NYC Health + Hospitals is conducting a Community Health Needs Assessment (CHNA) to identify, understand and respond to your community’s health needs. A health need is anything that is necessary to improve or maintain health in your community.

The assessment is conducted every three years.

Please complete the survey below to help us understand the health needs of the communities in New York City. When scoring the questions think of how health and well-being affects you and your community. We want your opinion!

If completing on a mobile device, please rotate your phone for best survey compatibility.

Share this survey with your community! If you have any questions, please e-mail chna@nychhc.org.

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* 1. Where is your community located?

A community is where you work, live, and play. It could also be where you spend most of your time with your family, neighbors, and friends, or where your clients live.

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* 2. What do you think are the top health problems that affect people in your community?

Score each option from 1 to 5, where 1 is not a health problem and 5 is a significant health problem. You can write in any health problems that you think are missing.

  1 2 3 4 5
Alcohol use
Asthma, breathing issues, and lung diseases
Autoimmune disease (such as lupus)
Cancer
Dementia and/or Alzheimer’s disease
Diabetes and high blood sugar
Falls and injuries
Heart disease
High blood pressure
HIV/AIDS
Infectious disease (COVID-19, flu, hepatitis)
Joint disease
Kidney disease
Maternal and women's health risks
Mental health disorders (such as depression)
Obesity (high BMI)
Sexually transmitted infections/diseases
Sickle cell disease
Stroke
Substance use, including opioids, stimulants, and other drugs
Suicide and self-harm
Tuberculosis
Violence
Gun violence

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* 3. What are the top factors that you think most likely contribute to health problems in your community?

HEALTHY LIVING – These are individual experiences that contribute to poor health
Score each option from 1 to 5, where 1 is not likely to contribute to health problems and 5 is most likely to contribute to health problems. You can write in any options that you think are missing.

  1 2 3 4 5
Aging and frailty
Cannabis use, including smoking, vaping, edibles
Domestic/ intimate partner violence
Hunger, food and nutrition instability
Lack of exercise and physical activity
Sexual assault
Stress and poor emotional health
Theft, crime, assault, violence
Tobacco use, including vaping

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* 4. What are the top factors that you think most likely contribute to health problems in your community?

COMMUNITY CHARACTERISTICS– These are social conditions or experiences that affect a whole group
Score each option from 1 to 5, where 1 is not likely to contribute to health problems and 5 is most likely to contribute to health problems. You can write in any options that you think are missing.

  1 2 3 4 5
Inadequate access to quality education
Increased access/ exposure to marijuana/ weed
Limited economic oppurtunity
Low graduation completion rates
Police activity, criminal acitivity and legal involvement
Poverty and limited resources
Social isolation
Social stigma
Unsafe neighborhoods
Unsafe working conditions

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* 5. What are the top factors that you think most likely contribute to health problems in your community?

LIVING AND ENVIRONMENTAL CONDITIONS – These are physical conditions or experiences that affect an individual and/or an entire group
Score each option from 1 to 5, where 1 is not likely to contribute to health problems and 5 is most likely to contribute to health problems. You can write in any options that you think are missing.

  1 2 3 4 5
Lack of green spaces
Lack of housing access, affordability and quality
Lack of internet access
Lack of reliable transportation
Poor outdoor air quality
Poor sanitation
Poor water quality

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* 6. What are the top factors that you think most likely contribute to health problems in your community?

HEALTH CARE ACCESS – These are reasons individuals and/or groups may not access health care
Score each option from 1 to 5, where 1 is not a reason people do not access health care and 5 is a reason people do not access health care. You can write in any options that you think are missing.

  1 2 3 4 5
Fear of engaging with health care due to immigration status
Fear of medical cost
High out-of-pocket costs
Lack of childcare
Lack of dental care providers
Lack of health insurance
Lack of knowledge of when and how to use healthcare services
Lack of language access/ translation services
Lack of mental and behavioral health care providers
Lack of primary care providers
Lack of specialty care providers, including cardiology, endocrinology, cancer screenings
Social/cultural stigma to seeking care

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* 7. Any other comments (optional): Note: Please leave a phone number we can call for additional comments with the help of an interpreter.

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