Black Men's Health & Wellness Survey

Your voice matters! Please answer these quick six questions about your health.

Complete this survey by May 1, 2025, for a chance to win a $100 gift card! Your feedback will help the African American Health Program gain valuable insights into your health perspectives and discover new ways to support Black men in living healthier, more fulfilling lives.

Question Title

1. What is your email address? (This will be used to enter you into the lottery for a $100 gift card.)

Question Title

2. How would you rate your overall health? (Required.)

Excellent

Good

Fair

Poor

Question Title

3. How often do you think about your health and wellness? (Required.)

Every day

A few times per week

A few times per month

Hardly ever

Question Title

4. Do you know your biometric numbers (blood pressure, blood sugar/A1C, cholesterol, etc.)? (Required.)

Yes, I check them regularly

I know some of them, but not all

No, but I want to learn more

No, and I'm not interested

Question Title

5. What is your biggest challenge when it comes to eating healthy? (check all that apply) (Required.)

Too expensive

Not enough time to cook

I don't know what's healthy

I don't like the taste of healthy food

I already eat healthy

Question Title

6. How important is oral health (teeth, gums, breath) to you? (Required.)

Very important

Somewhat important

Not that important

I rarely think about it

Question Title

7. What would help you take better care of your health? (check all that apply) (Required.)

More affordable healthy food options

Better access to doctors and health information

A workout plan that fits my lifestyle

Nothing, I'm already on top of my health

Thank you for taking the time to complete our survey!

Black Men's Health & Wellness Survey

Your voice matters! Please answer these quick six questions about your health.

Question Title

* 1. What is your email address? (This will be used to enter you into the lottery for a $100 gift card.)

Question Title

* 2. How would you rate your overall health? (Required.)

Question Title

* 3. How often do you think about your health and wellness? (Required.)

Question Title

* 4. Do you know your biometric numbers (blood pressure, blood sugar/A1C, cholesterol, etc.)? (Required.)

Question Title

* 5. What is your biggest challenge when it comes to eating healthy? (check all that apply) (Required.)

Question Title

* 6. How important is oral health (teeth, gums, breath) to you? (Required.)

Question Title

* 7. What would help you take better care of your health? (check all that apply) (Required.)

1. What is your email address? (This will be used to enter you into the lottery for a $100 gift card.)

2. How would you rate your overall health? (Required.)

3. How often do you think about your health and wellness? (Required.)

4. Do you know your biometric numbers (blood pressure, blood sugar/A1C, cholesterol, etc.)? (Required.)

5. What is your biggest challenge when it comes to eating healthy? (check all that apply) (Required.)

6. How important is oral health (teeth, gums, breath) to you? (Required.)

7. What would help you take better care of your health? (check all that apply) (Required.)