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We are interested in understanding how the local community feels about the impact of the COVID-19 pandemic on their families and community. We will take all possible steps to protect your privacy and will use your answers only for statistical research. This means that no individual will be identified in any of the analyses or reports from this study. The survey will take about five minutes to complete. We greatly appreciate you taking the time to share your thoughts.

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* 1. How concerned are you about the impact of COVID-19 on your own health?

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* 2. How concerned are you about the impact of COVID-19 on somebody else's health (e.g., friend or relative)?

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* 3. What other concerns do you have about the impact of COVID-19 on your community? Can include fraying social ties, negative behaviors, etc.

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* 4. What concerns do you have about the impact of COVID-19 on your well-being? Can include stress, social isolation, etc.

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* 5. Since the start of the pandemic, has your consumption of alcohol changed?

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* 6. Since the start of the pandemic, has your consumption of tobacco products changed?

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* 7. Since the start of the pandemic, has your consumption of illicit drugs changed?

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* 8. Has your consumption of junk food and sweets changed?

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* 9. Has your consumption of healthy, nutritious food changed?

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* 10. Has your access to healthy, nutritious food changed?

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* 11. Has your frequency of exercising changed?

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* 12. Has your time spent being inactive changed?

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* 13. Has your time spent on the internet changed?

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* 14. What is your employment status?

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* 15. Which of the following best describes the impact of COVID-19 on your household's ability to meet financial obligations (loan repayments, household bills, etc.)?

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* 16. How has COVID-19 impacted your household's wages and employment? Select all that apply.

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* 17. What is your household income?

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* 18. Do you feel that if you needed non-material help (e.g., somebody to talk to, help with doing something, or collecting something) you could receive it from relatives, friends, neighbors or other persons that you know?

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* 19. Given the topics discussed in this survey, how can your local health department better serve you?

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* 20. What is your age?

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* 21. What is your sex?

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* 22. In what ZIP code is your home located? (enter five-digit ZIP code; for example, 00544 or 94305)

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* 23. Which race/ethnicity best describes you? (Please choose only one.)

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 100% of survey complete.

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