Personal Health Risk Calculator

Please review your responses and ensure that all required * questions have been answered.

General
Diabetes
Coronary Heart Disease (CHD)
Alcohol Consumption
Healthy Eating
Physical Activity
Results

General

This health risk assessment is developed for NWT residents. It will provide you with a personalized risk assessment and screening recommendations. Please note this should not replace your planned visit with a health care provider. You can print the results to take with you on your next visit and start the conversation of promoting healthy choices.

This information is only for your personal use. It will not be saved after you exit the survey.

Are you currently a resident of the NWT? *

Yes

What community do you live in? *

What is your gender? *

Male

Female

What is your age? *

Have you ever been told by a doctor that you have high blood pressure, or have you ever taken high blood pressure pills? *

Yes

No/don't know

What blood pressure medication are you on (if known)?

If you know your blood pressure - or remember your last blood pressure reading - please enter it:

Personal History

Breast Cancer

Ovarian Cancer

Cervical Cancer (or lesions)

Colorectal Cancer

Inflammatory Bowel Disease

Crohn's

Ulcerative Colitis

Heart Disease

Stroke

Diabetes

Please select if you have ever been diagnosed with or have a personal history with any of these diseases

Family History

Breast Cancer

Ovarian Cancer

Colorectal Cancer

Inflammatory Bowel Disease

Crohn's

Ulcerative Colitis

Early Heart Disease (before the age of 55 in women, before the age of 65 in men)

Diabetes

Please select if any of your immediate family (parents, brothers, sisters or children) has had any of these diseases

Diabetes

What is your ethnicity? *

Aboriginal

Black/African American/Caribbean

Caucasian (White)

East Asian

South Asian

Other non-white (West Asian, Latin American, Arab)

What level of education have you completed? *

Some High School or Less

High School Diploma

Some University or College

University or College Degree

Body Mass Index (BMI) *

Use the this BMI Calculator to determine your body mass index, then come back here and enter in the number from the calculator as-is.
Note: BMI is not always representative of your overall health status.

What is your waist circumference? *

This would be the same as your pant waist size

Have you ever been found to have high blood sugar (from blood tests, illness, or during pregnancy)? *

Yes

No/don't know

Have you ever given birth to a baby weighing 9lbs (4.1kg) or more? *

Yes

No/don't know

Which of your blood relatives have been diagnosed with diabetes? *

Mother

Father

Brother/Sister

Children

Other/None/Don't know

Do you engage in some form of physical activity for at least 30 minutes a day, such as brisk walking (at work or at home)? *

Yes

How often do you eat vegetables or fruits? *

Every day

Not every day

Coronary Heart Disease (CHD)

Do you have diabetes? *

Yes

Do you have erectile dysfunction? *

Yes

Do you have chronic kidney disease? *

Yes

Do you have any inflammation of the heart and vessels (atherosclerosis)? *

Yes

Are you HIV positive? *

Yes

Do you have chronic obstructive pulmonary disease (COPD)? *

Yes

Do you smoke or chew tobacco? *

Yes

Do you want to quit using tobacco? *

Yes

Alcohol Consumption

Do you drink alcohol? *

Yes

Have you ever felt you should Cut down on your drinking? *

Yes

Have people Annoyed you by criticizing your drinking? *

Yes

Have you ever felt bad or Guilty about your drinking? *

Yes

Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)? *

Yes

Healthy Eating

How do you rate your healthy eating habits overall? *

Poor

Fair

Good

Very Good

Excellent

On an average day, how many times do you eat fast/fried food, or packaged snacks that are high in fat, salt or sugar? *

Less than 1

2-3

4-5

6 or more

On an average day, how many ½ cup servings of fresh, canned, frozen or dried fruit do you eat? *

None

2-3

4-5

6 or more

On an average day, how many ½ cup servings of fresh, canned, frozen or dried vegetables do you eat? *

None

2-3

4-5

6 or more

On an average day, how many sugar-sweetened beverages (soda, sweet tea, juice, energy/sports drinks, coffee) do you drink? *

None

2-3

4-5

6 or more

On an average day, how many times do you eat regular (not low fat) snack chips or crackers? *

Less than 1

2-3

4-5

6 or more

On an average day, how many times do you eat candy, sweet foods (not the low fat kind) or desserts, like chocolate or ice cream? *

Less than 1

2-3

4-5

6 or more

On an average day, how much margarine, butter, lard or muktuk/meat fat do you add to vegetables, bannock, potatoes, bread, corn or dried meat? *

Heaping amount

A lot

Some

Very little

None

On an average day, how many times do you eat dairy products (milk, unsweetened yogurt, low fat cheese)? *

Less than 1

2-3

4-5

6 or more

On an average day, how many times do you eat meat/fish/beans? *

Less than 1

2-3

4-5

6 or more

Physical Activity

In a typical week, how many times are you physically active enough to cause sweating and a rapid heartbeat? *

At least 3 times

Once or twice

Rarely or less than 1

When you are physically active, do you feel like you are making: *

An intense effort

A moderate effort

A light effort

How would you rate your current level of fitness? *

Very Good

Good

Average

Poor

Very Poor

On an average day, how many hours do you spend sitting at work? * Work days hours per day

On an average day, how many hours do you spend sitting after work, weekends, and on holidays? * Non work days hours per day

During the time you are sitting, how often do you get up and move around? *

Every half hour to an hour

Every 1-2 hours

Every 3 hours or more

Results

General

Diabetes

Coronary Heart Disease (CHD)

Alcohol Consumption

Healthy Eating

Physical Activity

Cancer Screening

Breast Cancer

Average Risk

Discuss the benefits and harms of mammography with your health care provider

Screening mammography is recommended every 2 years

High Risk

It is recommended that you start screening mammography yearly and/or consult with a specialist

Cervical Cancer

Average Risk

It is recommended that you initiate screening

It is recommended that you repeat a Pap smear every year until there are 3 consecutive normal smears, and then continue every 2 years

It is recommended that you discontinue screening if there are 3 or more normal tests in the last 10 years and no history of cervical cancer or leisons

Increased Risk

It is recommended that you screen annually for life

Colorectal Cancer

Average Risk

It is recommended that you initiate screening and repeat tests every 1-2 years

It is recommended that you discontinue screening

Increased Risk

It is recommended to begin screening colonoscopy

It is recommended to begin screening colonoscopy

It is recommended that you be referred to specialist

Additional Information:

Cancer Screening Saves Lives
Cancer Screening Saves Lives

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Personal Health Risk Calculator

Breast Cancer

Cervical Cancer

Colorectal Cancer

Additional Information: