West Central District Health Department mapp community Health Survey

___ Low crime / safe neighborhoods

___ Low level of child abuse

___ Good schools

___ Access to health care (e.g., family doctor)

___ Parks and recreation

___ Clean environment

___ Affordable housing

___ Arts and cultural events

___ 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___________________________

___ Cancers

___ Child abuse / neglect

___ Dental problems

___ Diabetes

___ Domestic Violence

___ Firearm-related injuries

___ High blood pressure

___ HIV / AIDS

___ Homicide

___ Infant Death

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

___ Mental health problems

___ Motor vehicle crash injuries

___ Respiratory / lung disease

___ Sexually Transmitted Diseases (STDs)

___ Suicide

___ Teenage pregnancy

___ Other ___________________

___ Being overweight

___ Dropping out of school

___ Drug abuse

___ Lack of exercise

___ Poor eating habits

___ Not getting “shots” to prevent disease

___ Tobacco use

___ Not using birth control

___ Not using seat belts / child safety seats

___ Unsafe sex

___ Other___________________________