2015 Surry County State of the County Health Report Surry County Health and Nutrition Center

Transcription

1 2015 Surry County State of the County Health Report Surry County Health and Nutrition Center 1

2 Percentage of Population Residents of Surry County White 2014 Surry County/North Carolina Race/Ethnicity Distribution Black or African American American Indians and Alaskan Native Asian Native Hawaiin and Other Pacific Islander Hispanic or Latino The median age of a Surry County resident is 42 years, with the majority of the population between 25 and 64 years of age. NC County Health Data Book 2016, NC DHHS, Two or More Races Surry County North Carolina U.S. Census Bureau. Surry County Quick Facts Division of Public Health State Center for Statistics North Carolina 2015 County Tier Designations Surry County has a diversity of ethnicities, rural and urban populations, education levels and economic opportunities that play a role in the overall health of the community. Demographics: There was no significant change in population of each diverse ethnicity from 2014 to Origin and Language: Approximately 5.4% of the total population in the county is foreign born and 8.9% of individuals, age 5 years and older, speak a language other than English at home. Education: Nearly 76% of those over the age of 25 have graduated from high school, meaning over 3/4 of Surry s population have a high school degree and 15.2% of those individuals have a bachelor s degree or higher. Work: According to the U.S. Bureau of Labor Statistics, the unemployment rate has been steadily declining in Surry County since In January 2010, the unemployment rate was 13.4% whereas the most recent report, completed in November 2015, stated that the unemployment rate is now at 5.2%. That is a significant change over the course of the last 5 years. Population Trends: According to the U.S. Census Bureau, in 2014 Surry County had an estimated population of 72,968 residents. The population percent by age is shown below. There has been no significant change in recent years Surry County Population Percent by Age NC Department of Commerce 25% 24% In 2015, Surry County continued to be designated as a Tier 1 county along with 40 other counties in North Carolina. Starting in 2016, the county will no longer be considered a Tier 1 County. Surry will be moving up to a Tier 2 Status. According to the N.C. Department of Commerce, County Tiers are calculated using four factors: average unemployment rate, median household income, percentage growth in population, and adjusted property tax base per capita. 11% 15% 11% 14% 2014 County Estimates, NC State Commerce

3 New & Emerging Issues Affecting Health Integrated Behavioral Health In 2013, the Surry County Health and Nutrition Center contracted with the Carolina Child and Family Services Behavioral agency to implement Fully Integrated Behavioral Health (IBH). There is a Licensed Clinical Social Worker on site two full days a week and a Qualified Professional on site 40 hours a week. The Integral Behavioral Health Program has been very successful over the past 3 years and continues to grow. From April 2013 to December 2015, the Surry County Health and Nutrition Center has seen 4,036 behavioral health contacts, consisting of individuals who have been referred to the health department by their medical provider, individual consultations, and those who come in for clinical services such as assessment and therapy. The Integrated Behavioral Health Team implements evidence based practices for the assessment and treatment of ADHD, as well as working collaboratively with medical providers to assist in addressing the impact of behavioral health issues on a patient s overall health status such as pre-diabetes/diabetes, cardiac disease, obesity, multiple sclerosis, and seizure disorders. The IBH Team uses cognitive behavioral therapy practices, motivational interviewing, and trauma focused therapy to assist patients addressing their challenges. The team has had the opportunity to be a part of a large grant with Adult Primary Care Clinic to provide behavioral health services, and also received a grant from the Surry County Health Foundation to provide services to uninsured individuals who could benefit from behavioral health services. Total Number of Adults and Children who Received Behavioral Services at the Surry County Health and Nutrition Center in 2015 Behavioral Services Provided by the Surry County County Health and Nutrition Center to County Residents in 2015 Other 45 80% 69% Care Management % 40% 20% 31% Adults Children Therapy Sessions Clinical Assessment Consultation % Based on the chart above, the Surry County Health and Nutrition Center s Integrated Behavioral Health Team provided services to far more children than adults in Over twice as many children were seen for behavioral services compared to adults. The chart above shows how many county residents were seen for each service provided by the SCHNC Integrated Behavioral Health Team. The majority of these residents were seen for consultations. A large number were also seen for therapy sessions. 3

