Community Health Survey

The Pima County Health Department wants your opinion about the health of the community. Results from this survey will assist the local health department and community organizations to design health services for the future. Your responses are confidential.

Question Title

1. In your opinion, what are the three most important factors needed to have a healthy community? Check only three: (Required.)

Access to health care (e.g., family doctor, emergency care)

Clean environment

Good jobs and healthy economy

Good schools

Health insurance coverage

Healthy behaviors and lifestyles

Healthy children

Healthy senior citizens

High quality inpatient care (hospitals, long term care, behavioral health)

High vaccination rates

Low crime/safe neighborhoods

Neighborhood parks and recreation

Strong stable families and/or social support

Other (please specify)

Question Title

2. In your opinion, what are the three health behaviors that have the greatest impact on the health of Pima County residents? Check only three. (Required.)

Abuse/neglect of child/partner/seniors

Alcohol/drug abuse

Delaying dental/health care

Dropping out of school

Lack of physical activity

No prenatal care when pregnant

Not being vaccinated

Not taking medications as directed

Not using seat belts/child safety seats

Poor eating habits

Street violence

Tobacco use

Unsafe driving

Unsafe job sites

Unsafe sex

Unsecured weapons/firearms

Other (please specify)

Question Title

3. In your opinion, what are the three most important health services that impact the health of Pima County residents? Check only three. (Required.)

Alternative/non-traditional health care

Behavioral health

Caregiver assistance and support

Community-based health services

Dental care

Emergency health services (e.g., emergency rooms, urgent care centers, paramedics)

Home health services

Hospice services

Local hospitals

Long-term care

Pharmacy

Primary care/family doctors

Specialty doctors

Substance abuse services

Wellness/preventive health programs

Other (please specify)

Question Title

4. In your opinion, what are the three greatest threats to the health of Pima County residents? Check only three. (Required.)

Abuse and neglect (child, partner, senior)

Behavioral health problems

Cancer

Contagious diseases

Diabetes

Heart disease and stroke

Homicide

Motor vehicle injuries/deaths

Overweight/obesity

Poor air/water quality

Rape/sexual assault

Respiratory diseases including asthma

Substance abuse

Suicide

Teenage pregnancy

Terrorism or security threats

Other (please specify)

Question Title

5. The overall health of Pima County residents is good.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

Question Title

6. Your health is generally good.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

Question Title

7. Pima County is a safe place to live.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

Question Title

8. Pima County is a good place to raise children.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

Question Title

9. Pima County is a good place to grow old.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

Question Title

10. There are adequate health care services in Pima County.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

Question Title

11. You are satisfied with the quality of life in Pima County.

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Rating	Rating Strongly Agree	Rating Somewhat Agree	Rating Neutral	Rating Somewhat Disagree	Rating Strongly Disagree

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12. Your Zip Code:

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13. Your Age:

18 to 24 years old

25 to 29 years old

30 to 39 years old

40 to 49 years old

50 to 59 years old

60 to 64 years old

65 years or older

Question Title

* 1. In your opinion, what are the three most important factors needed to have a healthy community? Check only three: (Required.)

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* 2. In your opinion, what are the three health behaviors that have the greatest impact on the health of Pima County residents? Check only three. (Required.)

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* 3. In your opinion, what are the three most important health services that impact the health of Pima County residents? Check only three. (Required.)

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* 4. In your opinion, what are the three greatest threats to the health of Pima County residents? Check only three. (Required.)

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* 5. The overall health of Pima County residents is good.

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* 6. Your health is generally good.

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* 7. Pima County is a safe place to live.

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* 8. Pima County is a good place to raise children.

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* 9. Pima County is a good place to grow old.

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* 10. There are adequate health care services in Pima County.

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* 11. You are satisfied with the quality of life in Pima County.

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* 12. Your Zip Code:

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* 13. Your Age:

1. In your opinion, what are the three most important factors needed to have a healthy community? Check only three: (Required.)

2. In your opinion, what are the three health behaviors that have the greatest impact on the health of Pima County residents? Check only three. (Required.)

3. In your opinion, what are the three most important health services that impact the health of Pima County residents? Check only three. (Required.)

4. In your opinion, what are the three greatest threats to the health of Pima County residents? Check only three. (Required.)

5. The overall health of Pima County residents is good.

6. Your health is generally good.

7. Pima County is a safe place to live.

8. Pima County is a good place to raise children.

9. Pima County is a good place to grow old.

10. There are adequate health care services in Pima County.

11. You are satisfied with the quality of life in Pima County.

12. Your Zip Code:

13. Your Age: