2016 Avery County Community Health Assessment Survey Question Title * 1. How many adults 18 and over live in the household? 1 2 3 4 5 6 or More Question Title * 2. What gender are you? Male Female Neutral Question Title * 3. Overall, how would you describe your county as a place to live? Would you say it is: Excellent Very Good Good Fair Poor Don't Know/Not Sure Question Title * 4. What is ONE THING that needs the most improvement in your county? Animal Control Availability of Employment Availability of Substance Abuse Treatment Better/More Health Food Choices Child Care Options Counseling/Mental Health/Support Groups Culturally Appropriate Health/Support Groups Elder Care Options Healthy Family Activities Higher Paying Employment More Affordable Health Care More Affordable/Better Housing Number of Health Care Providers Positive Teen Activities Recreational Facilities (Parks, Trails, Community Centers, etc.) Road Maintenance Road Safety Safe Places to Walk/Ride Bike for Commuting Safe Places to Walk/Ride Bike for Recreation Services for Disabled People Transportation Options Don't Know/Not Sure Other (please specify) Question Title * 5. Would you say that, in general, your health is: Excellent Very Good Good Fair Poor Don't Know/Not Sure Question Title * 6. Was there a time in the past 12 months when you needed medical care, but could not get it? Yes No Don't Know/Not Sure Not Applicable Question Title * 7. What was the MAIN reason you did NOT get this needed medical care? Cost/No Insurance Didn't Accept My Insurance Distance Too Far Inconvenient Office Hours/Office Closed Lack of Child Care Lack of Transportation Language Barrier No Access for People with Disabilities Too Long of Wait for Appointment Too Long of Wait in Waiting Room Don't Know/Not Sure Question Title * 8. Is there a particular place that you usually go to if you are sick or need advice about your health? Yes No Don't Know/Not Sure Question Title * 9. What kind of place? A Doctor's Office Health Department or Public Health Clinic Community Health Center An Urgent Care/Walk-In Clinic A Hospital Emergency Room A Military or Other VA Healthcare Facility Indian Health Services Don't Know/Not Sure Other (please specify) Question Title * 10. A routine check up is a general physical exam, not an exam for a specific injury, illness, or condition. About how long has it been since you last visited a doctor for a routine checkup? Within the Past Year (Less than 1 Year ago) Within the Past 2 Years (1 Year but less than 2 Years ago) Within the Past 5 Years (2 Years but Less than 5 Years ago) 5 or More Years ago Never Don't Know/Not Sure Question Title * 11. When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright lights. Within the Past 2 Years (Less than 2 Years ago) 2 or More Years ago Never Don't Know/Not Sure Question Title * 12. About how long has it been since you last visited a dentist or a dental clinic for any reason? This includes visits to dental specialists, such as orthodontists. Within the Past Year (Less than 1 Year ago) Within the Past 2 Years (1 Year but Less than 2 Years ago) Within the Past 5 Years (2 Years but Less than 5 Years ago) 5 or More Years ago Never Don't Know/Not Sure Question Title * 13. Have you ever suffered from or been diagnosed with COPD, or Chronic Obstructive Pulmonary Disease, including Bronchitis or Emphysema? Yes No Don't Know/Not Sure Question Title * 14. Has a doctor, nurse or other health professional EVER told you that you had any of the following: Heart Attack (Myocardial Infarction) Angina Coronary Heart Disease Stroke Question Title * 15. Have you ever been told by a doctor, nurse, or other health professional that you had asthma? Yes No Don't Know/Not Sure Question Title * 16. If so do you still have asthma? Yes No Don't Know/Not Sure Question Title * 17. Have you ever been told by a doctor that you have diabetes? Yes No Yes, but Female Only Told During Pregnancy Pre-Diabetes or Borderline Diabetes Don't Know/Not Sure Question Title * 18. Other than during pregnancy, have you ever been told by a doctor or other health professional that you have pre-diabetes or borderline diabetes? Yes No Don't Know/Not Sure Question Title * 19. Have you had a test for high blood sugar or diabetes within the past three years? Yes No Don't Know/Not Sure Question Title * 20. Are you currently taking action to help lower or control your high blood sugar, such as taking natural or conventional