South South Workers Survey

Remember to submit all responses to ssws@olydsa.org

Printable and digital versions of this survey, as well as the Survey Handbook, can be found at olydsa.org/ssws

Section 1: Identity

1. What’s your preferred name? (optional)

2. What area do you live in?

3. How old are you? (only circle one)

14-17 18-24 25-34 35-49 50-64 65+

4. What’s your gender? (circle one, multiple, or write-in)

Man Woman Nonbinary Prefer Not To Say Other:

5. Is your current gender different from the one you were assigned at birth? (circle one)

Yes No Prefer Not To Say

6. What’s your sexual orientation? (circle one, multiple, or write-in)

Gay Lesbian Bisexual Asexual Straight Prefer Not To Say Other:

7. What’s your race/ethnicity? (circle one, multiple, or write-in)

Latinx Black Native White Asian / Pacific Islander Southwest Asian / North African Other:

8. What type of people do you hang out with usually? Do you have a family or community and, if so,
who is in it? (open response)

9. Are you a member of any clubs or organizations? If so, please list them. (open response)
 10. What levels of school have you completed? (circle one or multiple)

Grade School High School Diploma GED College Post-graduate

11. Do you currently go to school?

Yes No

(If you’re currently attending school…)

Which do you attend? (circle one or multiple)

High School College Post-graduate Other:

Section 2: Labor

12. Are you employed?

Yes No

(If you’re employed…)

What line of work are you in? (open response)

How many hours per week do you work per week, on average? (circle one)

1-10 10-20 20-30 30-40 40-50 50+

How much do you get paid monthly? (circle one)

$1-1000 $1000-2000 $2000-3000

$3000-5000 $5000-7000 $7000+

How would you rate your overall satisfaction with your pay and benefits?
(1 = hell, 10 = heaven)

1 2 3 4 5 6 7 8 9 10
 What do you wish was different about work? (open response)

Are you in a union?

Yes No

(If you’re in a union…)

What’s the name of your union? (open response)

(If you’re not in a union…)

Would you like info about how to start or join a union?

Yes No

(If you’re not employed…)

How did your last job end? (circle one)

Resignation Termination Lay-off Never Employed Other:

How long have you been looking for work? (circle one)

0-1 month 1-3 months 3 months to 1 year More than a year Not currently looking

Why do you think you’re unemployed? (open response)

Section 3: Housing

13. How would you describe your living situation? (open response)

14. Are you currently housed?

Yes No
 (If you’re currently housed…)
How is housework divided at your place? (circle one)

I do most of it Someone else does the majority Housework is divided equally

Do you rent your place?

Yes No

(If you’re a renter…)

How much do you pay per month for rent? (circle one)

$1-500 $501-1000 $1001-1500

$1501-2000 $2001-3000 $3000+

What kinds of problems have you encountered as a renter?

(open response)

Are you interested in organizing with other renters/tenants for lower

rent and better conditions?

Yes No

(If you’re not currently housed…)

How long have you been homeless/houseless? (circle one)

0-1 month 1-6 months 6 months to a year 1-3 years 3+ years

Section 4: Health

15. How would you rate your overall satisfaction with life? (1 = hell, 10 = heaven)

1 2 3 4 5 6 7 8 9 10

16. How often do you self-medicate for emotional or physical pain? (circle one)

Always Often Sometimes Rarely Never

 17. Do you have health insurance?

Yes No

(If you have health insurance…)

Where do you get your health insurance? (circle one or multiple)

Medicaid/Medicare/Govt program Employer COBRA Other:

Do you consider yourself “under-insured”? That is, do you not have the money or
means to get the help and treatment you need?

Yes, I consider myself under-insured No, I do not consider myself under-insured

18. Would you say that you have a disability?

Yes No

(If you have a disability…)

How has your disability impacted your life and work? (open response)

Section 5: Politics

19. We live in a capitalist system. Do you think our society is organized fairly? (open response)

20. Are you interested in joining a socialist organization?

Yes No

21. What have been your personal experiences with the police and prison system? (open response)

22. What do you see as the biggest problems facing us and how do you believe we can fix them?
(open response)

23. When you imagine the future, what do you see? (open response)
24. Have you answered all of these survey questions truthfully?

Yes No

25. Do you have any questions or comments about this survey? And would you be interested in taking a
longer, more comprehensive version of this survey at a later time? (open response)

26. What’s the best way to contact you? (write-in)

Phone: Text: Email: Mail: