2017 State of the County Health Report

10 State of the County Health Report SOTCH 2017 Johnston County North Carolina 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 Table of Contents addition , this report serves as a resource for grant application , policy development , financial planning and Demographics 2 program implementation Health and Medical 3 Cancer 4 Injury Prevention 5 Priority Health Issues Sexually Transmitted Infections 5 Identified from the 2014 Community Health Assessment Access to Care 6 Obesity 8 • Access to Care Medical and Behavioral Physical Activity 10 • Obesity Nutrition 10 • Physical Activity and Nutrition New Initiatives and Emerging Issues 11 Data Sources 12 Johnston County Public Health Department Electronic copies of this document and other Johnston County health reports are available on our website 517 N Bright Leaf Blvd wwwjohnstonnccom 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 county health department 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 2014 To access the 2014 CHA visit wwwjohnstonnccom The submission of the 2017 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 2016 - 2017 , there are some categories where the most current data available is from earlier years Johnston’s Demographic and Economic Summary 1 2016 Johnston County Demographic Estimates Sex Estimate Percent Male 89,432 491 Female 92,723 509 Race Estimate Percent White 142,427 782 Black or African American 27,836 153 American Indian or Alaska 962 05 Native Asian 1,179 06 Native Hawaiian or Other 26 0 Pacific Islander Ethnicity Estimate Percent Hispanic or Latino any race 23,824 131 Non - Hispanic or Latino 158,331 869 Total Population 182,155 - 2 -PageHealth and Medical Care Overview of Leading Causes of Death The 2016 leading cause of death in Johnston County was diseases of the heart There were 7 1,496 total deaths in Johnston County Of which diseases of the heart was responsible for 352 nd deaths or 235 The 2 leading cause of death is cancer , which lead to 329 deaths or 22 of 8 total deaths Trachea , bronchus and lung cancers have the highest mortality rate in Johnston 2 County at 611 The rate for all cancer deaths in Johnston County has decreased from 1847 5,6 in 2015 to 1718 in 2016 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 2,3,4,5 2016 Cancer Mortality Statistics Johnston County Residents vs North Carolina Johnston County Johnston County NC Number of NC Number of Deaths Death Rate Deaths Death Rate Colon Rectum , and Anus Cancer 39 204 1,611 159 Trachea , Bronchus , and Lung 117 611 5,576 55 Cancer Female Breast Cancer 14 143 1,319 253 Prostate Cancer 12 128 936 19 Cancer - All Sites 329 1718 19,526 1924 - 3 -PageEconomic Glimpse • In 2016 , there were an estimated 66,254 total households , a 345 increase from last 9 year Of those households , 139 or 9,194 were receiving food stamps SNAP 10 • The unemployment rate decreased from 52 in 2015 to 49 in 2016 • In 2016 , 146 of the Johnston County population was below the poverty level , 11,12 compared to 154 in 2015 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 through outreach and education in Johnston County According to the 2017 County Health Rankings , 686 of Johnston County Medicare enrollees have received at least one 15 mammogram over a two year period The 2016 breast cancer mortality rate in Johnston 3 County is 143 compared to North Carolina at 253 It is recommended that women who are 50 - 74 years old have a screening mammogram every two years 3 Table Johnston County and peer county data related to 2016 breast cancer deaths County 2016 Number of Deaths Number of Deaths Death Rate 2016 2012 - 2016 Johnston 143 14 99 Craven 293 15 74 Davidson 261 22 127 Harnett 242 16 58 Randolph 33 24 95 Union 243 28 114 Wayne 348 22 89 Wilson 233 10 64 - 4 -PagePage pageNumber5Injury Prevention Healthy People 2020 Objective Reduce motor vehicle crash related deaths Objective Increase age - appropriate vehicle restraint 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 , decreasing speed , avoiding distractions , limiting passengers and caution at intersections Fifty - eight percent of Johnston County’s fatalities 16 were speed related and 92 of them occurred on 2 lane roads The JoCo Teen Driver’s peer - to - peer education is bringing awareness to all Johnston County drivers while decreasing fatalities Johnston County Yearly Ranking Teen Fatalities Year Rank Total th 2016 7 1 th 2017 4 2 Sexually Transmitted Infections Chlamydia is the most common disease in the United States and the most prevalent of all STDs 17 as identified by the Centers for Disease Control Chlamydia infection is often mildly symptomatic to asymptomatic If left untreated in women it may lead to infertility , pelvic inflammatory disease PID or problems during pregnancy Cases of Chlamydia continue to 18 increase from 727 in 2016 to 795 in 2017 In 2016 , 14 cases of HIV were diagnosed and in 2017 there 9 There has also been a slight decrease in AIDS diagnosis from 9 in 2016 to 5 in 2017 The Johnston County Public Health Department continues to offer screening and treatment for sexually transmitted infections Sexually Transmitted Infection Cases in Johnston County 2015 2016 2017 Gonorrhea 196 223 254 Chlamydia 715 727 795 Source Data http epipublichealthncgov cd stds figures vol17no4 pdf - 5 -PagePage pageNumber62017 HIV and AIDS Diagnosis County HIV Disease First Diagnosis AIDS Diagnosis Johnston 9 5 Craven 4 2 Harnett 14 8 Randolph 6 2 Union 16 9 Wayne 16 8 Wilson 14 6 Source Data http epipublichealthncgov cd stds figures vol17no4 pdf Access to Health Care Healthy North Carolina 2020 Objective Reduce the percentage of non - elderly uninsured individuals aged less than 65 years An estimated 173 of adults 18 - 64 years old were uninsured during 2016 compared to 165 13,14 in 2015 There were 2,982 youth under the age of 18 uninsured as well in 2016 Access to comprehensive , quality healthcare services is important for the achievement of health equity and for increasing the quality of life for the community https wwwhealthypeoplegov 2020 topics - objectives topic Access - to - Health - Services Access to healthcare can impact overall physical , social and mental health status and can have a positive effect on prevention of disease , disability , preventable death and life expectancy By increasing access to health care , we can reduce health disparities 2015 and 2016 Health Insurance Coverage Estimates 13,14 18 - 64 Years Old Uninsured County 2015 2015 2016 2016 Uninsured Uninsured Uninsured Uninsured Johnston 18,405 165 20,117 173 Craven 9,381 167 8,774 159 Davidson 16,118 161 16,769 172 Harnett 12,853 176 11,371 151 Randolph 17,794 208 17,303 202 Union 17,983 134 15,330 113 Wayne 11,678 16 15,269 213 Wilson 8,983 185 7,787 162 - 6 -PagePage pageNumber7Johnston County Community Health Assessment Action Plan • Increase the number of HealthNet providers and dental providers providing service to Johnston County residents • Offer Health Literacy workshops and distribute a local resource guide to members of the Johnston County community to increase their knowledge regarding navigation 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 • Mentor high school and college level students to increase the interest in becoming a Johnston County provider Progress to Date • Johnston County Public Health Department continues to support local Physician Assistant and Family Nurse Practitioner Students In addition , Benson Area Medical Center has two college students participating in the MedServe program • Johnston County Public Health Department hosted Affordable Care Act Enrollment Events in the spring and fall • Bentonville Church of Disciples Church held their first Health Literacy Workshop The workshop included activities and review of their insurance card • The Transportation Committee discussed and reviewed a survey analysis It was determined that an additional survey needed to be completed Members met with stakeholders to review options for transportation within the county • Commwell Health not - for - profit , Federally Qualified Health Center offered a Health Literacy Workshop • Delightful Temple Ministries offered Health Literacy information and resources during their Family Festival Career and Health Day Event • Johnston County Faith Network Collaborative met quarterly and provided guest speakers and health literacy materials as resources for participants to be shared with their congregations • Enrollment navigators are available bimonthly at the Project Access Office in Smithfield to provide assistance with insurance enrollment - 7 -PagePage pageNumber8Obesity Healthy NC 2020 Objective Increase the percentage of adults who are neither overweight nor obese Objective Increase the percentage of adults who are getting the recommended amount of physical activity Objective Increase the percentage of adults who consumed five or more servings of fruits and vegetables Adult obesity is often the result of poor diet and limited physical activity Obesity is a risk factor for heart disease , diabetes , cancer and other diseases and may complicate these conditions The 2017 , County Health Rankings indicate 36 of Johnston County adult residents are obese , reporting a Body Mass Index BMI of 30 or more , compared to 30 of adults in North 19 Carolina In Johnston County 309 of children ages 10 - 17 years old are overweight or obese 23 in 2016 Twenty six percent of adults aged 20 and over report no leisure - time physical activity , an increase from the previous year The Johnston County team chose to focus on prevention of obesity in young children and lifestyle modification programs in adults Johnston County Community Health Assessment Action Plan • Increase the number of early childhood education centers who offer healthy eating and physical activity education programming to improve fruit and vegetable intake and increase exposure to physical activity • Increase the number of local food pantries who offer nutrition education and food demonstrations to improve self - efficacy in choosing and 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 programs Progress to Date • Micro Original Free Will Baptist Church began and completed the Faithful Families Eating Smart Moving More program • Four Oaks United Methodist Church began and completed the Faithful Families Eating Smart Moving More program • Offered nutrition education to the local population at the Smithfield Ham and Yam Festival - 8 -PagePage pageNumber9• Nutrition education materials were offered to the general public during the Clayton Harvest Festival • Smithfield Senior Center offered Healthy Eating education to participating seniors • Brighter Hope Christian Fellowship Church offered nutrition education during their health fair • Selma Railroad Days and Benson Healthy Harvest offered opportunities to discuss nutrition education to adults and youth • Selma , Princeton and Clayton Senior Centers offered Nutrition education to their seniors • Cooperative Extension agent held an information session for Local Government staff about how to read food labels and making healthy food choices • St John AME Church held an information session on healthy eating and the benefits of being physically active • Seven worksites in Johnston County are now participating in worksite wellness programs and offering healthy food choices and on - site options to increase physical activity • Johnston County Government offers programs to employees to promote healthy eating and increased physical activity • Johnston Health completed ScoreCard in 2017 and participated with JOCO Health Department in the National Walk to Work Day event in April Enhanced walking trail for employees at Johnston Health through ODHDSP funds and provided environmental supports for physical activity within the workplace • Partnered with Liberty Commons in Benson , NC to work on employee wellness initiatives , to expand upon the Liberty Healthcare Corporate Employee Wellness Initiative on a more localized level ODHDSP Worksite Wellness Coordinator in process of providing agency signage and walking route maps for walking routes around the facilities , as well as health education resources employer can use for employee wellness challenges • Johnston Community College completed the CDC ScoreCard in April 2017 ODHDSP Worksite Wellness Coordinator worked with the JCC HR Department and wellness committee to enhance the walking routes around the campus through signage and benches , as well as provided additional environmental supports for physical activity including desk pedals and resistance bands , and provided a water bottle refill station for the campus to increase healthier beverage intake among staff and students • Continue to partner with Town of Smithfield on employee wellness and enhancing their current programs Provided town with a bike repair station for their green - way to offer equipment needed for any bike repairs on the local greenway in Smithfield , available for community use - 9 -Page0• Began partnership with South Smithfield Elementary School through connection made through the ARTS grant to assist in creation of an employee wellness program Partnership established in December 2017 , efforts on - going ODHDSP staff are in process of analyzing employee interest surveys to help with planning and creating a wellness program for staff • Partnership continues with Town of Clayton , assisting with adjusting their employee wellness annual action plan to focus more efforts from high blood pressure to physical activity Nutrition and Physical Activity Healthy NC 2020 Objective Increase the percentage of adults getting the recommended amount of physical activity Regular physical activity and healthy eating play an important role in promoting healthy weight Engaging in physical activity has many benefits including maintaining a healthy weight , reducing the risk of cardiovascular disease , some cancers and type 2 diabetes , and increases the chances of longer life According to the Behavioral Risk Factor Surveillance System in 2016 , 816 of Region 7 Edgecombe , Franklin , Granville , Halifax , Johnston , Nash , Wake , Vance , Warren , Wilson counties compared to 767 of North Carolina residents participated in any physical activities or exercises such as running , calisthenics , golf , gardening , or walking for exercise in 20 the past month Lack of physical activity can contribute to feelings of depression and anxiety , obesity , and is a leading cause of preventable death According to the CDC , only half of adults get the physical activity they need to help reduce and prevent chronic diseases For adults and generally fit adults above the age of 65 , the CDC recommends 150 minutes of moderate intensity aerobic activity and muscle - strengthening activities a week Children and adolescents are recommended to participate in 60 or more minutes of physical activity and muscle 21 strengthening at least 3 days a week Eat Smart Move More Weigh Less ESMMWL is a evidence - based statewide movement that promotes increased opportunities for healthy eating and physical activity wherever people live , learn , earn , play and pray In 2017 , 206 Johnston 22 County participants registered for the ESMMWL program 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 Activities - 10 -Page1Progress to Date • Johnston County Farm and Food Council attended the Farm Service Agency NC Agricultural Market Summit and discussed and developed ways to outreach and educate youth and adults about nutrition and farming • Johnston County Farm and Food Council offered a movie viewing to the local community to gain new interest in supporting local farms • Active Routes to Schools ARTS participated in the 2017 Health and Safety Fair to promote and share information regarding physical activity Seven Bike to School Day and six Walk to School Day Events were held in Johnston County • Established a Walk with the Doc program hosted monthly with Dr Pearson and open to all county agencies and expanded to community in 2018 Monthly walks that include a health topic discussion before the walk New Initiatives and Emerging Issues The opioid crisis has reached national , state , and local epidemic levels In 2016 , Johnston County had 24 opioid related deaths Monitoring of data through the Injury and Violence Prevention Branch Project Lazarus grant shows a continual increase in medication and heroin related overdoses To address the crisis , the health department and community partners held a leadership forum in November 2017 to engage elected officials and county leaders and to solicit input on community focused strategies An Opioid Task Force has been formed and meets regularly to implement ideas and to distribute and circulate information to the community In addition , elected officials are working to increase resources that address treatment and rehabilitation Johnston County is a largely rural county without public transportation but it is projected to be the fastest growing county in North Carolina , percentage wise , over the next 10 years As access to care is an area of focus for our community , increasing options for mobility will help decrease barriers to care According to the 2012 – 2016 American Community Survey , about 44 of households in Johnston County had no access to a vehicle Consequently , other modes of transportation , including bicycling and walking , are important considerations during this surge of planning and development As our population increases , the importance of expanding options for transportation to allow for efficient movement of people and resources will affect the health of our community and its economic development - 11 -Page2Data Sources 1 US Census Bureau American Fact Finder 2016 American Community Survey 1 - Year Estimates ACS Demographic and Housing Estimates Johnston County , North Carolina https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF 2 State Center for Health Statistics Mortality Statistics Summary for 2016 North Carolina Residents Cancer - Trachea , Bronchus and Lung http schsstatencus data vital lcd 2016 lunghtml Accessed 1 March 2018 3 State Center for Health Statistics Mortality Statistics Summary for 2016 North Carolina Residents Cancer - Female Breast http schsstatencus data vital lcd 2016 breastcancerhtml Accessed 1 March 2018 4 State Center for Health Statistics Mortality Statistics Summary for 2016 North Carolina Residents Cancer - Prostate http wwwschsstatencus data vital lcd 2016 prostatehtml Accessed 1 March 2018 5 State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - All Sites http wwwschsstatencus data vital lcd 2016 cancerhtml Accessed 1 March 2018 6 State Center for Health Statistics North Carolina Vital Statistics 2016 Leading Causes of Death Volume 2 http wwwschsstatencus data vital lcd 2016 pdf Vol2_2016_PRTpdf Accessed 1 March 2018 7 North Carolina Health and Human Services North Carolina State Center for Health Statistics Mortality Statistics Summary for 2016 North Carolina Residents http wwwschsstatencus data vital lcd 2016 allcauseshtml Accessed 1 March 2018 8 North Carolina State Center for Health Statistics Leading Causes of Death Health Data Query System Johnston County http schsstatencus interactive query lcd getleadcausescfm Accessed 1 March 2018 9 United States Census Bureau American Fact Finder Food Stamps Supplemental Nutrition Assistance Program SNAP 2016 American Community Survey 1 - Year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_1 5_1YR_S2201 & prodType table Accessed 1 March 2018 10 United States Census Bureau American Fact Finder Selected Economic Characteristics 2016 American Community Survey 1 - Year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Accessed 1 March 2018 - 12 -Page311 United States Census Bureau American Fact Finder Poverty Status in the Past 12 Months Johnston County 2015 https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Accessed 1 March 2018 12 United States Census Bureau American Fact Finder Poverty Status in the Past 12 Months Johnston County 2016 https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Accessed 1 March 2018 13 United States Census Bureau American Fact Finder 2015 American Community Survey 1 - year Estimates Selected Characteristics of Health Insurance Coverage in United States Johnston County 2015 https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_15 _1YR_S2701 & prodType table Accessed 1 March 2018 14 United States Census American Fact Finder 2016 American Community Survey 1 - year Estimates Selected Characteristics of Health Insurance Coverage in United States Johnston County 2016 https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_15 _1YR_S2701 & prodType table 20Retrieved Accessed 1 March 2018 15 County Health Rankings Johnston County NC Mammography Screening http wwwcountyhealthrankingsorg app north - carolina 2017 measure factors 50 data Accessed 1 March 2018 16 Johnston County Teen Crash Data 2012 - 2016 Email Communication 2016 February 22 , with Sandy Wood , Johnston County Emergency Services 17 Centers for Disease Control 2015 Sexually Transmitted Diseases Surveillance Chlamydia https wwwcdcgov std stats15 chlamydiahtm 18 Communicable Disease Branch Epidemiology Section North Carolina HIV STD Quarterly Surveillance Report Vol 2017 No 4 http epipublichealthncgov cd stds figures vol17no4 pdf 19 County Health Rankings & Roadmaps Adult Obesity & Physical Activity North Carolina , Johnston County http wwwcountyhealthrankingsorg app north - carolina 2017 rankings johnston county outcomes overall snapshot 20 North Carolina State Center for Health Statistics 2016 BRFSS Survey Results http wwwschsstatencus data brfss 2016 region7 exerany2 html Accessed 1 March 2018 - 13 -Page421 Centers for Disease Control Physical Activity Basics https wwwcdcgov physicalactivity basics indexhtm 22 Eat Smart Move More Holiday Challenge Numbers 2017 Email communication with Madison Johnson ESMMWL Specialist on 1 23 18 23 North Carolina Institute of Medicine Johnston County Health Data http nciomorg counties johnston - county Accessed 1 March 2018 - 14 -Page