2022 Community Health Needs Assessment Survey

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* 3. What is your race? (Select all that apply.)

African American or Black

Alaskan Native

Asian

Caucasian or White

Middle Eastern

Native American

Pacific Islander

Other (please specify)

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* 4. What is your ethnicity?

Hispanic or Latino/ LatinX

Non-Hispanic

Other (please specify)

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* 5. What is your primary language spoken at home?

English

Spanish

Other (please specify)

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* 6. What gender do you identify as?

Female

Male

Non-binary

Transgender

Other (please specify)

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* 7. What is your sexual orientation?

Asexual

Bisexual

Gay

Heterosexual (straight)

Lesbian

Pan

Questioning

Other (please specify)

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* 8. What town do you live in? (If your town is not listed, please exit the survey.)

Annapolis

Cazadero

Elk

Gualala

Irish Beach

Manchester

Point Arena

Stewarts Point

The Sea Ranch

Timber Cove

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* 9. I live in this community:

Full-time

Part-time

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* 10. How long do you see yourself living in this community?

1-3 years

4-9 years

10+ years

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* 11. What might make you leave the community?

Better educational opportunities

Family needs elsewhere (taking care of a loved one out of the area)

Health needs

Retired and want to leave the area

Aging

Work opportunities

Nothing will make me leave

Other (please specify)

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* 12. Are you a member of one of the following tribes?

Manchester-Point Arena Band of Pomo Indians

Stewarts Point Kashia Pomo Indian

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* 13. How do you typically travel locally for errands or appointments? (Select all that apply.)

Coastal Seniors Bus

Family or friends drive me

I drive myself

Public Transportation (Mendocino Transit Authority - MTA)

Rides coordinated by local community organizations

I do not have access to transportation locally

Other (please specify)

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* 14. How do you typically travel out of town for errands or appointments? (Select all that apply.)

Coastal Seniors Bus

Family or friends drive me

Medi-Cal Transportation Management (MTM)

I drive myself

Public transportation (Mendocino Transit Authority - MTA)

Rides coordinated by local community organizations

I do not have access to transportation out of town

Other (please specify)

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* 15. Is the cost of car insurance, registration or gas a barrier to you seeing the health care providers you prefer?

Yes

Somewhat

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* 16. Does the cost of rent/mortgage create barriers in accessing essential resources, such as food, health care, etc.?

Yes

Sometimes

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* 17. What is your employment status? (Select all that apply.)

Armed forces

Disabled

Full-time (32+ hours per week)

Part-time

Retired

Self-employed

Student

Unemployed for less than one year

Unemployed for one year or longer

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* 18. What are the top 3-5 most concerning health issues you see among your family, friends, and community?

Addiction

Alzheimer's/ Dementia

Arthritis

Cancer

Chronic pain

Dental health (including tooth pain)

Diabetes

Domestic Violence

Early sexual activity

Elder abuse

Heart disease/ heart attack

HIV/ AIDS

Hypertension

Infectious/ contagious disease such as flu, pneumonia, COVID, etc.

Injuries and accidents

Lung disease (asthma, COPD)

Mental health conditions

Obesity/ overweight

Sexually transmitted infections

Smoking

Stroke

Teen pregnancy

Other (please specify)

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* 19. Do you have any of the following health conditions? (Select all that apply.)

Addiction to Alcohol

Addiction to Benzodiazepines (Xanax, Valium, Klonopin, etc.)

Addiction to methamphetamine

Addiction to nicotine

Addiction to opioids (heroin, Oxy, fentanyl, etc.)

Alzheimer's or Dementia

Asthma

Cancer

Chronic pain

COPD

Dental issues

Diabetes

Domestic violence

Heart disease/ heart attack

HIV/AIDS

Hypertension (high blood pressure)

Mental health conditions (depression, hopelessness, anger, etc.)

Obesity/ overweight

Stroke

I don't have any health conditions

Other (please specify)

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* 20. With no local pharmacies available, how will/ do you access medications when needed?

Mail order through a pharmacy

Delivery from Mendocino Coast Pharmacy

Amazon or another major distributor

I or someone I know will pick medications up out of town

I am no longer able to access my prescriptions

Other (please specify)

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* 21. What is your housing status?

Single-family residence living alone

Single-family residence living with my immediate family (children and/or spouse)

Multi-generational single-family residence (families living with grandparents or adult children living with parents)

Single-family residence with more than one family (friends, siblings and their children, roommates, etc.)

