2022 State of the County Health Report

10 2022 JOHNSTON COUNTY This annual report provides an North Carolina 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 PRIORITY HEALTH ISSUES development , financial IDENTIFIED FROM THE 2021 COMMUNITY planning and program HEALTH NEEDS ASSESSMENT implementation ? Access to Care ? Substance Use ? Transportation TABLE OF CONTENTS ? Inside the SOTCH , pg 2 ? Demographics , pg 2 - 3 ? Health & Medical , pg 4 ? Access to Care , pg 5 ? Substance Use , Pg 5 - 6 ? Transportation , pg 6 ? New Initiatives & Emerging Issues , pg 7 - 9 Johnston County Public ? Data Sources , pg 10 Health Department Electronic copies of this document and other Johnston 517 N BrightLeaf Blvd County health reports are available on our website Smithfield , NC 27577 wwwjohnstonnccom health Phone 919 989 - 5200 Health Director Marilyn Pearson , MD 1PageInside 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 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 two 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 completed the Community Needs Assessment in 2021 To access the most recent CHNA , visit https wwwjohnstonhealthorg about - us chna The submission of the 2022 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 2021 - 2022 , there are some categories where the most current data available is from earlier years 1 Johnston County’s Demographic and Economic Summary 2Page3PageHealth and Medical Care 2 Overview of Leading Causes of Death Rank Cause Number 1 Cancer 364 200 2 Diseases of the heart 360 197 3 COVID - 19 121 66 4 Other Unintentional injuries 95 52 5 Cerebrovascular disease 93 51 6 Chronic lower respiratory 82 45 diseases 7 Alzheimers disease 73 40 8 Diabetes mellitus 55 30 9 Motor vehicle injuries 54 30 10 Nephritis , nephrotic 47 26 syndrome , & nephrosis All other causes Residual 479 263 Total Deaths - - - All Causes 1,823 100 In 2020 , there were 1,823 deaths in Johnston County and the number one leading cause 2 of death was cancer The percent of deaths due to cancer , 200 , is slightly higher than that of 1,2 North Carolina 183 Lung and bronchus cancer , followed by female breast and prostate 4 cancers , are responsible for the majority of the cancer deaths in Johnston County The second leading cause of death , with 360 deaths , is diseases of the heart Contributing to most of these preventable deaths were 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 Economic Glimpse ? In 2021 , there were estimated 28,256 or 126 of the population who were less than 3 100 of the federal poverty level 3 ? The 2021 Median Household Income was 69 , 394 3 ? The unemployment rate in 2021 was 31 4PagePage pageNumber5Access to Primary Care CHNA Priority Healthy North Carolina 2020 Objective Increase the number of practicing primary care providers and increase the percentage of adults reporting good , very good , or excellent health 4 Peer County Uninsured Rates number and County 2021 2021 2022 2022 Uninsured Uninsured Uninsured Uninsured Johnston 23,666 14 25,998 15 Craven 9,142 12 9,938 13 Davidson 19,205 14 19,706 15 Harnett 15,873 14 17,293 15 Randolph 18,370 16 20,225 17 Union 25,215 12 23,543 11 Wayne 14,854 15 15,268 15 Wilson 9,533 15 10,451 16 Johnston County Community Health Improvement Plan 2022 ? All people in Johnston County have access to comprehensive , high quality , and affordable healthcare by clinicians that identify with people they serve o UNC Johnston Health Mobile Telehealth Program Progress to Date ? The UNC Johnston Mobile Telehealth program hosted 22 events across Johnston county in 2022 Substance Use CHNA Priority Healthy North Carolina 2020 Objective Reduce the past - year nonmedical use of prescription drugs and 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 5PagePage pageNumber6Johnston County Community Health Improvement Plan 2022 ? Increase the number of doses of Narcan distributed in Johnston County ? Increase the number of Quitline Referrals ? Offer Evidence Based Smoking Cessation Class Progress to Date ? In 2022 , 1,140 doses of Narcan were distributed to various community partners and community members ? The number of quitline referrals increased by 329 individual referrals from 2020 - 2022 ? Freedom from Smoking , smoking cessation class was not offered in 2021 , due to the demands of the covid pandemic ? In 2022 , Smoking cessation was offered to patients referred from Johnston Health after discharge on Wednesday afternoons Transportation CHNA Priority Healthy North Carolina 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 Community Health Improvement Plan 2022 ? Johnston County residents will have access to WIC through mobile healthcare ? Increase the number of Women , Infant and Children satellite clinics in Johnston County Progress to Date ? Johnston County WIC services expanded to include telephone visits due to the covid pandemic beginning in 2020 ? The number of residents served between 2021 and 2022 increased by 12 In 2021 , WIC served 4,680 clients a month , and in 2022 , they served 5,260 clients a month ? In 2022 , Johnston County WIC was hopeful to re - open satellite sites , but ultimately used our main building and telephone visits , due to the ongoing covid pandemic The 3 satellite sites in Benson , Clayton and Princeton still exist with plans to resume services in 2024 6PagePage pageNumber7New Initiatives & Emerging Issues 5 Diabetes Type 2 Diabetes can lead to heart disease , stroke , kidney failure , blindness , and lower - limb amputation Recent research has also shown a connection between diabetes and dementia , hearing loss , and some forms of cancer Diabetes increases the risk of early death , and diabetes - related complications can lower quality of life About 422 million people worldwide have diabetes and 15 million deaths are directly attributed to diabetes each year Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few 8 decades In Johnston County , 11 of adults age 20 and older are diagnosed with Diabetes This is roughly 25,000 people Johnston County Public Health offers a Diabetes Prevention Program to provide information and education on lifestyle changes for healthy living to delay or prevent type 2 diabetes Covid - 19 & Increased Substance Use Covid - 19 continues to present many challenges in education , identification , treatment and recovery , both short and long term There have been several new strains mutants of the virus creating a necessity for additional types of vaccines for prevention and treatments for recovery and wellness Since 2020 , Covid has had periods of low incidence and periods of high incidence Covid incidence in Johnston County has been on an overall downward trend 9 since mid 2022 , likely due to covid - 19 vaccinations Johnston County Public Health continues to offer Covid - 19 information , education , testing , vaccinations At - home Covid - 19 tests are also available daily Tobacco and alcohol use increased during the Covid - 19 pandemic In 2020 , In Johnston County , 10 18 of adults were current cigarette smokers In 2021 that number increased to 20 Over the last two decades alcohol deaths increased around 22 per year , however , between 2019 - 2020 deaths involving alcohol jumped to 255 , totaling 99,107 deaths in North Carolina Tobacco use increased Pandemic - related anxiety , boredom , and irregular routines were cited as major drivers of increased nicotine and tobacco use during the initial COVID - 19 shutdown , according 7 to research just released by Columbia University Mailman School of Public Health researchers Johnston County has a youth empowerment group , a group of high schoolers who provide peer education on the dangers of substance use Quarterly evidence based smoking cessation classes are offered by the health department 6 Mental Health - Social Isolation Loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions A report from the National Academies of Sciences , Engineering , and Medicine NASEM points out that more than one - third of adults aged 45 and older feel lonely , and nearly one - fourth of adults aged 65 and older are considered to be socially isolated Older adults are at increased risk for loneliness and social isolation because they are more likely to face factors such as living alone , the loss of family or friends , chronic illnesses and hearing 11 loss In 2021 , 14 of the population in Johnston County was 65 or older This number continues to grow as Johnston County is the fastest growing county in the state 7PagePage pageNumber8The effects of social isolation on mental health are a challenge during the best of times , but social isolation has taken on a new meaning during the coronavirus pandemic As bars , restaurants , schools , and shopping centers closed , and we were all instructed to social distance with our immediate families at home , the opportunity for social interaction was greatly reduced Social isolation can exacerbate existing mental illnesses and it can make feelings of loneliness intensify , creating some serious negative effects on the health and well being of us all These include Increased risk of Anxiety and Depression , faster cognitive decline and progression of Alzheimer’s disease , increased stress , increased drug and alcohol use , and increased risk of heart disease Johnston County Public Health and Johnston County Behavioral Health in collaboration with its partners continue to offer assessments , evaluations , education , interventions and treatments outpatient , individual and group counseling In addition , Johnston County Public Health partners with Community and Senior Services to offer programs for seniors to encourage socialization Opioid use and misuse In 2021 , 3,961 people died of a suspected opioid overdose in North Carolina , a 21 increase from 2020 More than 760,000 people in the United States have died of opioid use since 1999 , 12 and in North Carolina that number is 13,000 people Between July 2021 and July 2022 alone , more than 100,000 people have died of a drug overdose In Johnston County , that number increased by 40 in 2021 Accidental drug overdose is the number one cause of accidental deaths in North Carolina and nationwide In March of 2022 , North Carolina Reported a 40 Increase in Overdose Deaths in 2020 Compared to 2019 Opioids , sometimes called narcotics , are substances that act on opioid receptors to produce morphine - like effects Medically , they are primarily used for pain relief , including anesthesia Other medical uses include suppression of diarrhea , replacement therapy for opioid use disorder , reversing opioid overdose , and suppressing cough Opioids , sometimes called narcotics , are medications prescribed by doctors to treat persistent or severe pain Opioids include drugs such as heroin and prescription pain medications such as morphine , codeine , methadone , oxycodone Oxycontin , Percodan , Percocet , hydrocodone Vicodin , Lortab , Norco , fentanyl Duragesic , Fentora , hydromorphone Dilaudid , Exalgo , and buprenorphine Suboxone The US Department of Health and Human Services declared the opioid crisis a public health emergency in 2017 Local and state public health agencies have been rolling out treatment and prevention programs that include medication assisted treatment such as methadone and suboxone clinics In July 2022 , Johnston County received funds from the state of North Carolina from the Opioid Settlement to address the opioid epidemic Johnston County will receive 81 Million to be spent over 18 years , to implement mitigation and prevention activities listed below A preliminary plan will be updated as needed over the grant period based on community needs 8PagePage pageNumber9Category Strategy Collaborative strategic Support Collaborative planning to address opioid misuse , addiction , overdose , planning including the or related issues including staff support , facilitation services opioid task force Evidence - Based Addiction Support evidence - based addiction treatment consistent with the American Treatment Society of Addiction Medicine national practice guidelines for the treatment of opioid use disorder - including Medication - Assisted Treatment MAT with any medication approved for this purpose by the US Food and Drug Administration - through Opioid Treatment Programs , Qualified providers of office based Opioid Treatment , Federally Qualified Health Centers , treatment offered in conjunction with justice system programs , or other community based programs offering evidence based addiction treatment Recovery Support Services Fund evidence based recovery services including peer support specialists or care navigators based in local health departments , social service offices , detention facilities , community based Early Intervention Fund Programs , services or training to encourage early identification for children or adolescents who may be struggling with problematic use of drugs or mental health conditions , including Youth Mental Health First Aid , peer based programs , or similar approaches Training programs may target parents , family members , caregivers , teachers , school staff , peers , neighbors , health or human services professionals , or others in contact with children or adolescents Naloxone distribution Support programs or organizations that distribute naloxone to persons at risk of Narcan overdose or their social networks , such as Syringe Programs , Post Overdose Response Teams , programs that provide naloxone to persons upon release from jail or prison , emergency medical providers or hospital emergency departments that provide services to people who use drugs , Programs or organizations involved in community distribution of naloxone may , in addition , provide naloxone to first responders Post - Overdose Response Support post overdose response teams that connect persons who have Team PORT experienced a non - fatal drug overdose to addiction treatment , recovery support , harm reduction services , primary healthcare , or services and support they may need to improve their health or well - being 9Page0Data Sources 1 US Census Bureau 2021 ACS 1 - year Estimates Data Profile Johnston County , NC https datacensusgov table g 0500000US37101 & tid ACSDP1Y2021 DP05 Retrieved 1 19 2023 2 Leading Causes of Death in North Carolina 2020 Johnston County https schsdphncdhhsgov interactive query lcd getleadcausescfm Retrieved 2 1 2023 Schafer , Zachary P Email to [ Mary Banks ] 31 January 2023 3 US Bureau of Labor Statistics 2023 , January 25 US Bureau of Labor Statistics US Bureau of Labor Statistics Retrieved January 30 , 2023 , from https wwwblsgov eag eagnchtm 4 Countyhealthrankingsorg nd Retrieved February 21 , 2023 , from https wwwcountyhealthrankingsorg explore - health - rankings county - health - rankings - model hea lth - factors clinical - care access - to - care uninsured state 37 & year 2021 & tab 1 5 Centers for Disease Control and Prevention What is Diabetes CDCgov diabetes basics diabeteshtml Retrieved 2 1 2023 6 National Academies Press napnationalacademies , org catalogs 25665 Social Isolation and Loneliness in adults Retrieved 2 1 2023 7 Columbia University Mailman School of Public Health researchers https wwwpublichealthcolumbiaedu public - health - now news covid - 19 - lockdown - linked - uptic k - tobacco - use Retrieved 2 1 2023 8 Diabetes Prevalence County Health Rankings nd Retrieved February 28 , 2023 , from https wwwcountyhealthrankingsorg explore - health - rankings county - health - rankings - model hea lth - outcomes quality - of - life diabetes - prevalence year 2022 & county 37101 9 NCDHHS Covid Cases and Deaths Dashboard 2022 Retrieved February 28 , 2023 , from https covid19 ncdhhsgov dashboard cases - and - deaths 10 Adult Smoking County Health Rankings nd Retrieved February 28 , 2023 , from https wwwcountyhealthrankingsorg explore - health - rankings county - health - rankings - model hea lth - factors health - behaviors tobacco - use adult - smoking keywords 275 & f 5B0 5D type 3Ast ates & f 5B1 5D type 3Acounties & year 2020 & county 37101 11 Census Quick Facts Censusgov 2021 Retrieved February 28 , 2023 , from https wwwcensusgov quickfacts fact table johnstoncountynorthcarolina PST045221 12 The Impact of Opioids MorepowerfulNCorg 2017 Retrieved February 28 , 2023 , from https wwwmorepowerfulncorg get - the - facts the - impact # ~ text More 20people 20die 20fr om 20opioid , lives 20to 20unintentional 20opioid 20overdoses 10Page