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Aspirus Health in partnership with the Taylor County Health Department is completing its 2022 Community Needs Assessment.  We’d appreciate your help by completing this important survey.

Why are we doing this? Every non profit healthcare facility is to conduct a Community Health Needs Assessment every three years.  Once data is collected, the health needs are prioritized to focus on the communities’ greatest need. Aspirus Health has people who work together to support community – based health programs and services. New programs are also implemented to help each community meet its specific needs.

Instructions: We want to know how you view our community, so we are inviting you to participate in a brief survey for community health needs.  Your opinions are important. This questionnaire will take approximately 15 minutes to complete.

All of your individual responses are confidential.  We will use results of the surveys to improve our understanding of health needs in the community.

Please read each question and mark the response that best represents your views of community needs.

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* 1. What is your sex?

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* 2. What is your age?

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* 3. What is your ethnicity/race?

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* 4. What is the zip code where you live?

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* 5. What is your highest level of education?

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* 6. What was your total income last year, before taxes?

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* 7. What is your current housing situation?

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* 8. How many people live in your home (including you)?

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* 9. What is your job status?

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* 10. If applicable, do you have access to affordable child care? 

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* 11. If you are in need of childcare, please indicate type of care you are seeking:

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* 12. If you are in need of childcare, please indicate type of hours you are in need of care: 

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* 13. Health Behaviors: please identify the two (2) most important health issues for this category, in our community:

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* 14. Social and Economic Factors: please identify the two (2) most important health issues for this category, in our community:

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* 15. Clinical Care: please identify the two (2) most important health issues for this category, in our community:

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* 16. Physical Environment: please identify the two (2) most important health issues for this category, in our community:

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* 17. How would you rate your physical health, in general? Please check one:

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* 18. How would you rate your mental health, in general? Consider things such as conserving stress, depression and problems with emotions. Please check one:

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* 19. During the past 12 months, did you seriously consider suicide?

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* 20. On average, how many days per week do you participate in physical activity or exercise (more than 15 minutes in one day)?

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* 21. On an average day, how many servings of fruit do you eat?

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* 22. On an average day, how many servings of vegetables do you eat?

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* 23. How many servings (1 serving – 12 ounces) of regular soda, diet soda and energy drinks do you consumer per week?

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* 24. In an average week, how many times do you eat out (fast food, restaurants, delivery, carry out)?

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* 25. In the past 30 days, did you use any of these tobacco or nicotine products? Select all that apply.

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* 26. Are you exposed to secondhand smoke or e-cigarette aerosol at home?

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* 27. In an average week, how many days do you have at least 1 drink of alcohol?

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* 28. On the days you drink alcohol, how many drinks do you have on average?

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* 29. In the past 30 days, have you used any of these mood-altering substances at least once? Select all that apply.

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* 30. Access to Care: When you get sick, where do you go? Please choose only one.

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* 31. How long has it been since you have been to the doctor to get a checkup when you were well (not because you were already sick)?

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* 32. In the last year, was there time when you needed medical care but were NOT able to get it within a reasonable timeframe?

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* 33. If you answered “yes” to the previous question, why weren’t you able to get medical care? Choose all that apply.

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* 34. Is there anything else you would like to tell us about community concerns, health concerns or services in the community?

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* 35. Want to be more involved in improving the health of your community?  We’d love for you to join a group session.  We’re looking for volunteers who are Taylor County residents to participate in a 1 hour virtual group session to share their thoughts about what makes communities healthy and how they can become healthier. Please reach out directly or provide your contact information below or contact Amanda Lange, Director – Community Health Improvement & Foundation by email at Amanda.lange@aspirus.org or by phone at 715-748-7507.

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