2019 State of the County Health Report

10 Johnston County NORTH CAROLINA What is a SOTCH Report This annual report provides an overview of the health and wellbeing of Johnston County residents It highlights the most current data , and the county’s top health priorities In addition , this report serves as a resource for grant application , policy development , financial planning and program implementation Priority Health Issues Identified from the 2019 Community Health Needs Assessment • Access to Health Services • Heart Disease & Stroke • Mental Health & Substance Abuse • Respiratory Diseases • TransportationPageJOHNSTON COUNTY PUBL IC HEALTH DEPARTMENT 517 N Bright Leaf Blvd Smithfield , NC 27577 Phone 919 989 - 5200 Marilyn Pearson , MD Health Director Table of Contents Demographics 3 Health and Medical 4 Access to Health Services 5 Respiratory Diseases 7 Mental Health & Substance Use 8 Transportation 8 Heart Disease & Stroke 9 New Initiatives & Emerging Issues 10 Data Sources 11 Electronic copies of this document and other Johnston County health reports are available on our website wwwjohnstonnccomPageInside the SOTCH Every three years the state of North Carolina requires Johnston County Public Health Department to conduct a Community Health Needs Assessment CHNA This assessment is a collaborative process between UNC Johnston Health and Johnston County Public Health Department Completion of the CHNA is a process that allows community members and stakeholders to gain a better understanding of the health needs and concerns of the community During the interim 2 years the health department is responsible for submitting a State of the County Health SOTCH report to the North Carolina Division of Public Health and Office of Healthy Carolinians Johnston County Health Department and UNC Johnston Health completed the Community Health Needs Assessment in 2018 To access the CHNA visit http wwwjohnstonnccom files health CHNA 202018 pdf The submission of the 2019 SOTCH addresses the most current data related to each priority health issue along with a summary of the progress to date Although this report reflects years 2018 - 2019 , there are some categories where the most current data available is from earlier years Johnston County’s Demographic and Economic Summary 2018 Johnston County Demographic Estimates 1 Sex Estimate Percent Male 98,113 484 Female 104,562 516 Race Estimate Percent White 155,875 769 Black or African American 33,049 163 American Indian or Alaska Native 737 4 Asian 1,159 6 Native Hawaiian or other Pacific Islander 323 2 Ethnicity Estimate Percent Hispanic or Latino any race 28,310 14 Non - Hispanic or Latino 174,365 86 Total Population 202 , 675Page12,918 14,029 15,963 13,439 11,036 25,117 28,200 30,653 12,580 11,344 17,262 6,999 3,135 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 Under 5 years 5 to 9 years 10 to 14 years 15 to 19 years 20 to 24 years 25 to 34 years 35 to 44 years 45 to 54 years 55 to 59 years 60 to 64 years 65 to 74 years 75 to 84 years 85 years and over Estimate population Age Groups 2018 Johnston County Population Estimate by # Health and Medical Care Overview of Leading Causes of Death12 JOHNSTON COUNTY 2018 TOP 10 LEADING CAUSES OF DEATH 1 Cancer - All Sites 356 232 2 Diseases of the heart 307 20 3 Chronic lower respiratory diseases 77 50 4 Cerebrovascular disease 72 47 5 Other Unintentional injuries 71 46 6 Alzheimers disease 64 42 7 Diabetes mellitus 52 34 8 Influenza and pneumonia 38 25 Nephritis , nephrotic syndrome , & nephrosis 38 25 10 Motor vehicle injuries 36 23 All other causes Residual 426 276 Total Deaths - - - - All Causes 1537 100 PagePage pageNumber5In 2014 - 2018 , there were a total of 7,157 deaths in Johnston County In 2018 , there were 1,537 deaths in Johnston County , and the number one leading cause of death was cancer 2 The percent of deaths due to cancer , 232 , is higher than that of NC 209 11 Trachea , bronchus and lung cancer followed by colon , rectum and anus cancer are responsible for the majority of the cancer deaths in Johnston County The second leading cause of death , with 307 deaths , is diseases of the heart 2 Contributing to most of these deaths are lifestyle behaviors such as tobacco use , alcohol consumption , lack of physical activity , poor nutrition and substance abuse Early detection and prevention are the two most effective ways to decrease the cancer death rate It is projected that in 2019 , there will be 1,107 new cancer cases in Johnston County 3 Economic Glimpse • In 2017 , there were estimated 26,622 or 145 of the total population 184,212 who were less than 100 of the poverty level 4 • Unemployment rate in 2017 is 42 percent 5 • 2017 Median Household income in 54,6106 Access to Health Service s CHNA Priority Healthy 2020 Objective Increase the number of practicing primary care providers & increase the percentage of adults reporting good , very good , or excellent health Access to comprehensive , quality health care services is important for promoting and maintaining health , preventing and managing disease , reducing unnecessary disability and premature death , and achieving health equity for all Americans 7 Several barriers exist that may prevent people from getting access to health services Some of the barriers to receiving health services include cost , insurance , availability of services , culturally competent care , and transportation This is one of the priority areas identified by the CHNA PagePage pageNumber6Peer County Uninsured Rates number and 8 County 2016 Uninsured 2016 Uninsured 