2019 Union County Community Health Assessment Survey For Adults (62 +)

Over the next six months, Union County Human Services, in collaboration with Novant Health and Atrium Health, will work together to develop the 2019 Community Health Assessment (CHA). The goal of CHA is to identify factors that affect the health of the population and determine the availability of resources within the county to address these factors. We need your input to help us identify health issues and concerns facing Union County seniors today, so we can help address them. Your voice and opinion matter to us.

Please take about 10-15 minutes to complete the survey. The survey is anonymous. Your answers will not be connected to you in any way.

Thank you for the gift of your time and for sharing your experiences and points of view.

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* 1. What is your Zip Code?

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* 2. In which Union County town or municipality do you reside?

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* 3. What is your Age?

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* 4. What is your Gender?

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* 5. Using the categories below, what do you consider yourself?

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* 6. What is your highest level of education?

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* 7. Are you a veteran or have you served in the military?

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* 8. What type of health insurance do people in your home have?

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* 9. Do you live alone?

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* 10. If no, you do not live alone, who do you live with?

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* 11. What most closely describes your income level?

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* 12. Do you feel your income or economic situation is negatively impacting your ability to access medical care or services?

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* 13. Overall, how would you rate your physical health?

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* 14. Overall, how would you rate your mental health?

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* 15. Listed below are health concerns. Please check three that concern you MOST.

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* 16. Listed below are mental health concerns. Please check three that concern you MOST.

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* 17. Listed below are behaviors that can cause poor health outcomes. Please check up to three behaviors you feel keep people in Union County from being healthy.

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* 18. Listed below are safety concerns that can impact your health. Please check three that concern you:

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* 19. If you were in an abusive situation / relationship, would you know who to call, or how to report it?

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* 20. In your opinion, which THREE issues or services most affects the quality of life in Union County?

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* 21. How do you view your weight?

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* 22. Do you feel your current weight is impacting your health status?

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* 23. Do you have a medical doctor you see on a regular basis?

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* 24. Was there a time that you needed to see a doctor during the last 12 months but did not?

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* 25. If yes, what was the main reason you did not see a doctor?

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* 26. Do you see a dentist on a regular basis?

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* 27. Was there a time during the last 12 months when you needed to see a dentist but did not?

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* 28. If yes, what was the main reason you did not see a dentist?

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* 29. Where do you go when you are sick and need medical care? Choose ONLY one.

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* 30. Have you ever felt that you needed mental health services and did not get them?

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* 31. If yes, why did you not go for mental health services? Check ALL that apply:

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* 32. Have you needed a prescription medication and did not get it?

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* 33. If yes, why did you not get your medicine?

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* 34. Does anyone help you take or manage your medications?

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* 35. Have you changed the way you take your prescription medications without talking to a doctor?

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* 36. If Yes, check all the reasons you changed the way you take your medicine:

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* 37. Do you receive any home health services in your home?

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* 38. Do you receive any non-medical in home assistance?

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* 39. Do you keep an emergency supply of your medications?

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* 40. Check ALL preventative health services you had during the past 12 months:

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* 41. If you did not receive any preventative services, please indicate why. Check ALL that apply.

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* 42. Did you receive a flu vaccine within the past year?

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* 43. If you did not receive a flu vaccine, please indicate why. Check ALL that apply.

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* 44. If you have a child or children age 6 or younger, is your child up to date on recommended immunizations?

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* 45. If you answered NO to the above question, please indicate why. Check ALL that apply.

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* 46. How do you normally get to your healthcare appointments?

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* 47. Where do you get most of your health information? Check ONLY one.

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* 48. How many days a week do you normally get 30 minutes of exercise?

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* 49. Are there enough opportunities for physical activity near your home?

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* 50. How many servings of fruits and vegetables do you normally eat per day?

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* 51. Do you purchase locally grown fruits / vegetables at retail markets, farm stands or Farmers Markets?

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* 52. Where do the majority of your meals come from?

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* 53. Please check if you do any of the following:

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* 54. If you checked any of the above, do you feel it impacts your health negatively?

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* 55. Listed below are safety hazards related to driving. Please check ALL that apply to you.

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* 56. Approximately how much time do you spend daily on social media? (Facebook, Instant Messaging, Snap Chatting, Texting)

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* 57. How much screen time do you spend daily? (TV, video games, computer, cell phone)

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* 58. Environmental Health (Check one answer per row)

  Great Concern Some Concern No Concern
Outdoor Air Quality
Indoor Air Quality (mold, allergens, etc)
Stream Water Quality
Preserving Green Space
Vector Control (mosquitoes)
Solid Waste Disposal (appliances, mattresses, tires, etc.)
Access to Convenience Centers for Trash Disposal
Bioterrorism
Weather Disasters / Yard Debris
Food Borne Illness

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* 59. What type of drinking water do you have?

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* 60. Are you concerned about your drinking water?

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* 61. If Yes, what is your primary concern?

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* 62. What specific things could be done to improve the health of Seniors in Union County? Please explain.

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