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Community Health Input - We Want to Hear from You!
The Aspirus Lake View Hospital and Lake County Public Health Department are conducting this anonymous survey to understand your opinions about health in your community.
*
1.
I live, work, and/or use services in Lake County
(select one)
(Required.)
Yes
No
2.
Choose the
top
Health Behavior
that is hurting our community the most
(select one)
:
Alcohol use
Cannabis/THC use: edibles, vapes, weed, etc.
Drug misuse (prescribed and illegal)
Excessive use of screen time
Lack of physical activity
Nicotine use: cigarettes, vaping, pouches, chewing tobacco, etc.
Not prioritizing seeking mental health care
Poor nutrition
Unsafe sexual activity
None of the above are concerns in my community
Choose not to answer
Other (please specify)
3.
Social and Economic Factors:
Choose the
top
Social and Economic Health Factor
that is hurting our community the most
(select one)
:
Access to affordable, quality childcare
Access to affordable, quality medical care
Access to affordable, quality mental health care
Family instability (ex: abuse, inattentive parenting, trauma)
Financial instability (ex: safe housing, household expenses, food)
Harassment or discrimination of groups of people (e.g., LGBTQ, racial or ethnic minorities)
Lack of knowledge of support services
Limited educational opportunities
Limited social opportunities
Reliable transportation
Violence in the home or community
None of the above are concerns in my community
Choose not to answer
Other (please specify)
4.
Clinical Care:
Choose the
top
Clinical Care
issue that is hurting our community the most
(select one)
:
Availability of dental care
Availability of mental health appointments
Difficulty getting the medical appointments that you want
Difficulty navigating the health care system/insurance
Fewer people using preventive services (ex: annual exams, mammograms, colonoscopies, vaccines)
None of the above are concerns in my community
Choose not to answer
Other (please specify)
5.
Physical Environment:
Choose the
top
aspect of the Physical Environment
that is hurting our community the most
(select one)
:
Air pollution
Drinking water quality
Limited access to green space, public parks and recreation
Limited access to healthy food
Limited access of public places for those with disabilities
Limited access to safe places to walk and bike
None of the above are concerns in my community
Choose not to answer
Other (please specify)
