2016 State of the County Health Report

10 State of the County Health Report SOTCH 2016 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 Access to Care 4 Cancer 6 Priority Health Issues Injury Prevention 6 Identified from the 2014 Community Health Assessment Obesity 8 Sexually Transmitted Infections 7 • Access to Care Medical and Behavioral Physical Activity 9 • Obesity Nutrition 9 • 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 2016 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 2015 - 2016 , there are some categories where the most current data available is from earlier years Johnston’s Demographic and Economic Summary 1 2014 Johnston County Demographic Estimates Sex Estimate Percent Male 90,935 49 Female 94,725 51 Race Estimate Percent White 139,949 754 Black or African American 26,806 144 American Indian or Alaska 918 05 Native Asian 1,215 05 Native Hawaiian or Other 15 0 Pacific Islander Ethnicity Estimate Percent Hispanic any race 23,489 127 Non - Hispanic or Latino 162,171 873 Total Population 185,660 - 2 -Page1 2015 Estimated Age Population 60 and over 0 - 19 181 284 35 - 59 20 - 34 367 169 Health and Medical Care Overview of Leading Causes of Death The 2015 leading cause of death in Johnston County was cancer There were 1,451 total deaths 7 in Johnston County in 2015 Of the total deaths , cancer is responsible for 343 deaths or 236 of the population and diseases of the heart closely following with 337 deaths or 232 of the 8 population Trachea , bronchus and lung cancers have the highest mortality rate in Johnston 2 County at 513 Cancer is a group of more than 100 different diseases , but all are 6 characterized by uncontrolled growth and spread of abnormal cells Early detection and prevention are the two most effective ways to decrease the cancer death rate The rate for all 5,9 cancer deaths has increased from 1681 in 2014 to 1847 in 2015 Contributing to most of these deaths are lifestyle behaviors such as tobacco use , alcohol consumption , lack of physical activity , poor nutrition and substance abuse 2,3,4,5 2015 Cancer Mortality Statistics Johnston County Residents vs North Carolina Johnston County Johnston County NC Number NC Number of Deaths Death Rate of Deaths Death Rate Colon Rectum , and Anus 34 183 1,677 167 Cancer Trachea , Bronchus , and Lung 102 549 5,468 544 Cancer Female Breast Cancer 28 296 1,396 277 Prostate Cancer 10 11 904 185 Cancer - All Sites 343 1847 19,309 1923 - 3 -PageEconomic Glimpse • In 2015 there were an estimated 64,045 total households Of those households , 10 7,497 or 117 were receiving food stamps SNAP 11 • The unemployment rate has decreased from 7 in 2014 to 52 in 2015 • In 2015 , 154 of the Johnston County population was below poverty , compared 12,13 to 164 in 2014 Access to Health Care Healthy North Carolina 2020 Objective Reduce the percentage of non - elderly uninsured individuals aged less than 65 years An estimated 165 of adults 18 - 64 years old were uninsured during 2015 compared to 20 in 14 44 2014 There were 10 , 915 males and 8,894 females who were uninsured Access to comprehensive , quality healthcare services is important for the achievement of health equity and for increasing the quality of healthy life for everyone https wwwhealthypeoplegov 2020 topics - objectives topic Access - to - Health - Services Access to healthcare can have an impact on overall physical , social and mental health status and can have an effect on prevention of disease , disability , quality of life , preventable death and life expectancy Disparities in access to healthcare impact our whole community By reducing barriers such as availability , cost and insurance coverage we can help our community members improve their quality of life 2014 and 2015 Health Insurance Coverage Estimates 15,16 18 - 64 Years Old Uninsured County 2015 2015 2014 2014 Uninsured Uninsured Uninsured Uninsured Johnston 18,405 165 22,008 20 Craven 9,381 167 12,629 228 Davidson 16,118 161 20,171 204 Harnett 12,853 176 15,135 206 Randolph 17,794 208 16,260 191 Union 17,983 134 21,179 162 Wayne 11,678 16 17,020 233 Wilson 8,983 185 13,073 27 - 4 -PagePage pageNumber5Johnston 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 01 2016 Access to Care Team Meeting - During this meeting finalized Health Literacy documents were distributed to meeting members for dissemination 3 2016 Food demonstrations at West Johnston High School Food Pantry and Clayton Area Ministries Pantry of Kale , Apple and Banana smoothie including distribution of recipe cards and nutrition education 09 2016 The Johnston County Faith Network Collaborative was established This Collaborative has agreed to host a Health Literacy Workshop at Bentonville Disciples of Christ Church in Four Oaks NC 09 2016 The Johnston County Transportation Committee disseminated surveys to study ways to improve transportation in Johnston County 12 2016 Two Affordable Care Act Enrollment opportunities were scheduled at the Project Access Medical Clinic 12 2016 Two Affordable Care Act Enrollment opportunities were scheduled at the Johnston County Public Health Department 12 2016 An Affordable Care Act Enrollment opportunity was scheduled at Benson Area Medical Center 12 2016 Johnston County Public Health Department continues to support local Physician Assistant and Family Nurse Practitioner Students Benson Area Medical Center also has two college students participating in the MedServe program - 5 -PagePage pageNumber6Cancer 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 2016 County Health Rankings , of the 1,488 Medicare enrollees in Johnston County , 68 of them have 17 received at least one mammogram over a two year period The 2015 breast cancer mortality 18 rate in Johnston County is 296 compared to North Carolina at 27 It is recommended that women who are 50 - 74 years old have a screening mammogram every two years 19 Table Johnston County and peer county data related to 2015 breast cancer deaths County Death Rate Number of Deaths in 2015 Number of Deaths 2011 - - 2015 Johnston 296 28 112 Craven 176 9 76 Davidson 358 30 129 Harnett 93 6 53 Randolph 222 16 90 Union 213 24 102 Wayne 222 14 92 Wilson 326 14 74 Injury 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 percent of Johnston County’s fatalities were 20 speed related and 92 of them occurred on 2 lane roads The JoCo Teen Driver’s peer - to - - 6 -PagePage pageNumber7peer education is bringing awareness to all Johnston County drivers while decreasing fatalities Johnston County Yearly Ranking Teen Fatalities Year Rank Total rd 2014 3 6 th 2015 5 2 th 2016 7 1 Sexually Transmitted Infections Chlamydia is the most common disease in the United States and the most prevalent of all STDs 21 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 decreased from 22 715 in 2015 to 650 in 2016 On December 1 , 2016 , the Johnston County Public Health Department partnered with Commwell Health to host the annual World Aids Day Testing Event offering free Rapid HIV Testing with same day results Sexually Transmitted Infection Cases in Johnston County 2014 2015 2016 Gonorrhea 109 190 205 Chlamydia 577 715 650 Source Data http epipublichealthncgov cd stds figures vol16no4 pdf - 7 -PagePage pageNumber82016 HIV and AIDS Diagnosis HIV Disease First Diagnosis AIDS Diagnosis Johnston 14 9 Harnett 10 2 Union 23 7 Wayne 11 11 Wilson 10 8 Source Data http epipublichealthncgov cd stds figures vol16no4 pdf CDC , 2015 Sexually Transmitted Diseases Surveillance https wwwcdcgov std stats15 chlamydiahtm Obesity 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 disease and may also complicate these conditions In 2016 , North Carolina County Health Rankings indicate 35 of Johnston County adult residents are obese , reporting a Body Mass Index BMI of 30 or more , compared to 29 of 23 adults in North Carolina 24 of adults aged 20 and over report no leisure - time physical 24 activity , a decrease from previous years 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 - 8 -PagePage pageNumber9• 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 3 2016 Food demonstrations at West Johnston High School Food Pantry and Clayton Area Ministries Pantry of Kale , Apple and Banana smoothie including distribution of recipe cards and nutrition education 04 2016 Fruit Salad and Black Bean Corn Salsa food demonstration Food demonstrations utilized foods available in the pantries of West Johnston High School Food Pantry and Clayton Area Ministries Food Pantry 06 2016 Quick Salsa and Easy Fruit Salad food demonstration Education and recipe cards were provided to participants of the food pantry 09 2016 Pizza Quesadilla and Peanut Butter Cereal Bars food demonstration The education team provided recipes and ingredients used in the tasting were available for patrons to take with them 10 2016 Town of Clayton offered a hypertension focused worksite wellness program in collaboration with Obesity , Diabetes , Heart Disease , Stroke Prevention Grants Team 10 2016 The Johnston County Public Health Department launched the Employee Wellness program to include monthly wellness activities and challenges to coincide with health observances Future components will include the Bike Share Program and the Healthy Snack Station 10 2016 Johnston County Wellness Committee continues to partner with other county government agencies to implement worksite wellness 12 2016 Town of Smithfield and Johnston UNC Healthcare has met with the Obesity , Diabetes , Heart Disease , Stroke Prevention Grants Team to discuss worksite wellness initiatives for 2017 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 2015 , 743 of Region 7 Edgecombe , Franklin , Granville , Halifax , Johnston , Nash , Wake , Vance , Warren , Wilson counties compared to 738 of North Carolina residents participated in any physical - 9 -Page0activities or exercises such as running , calisthenics , golf , gardening , or walking for exercise in 25 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 on 2 or more days a week Children and adolescents are recommended to participate in 60 or more minutes of physical 26 activity and muscle strengthening , 3 days a week Eat Smart Move More is a statewide movement that promotes increased opportunities for healthy eating and physical activity wherever people live , learn , earn , play and pray In 2016 , Johnston County was in the top 15 counties in North Carolina at number 10 , with 149 27 participants registered 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 Progress to Date 02 2016 Planning meeting for the 2016 Safe Kids Day event , to include the County - Wide Walk for Health Bike Rodeo 04 2016 County - Wide Safe Kids Day ; Walk for Health Bike Rodeo Event at East Clayton Community Park 05 2016 East Clayton Elementary , South Smithfield Elementary , Four Oaks Elementary , Powhatan Elementary Schools participated in Bike Walk to School Events 05 2016 Health Education Team met with Clayton Middle School staff to discuss options for school garden support and education 09 2016 Health Education Team met with additional Clayton Middle School staff and toured the onsite school garden 09 2016 Johnston County Master Gardener provided education