Nursing Home/Assisted Living Facilities (does not include Senior Living Establishments)
Excellent
Good
Poor
No Opinion
Outpatient Hospital Services
Excellent
Good
Poor
No Opinion
Pharmacy
Excellent
Good
Poor
No Opinion
Primary Care/Family Medicine
Excellent
Good
Poor
No Opinion
School Health
Excellent
Good
Poor
No Opinion
Telemedicine
Excellent
Good
Poor
No Opinion
Visiting Specialists
Excellent
Good
Poor
No Opinion
19.
When you need health care, where do you go for these services?
Heartland Health Care Clinic in Dickinson County (I am an established patient)
Heartland Health Care Clinic Walk-In Clinic (I use the walk-in option because I have not established care with a doctor)
Dickinson County Health Department
Memorial Hospital Emergency Department
I receive health care outside of Dickinson County. (please specify)
20.
How long has it been since you have seen a doctor for any kind of annual wellness exam, and NOT because you had a health issue that needed attention?
Within the last 12 months
1-2 years ago
3-5 years ago
Over 5 years ago
I never go for annual checkups
21.
In the last year, was there a time when you needed medical care, but you were unable to get it?
Yes
No
22.
If you answered yes, please check the following reasons that kept you from receiving medical care that you needed.
No Insurance
I could not afford to pay my co-pay or deductible.
My insurance was denied.
No Transportation
I didn’t know where to go for help.
The next available appointment was not soon enough.
Fear
Embarrassment
Other (please specify)
23.
In the last year, was there a time when you needed prescribed medicine, but you were unable to get it?
Yes
No
24.
If you answered yes, please describe why you were unable to receive the prescribed medication that you needed.
25.
When you need dental care, where do you go for these services?
I receive dental care in Dickinson County.
I receive dental care outside of Dickinson County.
I do not receive dental care.
26.
In the last year, was there a time you needed dental care, but you were unable to get it?
Yes
No
27.
If you answered yes, please check the following reasons that kept you from receiving the dental care that you needed.
No Insurance
I could not afford to pay my co-pay or deductible.
My insurance was denied.
No Transportation
I didn’t know where to go for help.
The next available appointment was not soon enough.
Fear
Embarrassment
Other (please specify)
28.
When you need eye care, where do you go for these services?
I receive eye care in Dickinson County.
I receive eye care outside of Dickinson County.
I do not receive eye care.
29.
In the last year, was there a time you needed eye care, but you were unable to get it?
Yes
No
30.
If you answered yes, please check the following reasons that kept you from receiving the eye care that you needed.
No Insurance
I could not afford to pay my co-pay or deductible.
My insurance was denied.
No Transportation
I didn’t know where to go for help.
The next available appointment was not soon enough.
Fear
Embarrassment
Other (please specify)
31.
When you need mental health services, where do you go for these services?
I receive mental health services in Dickinson County.
I receive mental health services outside of Dickinson County.
I do not receive mental health services.
32.
In the last year, was there a time you needed mental health services, but you were unable to get it?
Yes
No
33.
If you answered yes, please check the following reasons that kept you from receiving the mental health services that you needed.
No Insurance
I could not afford to pay my co-pay or deductible.
My insurance was denied.
No Transportation
I didn’t know where to go for help.
The next available appointment was not soon enough.
Fear
Embarrassment
Other (please specify)
34.
In the last week, how many times did you choose to engage in exercise that lasted AT LEAST 30 minutes or more? (jogging, walking, playing a sport, weight-lifting, fitness classes, etc.)
None
1 - 2 Times Per Week
3 Times Per Week
4 Times Per Week
5 Times or More Per Week
35.
If your answer to the previous question was none, what is keeping you from exercising? (check all that apply)
I don’t have the energy to exercise.
I lack the motivation to exercise.
I feel like I might injure myself trying to exercise.
Lack of self-management skills. (setting and achieving goals)
I don’t have money to spend on exercising.
I feel like I get enough exercise just going to work every day – my job is very physical.
I don’t have access to a facility that has the things I need to get adequate exercise.
I don’t have enough time to exercise.
I would need childcare to exercise, and I don’t have it.
I don’t want to exercise alone, and I don’t have anyone who wants to do it with me.
I don’t like exercising – it’s boring.
I don’t want to experience the muscle aches and labored breathing that comes with exercising.
I have disabilities that make it difficult to exercise.
I am overweight and I feel embarrassed to get the help I need to start exercising.
Other (please specify)
36.
On a typical day, how many servings of fruits or vegetables do you eat?
None
1 - 2 Servings Per Day
3 - 5 Servings Per Day
More than 5 Servings Per Day
37.
In a typical week how are your meals prepared?
My meals are prepared and cooked at home.
My meals are already prepared. I just have to warm them and serve.
My meals come from a restaurant. (sit down and/or drive-thru)
My meals are a combination of all options above.
I rely on community resources to provide my meals. (free community meals, etc.)
38.
Do you utilize any of the following resources for food?
Local Food Banks/Food Pantries
Commodities
Meals on Wheels
Free Community Meal Events
Other (please specify)
39.
Do you feel like you have a network of support during times of stress and need? (neighbors, family, faith groups, agencies and organizations, etc.)
Yes
No
40.
What do you think people in your community need more information about? (check all that apply)
Nutrition (healthy eating habits)
Exercising
Managing Weight
Suicide Prevention
Stress Management
Anger Management
Preventative Care (medical, dental, vision, etc.)
Vaccinations
Quitting Smoking (tobacco use or vaping)
Substance Abuse Prevention (drugs and alcohol)
Domestic Violence Prevention
Rape/Sexual Abuse Prevention
Caring for People with Disabilities
Safe Sex (preventing pregnancy or sexual transmitted disease)
Other (please specify)
41.
How do you get most of your health-related information?
Friends and Family
Licensed Healthcare Professionals (doctors, nurses, therapists, etc.)
Pharmacist
Internet Search
Help Lines
Books/Magazines
42.
Is there anything that you feel this survey did not address concerning health outcomes for Dickinson County?
43.
How did you come to fill out this survey?
I was at health care related appointment and I was asked by the staff to complete the survey.
A friend told me about it.
I was at a resource agency seeking help in Dickinson County, and a staff member encouraged me to complete it.
I saw a flyer about it that was distributed in Dickinson County.
The survey was shared on social media and I followed the link.
I saw an ad in the local newspaper and followed the link.
I was at a meeting where information was shared about the survey.
I received an email with a link to the survey.
I saw it in The Health Monitor, the monthly hospital newsletter.
Other (please specify)
