2002-2003 Cowley County Health Risk Survey

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COWLEY COUNTY SURVEY
2002-2003

Section 1: Health Status
1.1 Data Results 1.1	Would you say that in general your health is: Excellent Very good Good Fair Poor 7. Don't know/Not sure 9. Refused
Crosstabulation Table:		Percentage of Adults with Fair or Poor Self-Perceived Health Status
1.2 Data Results 1.2	Now thinking about your physical health, which includes physical illness and injury, for how may days during the past 30 days was your physical health not good?
1.3 Data Results 1.3	Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
Crosstabulation Table:		Percentage of Adults Who Reported Their Mental Health Was Not Good on 14 or More Days in the Past 30 Days
1.4 Data Results 1.4	During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as a self?care, work, or recreation?

Section 2: Health Care Access
2.1 Data Results 2.1	Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
Crosstabulation Table:		Percentage of Adults Who Lack Health Care Coverage
2.2 Data Results 2.2	Do you have one person you think of as your personal doctor or health care provider? [If "No", ask: "Is there more than one or is there no person who you think of?"]
Crosstabulation Table:		Percentage of Adults with No Personal Doctor or Health Care Provider
2.3 Data Results 2.3	Was there a time during the past 12 months when you needed to see a doctor but could not because of the cost?

Section 3: Cardiovascular Disease Awareness
3.1 Data Results 3.1	What do you think is the one greatest health problem facing your community today?
3.2 Data Results 3.2	What do you think is the one greatest health problem facing women today?
3.3 Data Results 3.3	What do you think is the one greatest health problem facing men today?
3.4 Data Results 3.4	As far as you know, what is the leading cause of death for all women?
3.5 Data Results 3.5	As far as you know, what is the leading cause of death for all men?
3.6 Data Results 3.6	Based on what you know, what are the major causes of heart disease?
3.7	Now I would like to discuss ways to prevent heart disease. Which of the following activities do you believe can prevent or reduce the risk of getting heart disease?
a. Data Results 3.7a	...Quitting smoking?
b. Data Results 3.7b	...Getting physical exercise?
c. Data Results 3.7c	...Taking special vitamins like E, C or A?
d. Data Results 3.7d	...Losing weight?
e. Data Results 3.7e	...Reducing dietary cholesterol intake?
f. Data Results 3.7f	...Reducing stress?
g. Data Results 3.7g	...Taking multivitamins with folic acid?
h. Data Results 3.7h	...Taking hormone replacement therapy?
i. Data Results 3.7i	...Reducing sodium or salt in the diet?
j. Data Results 3.7j	...Reducing animal products in your diet (such as meat, whole milk, butter and cream)?
k. Data Results 3.7k		...Aromatherapy?
3.8 Data Results 3.8	What is your primary source for health related information?

Section 4: Exercise
4.1 Data Results 4.1	During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?
Crosstabulation Table:		Percentage of Adults Not Participating in Any Physical Activity

Section 5: Diabetes
5.1 Data Results 5.1	Have you ever been told by a doctor that you have diabetes? [If "Yes" and respondent is female, ask: "Was this only when you were pregnant?"]
Crosstabulation Table:		Percentage of Adults with Diagnosed Diabetes

Section 6: Diabetes (Optional CDC Module)
If respondent has been diagnosed with diabetes [Q5.1 = "yes"], continue.
6.1 Data Results 6.1	How old were you when you were told you have diabetes?
6.2 Data Results 6.2	Are you now taking insulin?
6.3 Data Results 6.3	Are you now taking diabetes pills?
6.4 Data Results 6.4	About how often do you check your blood for glucose or sugar? Include times when checked by a family member or friend, but do not include times when checked by a health professional.
6.5 Data Results 6.5	About how often do you check your feet for any sores or irritations? Include times when checked by a family member or friend, but do not include times when checked by a health professional.
6.6 Data Results 6.6	Have you ever had any sores or irritations on your feet that took more than four weeks to heal?
6.7 Data Results 6.7	About how many times in the past 12 months have you seen a doctor, nurse, or other health professional for your diabetes?
6.8 Data Results 6.8	A test for hemoglobin "A one C" measures the average level of blood sugar over the past three months. About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for hemoglobin "A one C"?
If Q6.5 = 555, "no feet", go to Q6.10
6.9 Data Results 6.9	About how many times in the past 12 months has a health professional checked your feet for any sores or irritations?
6.10 Data Results 6.10	When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.
6.11 Data Results 6.11	Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?
6.12 Data Results 6.12	Have you ever taken a course or class in how to manage your diabetes yourself?

Section 7: Diabetes Accessory (KS State-added Module)
If respondent has been diagnosed with diabetes [Q5.1 = "yes"], continue. Otherwise, skip to next module.
7.1 Data Results 7.1	Is paying for your diabetes supplies a problem?
7.2 Data Results 7.2	When you go to your doctor for your diabetes, are you usually told to remove your socks and shoes before you see the doctor?
7.3 Data Results 7.3	Who decides when you need your next diabetes check-up?
7.4 Data Results 7.4	Were you hospitalized during the past two years?
7.5 Data Results 7.5	What was the reason for your most recent hospitalization?

Section 8: Hypertension Awareness
8.1 Data Results 8.1	Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?
Crosstabulation Table:		Percentage of Adults with Diagnosed Hypertension
8.2 Data Results 8.2	Are you currently taking medicine for your high blood pressure?
Crosstabulation Table:		Percentage of Adults Currently Not Taking Medication for Their High Blood Pressure

Section 9: Cholesterol Awareness
9.1 Data Results 9.1	Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
Crosstabulation Table:		Percentage of Adults Tested for High Cholesterol
9.2 Data Results 9.2	About how long has it been since you last had your blood cholesterol checked?
9.3 Data Results 9.3	Have you ever been told by a doctor, nurse, or other health professional that your blood cholesterol is high?
Crosstabulation Table:		Percentage of Adults Tested and Diagnosed with High Cholesterol

Section 10: Fruits and Vegetables
Crosstabulation Table:		Percentage of Adults Who Reported Consuming Fruits and Vegetables Less Than 5 Times per Day
These next questions are about the foods you usually eat or drink. Please tell me how often you eat or drink each one, for example, twice a week, three times a month, and so forth. Remember, I am only interested in the foods you eat. Include all foods you eat, both at home and away from home.
10.1 Data Results 10.1	How often do you drink fruit juices such as orange, grapefruit or tomato?
10.2 Data Results 10.2	Not counting juice, how often do you eat fruit?
10.3 Data Results 10.3	How often do you eat green salad?
10.4 Data Results 10.4	How often do you eat potatoes not including French fries, fried potatoes, or potatoes chips?
10.5 Data Results 10.5	How often do you eat carrots?
10.6 Data Results 10.6	Not counting carrots, potatoes, or salad, how many servings of vegetables do you usually eat? [Example: A serving of vegetables at both lunch and dinner would be two servings.]

Section 11: Weight Control
11.1 Data Results 11.1	Are you now trying to lose weight?
11.2 Data Results 11.2	Are you now trying to maintain your current weight that is to keep from gaining weight?
11.3 Data Results 11.3	Are you eating either fewer calories or less fat to... lose weight? keep from gaining weight?
11.4 Data Results 11.4	Are you using physical activity or exercise to... lose weight? keep from gaining weight?
11.5	How much would you like to weigh?
Crosstabulation Table:		Difference between current and desired weight.
11.6 Data Results 11.6	In the past 12 months, has a doctor, nurse, or other health professional given you advice about your weight?
Crosstabulation Table:		Percentage of Adults Who Reported Not Receiving Advice About Their Weight

Section 12: Tobacco Use
12.1 Data Results 12.1	Have you smoked at least 100 cigarettes in your entire life? [Note: 5 packs = 100 cigarettes.]
Crosstabulation Table:		Percentage of Adults Who Currently Smoke Cigarettes
12.2 Data Results 12.2	Do you now smoke cigarettes every day, some days, or not at all?
12.3 Data Results 12.3	During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?

Section 13: Alocohol Consumption
13.1 Data Results 13.1	A drink of alcohol is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. During the past 30 days, how many days per week or per month did you have at least 1 drink of any alcoholic beverage?
13.2 Data Results 13.2	On the days when you drank, about how many drinks did you drink on the average?
13.3 Data Results 13.3	Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion?
Crosstabulation Table:		Percentage of Adults Who Reported Consuming Five or More Alcohol Drinks on an Occassion in the Past 30 Days
		Percentage of Adults Who Reported Heavy Alcohol Consumption in the Past 30 Days

Section 14: Cardiovascular Disease (Physician Counseling)
14.1 Data Results 14.1	Have any of your doctors ever discussed heart disease with you when discussing your health?
Crosstabulation Table:		Percentage of Adults Who Have Not Received Physician Counseling about Heart Disease when Discussing Their Health
14.2 Data Results 14.2	Has a doctor or other health professional advised you that you are at increased risk for cardiovascular disease or heart attacks?
Crosstabulation Table:		Percentage of Adults Who Have Not Received Advice that they are at an Increased Risk for Cardiovascular Disease or Heart Attack
14.3 Data Results 14.3	Has a doctor or other health professional discussed with you the risks and benefits associated with daily intake of aspirin to help prevent heart attacks?