medicines or supplements, changing your diet, or exercising? Yes No Don't Know/Not Sure Question Title * 21. Have you ever been told by a doctor, nurse or other health care professional that you had high blood pressure? Yes No Don't Know/Not sure Question Title * 22. Are you currently taking any action to help control your high blood pressure, such as taking medication, changing your diet, or exercising? Yes No Don't Know?Not Sure Question Title * 23. About how long has it been since you last had your blood pressure taken by a doctor, nurse or other health professional? Within the Past 2 Years (Less Than 2 Years Ago) Within the Past 5 Years (2 Years But Less Than 5 Years Ago) 5 or More Years Ago Never Don't Know/Not Sure Question Title * 24. Blood cholesterol is a fatty substance found in the blood. Have you ever been told by a doctor, nurse, or other health care professional that your blood cholesterol is high? Yes No Don't Know/Not Sure Question Title * 25. Are you currently taking any action to help control your high cholesterol, such as taking medication, changing your diet, or exercising? Yes No Don't Know/Not Sure Question Title * 26. How long has it been since you last had your blood cholesterol checked? Within the Past 5 Years (Less Than 5 Years Ago) 5 or More Years Ago Never Don't Know/Not Sure Question Title * 27. Previously you had mentioned that you have suffered from or been diagnosed with Heart Attack, Angina, , Coronary Heart Disease, Stoke, COPD, Chronic Obstructive Pulmonary Disease, Bronchitis, Emphysema, Asthma, Diabetes, High Blood Pressure, and/or High Blood Cholesterol. Has any health provider ever helped you connect to a community resource such as classes or coaching to help you learn more about or manage this/these conditions? Yes No Don't Know/Not Sure Question Title * 28. What is your age? 18-25 26-35 36-45 46-55 56-65 66-75 76-85 85+ Don't Know/Not Sure Question Title * 29. Women: A mammogram is an x-ray of each breast to look for cancer. How long has it been since you had your last mammogram? Within the Past Year (Less Than 1 Year Ago) Within the Past 2 Years (1 Year But Less Than 2 Years Ago) Within the Past 3 Years (2 Years But Less Than 3 Years Ago) Within the Past 5 Years (3 Years But Less Than 5 Years Ago) 5 or More Years Ago Never Don't Know/Not Sure Question Title * 30. Do you NOW smoke cigarettes? Every Day Some Days Not At All Don't Know/Not Sure Question Title * 31. Do you currently use chewing tobacco, snuff, or snus? Every Day Some Days Not At All Don't Know/Not Sure Question Title * 32. Do you NOW smoke electronic cigarettes? Every Day Some Days Not At All Don't Know/Not Sure Question Title * 33. During how many of the past 7 days, at your workplace, did you breathe the smoke from someone who was using tobacco? None 1-2 Days 3-4 Days 5-7 Days Not Applicable Don't Know Question Title * 34. What is your level of agreement or disagreement that it is important for PARKS and PUBLIC WALKING and BIKING TRAILS in my county to be 100% tobacco free: Strongly Agree Agree Neither Agree Nor Disagree Disagree Strongly Disagree Not Applicable Don't Know/Not Sure Question Title * 35. During the past 30 days, on how many days did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage, or liquor? None 1 Day 2 Days 3-5 Days 6-9 Days 10-19 Days 20-29 Days All 30 Days Don't Know Question Title * 36. On the day(s) when you drank, about how many drinks did you have on average? 1-2 Days 3-5 Days 5+ Days Don't Know Question Title * 37. Males: Considering all types of alcoholic beverages, how many TIMES during the past 30 days did you have 5 or more drinks on an occasion? None 1 Day 2 Days 3-5 Days 6-9 Days 10-19 Days 20-29 Days All 30 Days Don't Know Question Title * 38. Females: Considering all types of alcoholic beverages, how many TIMES during the past 30 days did you have 4 or more drinks on an occasion? None 1 Day 2 Days 3-5 Days 6-9 Days 10-19 Days 20-29 Days All 30 Days Don't Know Question Title * 39. During the past 30 days, have you taken a prescription drug that was not prescribed to you? Yes No Don't Know/Not Sure Question Title * 40. Have you ever given your prescription medication to anyone else to use? Yes No Don't Know/Not Sure Question Title * 41. Do you keep your medicine in a locked place so that no one else can access it? Yes No Don't Know/Not Sure Question Title * 42. Was there a time in the past 12 months when you needed substance abuse treatment or