State of the County Health Report 2012

10 2 0 12 Johnston County State of the County Health Report This annual report provides an overview of the health and wellbeing Table of Contents of Johnston County residents It highlights the most current data Demographics 2 which includes demographics , leading causes of death , and the Health and Medical 3 county’s top health priorities In addition , this report serves as a Obesity 4 resource for grant application , policy development , financial planning , and program implementation Diabetes 6 Access to Healthcare 7 Priority Health Issues Cancer 9 Identified from the 2010 Injury Prevention 10 Community Health Assessment New Initiatives and Emerging Issues 11 • Obesity • Diabetes Data Sources 12 • Access to Healthcare Electronic copies of this • Cancer document and other Johnston County health reports are • Injury Prevention available on our website wwwjohnstonnccom Teen Motor Vehicle Deaths Johnston County Public Health Department 517 N Bright Leaf Blvd Smithfield , NC 27577 JCPH Phone 919 989 - 5200 Marilyn Pearson , MD Health DirectorPage2 Every four years the state of North Carolina requires each local county health department and Healthy Carolinians Partnership to conduct a community health assessment CHA Completion of the CHA 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 three interim years , the health department is responsible for submitting the state of the county health SOTCH report to the North Carolina Division of Public Health and Office of Healthy Carolinians Johnston County Public Health Department completed the Community Health Assessment CHA in 2010 To access the 2010 CHA visit wwwjoconchealthcom The submission of the 2012 SOTCH addresses the most current data related to each priority health issue along with a summary of the progress to date Although this report is a reflection of years 2011 - 2012 , there are some categories where the most current data available is from years 2009 and 2010 Johnston’s Demographic and Economic Summary 1 2011 Johnston County Demographics Sex Estimate Percent 2011 Economic Glimpse Male 83,858 486 2,13 Female 88,737 514 Race Estimate Percent ? 7,730 individuals or White 136,527 791 96 of the workforce , Black or African American 27,112 157 reported being American Indian or Alaska 304 02 unemployed , Native decreased from Asian 328 02 101 in 2010 Native Hawaiian or Other 0 0 ? 11,873 individuals Pacific Islander received SNAP Other Race 4,602 27 benefits Two or more races 3,722 22 ? 24,265 individuals Ethnicity Estimate Percent received Medicaid Hispanic any race 22,424 130 1 2011 Johnston County 2011 Estimated Age Population 1 Population by Age 60 and over Age Estimate 0 - 19 169 307 Population 0 - 19 53,098 Population 20 - 34 31,875 Population 35 - 59 58,431 35 - 59 339 Population 60 and 29,191 20 - 34 185 overPage3 Health and Medical Care Overview of Leading Causes of Death In 2010 , the rates for the two leading causes of deaths for Johnston County , diseases of the heart and cancer , were lower than North Carolinas rates The rate for diseases of the heart in Johnston 3 County was 1723 while North Carolina had a rate of 1792 There was a higher number of heart disease deaths in Johnston County among non - Hispanic Whites 237 compared to African Americans 48 in 2010 For all cancer deaths , the rate for Johnston County was 1605 compared to 3 North Carolina’s rate of 1889 Contributing to most of these deaths are lifestyle behaviors such as tobacco use , alcohol consumption , lack of physical activity , poor nutrition , and substance abuse Of all the leading causes of death , Johnston County had higher rates than the state for Alzheimer’s disease , Nephritis Nephrotic syndrome and Nephrosis , and all other unintentional injuries Many of the chronic diseases identified as the leading causes of death in Johnston County are also major 4 contributors of disabilities in the United States 3 Leading Causes of Death 2010 Rate per 100,000 1723 Heart Disease Cancer 1605 343 Chronic Lower Respiratory Diseases 326 All other Unintentional Injuries 302 Cerebrovascular Diseases 213 Nephritis , Nephrotic Syndrome and Nephrosis 166 Influenza and Pneumonia 16 Diabetes Mellitus 16 Motor Vehicle Injuries 148 Alzheimers Disease 0 20 40 60 80 100 120 140 160 180 200 2011 Health Professionals 2010 Number of Heart Disease Deaths 5 per 10,000 population in Johnston County 3 Aged 0 - 99 yrs Physicians 4 Registered White Nurses 74 1 23 Dentists 12 African American 48 409 Pharmacists 237 American 65 Indian Nurse Hispanic all 21 Practitioners race Physician AssistantsPage4 Obesity Healthy North Carolina 2020 Objective Increase the percentage of adults who consumed five or more servings of fruits and vegetables Objective Increase the percentage of adults getting the recommended amount of physical activity In 2010 , the demographics of adults considered to be overweight or obese was higher among 6 minority men who were over the age of forty - five with some level