Crawford County Health Prioritization Survey

Avita Health System and Crawford County Health Partners are collaborating to conduct a Community Health Needs Assessment that identifies and prioritizes needs that affect the health of our community. As part of our health assessment process, we would like to rank the health needs in our community according to the collected responses of leaders (who serve residents) and community members.

The following confidential survey should take no more than 5 minutes to complete. Please keep the Crawford County community in mind when you are responding. You may leave questions unanswered and exit the survey at any time.

Thank you for your time and assistance!

	1 (Health outcome with BIGGEST impact to your community)	2	3	4	5	6	7	8	9	10 (Health outcome with LEAST impact to your community)
Childhood conditions (asthma, lead)	Childhood conditions (asthma, lead) 1 (Health outcome with BIGGEST impact to your community)	Childhood conditions (asthma, lead) 2	Childhood conditions (asthma, lead) 3	Childhood conditions (asthma, lead) 4	Childhood conditions (asthma, lead) 5	Childhood conditions (asthma, lead) 6	Childhood conditions (asthma, lead) 7	Childhood conditions (asthma, lead) 8	Childhood conditions (asthma, lead) 9	Childhood conditions (asthma, lead) 10 (Health outcome with LEAST impact to your community)
Depression	Depression 1 (Health outcome with BIGGEST impact to your community)	Depression 2	Depression 3	Depression 4	Depression 5	Depression 6	Depression 7	Depression 8	Depression 9	Depression 10 (Health outcome with LEAST impact to your community)
Diabetes	Diabetes 1 (Health outcome with BIGGEST impact to your community)	Diabetes 2	Diabetes 3	Diabetes 4	Diabetes 5	Diabetes 6	Diabetes 7	Diabetes 8	Diabetes 9	Diabetes 10 (Health outcome with LEAST impact to your community)
Drug overdose deaths	Drug overdose deaths 1 (Health outcome with BIGGEST impact to your community)	Drug overdose deaths 2	Drug overdose deaths 3	Drug overdose deaths 4	Drug overdose deaths 5	Drug overdose deaths 6	Drug overdose deaths 7	Drug overdose deaths 8	Drug overdose deaths 9	Drug overdose deaths 10 (Health outcome with LEAST impact to your community)
Heart disease	Heart disease 1 (Health outcome with BIGGEST impact to your community)	Heart disease 2	Heart disease 3	Heart disease 4	Heart disease 5	Heart disease 6	Heart disease 7	Heart disease 8	Heart disease 9	Heart disease 10 (Health outcome with LEAST impact to your community)
Infant mortality	Infant mortality 1 (Health outcome with BIGGEST impact to your community)	Infant mortality 2	Infant mortality 3	Infant mortality 4	Infant mortality 5	Infant mortality 6	Infant mortality 7	Infant mortality 8	Infant mortality 9	Infant mortality 10 (Health outcome with LEAST impact to your community)
Maternal morbidity	Maternal morbidity 1 (Health outcome with BIGGEST impact to your community)	Maternal morbidity 2	Maternal morbidity 3	Maternal morbidity 4	Maternal morbidity 5	Maternal morbidity 6	Maternal morbidity 7	Maternal morbidity 8	Maternal morbidity 9	Maternal morbidity 10 (Health outcome with LEAST impact to your community)
Preterm births	Preterm births 1 (Health outcome with BIGGEST impact to your community)	Preterm births 2	Preterm births 3	Preterm births 4	Preterm births 5	Preterm births 6	Preterm births 7	Preterm births 8	Preterm births 9	Preterm births 10 (Health outcome with LEAST impact to your community)
Suicide	Suicide 1 (Health outcome with BIGGEST impact to your community)	Suicide 2	Suicide 3	Suicide 4	Suicide 5	Suicide 6	Suicide 7	Suicide 8	Suicide 9	Suicide 10 (Health outcome with LEAST impact to your community)
Youth drug use	Youth drug use 1 (Health outcome with BIGGEST impact to your community)	Youth drug use 2	Youth drug use 3	Youth drug use 4	Youth drug use 5	Youth drug use 6	Youth drug use 7	Youth drug use 8	Youth drug use 9	Youth drug use 10 (Health outcome with LEAST impact to your community)

1 (Health outcome with BIGGEST impact to your community)

10 (Health outcome with LEAST impact to your community)

Childhood conditions (asthma, lead)

Childhood conditions (asthma, lead) 1 (Health outcome with BIGGEST impact to your community)

Childhood conditions (asthma, lead) 2

Childhood conditions (asthma, lead) 3

Childhood conditions (asthma, lead) 4

Childhood conditions (asthma, lead) 5

Childhood conditions (asthma, lead) 6

Childhood conditions (asthma, lead) 7

Childhood conditions (asthma, lead) 8

Childhood conditions (asthma, lead) 9

Childhood conditions (asthma, lead) 10 (Health outcome with LEAST impact to your community)