4 New & Emerging Issues Affecting Health, cont d Hepatitis C in Surry County Hepatitis C is an infection of the liver caused by the Hepatitis C virus. Most people infected with Hepatitis C virus develop a chronic, lifelong infection with treatment focused on preventing progression, although there is a cure in its earliest stages. Many people with Hepatitis C do not have symptoms, nor do they know they are infected. If symptoms develop with chronic Hepatitis C, they may take decades to develop and are usually indicative of advanced liver disease. Hepatitis C is usually spread when blood from an infected person enters the body of someone who is not infected. Most infections today are a result of sharing needles, syringes, or other equipment to inject drugs. Prior to 1992, Hepatitis C was also spread through organ transplants and blood transfusions. Surry County s Hepatitis C rates are among the highest in the state, with the virus being predominantly seen among young white persons with no favor towards male or female. Due to the rates being so high, the NC Department of Public Health selected Surry County Health and Nutrition Center to offer free testing through the NC State Lab for patients that fall within a specific criteria. These criterion include: admitting to IV drug use currently or in the past, men who have sex with men, individuals who are HIV positive, or those who report multiple sexual partners. Since fall of 2014, SCHNC has tested 152 patients for acute Hepatitis C infection. In addition to offering testing, our nurses and health education staff have spent many hours meeting with commissioners, law enforcement, local EMS, hospitals, schools, and other community partners to discuss this growing problem and determine strategies to assist in reducing our rates. In our communities, IV drug use seems to be the primary factor contributing to our growing Hepatitis C rates. It is not always needle sharing that is the problem, but also sharing of drug paraphernalia, such as spoons, cotton balls, etc. It is a goal for Surry County Health and Nutrition Center in union with our various community partners to reach out to the most vulnerable populations and teach them how to reduce the spread of disease, how to safely inject drugs if they are going to continue to inject them, and implement control measures as outlined by NC General Statutes. 4

5 Morbidity and Mortality Leading Causes of Death, Surry County vs. North Carolina 2014 data Rank Surry County Leading Causes Number % 1 Cancer Diseases of the heart Chronic lower respiratory diseases Cerebrovascular diseases Alzheimer s disease Nephritis, nephrotic syndrome, nephrosis All other unintentional injuries Diabetes mellitus Influenza and pneumonia Septicemia Source: State Center for Health Statistics, NC Rank North Carolina Leading Causes 1 Cancer 2 Diseases of the heart 3 Chronic lower respiratory diseases 4 Cerebrovascular diseases 5 Alzheimer s disease 6 All other intentional injuries 7 Diabetes mellitus 8 Influenza and pneumonia 9 Nephritis, nephrotic syndrome, nephrosis 10 Motor vehicle injuries Source: State Center for Health Statistics, NC The top five leading causes of death in Surry County align with that of North Carolina. It can be concluded from the statistics that these health related areas need to be highly focused on, not only within the county but the state Surry Peer County Review: Causes of Death Cancer Heart Lung Cerebrovascular Diseases Caldwell Rutherford Surry Wilkes Alzheimer's Peer County Comparison: In order to understand county health it is important to compare Surry County with other counties in the state who are similar in demographics, socioeconomics, and total population. The NC State Center for Health Statistics indicates that in 2014 the top five causes of death in Surry County were cancer, diseases of the heart, chronic lower respiratory disease, cerebrovascular disease, and Alzheimer s disease. Based on the chart, Surry s overall number of deaths from each category fell in close proximity with that of its peer counties. The number of deaths caused by each condition do not exceed nor fall below that of its peer counties. Interestingly, Caldwell County ranked the highest in each category. 5

6 Percentage of Population Percentage of Population Percentage of Population Priority Selection and Data Review Priority Health Concerns Surry County s Community Health Assessment was completed in At this time surveys were distributed amongst the county asking residents what they felt the biggest health issues are that the community faces. The report concluded that the top three biggest issues were: 1. Obesity/Weight 2. Substance Abuse 3. Lack of Insurance/Affordable Healthcare Digging a little deeper, residents listed that marijuana, alcohol abuse, drinking and driving, and abuse of prescription drugs are among the top substances that are an issue within the county. Residents also stated that their number one environmental health concern is second hand smoke. Percentage of Surry County Residents Who are Obese and Physically Inactive Compared to North Carolina Percentage of Surry County Uninsured Adults and Children Compared to North Carolina 35% 30% 25% 20% 15% 10% 5% 0% Adult Obesity Physically Inactive Surry County 31% 31% North Carolina 29% 25% Percentage of Surry County Adult Smokers and Alcohol Impaired Driving Deaths Compared to North Carolina 35% 30% 25% 20% 15% 10% 5% 0% Adult Smoking Alcohol Impaired Driving Deaths Surry County 28% 32% North Carolina 20% 33% 30% 25% 20% 15% 10% 5% 0% Uninsured Adults Surry County 27% 9% Data Review Obesity: While Surry County has slightly more obese adults on average than North Carolina, the county has a significantly higher amount of people that are physically inactive compared to the state. Interestingly, not only are 31% of the county s adult residents obese but 31% of the county s population are physically inactive as well. It is very likely that there is a correlation between the two. Uninsured Adults and Children: Surry County has a considerably higher percentage of uninsured adults compared to North Carolina, while there is only a slight increase in the number of uninsured children compared to the state. Substance Abuse: Surry County has 8% more adult smokers than North Carolina which is a big difference. A contributing factor to this may be due to Surry being a large farming and agricultural community. The county falls 1% below the state s overall incidents of alcohol impaired driving deaths. Uninsured Children North Carolina 23% 8% 6

7 Obesity Prevention/Interventions International Walk to School Day The Surry County Health and Nutrition Center has partnered with Active Routes to School along with other organizations within the county such as local police departments and recreational centers to promote walking and biking as exercise that could lead to a healthier lifestyle. Active Routes to School is an organized effort to increase safety for children who walk and bike to school, by raising awareness and providing those students with the information to choose the safest route. The overall goal of the event is to educate students as well as parents on how important it is for kids to become more active and how to do so in a safe setting and performing safe and fit activities. For the year 2015, Surry County had a total of 19 schools participate in the International Walk to School day which took place on October 7 th. These schools consisted of the Elementary and Middle Schools. During this event students and teachers took time during the school day to walk on their school s track or other walkways around the school. Surry County had more schools participate in this event than any other county in Region 3 of the state. A Walk/Bike to School event was held on October 8 th at Mount Airy Middle School as well. That morning parents dropped off their kids at the Ararat River Greenway before school began so that the students could walk or bike to school with adult chaperones to the middle school. These events were very successful, where both students and teachers had fun l earning new and safe ways to be active and taking some time out of the day for physical activity! Women, Infants, and Children Women, Infants, and Children (WIC), is a federal program that helps provide high quality, nutritious foods to low-income pregnant women, post-partum and breastfeeding women, as well as infants and children until they reach age 5. WIC provides education on proper nutrition, supplemental foods, and breastfeeding support. Surry County Health and Nutrition Center s WIC program remains to be a steady service in the community. On average, WIC serves approximately 400 families per month, but still strives to reach out to the community in efforts to increase and maximize accessibility for participants. Since October of 2015, Surry County Health and Nutrition Center s nutritionists reached out to three child care centers, providing nutrition education through Smart Start Presentations for the daycare staff. Breastfeeding Breastfeeding is a wonderful way for women to bond with their new babies, and give them proper nutrition for growth and development. The Surry County Health and Nutrition Center s Lactation program developed a breastfeeding support group in 2013 and it is still going strong to this day. It is free and open to all breastfeeding or expectant mothers. Discussion about everything related to breastfeeding are led by a Lactation Specialist. In this setting, pregnant women and mothers who are breastfeeding explore options that result in a satisfying breastfeeding experience. Mothers share information and experiences and offer support to other women in an atmosphere of trust and respect. The support group continues to meet the first Thursday of each month from 1:00 until 2:00 pm at Salem Baptist Church. A Lactation Specialist also continues to lead a breastfeeding support group on the second Thursday of each month for the Hispanic community and on the third Thursday of each month for those whose primary language is English. The support groups take place at the Surry County Health and Nutrition Center from 5:45 until 7:00 pm on the respective days. 7

8 Substance Abuse Prevention/Interventions Worksite Tobacco Cessation Programs Over the course of 2015 a Surry County Health and Nutrition Center Health Educator held a 6 week tobacco cessation program at three different worksites within the county. In this program employees learned how to identify why they smoke, their habits, triggers of smoking, the barriers and benefits to quitting, the different forms of nicotine as well as Nicotine Replacement Therapy options, tips for quitting, and setting up their own individual quit plan. The program allows participants to gain the information and resources they need in order to make smarter and healthier decisions while on their journey to becoming a non-smoker or non-tobacco user. Candy vs. Medicine Board Initiative The purpose of this initiative is to multi-generationally educate the community as to how similar candy now looks like medicine as well as how almost all medicines now have candy coating or are candy flavored. By talking with grandparents/parents we are getting their attention that they need to securely store their medicines. A large intent of this initiative is to open up the dialogue within the family setting about how medicine is serious business, even at a young age. Local high school students built and decorated mobile medicine cabinets which contained 50% candy and 50% medicine inside that was donated by local pharmacists. These medicine cabinets were presented in a multitude of settings such as Pre-K to third grade classrooms, health fairs, local festivals, civic organizations and the NC State Fair. Every school within Surry County participated in some way throughout this process in Over 10,000 flyers were sent home in children s folders regarding the permanent medication drop back box in the county as well as Medication Take back dates that took place at the hospital, hospice and police departments. All media outlets covered this initiative at least one time. PDA (Prescription Drug Abuse) T-Shirt/Pledge Initiative The PDA T-Shirt/Pledge Initiative is meant to educate pre-teens/teens about the dangers associated with misusing prescription medication as well as the 911 Good Samaritan Law. The 911 Good Samaritan Law protects people from arrest and prosecution for drug possession when they call 911 to report an overdose. Surry s Project Lazarus Coordinator speaks with teen groups during their lunch breaks, PE and health fairs about how prescription drug abuse is negatively impacting their age group. Discussion is held about the Good Samaritan Law and what it means. Teens read and sign the PDA Pledge which reads: I will share my class notes, NOT my medications. I will not take anyone else s medications. If a friend is in trouble I will call 911. Once the pledge is signed students are then placed in a drawing for a free PDA T-shirt. Every school system in Surry County participated in this initiative. Over 1,500 pledges were signed and 300 t-shirts were awarded. Naloxone Distribution Initiative Distribution of Naloxone within the community is helping to save the lives of those who experience a drug overdose, whether it is intentional or accidental. This initiative consisted of encouraging prescribers of high-risk medications to co-prescribe Naloxone, providing free naloxone kits to high risk populations, and starting the process of getting a blanket prescription for naloxone to be in place within multiple pharmacies throughout the county. In 2015 there was a 400% increase in Naloxone being co-prescribed and over 500 naloxone kits were placed in the community. 8

9 New Initiatives Faithful Families Program Surry County Health and Nutrition Center s Health Educators will be offering a Faithful Families Eating Smart and Moving More Program to various faith based communities in the upcoming year. This program promotes healthy eating and physical activity in communities of faith. It is made up of a 9 session curriculum taking place over a period of 9 weeks. The program will be co-taught by a health educator that is trained in Faithful Families and a trained lay leader from the faith community. Lay leaders bring the spiritual elements into each session through discussion questions and prayer. Topics covered in the program are meal planning, getting the best for less, shopping for value and checking labels, choosing more fruits and vegetables, making smart drink choices, and moving more throughout the day. One goal to be accomplished through this program is assisting faith leaders in adopting policy and environmental change for their faith community and establishing health committees. Health Educators are already at work reaching out to the churches within the community that are in need of this program and willing to participate. Tai Chi for Arthritis Originating in China, Tai Chi is one of the most effective exercises for the health of mind and body. It is a gentle exercise for the entire body. Tai Chi is one of the most popular evidence based programs in North Carolina. Numerous studies have shown that Tai Chi works to improve muscular strength, flexibility, and fitness. Surry County Health and Nutrition Center s Health Educator is in the process of teaching their first Tai Chi Class to a church group and is already planning a class to start this coming spring for the Surry County Health and Nutrition Center s diabetes patients. Everyone can benefit from this form of exercise. Not only is it used to improve muscular strength, flexibility, and fitness but it also improves heart and lung function, aids in weight loss, and reduces stress. The benefits that this form of exercise provides is endless. Mission Possible The purpose of this initiative is to multi-generationally educate the community about the dangers associated with misusing prescription medication, with a focus on what it is like to live as a survivor of an overdose. There are many parents that do not realize that it is against the law to share someone s medication. Reminding people about the Good Samaritan Law and encouraging them to call 911 if a family member or friend overdoses is crucial if this circumstance occurs. Mission Possible is a video compiled of community leaders such as the EMS Director, ER Doctor, Sheriff, Medical Examiner, and School Superintendent speaking about tragedies they are seeing in Surry County. The Overtaken documentary shows stories of individuals who survived an overdose and how it has affected their life. The video also includes a mother sharing what it was like to say good-bye to her son as he was being unplugged from life support due to an accidental overdose. Surry County Health and Nutrition Center s Project Lazarus Coordinator will be approaching the school systems, civic groups, churches, and other community centers to show this video. The first showing of Mission Possible took place at the Historic Earle Theatre in October of 2015, which was so successful that it encouraged surrounding counties to plan similar events related to prescription drug abuse. 9

10 New Initiatives Surry County Health and Nutrition Center Diabetes Self-Management Education Program Surry Medical Ministries (SMM) is a free medical clinic in Mount Airy serving those in the community who are uninsured and financially disadvantaged. A large portion of the SMM total budget is currently being used to cover diabetes medications and treatments. SCHNC Diabetes Self-Management Education Program is now partnering with SMM to provide free education to improve self-care, ultimately, lowering diabetes medical expenses and improving the health of the indigent population in the community. Surry Medical Ministries received a small grant from the Mount Airy Rotary Club to sponsor a diabetes education series. The SCHNC Diabetes Self-Management Education Program is partnering with Mount Airy City Schools and area healthcare providers to offer this comprehensive, on-site diabetes program for SMM s patients. The six part series will include information related to nutrition, exercise, monitoring blood glucose, medications, preventing diabetes complications, skin care, and tobacco cessation. This grant will cover diabetes education materials for the programs and incentives for the participants such as pedometers and testing supplies. Brenner s Fit Program As obesity trends continue to increase among adults and children, tailored health education programs continue to be an area of need among families in Surry County. Rural families who express interest in participating in nutrition education interventions such as the Brenner Families in Training (F.I.T) Program are limited by transportation and/or time constraints and are unable to participate in classes offered directly by Brenner F.I.T which is located in Winston Salem, NC. In order to address this barrier, Surry County Health and Nutrition Center Registered Dieticians are partnering with the Northwest Community Care Network, Wake Forest Baptist Health Brenner Children s Hospital and the Brenner F.I.T Program to offer free nutrition education classes within Surry County on a quarterly basis. With this partnership, SCHNC is able to support families with developing healthy lifestyle skills following the Brenner F.I.T course materials. Over the course of the lessons, the aim is to build and strengthen the partnership between SCHNC and Brenner F.I.T in order to yield increased participation in health education programs and further decrease obesity trends and related chronic disease risk factors among all residents within Surry County. For more information about any of our programs or services, please contact Surry County Health and Nutrition Center: 118 Hamby Rd, Dobson, NC (336) Our mission is to protect and promote personal, family and community health; ensure a safe and healthy environment; and prevent or control the incidence and spread of disease. 10