of college education In 2010 , 6 708 of adults were overweight or obese while North Carolina had a rate of 653 This was a 6 decrease from 72 in 2009 A few of the factors associated with overweight or obesity are poor eating habits , consumption of high sugar foods and beverages , minimal fruit and vegetable consumption and physical inactivity The tables below reveal that Johnston County had a higher percentage of people who had a body mass index greater than twenty - five compared to North Carolina However , according to the 2010 Behavioral Risk Factor Surveillance System , 691 of Johnston County residents compared to 743 of state residents participated in some type of 7 physical activity or exercise in the past month that was not related to work The rate of Johnston County residents who did not eat more than five fruits and vegetables 832 is higher than the rate for North Carolina 794 2010 BMI and Physical Activity County Body Mass Index gt; 25 Overweight or 6,7 6 and State Comparison Obese 76 80 743 72708 698 704 74 70 591573 60 72 Percentage 708 Percentage 691 50 70 40 68 653 30 66 20 64 10 62 0 60 Johnston Wayne Union Harnett Wilson BMI gt; 25 Physical activity or Exercise past month 2009 2010 North Carolina Johnston Note - No data in Behavior Risk Factor Surveillance System BRFSS for Harnett and Wilson Counties 2011 BRFSS data is currently unavailable for peer counties PagePage pageNumber55 8 2009 Fruit and Vegetable Consumption 100 832 Percentaege794 80 60 40 168 206 20 0 Did not eat more than five More than five North Carolina Johnston County Johnston County Action Plan ? Increase opportunities for exercise in the community by fostering environments conducive to physical activity ? Increase availability of Farmer’s Market and access to healthy foods in communities throughout the county ? Increase the amount of fruits and vegetables consumed on a daily basis Progress to Date ? In 2012 , Johnston County Health Department , as lead health department for Region 7 including Franklin , Granville , Halifax , Nash , Vance , Warren , and Wilson , received the Community Transformation Grant CTG The CTG is a project funded through the NC Division of Public Health by the Centers for Disease Control CDC and focuses on developing and implementing initiatives to prevent chronic disease , promote healthier lifestyles , reduce health disparities and control health care spending One focus of the project is on increasing physical activity through joint use agreements and healthy eating Physical activity and obesity toolkits were developed and will be utilized by facilities participating in joint use agreements and during initiatives involving the Farmers Markets in Johnston County ? In April 2011 , Johnston County Health Department sponsored its first annual Walk for Health event that is focused on promoting physical activity in Johnston County In total , there were 61 participants who utilized the Greenway Trail for physical activity during the event Since the Greenway trail has been developed , many Johnston County residents continue to utilize the trail on a daily basis The trail offers residents the ability to participate in different types of physical activity such as running , walking , and biking ? The Town of Smithfield continues to provide the community with access to locally grown fruits and vegetables through the establishment of the Smithfield Farmers Market The Smithfield Farmers Market opened in the Spring of 2011 ? In the fall of 2011 , Clayton Parks and Recreation started a community garden that is used for teaching purposes and also provides Clayton Area Ministries with fresh produce to help serve residents in need of food Clayton Area Ministries received approximately 250 pounds of 9 produce in 2011 and 515 pounds in 2012 ? For the 2011 - 2012 school year , a total of three elementary schools were involved in the school garden program offered through Cooperative Extension of Johnston County The schools involved in the program are Fours Oaks Elementary , East Clayton Elementary , and Cooper Elementary ? The Town of Selma participated in the Eat Smart Move More Weigh Less program This program focused on healthy eating and physical activity Fifteen town employees started the program and 7 completed the fifteen week program Of those 7 participants , there was a total weight loss of 99 pounds PagePage pageNumber66 Diabetes Healthy North Carolina 2020 Objective Decrease the percentage of adults with type II diabetes In Johnston County , diabetes is the eighth leading cause of death Diabetes is a chronic disease with several health implications including heart disease , nephropathy , neuropathy , foot problems , and vision impairment Obesity and lack of physical activity are major risk factors in developing diabetes Johnston County had 135 of its residents diagnosed with diabetes in 2010 compared to 81 in 10 11 2009 In 2010 , 71 of residents were diagnosed as pre - diabetic or borderline diabetic 10 Told by doctor that you have Diabetes Told by doctor that you have pre - diabetes 11 or borderline diabetes 2010 15 135 13 150 Percentage 102 Percentage10 929 929 81 71 100 63 5 50 71 71 0 0 Johnston Wayne Union Harnett Wilson Yes No 2009 2010 North Carolina Johnston Note - No data in Behavior Risk Factor Surveillance System BRFSS for Harnett and Wilson Counties 2011 BRFSS data is currently unavailable for peer counties Johnston County Action Plan ? Improve diabetes self - management for those currently diagnosed with diabetes Progress to Date ? The Diabetes Recognition Program DERP is a self - management class for diabetics offered by the health department In 2011 , there were a total of 131 patients in the DERP program The results of the program revealed a 40 reduction in HgbA1c levels and improved glucose 12 control Of the 131 participants , 100 did monthly foot exams and 45 returned for their 12 three month follow - up in the program ? In 2012 , the health department implemented the Living Healthy Diabetes Self - Management program The program provides participants with different techniques to help manage their diabetes as well as other problems associated with the chronic disease A total of three 24 participants completed the program in May ? Johnston Health is continuing to provide both inpatient and outpatient diabetes education by nurse educators In 2011 , there were approximately 133 outpatient participants in the diabetes 14 class PagePage pageNumber77 Access to Healthcare Healthy North Carolina 2020 Objective Reduce the percentage of non - elderly uninsured individuals aged less than 65 years In 2011 , 17 of Johnston County Adults report having no health insurance , lower than the state rate of 249 The rate of health insurance is correlated with the economy and employment since many health insurance plans are employer provided In 2011 , Johnston County had an unemployment rate of 96 compared to the state rate of 104 With the rate of unemployment remaining around 10 since 2009 , we continue to have a large number of individuals who are not able to receive regular th medical care Johnston County ranks at 67 for access to clinical care according the 2012 County 15 th th Health Rankings This is an improvement from 85 in 2011 and 96 in 2010 Below are tables comparing Johnston County to peer counties related to employment , poverty level and health insurance 16 2011 Estimate of Uninsured Aged 0 - 64 by Percent 178 173 177 146 137 20 15 Percentage 10 5 0 Johnston Wayne Union Harnett Wilson County 2011 Estimate of Persons Below Poverty 17 Level by Percent 26 30 Percentage 234 179 152 20 10 10 0 Johnston Wayne Union Harnett Wilson County 18 AnnualAverage Unemployment Rate by Percentage 135 133 131 129 15 115 116 116 116 101 101 101 102 Percentage 95 2009 96 94 93 89 89 84 84 10 2010 2011 5 2012 August 0 Johnston Wayne Union Harnett Wilson CountyPagePage pageNumber88 Johnston County Action Plan Reduce the number of Johnston County citizens under age 65 that do not have access to health care While we are not able to impact the number of uninsured individuals , our goal is to provide medical care to the uninsured Johnston County is taking the following action steps to meet this goal Progress to Date ? Project Access is a physician - volunteer initiative that provides low - income , uninsured county residents access to comprehensive medical care Through Project Access , physicians and community partners like Johnston Medical Center and the health department have donated over nine million dollars of medical services Project Access is not health insurance but an innovative program designed to help community residents stabilize their health in a time of need when health insurance is not available In the last five years , over 1,300 patients have 19 received services through Project Access ? The HealthNet committee meets on a monthly basis with several partners – Project Access , Community Care of Wake & Johnston County , Benson Area Medical Center , NC Office of Rural Health and Community Care , Johnston County Health Dept , Johnston County DSS , Johnston Health Hospital System , CommWell Health , Cooperative Extension and Mental Health – to address the issues of providing care to the uninsured ? Benson Area Medical Center is piloting a program to assist the uninsured in obtaining Primary Care services Physicians Care Direct is a new way to pay for primary care without having the expense of insurance overhead The program will allow the uninsured to purchase primary healthcare or for small businesses to assist their employees with having access to primary care by paying an annual fee and set co - pay for office visits ? CommWell Health , a non profit Federally Qualified Health Center FQHC , provides comprehensive affordable primary and preventive care to all individuals regardless of their insurance status or ability to pay The expansion of services continued through the opening of CommWell Health of Smithfield in 2011and in 2012 , the newest OB GYN Pediatric practice 20 opened at McGee’s Crossroads ? Johnston County Health Department is the lead agency in Health Director’s Region 7 for the Community Transformation Grant Project which will focus on evidence - based clinical and preventive services ? The Johnston County Health Department provides access to primary care to the uninsured and low income residents through sliding fee scales based on household income PagePage pageNumber99 Cancer Healthy People 2020 Objective Increase the proportion of women who receive a breast cancer screening based on the most recent guidelines Johnston County is focusing on increasing the number of women who are getting screened for early detection of breast cancer In 2010 , 748 of women reported receiving a mammogram in their lifetime in Johnston County while the state rate was 674 for the same year Below is a table comparing Johnston County to peer county data related to breast cancer deaths 2010 Breast Cancer Deaths Per 21 100,000 Population 50 424 40 Rate 30 222 205 207 196 20 10 0 Johnston Wayne Union Harnett Wilson County Johnston County Action Plan Increase the number of women reporting mammogram screening Progress to Date ? Johnston County has partnered with the NC BCCCP to provide screenings for 231 women in the past 12 months ? A new partnership with the Rex Mobile Unit has allowed for screening mammograms to be offered in Smithfield to uninsured and low income women ? Project Access makes referrals to the NC BCCCP for uninsured women and Johnston Health provides mammograms for Project Access clinic patients Page010 Injury Prevention Healthy People 2020 Objective Reduce motor vehicle crash - related deaths Objective Increase age - appropriate vehicle restraint system use in children Unintentional injuries have been one of the leading causes of death in Johnston County over the last several years According to Johnston County Teen Crash Data from 2006 - 2010 , Johnston County ranked 2nd in the state with 32 teen driving fatalities In 2009 , Johnston County ranked fourth in the state In 2010 , vehicular accidents resulted in the death of 3 teenagers , down from 10 in 2009 In 2011 , 4 teenagers died in motor vehicle accidents Below is a table comparing Johnston County data to peer county data related to teen motor vehicular deaths 22 MotorVehicle Deaths Involving Drivers Ages 15 - 19 12 10 Deaths 9 10 8 2009 of 2010 6 4 4 Number4 4 4 3 3 3 2011 4 2 1 1 2 0 0 0 Johnston Wayne Union Harnett Wilson County The Healthy North Carolina 2020 Objective is to reduce motor vehicle deaths from 138 to the target 124 per 100,000 which reflects a 10 improvement This applies to all age groups , but the incidence of teen deaths from motor vehicular accidents is significant enough to develop inventions specific to teens Johnston County Action Plan Reduce the number of child motor vehicle deaths and encourage the use of safety restraints Progress to Date ? The Johnston County Teen Driving Committee promotes the Johnston County Teen Drivers Program The Johnston County Teen Drivers is a peer - to - peer safety program for young drivers , involving teenagers directly in developing and delivering driving safety messages ? Safekids Coalition of Johnston County served 112 families and checked 188 child safety seats Of the seats checked 156 were found to be installed incorrectly , out of date recalled , or not in 23 working order ? Enhanced Safety Check Points in School ZonesPage111 New Initiatives Mental Health The Johnston County Local Management Entity LME has entered into an agreement with Durham , Wake , and Cumberland Counties to join Alliance Behavioral Health Care The Managed Care Organization MCO will manage the public mental health , intellectual developmental disability and substance abuse services for the residents of Johnston County As a result of this agreement , the Johnston County Health Department has been asked to assume the safety net provider functions of the LME in 2013 to maintain continuity of care In FY 2011 , the Johnston County Public Mental Health Safety Net served 3200 individuals The LME continues to work with the Health Department through a Kate B Reynolds grant to provide co - located behavioral health services at the health department Community Care of Wake and Johnston Counties also supports initiatives that support behavioral health care at primary care visits Community Transformation Project CTP The CTP is a 5 year regional grant to focus on system and environmental changes that support tobacco free living , active living , healthy eating , and evidence based clinical and preventive services Since regional implementation is a new approach , Health Directors ’ Region 7 decided to hire Regional Coordinators and a Facilitator to develop regional strategies Year one of the Community Transformation Implementation Plan CTIP was initiated in the fall of 2012 Emerging Issues Decrease in the Drop - Out Rate Adults who do not graduate from high school are more likely to suffer from chronic illnesses and engage in risky behaviors according to the Institute of Medicine Johnston County Schools , with the initiation of outreach programs targeted to at risk students , has decreased the drop - out rate from 328 in 2010 - 11 to 264 in 2011 - 12 A continued decrease in the drop - out rate and improved graduation rate will positively affect the social determinants of health and improve the overall health status of the county County Hospital System Affiliation Johnston Health , Johnston County’s hospital system , is currently seeking an affiliation partnership to prepare for changes in the healthcare industry The Johnston Health Board of Commissioners is seeking to partner with a larger healthcare system while retaining a majority voice in decision making Currently , the system includes Johnston Medical Center - Smithfield , Johnston Medical Center - Clayton , primary care offices in Kenly and Clayton , and an urgent care center in Smithfield With this new partnership , access to healthcare services and the types of services available in Johnston County could be enhanced Members of the community are welcome to participate on any committee with a focus on improving the health of the citizens of Johnston County If anyone is interested they can visit the website with meeting dates and locations for the different coalitions Interested parties may contact the Health Education Department at 919 - 989 - 5200 Page212 Data Sources 1 US Census Bureau 2011 American Community Survey 1 - Year Estimates ACS Demographic and housing estimates Johnston County , North Carolina http factfindercensusgov 2 North Carolina Employment Security Commission Civilian Labor Force Estimates for NC Counties for 2011 http wwwncesccom lmi workForceStats workForceMainasp 3 North Carolina State Center for Health Statistics 2010 Leading Causes of Death in North Carolina http wwwschsstatencus schs data lcd getleadcausescfm 4 Centers for Disease Control and Prevention 2012 Chronic Disease and Health Promotion http wwwcdcgov chronicdisease overview indexhtm 5 North Carolina Health Professions Data System 2011 Health Professionals - State and County Totals http wwwshepscenteruncedu hp prof2011 htm 6 North Carolina State Center for Health Statistics 2010 BRFSS Survey Results North Carolina Counties and Regions Derived Variables and Risk Factors http wwwschsstatencus schs brfss 2010 nc nccr rf2 html 7 North Carolina State Center for Health Statistics 2010 BRFSS Survey Results North Carolina Counties and Regions Exercise http wwwschsstatencus schs brfss 2010 nc nccr exerany2 html 8 North Carolina State Center for Health Statistics 2009 BRFSS Survey Results North Carolina Counties and Regions Fruit and Vegetable http wwwschsstatencus schs brfss 2009 nc nccr _FV5SRVhtml 9 Clayton Parks and Recreation Phone Communication 2012 , November 16 , with Larry Bailey , Director Clayton Parks and Recreation 10 North Carolina State Center for Health Statistics 2010 BRFSS Survey Results North Carolina Counties and Regions Diabetes http wwwschsstatencus schs brfss 2010 nc nccr diabete2 html 11 North Carolina State Center for Health Statistics 2010 BRFSS Survey Results North Carolina Counties and Regions Pre - diabetes http wwwschsstatencus schs brfss 2010 nc nccr PREDIAB1 html 12 Johnston County Public Health Department Email Communication 2012 , November 16 , with Sherry Creech RN , Primary Care Manager 13 Johnston County Department of Social Services Phone Communication 2012 , November 20 with Tina Corbett , Deputy Director 14 Johnston Health Phone Communication 2012 , November 20 with Patsy Stewart RN 15 County Health Rankings Summary May 2012 Johnston , NC http wwwjohnstonnccom files health CHealthRank2012 pdf 16 US Census Bureau , American FactFinder 2011 Estimate of Uninsured Johnston County , NC http factfinder2 censusgov faces tableservices jsf pages productviewxhtml pid ACS_11_1YR_C P03 & prodType table 17 US Census Bureau , American FactFinder 2011 Estimate of Persons Below Poverty Level Johnston County , NC http factfinder2 censusgov faces tableservices jsf pages productviewxhtml pid ACS_11_1YR_D P03 & prodType table 18 Employment Security Commission of NC Annual Unemployment Rate http eslmi03 escstatencus ThematicLAUS clfasp CLFSAAYResultsasp 19 Johnston Health Phone Communication 2012 , November 19 with Georgia Anthony , Director of Project Access 20 CommWell Health Background and History http wwwcommwellhealthorg historyhtml 21 State Center for Health Statistics Mortality Statistics Summary for 2010 Johnston County , NC http wwwschsstatencus schs deaths lcd 2010 breastcancerhtml Page313 22 UNC Highway Safety Research Center Phone & Email Communication 2012 , November 16 , with Eric Rodgman , Senior Database Analyst 23 Partnership for Children of Johnston County Email Communication 2012 , November 28 , with Christina Petersen , Safe Kids Johnston County Coordinator 24 Triangle J Area Agency on Aging Email Communication 2012 , November 21 , with Jane Armstrong Page