Skip to content

Effingham County Community Health Needs Survey

Please take a few minutes to complete the survey below.

The purpose of this survey is to get your opinions about health issues in our community. This survey is conducted by the Effingham County Health Department.  The results of this survey along with other information will be used for the development of a community health improvement plan for the county in which you reside.  Your opinion is important to us! Thank you!      
***Note - This survey is anonymous
Part 1: Community Health
1.In the following list, what do you think are the three most important factors for a healthy community?  (Those factors which most improve the quality of life in a community.)

Check only three (3):
2.In the following list, what do you think are the three most important health problems in our community?  (Those problems which have the greatest impact on overall community health.)

Check only three (3):
3.In the following list, what do you think are the three most important risky behaviors in our community? (Those behaviors which have the greatest impact on overall community health.)

Check only three (3):
4.How would you rate our community as a “Healthy Community?”
5.How would you rate your own personal health?
Part 2: Housing
6.How often in the past 12 months would your household say they were worried or stressed about having enough money to pay your rent/mortgage? Would you say you were worried or stressed-
7.Do you feel your home is currently physically safe to live in?
8.If No, why not? Choose all that apply
9.What type of structure is your home?
10.How many people are currently living in your household
11.How many people living in your household are:
12.Does your household have a working smoke detector?
13.Does your household have a working carbon monoxide detector?
Part 3 - Health Status
14.How often do you seek medical attention?
15.What is the most significant barrier for seeking medical attention for you and or your family? (Choose all that apply.)
16.How do you pay for your health care?
17.Do you have one person / clinic you think of as your primary health care provider?
18.Have you or a member of your household ever been told by a healthcare professional that you or he/she has: (Choose all that apply) 
19.Has a health care provider ever discussed cancer risk or early detection cancer screenings with you or a member of your household?  
20.Do you or does any member of your household currently use…… (Choose all that apply.)
21.How many COVID Vaccines have you received?
22.How many times have you tested positive for COVID?
23.If you have had COVID, which symptoms lasted more than 12 weeks from the first diagnosis
Part 4: Mental Health Status
24.Thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
Part 5: Oral Health Status
25.How would you rate your oral health status?
26.Do you have a regular dental provider?
27.What is the most significant barrier to seeking regular dental care? (Choose all that apply)
28.How do you pay for you and your family's dental care?
Part 6 - Drug/Substance Use and/or Abuse
29.How concerned are you with prescription drug abuse in your community?
30.How concerned are you with illegal drug use in your community?
31.In the past 12 months, how many members of your household have tried to quit smoking cigarettes (or using a tobacco product)?:

Part 7 - Alcohol Use
32.During the past 30 days, how many days per week did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
33.Considering all types of alcoholic beverages, how many times during the past 30 days did you have 4 or more drinks on one occasion?
Part 8 - Nutrition and Exercise
34.How many times a week do you exercise?
35.Is there anything that prevents your household from exercising? 
Check all that apply:  
36.How often in the past 12 months would your household say they were worried or stressed about having enough money to buy food? Would you say you were worried or stressed - 
37.During the past month, not counting juice, how many times did you eat fruit?
38.During the past month, how many times did you eat vegetables?
39.How many days during the last 7 days did you or a member of your household eat a meal from a restaurant or other food vender?
40.Is there anything that prevents your household from eating nutritious food?
Check all that apply:
41.Are you satisfied with the quality of life in our community? (Consider your sense of safety, well-being, participation in community life and associations, etc.)
42.Is there economic opportunity in the community? (Consider locally owned and operated businesses, jobs with career growth, job training/higher education opportunities, affordable housing, reasonable commute, etc.)
43.Do you feel the community is a safe place to live? (Consider resident's perceptions of safety in the home, the workplace, schools, playgrounds, parks, and the mall. Do neighbors know and trust one another? Do they look out for one another?)
44.Does the community offer networks of support for individuals and families during times of stress and need? (such as neighbors, support groups, faith community outreach, agencies, organizations)
Part 9 - Emergency Preparedness
45.Has your household prepared an Emergency Supply Kit with supplies like water, food, flashlights, and extra batteries that is kept in a designated place in your home?
46.If your household had to evacuate due to a large scale disaster or emergency, where would you go?
Check only one (1) please:
47.Does your household have any emergency plans, such as a list of emergency contact numbers and designated out-of-town contacts, designated meeting place, copies of important documents in a safe location?
48.What would be the main reason that might prevent you from evacuating?  Check only one (1) please:
49.Does your household currently have a 7 day supply of medication for each person who takes prescribed meds?
50.Where would you first look for reliable information regarding a disaster?
Part 10 - Demographics
51.Zip Code of City/Village where you live
52.Age
53.Sex
54.Ethnic group you most identify with
THANK YOU FOR YOUR TIME!