counseling, but did not get it at that time? Yes No Don't Know/Not Sure Question Title * 43. What was the MAIN reason you did not get substance abuse treatment or counseling? Apprehension/Fear/Nervousness/Embarrasement Condition Not Serious Enough Didn't Accept Medicaid/Insurance Didn't Know Where To Go Difficulty Getting Appointment Don't Have Insurance/Could Not Afford It Don't Like/Trust/Believe in Counselors Health of Another Family Member Inconvenient Hours Lack of Transportation Never Got Around to Going No Counselor Available No Place I feel Welcome Speak a Different Language Wait Too Long In Clinic/Office Don't Know/Not Sure Other (please specify) Question Title * 44. How difficult is it for you to buy fresh produce like fruits and vegetables at a price you can afford? Would you say: Very Difficult Somewhat Difficult Not Too Difficult Not At All Difficult Don't Know/Not Sure Question Title * 45. In the last 12 months, did you or someone in the household cut the size of your meals or skip meals because there wasn't enough money for food? Yes No Don't Know/Not Sure Question Title * 46. How often is this statement true: I was worried about whether our food would run out before we got money to buy more. Often True Sometimes True Never True Don't Know/Not Sure Question Title * 47. During the past month, other than your regular job, did you participate in any physical activities or exercises, such as running, calisthenics, golf, gardening, or walking for exercise? Yes No Don't Know/Not Sure Question Title * 48. Now, thinking about when you are not working, how many days per week do you do VIGOROUS activities for at least 20 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing and heart rate? 1-2 Days 3-5 Days 5+ Days No Vigorous Activity Unable to Do Vigorous Activity Don't Know/Not Sure Question Title * 49. And how many days per week do you do MODERATE activities for at least 30 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes some increase in breathing or heart rate? 1-2 Days 3-5 Days 5+ Days No Moderate Activity Unable to do Moderate Activity Don't Know/Not Sure Question Title * 50. How many days per week do you do physical activities or exercises to STRENGTHEN your muscles? Do NOT count aerobic activities like walking, running, or bicycling. Please include activities using your own body weight, such as yoga, sit-ups or push-ups, and those using weight machines, free weights, or elastic bands. 1-2 Days 3-5 Days 5+ Days No Strengthening Activity Unable to Do Strengthening Activity Don't Know/Not Sure Question Title * 51. How important do you feel it is for organizations in the community to explore ways to increase the public's access to these types of facilities during off times? Would you say: Very Somewhat Not At All Important Don't Know/Not Sure Question Title * 52. In general, how satisfied are you with your life? Would you say: Very Satisfied Satisfied Dissatisfied Very Dissatisfied Don't Know/Not Sure Question Title * 53. How often do you get the social and emotional support you need? Would you say: Always Usually Sometimes Seldom Never Not Applicable Don't Know/Not Sure Question Title * 54. Now 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? None 1 Day 2 Days 3-5 Days 6-9 Days 10-19 Days 20-29 Days All 30 Days Don't Know Question Title * 55. What was the MAIN reason you did not get mental health care or counseling? Apprehension/Fear/Nervousness/Embarrasement Condition Not Serious Enough Didn't Accept Medicaid/Insurance Didn't Know Where To Go Difficulty Getting Appointment Don't Have Insurance/Could Not Afford It Don't Like/Trust/Believe in Counselors Health of Another Family Member Inconvenient Hours Lack of Transportation Never Got Around to Going No Counselor Available No Place I feel Welcome Speak a Different Language Wait Too Long In Clinic/Office Don't Know/Not Sure Other (please specify) Question Title * 56. Was there a time in the past 12 months when you needed mental health care or counseling, but did not get it at that time? Yes No Don't Know/Not Sure Question Title * 57. Are you limited in any way in any activities because of physical, mental or emotional problems? Yes No Don't Know/Not Sure Question Title * 58. What is the major impairment or health problem that limits you? Arthritis/Rheumatism Back or Neck Problem Cancer Depression/Anxiety/Emotional Problem Diabetes Eye/Vision Problem Fractures, Bone/Joint Injury Hearing Problem Heart Problem Hypertension/High Blood Pressure Lung/Breathing Problem Stroke Problem Substance Abuse/Addiction Walking Problem Other Impairment/Problem Don't Know/Not Sure Question Title * 59. If over 45 years old: In the past 12 months, how many times have you fallen? 