2017 Uninsured 2017 Uninsured Johnston 20,117 173 26,895 138 Craven 8,774 159 10,413 11 Davidson 16,769 172 18,716 115 Harnett 11,371 151 14,021 11 Randolph 17,303 202 18,047 127 Union 15,330 113 18,382 8 Wayne 15,269 213 16,356 136 Wilson 7,787 162 9,679 12 Johnston County CHNA Action Plan • Increase the number of medical providers in Johnston County • Expand Medical student education in Johnston County • Increase Safety Net participation to ensure that evidence based care is planned , delivered and promoted amongst health care providers accepting uninsured and low - income residents for preventive , acute and chronic care • Referral to Department of Social Services DSS if uninsured • Expand the health care provider network by offering internships , mentoring and volunteer opportunities to local students and working with local practices and agencies Progress to Date • In 2018 - 19 there were 7 providers recruited , and in 2019 - 20 there were 14 providers recruited • Johnston Health’s Student Medical Education Coordinator works with practices to schedule rotations To date , the number of students rotating through Johnston Health and with practices has increased by 50 • Johnston County Public Health Departments ’ Physicians have agreed to precept 3rd year DO Medical Students from Campbell University Four CUSOM students have rotated through to date These students will return to JCPHD for 4th year rotations PagePage pageNumber7• 2019 - Wake Med Children’s Clinic and Shephard’s Clinic joined the Johnston County Safety Net Collaborative • Patients presenting to Johnston Health who are uninsured are referred to DSS to determine if they are eligible for Medicaid • Benson Area Medical Center BAMC currently hosts 2 MedServe Students • Johnston County Public Health precepted 4 health education interns , 2 nutrition interns WIC , and 2 social work interns in 2019 Respiratory Diseases CHNA Priority Healthy 2020 Objective Reduce tobacco use by adults & increase smoking cessation attempts by adult smokers Johnston County CHNA Action Plan • Increase number of COPD patients successfully referred to a smoking cessation program by completing fax referral during patient education and faxing the form prior to patients discharge • Johnston County Health Department will offer an evidence based smoking cessation program once per year for the next three years Progress to Date • Johnston Health has reached out to the Division of Public Health , Tobacco Prevention and Control Branch to create a new account specifically for Pulmonary Vascular Services Expect completion by March 2020 The process to identify candidates has been established and we will be exploring this policy change • Evidence based smoking cessation programs were offered April 2019 , July 2019 and January 2020 to the community • Johnston County Public Health offers monthly smoking cessation classes for those referred from Johnston Health Behavioral Health inpatient unit PagePage pageNumber8Mental Health and Substance Abuse CHNA Priority Healthy 2020 Objective Reduce the past - year nonmedical use of prescription drugs & Increase the proportion of persons who are referred for follow - up care for alcohol problems , drug problems after diagnosis , or treatment for one of these conditions in a hospital emergency department ED Johnston County CHNA Action Plan • Expand capability to address growing mental health needs of the community • Opioid Task Force will host one Operation Medicine Drop event per year for the next 3 years Progress to Date • Johnston Health has successfully requested and obtained a Certificate of Need from Department of Health and Human Services for an additional six behavioral health beds They are currently working on a timeline to begin expansion • An Operation Medicine Drop Event was held in October 2019 at Temple Church , which included a resource fair with multiple community partners The next event is scheduled for April 2020 at Johnston County Public Health Department Tra nsportation CHNA Priority Healthy 2020 Objective Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care , dental care , or prescription medicines Johnston County CHNA Action Plan • Increase number of COPD telehealth consults with Johnston Health Respiratory Therapists via Community Paramedic program • Enhance the Johnston Health Medical and Radiation Oncology Transportation program • Provide Mobile Women , Infant and Children WIC food supplemental program services in Johnston County PagePage pageNumber9Progress to Date • The Community Paramedics are currently connecting with Respiratory Therapists by phone when visiting in the homes of the client Currently the team interacts with 10 - 30 of those meeting criteria The goal is to increase that number and implement the telehealth consult this year • The Johnston Health Medical and Radiation Oncology Transportation Program presented at the February 6th , 2020 Cancer Committee We expect positive progression improvement with the upcoming year for the oncology transportation program • The WIC program has new sites open in Princeton and Clayton , and we will have an additional site at Wake Med Pediatrics in Clayton in 2020 Heart Disease and Stroke CHNA Priority Healthy 2020 Objectives Increase the proportion of adults who have had their blood pressure measured within the preceding 2 years and can state whether their blood pressure was normal or high Increase the proportion of adults aged 20 years and older who are aware of the symptoms of and how to respond to a heart attack & increase the proportion of eligible patients with heart attacks or strokes who receive timely artery - opening therapy as specified by current guidelines Johnston County CHNA Action Plan • Systematically improve outcome of stroke patients at Johnston Health • Inform the Johnston County workforce about the importance of heart health and offer prevention and education • Conduct Faithful Families program at local faith organizations Progress to Date • Johnston Health has a stroke committee that is meeting frequently to work on processes so that we can apply to become a Primary Stroke Center with the Joint Commission We are working closely with our UNC Health partners to standardize orders , policies and protocols to provide excellent stroke care to our patients One big accomplishment to date is that we are now keeping patients at both JH - Smithfield and JH - Clayton that receive alteplase instead of shipping those patients to a tertiary facility This allows the patients to stay close to home for their stroke care Page0• Johnston Health’s WellnessWorks program facilitated 26 Blood Pressure Screenings from January 2019 – February 2020 Some of the businesses who participated included Browe Construction , Caterpillar , Johnston Community College , Johnston County Government , Novo Nordisk , Rooms to Go , and The Hales Group Structural Steel Products One of most popular events involved Johnston Health Ladies Night Out with 275 participants Thus far , 3 additional Blood Pressure Screenings are scheduled over the next 3 months • Three faithful families programs were offered at Johnston County churches to date • Johnston County Government supports a Walk with the Doc program monthly that provides health education to employees and the community The county plans to expand the program this calendar year to more community - oriented events New Initiatives and Emerging Issues Youth Tobacco Epidemic - E - cigarettes have several names such as “ e - cigs , e - hookahs , mods , vape pens , vapes and tank systems ” 9 E - cigarettes are rapidly evolving devices They typically deliver nicotine , flavoring and additives as an aerosol that is inhaled Many e - cigarettes contain nicotine which is highly addictive The brain continues to develop until about age 25 The surgeon general report states that nicotine can harm brain development and impact your memory and ability to concentrate in a negative way 12 Public Health continues to educate youth and adults about the negative impact of e - cigarettes on our youth We have provided e - cigarette education to 3,967 youth and 685 adults to date Poe center for Health Education has provided drug education programs in high schools in our county for youth and adults In addition to education , the Substance Use Prevention Coalition , which focuses on preventing youth substance use , was formed to help educate and facilitate change among behaviors as they relate to the vaping epidemic Johnston County Public Health Department has partnered with Harbor Inc , an agency that supports victims of domestic violence and families in transition , to implement a Sexual Assault Nurse Examiner Program SANE for Johnston County Partners include Johnston Health , Johnston County District Attorney’s Office , Johnston County Sheriff’s Office , and UNC Women’s Health In addition , Harbor partnered with Campbell University to provide training for the SANE nurses The program will focus on those 18 and older to be able to provide support and services locally Page1Data Sour ces 1 Data link US Census Bureau 2018 ACS 1 - year Estimates Data profile https datacensusgov cedsci table q Johnston 20County , 20North 20Carolina & g 05000 00US37101 & hidePreview true & tid ACSDP1Y2018 DP05 & table DP05 Retrieved 3 1 2020 2 2014 - 2018 Race Specific and Sex - Specific Age - Adjusted Death Rates by County https schsdphncdhhsgov data databook CD12B 20racespecific 20and 20sexspecific 2 0ratesrtf Retrieved 3 1 2020 3 Projected New Cancer Cases and Deaths for Selected Sites by County , 2019 https schsdphncdhhsgov data databook CD13B 20Cancer 20Projections 20by 20Countyxlsx Retrieved 3 1 2020 4 POVERTY STATUS IN THE PAST 12 MONTHS 2013 - 2017 American Community Survey 5 - Year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Retrieved 3 1 2020 5 SELECTED ECONOMIC CHARACTERISTICS 2013 - 2017 American Community Survey 5 - Year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Retrieved 3 1 2020 6 SELECTED ECONOMIC CHARACTERISTICS 2013 - 2017 American Community Survey 5 - Year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Retrieved 3 1 2020 7 Healthy People 2020 Access to Health Services https wwwhealthypeoplegov 2020 topics - objectives topic Access - to - Health - Services Retrieved 3 1 2020 8 Selected Characteristics of Health Insurance Coverage in the United States 2017 American Community Survey 1 - year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_15_1Y R_S2701 & prodType table Retrieved 3 1 2020 9 Smoking and Tobacco Fast Facts https wwwcdcgov tobacco data_statistics fact_sheets indexhtm # fast - facts Retrieved 3 1 2020 10 Mortality statistics Summary for 2018 North Carolina Residents Total Deaths - All Causes https schsdphncdhhsgov data vital lcd 2018 allcauseshtml Retrieved 3 1 2020 11 Leading Causes of Death in North Carolina Johnston County https schsdphncdhhsgov interactive query lcd getleadcausescfm Retrieved 3 1 2020 12 E - cigarette use among youth and youth adults A report of the surgeon general https e - cigarettessurgeongeneralgov documents 2016_SGR_Fact_Sheet_508 pdf Retrieved 3 1 2020Page