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Logan County and Mason City - Community Health Survey
Lincoln Memorial Hospital and the Logan County Department of Public Health are conducting their 3-year community health survey. Thank you for helping us identify the most important ways we can help our communities become as healthy as possible.
This survey should take no more than 7 minutes. Sharing your experience is so important! We appreciate your time.
ABOUT YOU
1.
Please enter your zip code
2.
Please select your age range
Under 18
18-24
25-34
35-44
45-54
55-64
65+
3.
Select your gender
Male
Female
Nonbinary
Prefer Not to Answer
A gender not listed
4.
Select your highest level of education??
Did not attend school
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
Graduated from high school
1 year of college
2 years of college
3 years of college
Graduated from college
Some graduate school
Completed graduate school
5.
Please select your household income
Less than $20,000
$20,001-40,000
$40,001-60,000
$60,001-80,000
$80,001-100,000
$100,000+
Retired
Prefer not to say
6.
Which categories describe you (check all that apply)
American Indian or Alaska Native (Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, etc.)
Asian (Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc.)
Black of Afridan American (African American, JAmaican, Haitian, Nigerian, Ethiopian, Somalian, etc.)
Hispanic, Latino or Spanish Origin (Mexican, Mexican American, Puerto Rican, Cuban, Dominican, etc.)
Native Hawaiian or Other Pacific Islander (NAtive Hawaiian, Samoan, Chamorro, Tongan, Fijian, etc.)
White (German, Irish, English, Italian, Polish, French, Lebanese, Egyptian, Iranian, Slavic, Cajun, etc. )
Other race, ethnicity or origin not listed:
7.
Which describes you (check all that apply)
Underinsured/Uninsured
Disabled
LGBTQIA+
Immigrant/Refugee
Prefer not to answer
Individual with mental health challenges
Married/Life Partner
Veteran
None of these
8.
Which best describes your employment status?
Employed, full-time
Employed, part-time
Not employed, looking for work
Not employed, not looking for work
Retired
Disabled, not able to work
Student
Stay at home parent/caregiver
YOUR HEALTH
Imagine a ladder with steps numbered from 0 (the worst possible life) to 10 (the best possible life). Use this ladder to rate your current life and our expectations for the future.
9.
On which step of the ladder would you say you personally feel you stand at this time?
1 - suffering
2 - suffering
3 - suffering
4 - struggling
5 - struggling
6 - struggling
7 - thriving
8 - thriving
9 - thriving
10 - thriving
10.
On which step of the ladder do you think you'll stand about five years from now?
1 - suffering
2 - suffering
3 - suffering
4 - struggling
5 - struggling
6 - struggling
7 - thriving
8 - thriving
9 - thriving
10 - thriving
11.
What prevents YOU from accessing healthcare when you need it? (check all that apply)
Lack of health insurance coverage
Lack of transportation
Language/cultural barriers
Availability of providers/appointments
Lack of child care
Lack of access to a dentist
Inability to pay out-of-pocket expenses
Inability to pay for prescriptions
Basic needs not met (food/shelter)
Time limitations
Lack of trust
Lack of access to mental health providers
Lack of access to physicians/providers
Lack of concern or health is not a priority/valued
Not applicable/I can access healthcare when I need it
Other (please specify)
12.
Check any challenges you face trying to maintain a healthy lifestyle. (check all that apply)
Recreation opportunities
Affordable housing
Access to healthy foods
Motivation/effort/concern
Time/convenience
Lack of education/knowledge
Safety/crime
Cultural barriers
None of these
Other (please specify)
13.
Have you or anyone in your household EVER experienced any of the following? (check all that apply)
Physical abuse (push, grab, slap, throw something at you, kicked, threatened with a weapon, bruised)
Emotional abuse (swear at, insult, put you down, humiliate, act in a way you were afraid)
Sexual abuse
Physical neglect (not enough to eat, had to wear dirty clothes, parents too drunk/high to take care of you)
Emotional neglect (often feel that no one in your family loves you, family does not support one another)
Mental illness in the household
Mother treated violently
Parents divorced or separated
Chronic substance use/dependency (alcohol, prescription opioids, recreational drugs, etc.)
Household member incarcerated
Gun violence
None of these
If you need help, please call 211 for local resources or visit www.connect.findhelp.com.
For mental health support, call/text 988.
If you are experiencing domestic violence, please reach out to 1-800-559-SAFE (7233).
14.
What is ONE thing you could do to make the health of your community better?
15.
What is the ONE thing you could do to make YOUR health better?
16.
What contributes to YOUR good health the MOST?
YOUR PHYSICAL ENVIRONMENT
17.
In the past 12 months, have any of these environmental conditions affected your health or daily life? (check all that apply)
Heat
Air Quality
Water Quality
Flooding
Storms
None of these
Other (please specify) or further explanation:
18.
What is your current housing situation?
I have stable, permanent place to live.
I have a place to live, but I am concerned about losing it in the near future.
I do not have a stable place to live and am staying with others temporarily
I am staying in a temporary shelter, hotel, or other short-term accommodation.
I do not have any shelter and am staying outside (on the street, in a car, in a park/public place)
YOUR TRANSPORTATION
19.
How many minutes does it take you to get from your home to the following locations?
0-15 minutes
16-30 minutes
31-45 minutes
46 minutes - 1 hour
1 hour+
Not applicable
Work
0-15 minutes
16-30 minutes
31-45 minutes
46 minutes - 1 hour
1 hour+
Not applicable
School
0-15 minutes
16-30 minutes
31-45 minutes
46 minutes - 1 hour
1 hour+
Not applicable
Grocery Store
0-15 minutes
16-30 minutes
31-45 minutes
46 minutes - 1 hour
1 hour+
Not applicable
Dentist
0-15 minutes
16-30 minutes
31-45 minutes
46 minutes - 1 hour
1 hour+
Not applicable
Hospital/Health Clinic
0-15 minutes
16-30 minutes
31-45 minutes
46 minutes - 1 hour
1 hour+
Not applicable
20.
How often do you have a situation where you can't reach your desired location because of a transportation issue?
Rarely or infrequently
Several times a year
About once a month
More than once a month
Once a week or more
YOUR COMMUNITY AND SOCIAL CONNECTIONS
21.
What places do you go for community and belonging? (check all that apply)
Church/Mosque/Temple/Synagogue/Place of Worship
School
Community Resource Centers/ Organizations
Parks/Public Spaces
Friends' Homes/Residences
Online Communities or Social Media Group
I have nowhere to go for community belonging
Other/Specific Organization
22.
In the past 12 months, how often did you feel lonely or isolated from those around you?
Never
Rarely
2-3 times a week
4-5 times a week
More than 5 times a week
23.
Have you or anyone in your household EVER experienced any of the following? (check all that apply)
An adult has made you feel safe and protected in your home.
Felt a sense of belonging in high school
Feel supported by friends
Two or more non-parent adults have taken a genuine interest in you.
Family support during difficult times
Enjoyment in community traditions
Comfortable talking to family (or friends) about your feelings
You did it! Your voice matters.
Thank you for taking this survey.
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