Iowa Specialty Hospital

Community Health Needs Assessment Survey 2022

Every three years in Iowa, healthcare groups lead a community-wide discussion about their community’s health needs. From this discussion, community goals and projects are developed. The following survey is based on six factors important for the health and well-being of everyone in your community.  By completing this survey, your input will help the team determine what is needed in your county and to set a level of importance of these service needs.

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Section 1 - Promoting Healthy Living

Promoting healthy living includes such health services as the prevention and treatment of addictive behaviors (tobacco, alcohol, other drugs, gambling) and chronic disease (mental health, heart disease and stroke, cancer, asthma, diabetes, arthritis, etc.); elderly wellness; family planning; infant, child and family health; nutrition; oral health; physical activity; and pregnancy and birth.  


How important are these services? (Check one.):
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If you answered very important or important, which services should be considered a priority for attention? (Check all that apply.):
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Of the services that you chose, please select the 3 that you believe are the most important to your community.:
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From the services you chose above, please list the first priority.:
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Select one of the following based on the service you chose as a first priority.:
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From the services you chose above, please list the second priority.:
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Select one of the following based on the service you chose as a second priority.:
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From the services you chose above, please list the third priority.:
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Select one of the following based on the service you chose as a third priority.:
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Section 2 - Preventing Injuries

Preventing injuries includes such services as brain injury prevention, disability, Emergency Medical Services, intentional injuries (violent and abusive behavior, suicide), occupational health & safety, and unintentional injuries (motor vehicle crashes, falls, poisoning, drowning, etc.). 


How important are these services? (Check one.):
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If you answered very important or important, which services should be considered a priority for attention? (Check all that apply.):
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Of the services that you chose, please select the 3 that you believe are the most important to your community.:
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From the services you chose above, please list the first priority.:
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Select one of the following based on the service you chose as a first priority:
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From the services you chose above, please list the second priority.:
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Select one of the following based on the service you chose as a second priority.:
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From the services you chose above, please list the third priority.:
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Select one of the following based on the service you chose as a third priority.:
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Section 3 - Preventing Epidemics

Preventing epidemics includes such services as child and adult immunizations/vaccinations, and surveillance and control of infectious diseases including: HIV/AIDS, influenza, sexually transmitted diseases, tuberculosis (TB) and other reportable diseases. 


How important are these services? (Check one.):
*

If you answered very important or important, which services should be considered a priority for attention? (Check all that apply.):
*

Of the services that you chose, please select the 3 that you believe are the most important to your community.:
*

From the services you chose above, please list the first priority.:
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Select one of the following based on the service you chose as a first priority.:
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From the services you chose above, please list the second priority.:
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Select one of the following based on the service you chose as a second priority.:
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From the services you chose above, please list the third priority.:
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Select one of the following based on the service you chose as a third priority.:
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Section 4 - Protecting Against Environmental Hazards

Protecting against environmental hazards includes such concerns as drinking water protection, food safety, food waste, hazardous materials, hazardous waste, healthy homes, lead poisoning, nuisances such as noise and litter, onsite wastewater systems, radon, radiological health, soil erosion, and vector (disease-carrying animals and insects) control. 


How important are these services? (Check one.):
*

If you answered very important or important, which services should be considered a priority for attention? (Check all that apply.):
*

Of the services that you chose, please select the 3 that you believe are the most important to your community.:
*

From the services you chose above, please list the first priority.:
*
Select one of the following based on the service you chose as a first priority.:
*

From the services you chose above, please list the second priority.:
*
Select one of the following based on the service you chose as a second priority.:
*

From the services you chose above, please list the third priority.:
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Select one of the following based on the service you chose as a third priority.:
*

Section 5 - Prepare for, Respond to, and Recover from Public Health Emergencies

Preparing for, responding to, and recovering from public health emergencies includes such concerns as communication networks, emergency planning, emergency response, individual preparedness, recovery planning, risk communication (communication before, during, and after a crisis), and surge capacity (the capacity to continue normal duties during emergencies). 


How important are these services? (Check one.):
*

If you answered very important or important, which services should be considered a priority for attention? (Check all that apply.):
*

Of the services that you chose, please select the 3 that you believe are the most important to your community.:
*

From the services you chose above, please list the first priority.:
*
Select one of the following based on the service you chose as a first priority.:
*

From the services you chose above, please list the second priority.:
*
Select one of the following based on the service you chose as a second priority.:
*

From the services you chose above, please list the third priority.:
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Select one of the following based on the service you chose as a third priority.:
*

Section 6 - Strengthen the Health Infrastructure

Strengthening the health infrastructure (the framework to support being healthy) includes topics such as access to quality health services, community engagement, evaluation, food security, food systems, food and nutrition assistance (SNAP, WIC), health facilities, health insurance, medical care, organizational capacity, planning, quality improvement, social determinants (e.g., education & poverty levels), transportation, and workforce (e.g., primary care, dental, mental health, public health).workforce development, and an equal opportunity to live a long, healthy life regardless of income, education, or ethnic background. 


How important are these services? (Check one.):
*

If you answered very important or important, which services should be considered a priority for attention? (Check all that apply.):
*

Of the services that you chose, please select the 3 that you believe are the most important to your community.:
*

From the services you chose above, please list the first priority.:
*
Select one of the following based on the service you chose as a first priority.:
*

From the services you chose above, please list the second priority.:
*
Select one of the following based on the service you chose as a second priority.:
*

From the services you chose above, please list the third priority.:
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Select one of the following based on the service you chose as a third priority.:
*

Section 7 - Healthier Community
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In regards to your community's physical environment, select all that apply.:
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Rank the items below in importance to you with 1 being most important and 5 being least important.

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Please mark all that you see within your community.:
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In your opinion, mark what you feel applies to your community regarding smoking and/or vaping.:
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In your opinion, mark what you feel applies to your community regarding alcohol use.:
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In your opinion, mark what you feel applies to your community regarding drug use.:
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Section 8 - Optional Questions

The following questions are optional.


Do you have any concerns about your safety that impacts your well-being?:

Do you feel the education system has prepared you to lead a healthy life?:

When I finished school I was aware of the following: (Check all that apply.):

When I retired I was aware of the following: (Check all that apply.):

When I started a family I was aware of the following: (Check all that apply.):

Section 9 - Demographics

The following questions pertain to your individual demographics.


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Age:
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Gender (Select all that apply.):
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Race / Ethnicity (Select all that apply.):
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Yearly Income:
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Current Health Insurance Coverage:
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