1-5 times 6-10 times 11-15 times 16-20 times 21-25 times 26-35 times 36-45 times None Don't Know/Not Sure Question Title * 60. During the past 30 days, did you provide any such care or assistance to a friend or family member? Yes No Don't Know/Not Sure Question Title * 61. Where do you get most of your health care information? Don't Receive Any Books/Magazines Child's School Church Family Doctor Friends/Relatives Health Department Help Lines Hospital Hospital Publications Insurance Internet Library Newspaper Pharmacist Don't Know/Not Sure Other (please specify) Question Title * 62. How many children under the age of 18 are currently LIVING in your household? One Two Three Four Five or More None Question Title * 63. Are you Hispanic or Latino origin, or is your family originally from a Spanish-speaking country? Yes No Don't Know/Not Sure Question Title * 64. What is your race? American Indian/Alaska Native Native Hawaiian/Pacific Islander Asian Black/African American White Latino/Hispanic Don't Know/Not Sure Other (please specify) Question Title * 65. Which of the following BEST describes you? An Enrolled Member of the Eastern Band of Cherokee Indians, Living ON the Boundary An Enrolled Member of the Eastern Band of Cherokee Indians, Living OFF the Boundary Don't Know/Not Sure Other (please specify) Question Title * 66. Are you: Married Divorced Widowed Separated Never Been Married In a Domestic Partnership or Civil Union A Member of an Unmarried Couple Don't Know/Not Sure Question Title * 67. About how much do you weigh without shoes? 40-60 lbs 61-80 lbs 81-100 lbs 101-120 lbs 121-140 lbs 141-160 lbs 161-180 lbs 181-200 lbs 201-250 lbs 251-300 lbs 301-350 lbs 351-400 lbs 401-450 lbs 451-500 lbs 501-550 lbs 551-600 lbs Question Title * 68. About how tall are you without shoes? 3' to 3'11" 4' to 4'11" 5' to 5'11" 6' to 6'11" 7' to 7'11" 8' to 8'11" Don't Know/Not Sure Question Title * 69. What is your highest grade or year of school you have completed? Never Attended School or Kindergarten Only Grades 1 Through 8 (Elementary) Grades 9 Through 11 (Some High School) Grade 12 or GED (High School Graduate) College 1 Year to 3 Years (Some College or Technical School) Bachelor's Degree (College Graduate) Postgraduate Degree (Master's, M.D., Ph.D., J.D.) Don't Know/Not Sure Question Title * 70. Are you currently: Employed for Wages Self-Employed Out of Work for More Than 1 Year Out of Work for Less Than 1 Year A Homemaker A Student Retired Unable to Work Don't Know/Not Sure Question Title * 71. Do you live in this area year-round (permanent address), or are you a seasonal (part-time) resident? Permanent Resident Seasonal Resident Don't Know/Not Sure Question Title * 72. Do you have any kind of health care coverage, including health insurance, a prepaid plan such as an HMO, or a government-sponsored plan such as Medicare or Indian Health Services? Yes No Don't Know/Not Sure Question Title * 73. An Advanced Directive is a set of directions you give about the medical health care you want if you ever lose the ability to make decisions for yourself. Formal Advance Directives include Living Wills and Health Care Powers of Attorney.Do you have any completed Advance Directive documents? Yes No Don't Know/Not Sure Question Title * 74. Have you communicated these health care decisions to your family or your doctor? Yes No Don't Know/Not Sure Question Title * 75. Have you ever served on ACTIVE DUTY in the U.S. Armed Forces, either in the regular military or in a National Guard or Military Reserve Unity? Active Duty does NOT include training for the National Guard or the Reserves, but DOES include activation, for example, for the Persian Gulf War. Yes, Was on Active Duty No, Was Never on Active Duty Don't Know/Not Sure Question Title * 76. Total Family Household Income: Under $11,700 $11,700 to $15,699 $15,700 to $19,799 $19,800 to $23,599 $23,600 to $27,899 $27,900 to $31,799 $31,800 to $35,999 $36,000 to $39,899 $39,00 to $44,199 $44,200 to $47,999 $48,000 to $52,299 $52,300 to $56,099 $56,100 to $63,899 $63,900 to $72,099 $72,100 to $80,199 $80,200 to $88,299 $88,300 to $96,399 $96,400 to $104,499 $104,500 to 112,699 $112,700/Over Don't Know/Not Sure Done