Section 15: Demographics
15.1 Data Results 15.1	What is your age?
15.2 Data Results 15.2	Are you of Hispanic or Latino?
15.3 Data Results 15.3	Which one or more of the following would you say is your race?
15.4 Data Results 15.4	Which one of these groups would you say best represents your race?
15.5 Data Results 15.5	Are you:
	Married Divorced Widowed Separated Never been married A member of an unmarried couple
15.6 Data Results 15.6	How many children less than 18 years of age live in your household ?
15.7 Data Results 15.7	What is the highest grade or year of school you completed?
15.8 Data Results 15.8	Are you currently:
	Employed for wages Self-employed Out of work for more than 1 year Out of work for less than 1 year Homemaker Student Retired Unable to work
15.9 Data Results 15.9	Is your annual household income from all sources: Less than $25,000 ($20,000 to less than $25,000) Less than $20,000 ($15,000 to less than $20,000) Less than $15,000 ($10,000 to less than $15,000) Less than $10,000 or Less than $35,000 ($25,000 to less than $35,000) Less than $50,000 ($35,000 to less than $50,000) Less than $75,000 ($50,000 to less than $75,000) $75,000 or more
15.10	About how much do you weigh without shoes?
15.11	About how tall are you without shoes?
Crosstabulation Table:		Percentage of Adults who are Overweight or Obese (BMI >= 25)
		Percentage of Adults who are Obese (BMI >= 30)
15.12	What is your zip code?
15.13 Data Results 15.13	Do you have more than one telephone number in your household? Do not include cell phones or numbers that are only used by a computer or fax machine.
15.14 Data Results 15.14	How many of these are residential numbers?
15.15 Data Results 15.15	Indicate sex of respondent. Ask Only if Necessary
15.16 Data Results 15.16	To your knowledge, are you now pregnant?

Section 16: Community Involvement
16.1 Data Results 16.1	How would you rate your community as a place to live?
16.2 Data Results 16.2	How long have you lived in the community in which you now live?
16.3 Data Results 16.3	During the past 5 years, have you been active in a coalition or civic group which attempted to address one or more community problems?
Next, I'd like you to rate your community on each of several issues as excellent, very good, good, fair, or poor.
16.4 Data Results 16.4	How would you rate your community on it's... Willingness of citizens to become involved in community issues?
16.5 Data Results 16.5	(How would you rate your community on its)... Availability of effective leadership for solving community problems?
16.6 Data Results 16.6	(How would you rate your community on its)... Cooperation and communication between community organizations, including government, civic organizations, and social agencies?
16.7 Data Results 16.7	(How would you rate your community on its)... People sharing a sense of belonging to the community?
16.8 Data Results 16.8	(How would you rate your community on its)... Past history of community success at problem solving?
16.9 Data Results 16.9	(How would you rate your community on its)... Community decision making shared among community members and among community organizations?
16.10 Data Results 16.10	(How would you rate your community on its)... Community investment of financial resources in community problem-solving?
16.11 Data Results 16.11	(How would you rate your community on its)... Availability of people in the community with skills to solve community problems?
16.12 Data Results 16.12	(How would you rate your community on its)... Shared values and vision among community citizens?
16.13 Data Results 16.13	(How would you rate your community on its)... Self-honesty and ability to learn from mistakes?

Section 17: Disability
17.1 Data Results 17.1	Are you limited in any way in any activities because of physical, mental, or emotional problems?
17.2 Data Results 17.2	Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?

Section 18: Physical Activity
18.1 Data Results 18.1	When you are at work, which of the following best describes what you do? [NOTE: If respondent has multiple jobs, include all jobs.] Would you say: Mostly sitting or standing Mostly walking Mostly heavy labor or physically demanding work
18.2 Data Results 18.2	In a usual week, do you walk for at least 10 minutes at a time?
18.3 Data Results 18.3	How many days per week do you walk for at least 10 minutes at a time?
18.4 Data Results 18.4	On days when you walk for at least 10 minutes at a time, how much total time per day do you spend walking?
18.5 Data Results 18.5	In a ususal week, do you do any actvities to increase muscle strength or tone, such as lifting weights, pull-ups, push-ups, or sit-ups?
18.6 Data Results 18.6	How many days a week do you do these activities?
We are interested in two types of physical activity - vigorous and moderate. Vigorous activities cause large increases in breathing or heart rate while moderate activities cause small increases in breathing or heart rate.
Crosstabulation Table:		Percentage of Adults Not Participating in Recommended Level of Physical Activity
18.7 Data Results 18.7	Now, thinking about the moderate physical activities you do [fill in (when you are not working) if "employed" or "self-employed" to core Q15.8] in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate?
18.8 Data Results 18.8	How many days per week do you do these moderate activities for at least 10 minutes at a time?
18.9 Data Results 18.9	On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Crosstabulation Table:		Percentage of Adults Not Participating in Recommended Level of Moderate Physical Activity
18.10 Data Results 18.10	Now thinking about the vigorous physical activities you do [fill in (when you are not working) if "employed" or "self-employed" to core Q15.8] in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
18.11 Data Results 18.11	How many days per week do you do these vigorous activities for at least 10 minutes at a time?
18.12 Data Results 18.12	On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Crosstabulation Table:		Percentage of Adults Not Participating in Recommended Level of Vigorous Physical Activity

Section 19: Barriers to Physical Activity
19.1 Data Results 19.1	What was the major reason that you did not participate in any physical activity or exercises during the past month?
19.2 Data Results 19.2	Was there anything that prevented you from participating in more physical activity or exercises during the past month?