Mobile trailer

I live in my vehicle

I stay with family or friends temporarily

I am currently unhoused

Other (please specify)

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* 22. How satisfied are you with the quality of life in our community?

	Extremely	Very	Somewhat	Not at all
How satisfied are you with the quality of life in the community?	How satisfied are you with the quality of life in the community? Extremely	How satisfied are you with the quality of life in the community? Very	How satisfied are you with the quality of life in the community? Somewhat	How satisfied are you with the quality of life in the community? Not at all
How satisfied are you with the health care available in the community?	How satisfied are you with the health care available in the community? Extremely	How satisfied are you with the health care available in the community? Very	How satisfied are you with the health care available in the community? Somewhat	How satisfied are you with the health care available in the community? Not at all
How satisfied are you with the community as a place to raise children?	How satisfied are you with the community as a place to raise children? Extremely	How satisfied are you with the community as a place to raise children? Very	How satisfied are you with the community as a place to raise children? Somewhat	How satisfied are you with the community as a place to raise children? Not at all
How satisfied are you with the community as a place to grow old?	How satisfied are you with the community as a place to grow old? Extremely	How satisfied are you with the community as a place to grow old? Very	How satisfied are you with the community as a place to grow old? Somewhat	How satisfied are you with the community as a place to grow old? Not at all
How satisfied are you with the economic opportunities in the community, such as available jobs, career growth, and higher education?	How satisfied are you with the economic opportunities in the community, such as available jobs, career growth, and higher education? Extremely	How satisfied are you with the economic opportunities in the community, such as available jobs, career growth, and higher education? Very	How satisfied are you with the economic opportunities in the community, such as available jobs, career growth, and higher education? Somewhat	How satisfied are you with the economic opportunities in the community, such as available jobs, career growth, and higher education? Not at all
How satisfied are you with the level of social services available in the community?	How satisfied are you with the level of social services available in the community? Extremely	How satisfied are you with the level of social services available in the community? Very	How satisfied are you with the level of social services available in the community? Somewhat	How satisfied are you with the level of social services available in the community? Not at all

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* 23. In your experience, do any of the following barriers exist with local health care? (Select all that apply.)

Ability to schedule an appointment at a time that works for me

Confidentiality

Medical providers don't speak my language

Medical providers don't understand my culture

Medical providers judge me

Medical providers don't spend enough time understanding my needs

No or minimal follow-up provided after appointments

The specialists I need are not available

The quality of care provided is not good

None of these barriers exist for me

Other (please specify)

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* 24. What is needed to improve the quality of life for you and your loved ones in this community? Please choose your top 3-5.

Addiction recovery services

Addiction rehabilitation services

Affordable housing

Better access to affordable, nutritious food or food pantries

Educational opportunities

Free or affordable health screenings

Job opportunities

Law enforcement

Mental health services

Recreation facilities

Safe places to walk/play

Specialty doctors

Transportation options

Youth activities

Other (please specify)

2022 Community Health Needs Assessment

Timber Cove through Elk

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* 1. What is your age?

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* 2. Are you a veteran?

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* 3. What is your race? (Select all that apply.)

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* 4. What is your ethnicity?

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* 5. What is your primary language spoken at home?

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* 6. What gender do you identify as?

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* 7. What is your sexual orientation?

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* 8. What town do you live in? (If your town is not listed, please exit the survey.)

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* 9. I live in this community:

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* 10. How long do you see yourself living in this community?

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* 11. What might make you leave the community?

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* 12. Are you a member of one of the following tribes?

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* 13. How do you typically travel locally for errands or appointments? (Select all that apply.)

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* 14. How do you typically travel out of town for errands or appointments? (Select all that apply.)

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* 15. Is the cost of car insurance, registration or gas a barrier to you seeing the health care providers you prefer?

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* 16. Does the cost of rent/mortgage create barriers in accessing essential resources, such as food, health care, etc.?

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* 17. What is your employment status? (Select all that apply.)

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* 18. What are the top 3-5 most concerning health issues you see among your family, friends, and community?

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* 19. Do you have any of the following health conditions? (Select all that apply.)

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* 20. With no local pharmacies available, how will/ do you access medications when needed?

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* 21. What is your housing status?

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* 22. How satisfied are you with the quality of life in our community?

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* 23. In your experience, do any of the following barriers exist with local health care? (Select all that apply.)

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* 24. What is needed to improve the quality of life for you and your loved ones in this community? Please choose your top 3-5.

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* 25. If you would like to provide additional thoughts about community needs, please write your thoughts here: