Healthy Harnett

 
The purpose of this survey is to learn more about health and quality of life in Harnett County. Healthy Harnett will use the results of this survey and other information to identify and address our county’s most pressing health problems. Your answers on this survey will not be linked to you in any way.
1. If you moved to Harnett County in the last 4 years, why did you do so?
2. In your opinion, how large a problem do you think each community issue listed below is in Harnett County? Please check in the box whether you think it is a major problem, a problem, a minor problem or not a problem.
Major ProblemProblemMinor ProblemNot a ProblemDon't Know
Lack of affordable housing
Unemployment and under-employment
Shortage of recreational programs and facilities (parks, trails, etc.)
Shortage of cultural programs (music,art, theater, etc.)
Shortage of job training and other educational opportunities for adults
Lack of after school and summer youth activities
High quality schools (K-12)
Racial and ethnic discrimination
Lack of public transportation
Crime
Animal Control
Inadequate water supply or quality
Poor air quality
Safe roads and bridges
3. In your opinion, how large a problem do you think each social issue listed below is in Harnett County? Please check in the box whether you think it is a major problem, a problem, a minor problem or not a problem.
Major ProblemProblemMinor ProblemNot a ProblemDon't Know
Difficulty earning a living and making ends meet / poverty
Isolation and loneliness among the elderly
Homelessness
Illiteracy
Lack of money management skills and other life management skills
Lack of appropriate parenting skills
Child abuse and neglect
Abuse and neglect of the elderly
Domestic violence and abuse
Juvenile delinquency
Gangs and gang violence
Unsafe school environment/bullying
4. In your opinion, how large a problem do you think each unhealthy behavior listed below is in Harnett County?
Major ProblemProblemMinor ProblemNot a ProblemDon't Know
Alcohol abuse
Use of illegal drugs / substance abuse
Overweight / obesity
Tobacco use (all types)
Drinking and driving
Reckless / careless driving
Driving or riding without using seatbelts or proper infant / child seats
Lack of physical activity or exercise
Food Safety/ in your home
Poor eating habits / lack of good nutrition
Unsafe sexual practices
Teen pregnancy
5. . In your opinion, how large a problem do you think each health problem listed below is in Harnett County? Please check in the box whether you think it is a major problem, a problem, a minor problem or not a problem.
Major ProblemProblemMinor ProblemNot a ProblemDon't Know
Heart Disease
Cancer
Asthma
Stroke
Diabetes
Suicide
Oral/Dental Health
Mental Illness
Locating a Health Provider
6. In the last year, have you gotten health-related information from any of the following? Check all that apply
7. About how long has it been since you last visited a health care provider for a routine check up? This does not include a visit because you were sick or pregnant.
8. When your are sick, do your feel that you are able to see your primary care provider in a timely way?
9. About how long has it been since you last visited a dentist for a routine check up? Do not include times you visited the dentist because of an emergency.
10. When you have a toothache do you feel that you are able to see your dentist in a timely way?
11. During the past week, other than your regular job, did you engage in any exercise activity that lasts at least thirty minutes?
12. Since you said “yes”, how many times would you say you engaged in this activity during the past week?
13. Since you said "yes" in question 11, where do you go to exercise of engage in physical activity? Select all that apply
14. Since you said no, what were the reasons? Check all that apply.
15. In an average week, how many servings do you eat of fruits?
16. In an average week, how many servings do you eat of vegetables?
17. Do you use any type of tobacco products?
18. This question is for males only. If you are over the age of 40, do you have an annual prostate exam?
19. This question is for females only. If you are over 40, do you have an annual mammogram?
20. This question is for females only. If you are over age 18, do you have a pap smear at least every other year?
21. If you are over age 50, have you ever had a colon cancer screening?
22. If yes, did you ever have a colonoscopy?
23. Where do you usually go for health care when you are sick? Please choose only one answer.
24. Is this place in Harnett County?
25. If no, what county is it located.
26. If you or a family member needed care at a hospital, and it could be provided locally, where would you likely seek it?
27. If you stated you would not go to a local hospital please indicate reason(s): Check all that apply
28. If you have not been able to to find a local physician to meet your needs, please indicate the type of physician you feel you need.
29. What kind of health care coverage or insurance, do you have? Check all that apply
30. If you have private insurance, who pays the monthly cost or premium?
31. What other people living in your household do not have health care coverage or insurance?
32. In a disaster, where would you likely look for information?
33. Does your family have a basic emergency supply kit set aside for immediate use that could sustain all members of the family for 72 hours?
34. Do you have a plan for how to communicate with family members in the event of an emergency and everyone is away from home?
35. Are you aware of an emergency preparedness plan for Harnett County?
36. What is the zip code for your home?
37. How long have you lived in Harnett County?
38. Do you work outside of Harnett County?
39. What is your age?
40. Are you:
41. How would you identify your race or ethnicity?
42. What is your relationship status?
43. What is the highest educational level you have completed?
44. What is your employment status? Please check all that apply.
45. Approximately what was your adult household income last year? (Household income is the total before-tax income of the adults living in your household.)
46. How many children under the age of 18 does this household income support?
47. How many adults age 18 and older does this household income support?
48. Are you the primary caregiver for any of the following?
49. Do you have access to the internet?
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