Depression

Depression 1 (Health outcome with BIGGEST impact to your community)

Depression 2

Depression 3

Depression 4

Depression 5

Depression 6

Depression 7

Depression 8

Depression 9

Depression 10 (Health outcome with LEAST impact to your community)

Diabetes

Diabetes 1 (Health outcome with BIGGEST impact to your community)

Diabetes 2

Diabetes 3

Diabetes 4

Diabetes 5

Diabetes 6

Diabetes 7

Diabetes 8

Diabetes 9

Diabetes 10 (Health outcome with LEAST impact to your community)

Drug overdose deaths

Drug overdose deaths 1 (Health outcome with BIGGEST impact to your community)

Drug overdose deaths 2

Drug overdose deaths 3

Drug overdose deaths 4

Drug overdose deaths 5

Drug overdose deaths 6

Drug overdose deaths 7

Drug overdose deaths 8

Drug overdose deaths 9

Drug overdose deaths 10 (Health outcome with LEAST impact to your community)

Heart disease

Heart disease 1 (Health outcome with BIGGEST impact to your community)

Heart disease 2

Heart disease 3

Heart disease 4

Heart disease 5

Heart disease 6

Heart disease 7

Heart disease 8

Heart disease 9

Heart disease 10 (Health outcome with LEAST impact to your community)

Infant mortality

Infant mortality 1 (Health outcome with BIGGEST impact to your community)

Infant mortality 2

Infant mortality 3

Infant mortality 4

Infant mortality 5

Infant mortality 6

Infant mortality 7

Infant mortality 8

Infant mortality 9

Infant mortality 10 (Health outcome with LEAST impact to your community)

Maternal morbidity

Maternal morbidity 1 (Health outcome with BIGGEST impact to your community)

Maternal morbidity 2

Maternal morbidity 3

Maternal morbidity 4

Maternal morbidity 5

Maternal morbidity 6

Maternal morbidity 7

Maternal morbidity 8

Maternal morbidity 9

Maternal morbidity 10 (Health outcome with LEAST impact to your community)

Preterm births

Preterm births 1 (Health outcome with BIGGEST impact to your community)

Preterm births 2

Preterm births 3

Preterm births 4

Preterm births 5

Preterm births 6

Preterm births 7

Preterm births 8

Preterm births 9

Preterm births 10 (Health outcome with LEAST impact to your community)

Suicide

Suicide 1 (Health outcome with BIGGEST impact to your community)

Suicide 2

Suicide 3

Suicide 4

Suicide 5

Suicide 6

Suicide 7

Suicide 8

Suicide 9

Suicide 10 (Health outcome with LEAST impact to your community)

Youth drug use

Youth drug use 1 (Health outcome with BIGGEST impact to your community)

Youth drug use 2

Youth drug use 3

Youth drug use 4

Youth drug use 5

Youth drug use 6

Youth drug use 7

Youth drug use 8

Youth drug use 9

Youth drug use 10 (Health outcome with LEAST impact to your community)

	1 (Health factor with the BIGGEST impact to my community)	2	3	4	5
Access to childcare	Access to childcare 1 (Health factor with the BIGGEST impact to my community)	Access to childcare 2	Access to childcare 3	Access to childcare 4	Access to childcare 5
Access to healthy foods	Access to healthy foods 1 (Health factor with the BIGGEST impact to my community)	Access to healthy foods 2	Access to healthy foods 3	Access to healthy foods 4	Access to healthy foods 5
Adverse childhood experiences	Adverse childhood experiences 1 (Health factor with the BIGGEST impact to my community)	Adverse childhood experiences 2	Adverse childhood experiences 3	Adverse childhood experiences 4	Adverse childhood experiences 5
Crime and/or violence	Crime and/or violence 1 (Health factor with the BIGGEST impact to my community)	Crime and/or violence 2	Crime and/or violence 3	Crime and/or violence 4	Crime and/or violence 5
Economic security	Economic security 1 (Health factor with the BIGGEST impact to my community)	Economic security 2	Economic security 3	Economic security 4	Economic security 5
Health insurance coverage	Health insurance coverage 1 (Health factor with the BIGGEST impact to my community)	Health insurance coverage 2	Health insurance coverage 3	Health insurance coverage 4	Health insurance coverage 5
Housing affordability and quality	Housing affordability and quality 1 (Health factor with the BIGGEST impact to my community)	Housing affordability and quality 2	Housing affordability and quality 3	Housing affordability and quality 4	Housing affordability and quality 5
K-12 student success	K-12 student success 1 (Health factor with the BIGGEST impact to my community)	K-12 student success 2	K-12 student success 3	K-12 student success 4	K-12 student success 5
Local access to healthcare providers	Local access to healthcare providers 1 (Health factor with the BIGGEST impact to my community)	Local access to healthcare providers 2	Local access to healthcare providers 3	Local access to healthcare providers 4	Local access to healthcare providers 5
Nutrition education	Nutrition education 1 (Health factor with the BIGGEST impact to my community)	Nutrition education 2	Nutrition education 3	Nutrition education 4	Nutrition education 5
Poverty	Poverty 1 (Health factor with the BIGGEST impact to my community)	Poverty 2	Poverty 3	Poverty 4	Poverty 5
Physical activity	Physical activity 1 (Health factor with the BIGGEST impact to my community)	Physical activity 2	Physical activity 3	Physical activity 4	Physical activity 5
Substance use	Substance use 1 (Health factor with the BIGGEST impact to my community)	Substance use 2	Substance use 3	Substance use 4	Substance use 5
Tobacco/nicotine use	Tobacco/nicotine use 1 (Health factor with the BIGGEST impact to my community)	Tobacco/nicotine use 2	Tobacco/nicotine use 3	Tobacco/nicotine use 4	Tobacco/nicotine use 5
Transportation	Transportation 1 (Health factor with the BIGGEST impact to my community)	Transportation 2	Transportation 3	Transportation 4	Transportation 5
Unmet need for mental health care	Unmet need for mental health care 1 (Health factor with the BIGGEST impact to my community)	Unmet need for mental health care 2	Unmet need for mental health care 3	Unmet need for mental health care 4	Unmet need for mental health care 5

1 (Health factor with the BIGGEST impact to my community)

Access to childcare

Access to childcare 1 (Health factor with the BIGGEST impact to my community)

Access to childcare 2

Access to childcare 3

Access to childcare 4

Access to childcare 5

Access to healthy foods

Access to healthy foods 1 (Health factor with the BIGGEST impact to my community)

Access to healthy foods 2

Access to healthy foods 3

Access to healthy foods 4

Access to healthy foods 5

Adverse childhood experiences

Adverse childhood experiences 1 (Health factor with the BIGGEST impact to my community)

Adverse childhood experiences 2

Adverse childhood experiences 3

Adverse childhood experiences 4

Adverse childhood experiences 5

Crime and/or violence

Crime and/or violence 1 (Health factor with the BIGGEST impact to my community)

Crime and/or violence 2

Crime and/or violence 3

Crime and/or violence 4

Crime and/or violence 5

Economic security

Economic security 1 (Health factor with the BIGGEST impact to my community)

Economic security 2

Economic security 3

Economic security 4

Economic security 5

Health insurance coverage

Health insurance coverage 1 (Health factor with the BIGGEST impact to my community)

Health insurance coverage 2

Health insurance coverage 3

Health insurance coverage 4

Health insurance coverage 5

Housing affordability and quality

Housing affordability and quality 1 (Health factor with the BIGGEST impact to my community)

Housing affordability and quality 2

Housing affordability and quality 3

Housing affordability and quality 4

Housing affordability and quality 5

K-12 student success

K-12 student success 1 (Health factor with the BIGGEST impact to my community)

K-12 student success 2

K-12 student success 3

K-12 student success 4

K-12 student success 5

Local access to healthcare providers

Local access to healthcare providers 1 (Health factor with the BIGGEST impact to my community)

Local access to healthcare providers 2

Local access to healthcare providers 3

Local access to healthcare providers 4

Local access to healthcare providers 5

Nutrition education

Nutrition education 1 (Health factor with the BIGGEST impact to my community)

Nutrition education 2

Nutrition education 3

Nutrition education 4

Nutrition education 5

Poverty

Poverty 1 (Health factor with the BIGGEST impact to my community)

Poverty 2

Poverty 3

Poverty 4

Poverty 5

Physical activity

Physical activity 1 (Health factor with the BIGGEST impact to my community)

Physical activity 2

Physical activity 3

Physical activity 4

Physical activity 5

Substance use

Substance use 1 (Health factor with the BIGGEST impact to my community)

Substance use 2

Substance use 3

Substance use 4

Substance use 5

Tobacco/nicotine use

Tobacco/nicotine use 1 (Health factor with the BIGGEST impact to my community)

Tobacco/nicotine use 2

Tobacco/nicotine use 3

Tobacco/nicotine use 4

Tobacco/nicotine use 5

Transportation

Transportation 1 (Health factor with the BIGGEST impact to my community)

Transportation 2

Transportation 3

Transportation 4

Transportation 5

Unmet need for mental health care

Unmet need for mental health care 1 (Health factor with the BIGGEST impact to my community)

Unmet need for mental health care 2

Unmet need for mental health care 3

Unmet need for mental health care 4

Unmet need for mental health care 5

Crawford County Health Prioritization Survey

Welcome

Question Title

* 1. Provide your name and organization

Question Title

* 2. Below are a list of health outcomes that affect many communities. Please rank the following health outcomes that affect your community (1=Biggest impact to your community and 10=Least impact to your community)

Question Title

* 3. Below are a list of factors that affect the health of communities. Please rank and list the top five health factors that affect your community. (Please ONLY choose five!)

Question Title

* 4. Do you have any other comments or concerns related to the needs above?