Adult Well-Being Survey

This brief survey is for nonprofit leaders and social innovators in the Greater Pittsburgh Region and The Forbes Funds’ ecosystem and it uses the Cantril Scale. There will be questions about your present and future well-being, including your personal health, and optional questions regarding your demographics (#8-12) and location (#14). Your answers are confidential and will be used in the Annual Pittsburgh Leaders’ Well-Being Index.

For the first three questions please imagine a ladder with steps numbered from zero at the bottom to ten at the top. The top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you.

Cantril Scale - Ladder graphic depicting 0 at the bottom and 10 at the top

    1. Indicate where on the ladder you feel you personally stand right now.*

    2. On which step do you think you will stand about five years from now?*

    3. Now imagine the top of the ladder represents the best possible financial situation for you, and the bottom of the ladder represents the worst possible financial situation for you. Please indicate where on the ladder you stand right now.*

    5. In general, how would you rate your mental health, including your mood and your ability to think?*

    6. How often do you get the social and emotional support you need?*

    7. How strongly do you agree with this statement? “I lead a purposeful and meaningful life.”*

    8. What is your age? _________ years

    9. What is your gender?

    10. Are you of Hispanic, Latino/a, or Spanish origin?

    11. Which one or more of the following would you say is your race? (select all that apply)

    12. What is the highest grade or year of school you completed?

    13. Have you ever served on active duty in the United States Armed Forces, either in the regular military or in the National Guard or Reserves?*

    14. What is the ZIP code where you live?

    The survey should take about 10 minutes. Your answers are confidential and will be used in our Annual Pittsburgh Leaders Well-Being Index. When it is published, Fred Brown and The Forbes Funds will share results via our website, the email newsletter (subscribe below), and LinkedIn.

    Credits: 100 Million Healthier Lives, as well as the Institute for Healthcare Improvement.

    For more information about how data will be used, you can find our privacy statement here.

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