Health and ill health questionnaire

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Health and ill health

        The aim of this questionnaire is to find out about what a varied group of people think about the concepts of health and health and lifestyle factors which are; eating sensibly, taking regular exercise, monitoring weight, limited alcohol consumption, smoking and visiting the GP.

This questionnaire is for my AS level health and social coursework, it will take approximately 10 to 15 minutes to fill in. it is anonymous and the only people to see it will be myself, the teacher that marks it and possibly and examiner. You do not need to answer every question and can also refuse to fill it in but I would be very grateful if you would take part.

Respondent         

1) Male         Female

2) Occupation ________________________

3) Age:    16-20       21-30       31-40      41-50      51-60        61+

4) Weight (Kg):      40-60   61-80   81-100   101-120   121-140   141-160   161+  

5) Height (m):  _____m

Health and ill health

6) Do you suffer from any illness?

Yes         No         

7) Some people describe being healthy as having a well-balanced physical mental and emotional well-being.

How would you describe being healthy?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

8) People believe that ill health is having an illness. How would you describe ill health?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________

9) How would you describe your current health?

I don’t feel unwell

I am very healthy; I exercise regularly and eat a balanced diet

I feel good about my self, and make sure that I eat right and exercise

Smoking

10) Do you smoke?

    Yes        No        (if no move on to question 13)

11) Why did you take up smoking and carry on with it now?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12) If you smoke cigarettes how many do you smoke a day?

Under 10   11-20     21-30     31-40    40+

        

13) How do you feel when people smoke around you?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

14) Do you agree with the government’s idea of banning smoking in public areas?

Yes         No        

15) Why do you think this?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Diet

16) Which of the following would you say refer to your diet?

Very Healthy   Quite Healthy   Sometimes Healthy          Unhealthy         Very Unhealthy

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17) Why would you describe your diet like this?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

18) Do you eat five portions of fruit and veg. every day?

Yes        No

19) The NHS 5 A day campaign says “Fruit and vegetables can help keep your body fitter, healthier and happier.” What do you think?

Strongly Agree     Agree      Don’t know        Disagree      Strongly Disagree

Exercise

20) The AS level for AQA Health and Social care textbook states, “The most potent combination to avoid weight gain is a combination of physical ...

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