Physical
I participate regularly (three times a week or more) in a vigorous physical-exercise program.
- Yes
- No
I eat a well-balanced diet.
- Yes
- No
My weight is within 10 lbs. Of the ideal weight for my height.
- Yes
- No
My alcohol consumption is seven drinks (shot, beer, or glass of wine) or fewer per week.
- Yes
- No
I always wear my seat belt.
- Yes
- No
I do not smoke cigarettes, cigars, or a pipe.
- Yes
- No
I generally get adequate and satisfying sleep.
- Yes
- No
Mental
I seldom experience periods of depression.
- Yes
- No
I generally face up to problems and cope with change effectively.
- Yes
- No
I worry very little about future possibilities or things I can’t change.
- Yes
- No
I laugh several times a day and usually fit “play” into my schedule.
- Yes
- No
I am curious and always on the lookout for new learning.
- Yes
- No
I maintain a realistic and basically positive self-image.
- Yes
- No
I choose to feel confident and optimistic.
- Yes
- No
Relational
I seek help and support when I need it.
- Yes
- No
I have at least one friend with whom I can share almost anything.
- Yes
- No
I have nourishing intimate relationships with family and/or friends.
- Yes
- No
I experience and express a wide range of emotions and respond to others’ feelings appropriately.
- Yes
- No
Each day includes comfortable and stimulating interaction with others, frequently new acquaintances.
- Yes
- No
I solicit and accept feedback from others.
- Yes
- No
I stick up for myself when it’s necessary and appropriate.
- Yes
- No
Spiritual
I set aside 15-20 minutes each day for prayer or meditation.
- Yes
- No
I participate in regular spiritual rituals with people who share my beliefs.
- Yes
- No
I accept my limitations and inadequacies without embarrassment or apology.
- Yes
- No
I keep the purpose of my life clearly in mind and let it guide my goal setting and decision making.
- Yes
- No
I regularly offer my time and possessions in service to others.
- Yes
- No
I am sensitive to ultimate truths and the spiritual dimensions of life.
- Yes
- No
I readily forgive myself and others.
- Yes
- No
Count up your yes responses for each category and record them below.
Physical ___ Yes responses
Mental ___ Yes responses
Relational ___ Yes responses
Spiritual ___ Yes responses
Total ____ Out of 28 questions
How to Interpret your Score
Your total of yes responses on the Health Habit Inventory provides a general idea of how well you take care of your health across all dimensions of life. Compare your total score to the Caring Question Standards:
24-28 Excellent Your habits are enhancing your health.
16-23 Average you’re obviously trying, but there=s room for improvement.
Below 16 Poor The quality of your health is probably diminished by your poor habits.
From: The Caring Question
Donald Tubesing and Nancy Loving Tubesing
Augsburg Publishing House - Minneapolis
1983 page 35