2015 State of the County Health Report

10 State of the County Health Report SOTCH Johnston County North Carolina Johnston County Public Health Department 2015 Table of Contents Demographics 2 He alth and Medical 3 Access to Care 5 Cancer 6 Injury Prevention 7 Obesity 9 Sexually Transmitted Infections 8 Physical Activity 10 Nutrition 10 New Initiatives and Emerging Issues 11 Data Sources 12 Electronic copies of this document and other Johnston County health reports are available on our website wwwjohnstonnccom 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 addi tion , this report serves as a resource for grant application , policy development , financial planning and program implementation Priority Health Issues Identified from the 2014 Community Health Assessment ? Access to Care Medical and Behavioral ? Obesit y ? Physical Activity and Nutrition 517 N Bright Leaf Blvd Smithfield , NC 27577 Phone 919 989 - 5200 Marilyn Pearson , MD Health DirectorPageInside the SOTCH Every four years the state of North Carolina requires each local health department to conduct a com munity 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 re sponsible for submitting the state of the county health SOTCH report to the North Carolina Division of Public Health Johnston County Public Health Department completed the Community Health Assessment CHA in 2014 To access the 2014 CHA document visi t wwwjohnstonnccom The submission of the 2015 SOTCH addresses the most current data related to each priority health issue along with a summary of progress to date Although , this report is a reflection of year s 2014 - 2015 , there are some categories where the most current data available is from earlier years Johnston’s Demograp hic and Economic Summary 2014 Johnston County Demographic Estimates 1 Sex Estimate Percent Male 87,830 484 Female 93,593 516 Race Estimate Percent White 139,514 769 Black or African American 26,861 148 American Indian or Alaska Native 1,080 06 Asian 1,592 09 Native Hawaiian or Other Pacific Islander 0 0 Ethnicity Estimate Percent Hispanic any race 24,257 134 Non - Hispanic or Latino 157,166 866 Total Population 181,423Page52,867 31,109 64,609 32,838 0 10,000 20,000 30,000 40,000 50,000 60,000 70,000 Population Age 2014 Johnston County Population by Age 1 Population 0 - 19 Population 20 - 34 Population 35 - 59 Population 60 and over Health and Medical Care Overview of Leading Causes of Death Cancer was the leading cause of death in Johnston County and North Carolina in 2014 Cancer affects pe ople of all genders , ages , races and ethnic groups Cancer is a group of more than 100 different diseases , but all are characterized by uncontrolled growth and spread of abnormal cells 5 In 2016 , an estimated 973 projected new cases of cancer and 326 pro jected deaths will occur in Johnston County 6 Early detection and prevention are the two most effective ways to decrease the cancer death rate Trachea , bronchus and lung cancer have the highest mortality rate in Johnston County during 2014 For all c ancer deaths , the rate for Johnston C ounty was 1681 compared to North Carolina’s rate of 1941 7 Contributing to most of these deaths are lifestyle behaviors such as tobacco use , alcohol consumption , lack of physical activity , poor nutrition and substance abuse 2014 Mortality Statistics Johnston County Residents vs North Carolina 8,9 , 10,11,12 Johnston County Number of Deaths Johnston County Death Rate NC Number of Deaths NC Death Rate Colon Rectum , and Anus Cancer 21 116 1,625 163 Trachea , Bron chus , and Lung Cancer 93 513 5,602 563 Female Breast Cancer 22 238 1,308 257 Prostate Cancer 9 101 900 186 Cancer - All Sites 305 1681 19,301 1941Page0 20 40 60 80 100 120 140 160 180 Rate per 100,000 Cause of Death Johnston County Leading Causes of Death 2014 2,3 Cancer Diseases of heart Chronic lower respiratory diseases Cerebrovascular diseases Nephritis , nephrotic syndrome and nephrosis All other unintentional injuries Alzheimer’s disease Intentional self - harm suicide Motor vehicle injuries Diabetes mellitus 2013 Johnston County Health Professionals per 10,000 population 4 P hysicians 733 Primary Care Physicians 389 Dentists 197 Registered Nurses 4219 Pharmacists 728 Economic Glimpse ? The unemployment rate has decrease d from 104 in 2013 to 7 in 2014 13 ? In 2014 , 10 , 213 households received food stamps SNAP benef its 14 ? In 2014 , 153 of the Johnston County population was below poverty , compared to 168 in 2013 15,16PagePage pageNumber5Access to Health Care Healthy North Carolina 2020 Objective Reduce the percentage of non - elderly uninsured individuals aged less than 65 yea rs According to the American Community Survey for 2014 , an estimated 200 of adults 18 - 64 years old in Johnston County are uninsured 17 Access to h ealth insurance is a factor when considering medical care Those who are uninsured or underinsured are more likely to report barriers to care Regular preventive care can create better health outcomes ; consequently uninsured patients are less like ly to recei ve preventive care While we are not able to impact the number of insured individuals , our goal is to provide medical care to the uninsured , underinsured and promote Affordable Care Act Marketplace enrollment In 2014 , the re were 139 of the population under 65 in Johnston County which is slightly lower than North Carolina rate of 198 18 Percent of population under age 65 without health insurance Johnston Wayne Union Harnett Wilson 2014 139 158 11 134 177 2013 168 141 139 159 19 Source Chart Data http factfindercensusgov faces tableservices jsf pages productviewxhtm l pid ACS_12_1YR_DP03 & prod_Typ e table 2014 2013 Johnston County Community Health Assessment Action Plan ? Increase the number of HealthNet providers and dental providers providing service to Johnston County residents ? O ffer Health Literacy workshops an d distribute a local resource guide to members of the Johnston County community to increase the ir knowledge regarding navigat ion of their healthcare system ? Establish a community transportation committee to explore options and possible solutions to improve health related transportation in Johnston County ? Expand access to Marketplace enrollment navigators and Certified Application Counselors in Johnston County ? M entor high school and college level students to increase the interest in becoming a Johnston Cou nty provider PagePage pageNumber6Progress to Date 01 2015 Community Health Assessment Committee developed focus areas for 2014 - 2018 based on demographics , County Health Rankings , 2014 SOTCH , community input and review of county strengths and challenges The committee selected 1 Access to Care Medical and Behavioral Health 2 Obesity and Overweight 3 Nutrition and Physical Activity as our priority areas 05 2015 Project Access Clinic held at Johnston County Public Health Department During the clinic HealthNe t providers provided medical care to patients 07 2015 Community Health Assessment Steering Committee participated in the 2014 - 2018 Action Plan Workgroup Meeting During this meeting details about how to address our three priority areas were outlined 08 2015 The Action Plans were finished and ready for review by the Action Teams 08 2015 All three Action Plans were sent to the Action Teams for review electronically 10 2015 The Access to Care Action Team met to discuss their interventions , updates a nd action items November 1 - January 31 , 2016 is the Affordable Care Act ACA open enrollment period Expanding access to navigators and dissemination of educational materials for open enrollment for ACA were discussed Draft Health Literacy documen ts were shared and later approved by the group for distribution to the local community The Health Related Transportation Committee had met with Johnston County Area Transit System , Johnston County Department of Social Services , Commwell Health , Benson Area Medical Center and Wake County Transportation to gain new information regarding barriers Cancer Healthy People 2020 Objective Increase the proportion of women who receive a breast cancer screening based on the most recent guidelines The current focus is to increase the number of women who are receiving breast cancer screenings Progress on this objective is being made through outreach and education in Johnston County The 2015 County Health Rankings indicate of the 1,465 Medicare enrollees in Johnston County , 691 of them have received at least one m ammogram over a two year period 19 The breast cancer mortality rate in Johnston County is 215 compared to North Carolina at 216 20 It is recommended that women who are 50 - 74 years old have a sc reening mammogram every two years PagePage pageNumber7B elow is a table comparing Johnston County to peer county data related to breast cancer deaths 0 10 20 30 Rate County 2010 - 2014 Breast Cancer Mortality Rates per 100,000 Population North Carolina Johnston Harnett Union Wayne Wilson Chart Source Data http wwwschsstatencus schs CCR mort1014cntypdf Injury Preventi on Healthy People 2020 Objective Reduce motor vehicle crash related deaths Objective Increase age - appropriate vehicle re straint system use in children JoCo Johnston County Teen Drivers was created in 2007 to address the number of teen driving deaths in Johnston County Every high school in Johnston County has a JoCo Teen Driving group that creates peer - to - peer educational activities for the students The focuses of these activities are parent involvement , seat - belt use , decreas ing speed , avoiding d istractions , limiting passengers and caution at intersections Seventy - five percent of Johnston County’s fatalities were speed related and 100 of them occurred on 2 lane road s 24 The JoCo Teen Driver’s peer - to - peer education is bringing awareness to all Johnston County drivers while decreasing fatalit ies In Johnston County , 108 s eat c hecks were done through permanent checking stations 94 of the 108 seats were found to be installed incorrect ly and 86 seats were replaced There were two special events held and 35 seats were checked Of the 35 checked seats , 28 were installed incorrect ly and 13 seats were replaced The Child Restraint Diversion program serviced 30 individuals and 35 total seats were checked In 2015 , Safekids of Johnston County held four events to address bike pedestrian safety , fire prevention , poison prevention or other safety needs and there are 39 nationally certified C hild P assenger S afety T echnicians in J ohnston C ounty 27PagePage pageNumber8Johnston County Yearly Ranking Teen Fatalities Year R ank Total 2013 6 th 1 2014 3 rd 6 2015 5 th 2 Sexually Transmitted Infections The Centers for Disease Control identify Chlamydia as the most frequently report ed sexually transmitted infection in the United States 21 In 2015 , there were 731 cases of Ch lamydia reported in Johnston County 22 Chlamydia is usually asymptomatic in women Human Papillomavirus HPV , Human Immunodeficiency Virus HIV , Herpes and Hepatitis are viruses Although there are no cures , there are treatments and targeted education for prevention Sexually Transmitted Infection Cases in Johnston County 2013 2014 2015 Gonorrhea 117 109 190 Chlamydia 550 493 731 Source Data http epipublichealthncgov cd stds figures vol15no4 pdf 2015 HIV and AIDS Diagnosis HIV Disease First Diagnosis AIDS Diagnosis Johnston 13 10 Harnett 12 9 Union 16 7 Wayne 14 6PagePage pageNumber9Wilson 9 10 Source Data http epipublichealthncgov cd stds figures vol15no4 pdf Obesity Healthy NC 2020 Objective Increase the percentage of adults who are neither ov erweight nor obese Objective Increase the percentage of adults getting the recommended amount of physical activity Objective Increase the percentage of adults who consumed five or more serving s of fruits and vegetables Overweight and obesity are not o nly risk factors for several serious diseases , but may also complicate existing conditions In 2015 , North Carolina County Health Rankings indicate 34 of Johnston County residents report a Body Mass Index BMI of 30 or more 23 and 27 of adults aged 20 an d over report no leisure - time physical activity 25 Childhood obesity is also a priority for Johnston County Johnston County Community Health Assessment Action Plan ? Increase the number of early childhood education centers who offer healthy eating and ph ysical activity education programming to improve fruit and vegetable intake and increase exposure to physical activity ? Increase the number of local food pantries who offer nu trition education and food demonstrations to improve self - efficacy in choosing an d preparing foods that are healthier food choices ? Increase the number of opportunities for worksite wellness as it relates to obesity by encouraging healthy weight management or weight loss Progress to Date 11 2015 A display board was made to announce the Eat Smart Move More Holiday Challenge at the Johnston County Public Health Department This is one worksite wellness activity that relates to obesity Page011 2015 The Johnston County Public Health Department Staff were invited to participate in the web - based Eat Smart , Move More Holiday Challenge which ended 12 31 15 Johnston County ranked 10 th in the state with 123 participants 29 11 2015 Johnston County Food Council Taskforce is a new initiative that is working to create accessible local food system options to individuals a nd families in Johnston County 12 2015 Johnston County Food Council Taskforce narrow ed down specific objectives based on current stakeholders ’ interests Nutrition and Physical Activity Healthy NC 2020 Objective Increase the percentage of adults getting the recommended amount of physical activity Nutrition and physical activity impact obesity rates Physical inactivity , unhealthy eating , meals eaten away from home , portion sizes , soft drink consumption and screen time a re some of the key behaviors that are associated with obesity According to the Behavioral Risk Factor Surveillance System in 2014 , 814 of Region 7 Edgecombe , Franklin , Granville , Halifax , Johnston , Nash , Wake , Vance , Warren , Wilson counties compared to 768 of North Carolina residents participated in any physical activities or exercise such as running , calisthenics , and golf , gardening or walking for exercise in the past month 26 Participating in physical activity has many benefits which include ma intaining weight , reducing high blood pressure , reducing the risk of type 2 diabetes , heart attack , stroke and reducing symptoms of depression anxiety According the to the Centers for Disease Control and Prevention CDC c hildren and adolescents should p articipate in 60 minutes or more of physical activity each day while adults need at least 2 hours and 30 minutes 150 minutes of moderate intensity aerobic activity and muscle strengthening activities If you are over 65 years of age , are generally fit a nd have no limiting health conditions then at least 2 hours and 30 minutes 150 minutes of m oderate intensity aerobic and muscle strengthening activities are recommended Eat Smart Move More is a statewide m ovement that promotes increase d opportunities for health y eating and physical activity wherever people live , learn , earn , play and pray In Region 7 , 322 of people had heard of Eat Smart , Move More North Carolina which is slightly higher than the state’s 311 Johnston County Community Health Assessment Action Plan ? To implement a walking campaign Walk More , Connect More ? Increase access to healthy foods via school gardens ? Increase the number of elementary schools participating in Active Routes to Schools ARTS ActivitiesPage1Progress to Date 02 2015 Planning meetin g for the 2015 Walk for Health Bike Rodeo Community Event 03 2015 East Clayton Elementary School g arden activities such as planting vegetables in garden and n utrition e ducation offered during the salad celebration 04 2015 County - Wide Walk for Health Bike Rodeo Event at East Clayton Community Park 05 2015 East Clayton Elementary , Four Oaks Elementary and Powhatan Elementary School s Bike to School Events 07 2015 Regional Staff h osted and attend ed the Let’s Go NC regional tr aining 07 2015 Active Routes to School Event at a Clayton Summer Camp which includ ed a Bike Rodeo New Initiatives and Emerging Issues ? Project Lazarus is a new initiative that focuses on reducing the number of deaths from opio id overdose Johnston Cou nty EMS ha d an estimated 200 encounters in which naloxone was used during 2015 28 In 2015 , approximately 357 Johnston County residents were treated throughout the state for medication or drug overdose 28 Project Lazarus aims to educate the community on p reventing , recognizing and managing opioid overdose , increasing medication disposal and increasing the number of people who are able to respond to an opioid overdose As a part of Johnston County’s initiative , a meeting to discuss use of naloxone with loc al law enforcement was arranged with plans to implement the use of kits in 2016 An educational pamphlet to inform the public and those at risk about availability of naloxone kits is being developed for distribution ? Community Paramedic Program - Johnston UNC Healthcare was awarded a Duke Endowme nt grant and partnered with Johnston EMS to initiate the community paramedic program Funding for the program started November 2014 and runs through November 2016 The grant covers fuel , medical supplies , equipmen t , laptop computers and the salary for two paramedics The program goal is to connect patients with community resources , navigating the healthcare system , and any other needs that they may have There are three target populations Hospital discharges with a chief diagnosis of congestive heart failure CHF , chronic obstructive pulmonary disease COPD , or diabetes mellitus DM ; Johnston County Citizens with 4 or more 911 utilizations within 30 days res ulting in an ambulance dispatch ; and 7 or more E mergen cy D epartment ED utilizations in a 6 month period As of February 2016 , this program has reached 214 clients and is expected to greatly decrease non - emergency room visits to the ED T he program serves as a mobile office and reaches out to community memb ers who have issues with lack of insurance and problems with tra nsportation Page2Data Sources 1 US Census Bureau American Fact Finder 2014 American Community Survey 1 - Year Estimates ACS Demographic and Housing Estimates Johnston County , North Carolina http factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_12 _1YR_DP05 & prodType table 2 North Carolina State Center for Health Statistics 2014 Leading Causes of Death in North Carolina http wwwschsstatencus interactive query lcd getleadcausescfm 3 North Carolina Vit al Statistics 2014 Leading Causes if Death Volume 2 , October 2015 http wwwschsstatencus data vital lcd 2014 pdf Vol2_2014_PRTpdf 4 UNC The Cecil G Sheps Cente r for Health Services Research North Carolina Health Professionals 2013 Data Book http wwwshepscenteruncedu wp - content uploads 2015 05 2013 - HPDS - DataBo okpdf 5 State Center for Health Statistics North Carolina Central Cancer Registry Johnston County Cancer Profile October 2015 http wwwschsstatencus schs CCR cp20 15 Johnston_CP_2015 pdf 6 State Center for Health Statistics North Carolina Central Cancer Registry Projected New Cancer Cases and Deaths for Selected Sites by County 12 2015 http www schsstatencus schs CCR proj16copdf 7 North Carolina State Center for Health Statistics Mortality Statists Summary for 2014 North Carolina Residents Cancer All Sites http wwwschsstatencus data vital lcd 2014 cancerhtml 8 North Carolina State Center for Health Statistics Mortality Statists Summary for 2014 North Carolina Residents Cancer Colorectal http wwwschsstatencus data vital lcd 2014 colorectalhtml 9 North Carolina State Center for Health Statistics Mortality Statists Summary for 2014 North Carolina Residents Cancer All Sites http wwwschsstatencus data vital lcd 2014 cancerhtml 10 North Carolina State Center for Health Statistics Mortality Statists Summary for 2014 North Carolina Residents Cancer Prostate http wwwschsstatencus data vital lcd 2014 prostatehtmlPage311 North Carolina State Center for Health Statistics Mortality Statists Summary for 2014 North Carolina Residents Cancer Breast Cancer http wwwschsstatencus data vital lcd 2014 breastcancerhtml 12 North Carolina State Center for Health Statistics Mortality Statists Summary for 2014 North Carolina R esidents Cancer Lung http wwwschsstatencus data vital lcd 2014 lunghtml 13 US Census Bureau American Fact Finder 2014 American Community Survey 1 - Year Estimates Employme nt Status Johnston County , North Carolina http factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS _14 _1YR_CP03 & prodType table 14 US Census Bureau American Fact Finder 2014 American Community Survey 1 - Year Estimates Receipt of Food Stamps SNAP in the Past 12 Months by Poverty Status in the Past 12 Months for Households Johnston County , North Carol ina http factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_14 _1YR_B22003 & prodType table 15 US Cen sus Bureau American Fact Finder 2014 American Community Survey 1 - Year Estimates Poverty Status in the Past 12 Months Johnston County , North Carolina http factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_14 _1YR_S1701 & prodType table 16 US Census Bureau American Fact Finder 2013 American Community Survey 1 - Year Estimates Poverty Status in th e Past 12 Months Johnston County , North Carolina http factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_14 _1YR_S1701 & prodType table 17 US Census Bureau American Fact Finder 2014 American Community Survey 1 - Year Estimates Health Insurance coverage Status Johnston County , North Carolina http factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_14 _1YR_S2701 & prodType table 18 US Census Bureau American Fact Finder 2014 American Community Survey 1 - Year Estimates Selected Economic Characteristics Johnston County , North Carolina http factfindercensusgov faces tablese rvices jsf pages productviewxhtml pid ACS_12 _1YR_DP03 & prod_Type table 19 County Health Rankings & Roadmaps North Carolina , Johnston County Snapshot http wwwcountyhealthrankingsorg app north - carolina 2015 rankings johnston county outcomes overall snapshotPage420 NC Central Cancer Registry 2010 - 2014 Cancer Mortality Rates by County for Selected Sites per 100,000 Population Age Adjus ted http wwwschsstatencus schs CCR mort1014cntypdf 21 Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report MMWR Prevalence of Chlamydia trachomatis Genital Infection Among Persons Aged 14 - 39 Years United States September 2014 http wwwcdcgov mmwr preview mmwrhtml mm6338a3 htm3 22 Communicable Disease Branch Epidemiology Section North Carolina HIV STD Quarter Surveillance Report Vol 2015 No 4 http epipublichealthncgov cd stds figures vol15no4 pdf 23 County Health Rankings & Roadmaps Adult Obesity North Carolina , Johnston County http wwwcountyhealthrankingsorg app north - carolina 2015 measure factors 11 map 24 Johnston County Teen Crash Data 2011 - 2 015 Email Communication 2016 February 26 , with Jaime Long , JoCo Teen Drivers Committee Member Johnston County Human Resources 25 County Health Rankings & Roadmaps Physical Activity North Carolina , Johnston County http wwwcountyhealthrankingsorg app north - carolina 2015 measure factors 70 map 26 North Carolina State Center for Health Statistics 2014 BRFSS Survey Results http wwwschsstatencus data brfss 2014 nc nccr exerany2 html 27 Child Passenger Safety & Child Restraint Diversion Statistics 2014 Email Communication 2016 February 22 , Jennifer Williams , Special P rojects Coordinator Partnership for Children of Johnston County 28 Project Lazarus Data Breakdown January 2016 Email Communication 2016 March 01 , with Kimberly Johnson MD , Project Lazarus Coordinator Johnston County Behavioral Health 29 Eat Smart Mo ve More Holiday Challenge Report 2015 Email Communication 2016 January 27 with Madison Johnson , Eat Smart Move More Weigh Less Specialist NC State University Page