Darke County 2023 Community Health Survey

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If you are a Darke County resident, please take a minute to complete the survey below. If you are NOT a Darke County resident please stop and disregard this survey. The purpose of this survey is to get your opinions about community health problems in Darke County, Ohio. The Darke County General Health District Community Health Committee will use the results of this survey and other information to identify the most pressing problems which can be addressed through community action. If you have previously completed this survey, please ignore this. Remember… your opinion is important! Thank you and if you have any questions, please call us at 937-548-4196 ext. 261.

In the following list, what do you think are the three most important factors for a “Healthy Community?” (Those factors which most improve the quality of life in a community.) SELECT ONLY THREE

Good place to raise children

Low crime / safe neighborhoods

Low level of child abuse

Good schools

Access to health care (e.g., family doctor, dentist, mental health services)

Parks and recreation

Clean environment

Affordable housing

Arts and cultural events

Excellent race relations

Good jobs and healthy economy

Strong family life

Healthy behaviors and lifestyles

Low adult death and disease rates

Low infant deaths

Religious or spiritual values

Other:

In the following list, what do you think are the three most important “health problems” in our community? (Those problems which have the greatest impact on overall community health.) SELECT ONLY THREE

Aging problems (e.g., arthritis, hearing/vision loss, etc.)

Cancers

Substance abuse (e.g., alcohol and/or drugs)

Child abuse / neglect

Dental problems

Diabetes

Domestic Violence

Firearm-related injuries

Heart disease and stroke

High blood pressure

HIV / AIDS

Homicide

Infant Death

Infectious Diseases (e.g., hepatitis, TB, etc.)

Mental health problems

Motor vehicle crash injuries

Rape / sexual assault

Respiratory / lung disease

Sexually Transmitted Diseases (STDs)

Suicide

Teenage pregnancy

Other:

In the following list, what do you think are the three most important “risky behaviors” in our community? (Those behaviors which have the greatest impact on overall community health.) SELECT ONLY THREE

Alcohol abuse

Being overweight

Dropping out of school

Drug abuse

Lack of exercise

Poor eating habits

Not getting "shots" to prevent disease

Racism

Tobacco use

Unsafe sex/Not using birth control (e.g., oral contraceptives, condoms, etc.)

Not using seat belts / child safety seats

Other:

How would you rate our community as a "Healthy Community?"

Very unhealthy

Unhealthy

Somewhat healthy

Healthy

Very healthy

Clear selection

How would you rate your own personal health?

Very unhealthy

Unhealthy

Somewhat healthy

Healthy

Very healthy

Clear selection

Approximately how many hours per month do you volunteer your time to community service? (e.g., schools, voluntary organizations, churches, hospitals, etc.)

None

1-5 hours

6-10 hours

Over 10 hours

Clear selection

Please answer questions #7-15 so we can see how different types of people feel about local health issues.

Zip code where you live:

Age

25 or less

26-39

40-54

55-64

65 or over

Clear selection

Sex:

Male

Female

Clear selection

Ethnic group(s) you most identify with:

African American / Black

Asian / Pacific Islander

Hispanic / Latino

Native American

White / Caucasian

Other:

Marital Status

Married or Living Together

Not married / Single

Clear selection

Education

Less than high school

High school diploma or GED

College degree or higher

Other:

Clear selection

Household income

Less than $20,000

$20,000 to $29,000

$30,000 to $49,000

$50,000 to $64,000

$65,000 to $84,000

$85,000 to $100,000

Over $100,000

Clear selection

How do you pay for your health care? (Check all that apply)

Pay cash (no insurance)

Health insurance (e.g., private insurance, Blue Cross Blue Shield, HMO)

Medicaid (e.g., CareSource, Molina, Buckeye, UnitedHealthcare, Anthem Medicaid)

Medicare

Veterans' Administration

Indian Health Services

Other:

Where / how you got this survey:

County Fair

Social Media

Darke County Health Department

Community Meeting

Grocery Store / Shopping Mall

Newsletter

Personal Contact

Workplace

Church

Other:

Clear selection

Submit

Clear form

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