to 8th grade students regarding soil testing , composting and pests 09 2016 Riverwood Elementary participated in the Let’s Go NC Curriculum 10 2016 Riverwood Elementary , Polenta Elementary , East Clayton and Powhatan Elementary Schools participated in Walk to School Day Events - 10 -Page1New Initiatives and Emerging Issues Project Lazarus is a continuing initiative that focuses on reducing the number of deaths from opioid overdose The project aims to provide education on preventing , recognizing and managing opioid overdose and increasing medication disposal and the number of people who are able to respond to an opioid overdose Johnston County Public Health Department has been monitoring opioid and medication overdose encounters for Johnston County residents and providing information and resources to medical providers and community partners to address the rising number of cases in our county Free Naloxone kits and educational pamphlets are being distributed throughout the county and residents and families are encouraged to utilize these resources An additional focus is medication safety for children as there have been noted medication overdoses for children as young as one Medication safety pamphlets have been developed and are being distributed to pediatricians and community agencies and partners to encourage safe disposal and storing of medications Johnston County is a largely rural county without public transportation An area of focus from our Community Health Assessment is access to care , including transportation Although medical transportation to appointments is available for the Medicaid population , transportation for the uninsured , other insured , and for additional needs is a barrier to improving health The access to care transportation subcommittee distributed transportation surveys throughout the county and will be summarizing and providing the data and resident concerns to county leadership and community partners to develop a strategy for addressing movement of people and resources throughout the county Behavioral health issues continue to be a priority for county residents Partnering with Alliance Behavioral Healthcare , a project to enhance integration of medical and behavioral health services is being implemented through the Johnston County Public Health Department Behavioral Health Division This project aims to connect and reconnect those seeking behavioral health services to primary care and provide support services to improve adherence to therapy and health outcomes - 11 -Page2Data Sources 1 US Census Bureau American Fact Finder 2015 American Community Survey 1 - Year Estimates ACS Demographic and Housing Estimates Johnston County , North Carolina https factfindercensusgov faces nav jsf pages community_factsxhtml 2 State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - Trachea , Bronchus and Lung http schsstatencus data vital lcd 2015 lunghtml Accessed 2 February 2017 3 State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - Female Breast http schsstatencus data vital lcd 2015 breastcancerhtml Accessed 2 February 2017 4 State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - Prostate http schsstatencus data vital lcd 2015 prostatehtml Accessed 2 February 2017 5 State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - All Sites http schsstatencus data vital lcd 2015 cancerhtml Accessed 2 February 2017 6 State Center for Health Statistics North Carolina Central Cancer Registry Johnston County Cancer Profile October 2015 http wwwschsstatencus schs CCR cp2015 Johnston_CP_2015 pdf 7 North Carolina Health and Human Services North Carolina State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents http wwwschsstatencus data vital lcd 2015 allcauseshtml Retrieved 02 09 2017 8 North Carolina State Center for Health Statistics Leading Causes of Death Health Data Query System Johnston County http wwwschsstatencus interactive query lcd getleadcausescfm Retrieved 02 09 2017 9 North Carolina State Center for Health Statistics Mortality Statistics Summary for 2014 North Carolina Residents Cancer All Sites http wwwschsstatencus data vital lcd 2014 cancerhtml 10 United States Census Bureau American Fact Finder Food Stamps Supplemental Nutrition Assistance Program SNAP 2015 American Community Survey 1 - Year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_1 5_1YR_S2201 & prodType table Retrieved on 2 27 17 - 12 -Page311 North Carolina Economic Data and Site Information AccessNC Johnston County Profile http accessnccommercestatencus docs countyProfile NC 37101 pdf Retrieved 2 27 17 12 United States Census Bureau American Fact Finder Poverty Status in the Past 12 Months Johnston County 2014 https factfindercensusgov faces tableservices jsf pages productviewxhtml src CF Retrieved on 2 27 17 13 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 Retrieved on 2 27 17 14 United States Census Bureau American Fact Finder Selected Characteristics of Health Insurance Coverage in United States Johnston County 2015 https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_1 5_1YR_S2701 & prodType table Retrieved 2 27 17 15 15 United States Census American Fact Finder 2015 American Community Survey 1 - year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_1 5_1YR_S2701 & prodType table Retrieved 03 01 2017 16 16 United States Census American Fact Finder 2014 American Community Surevey 1 - year Estimates https factfindercensusgov faces tableservices jsf pages productviewxhtml pid ACS_1 4_1YR_S2701 & prodType table Retrieved 03 01 2017 17 County Health Rankings Johnston County NC http wwwcountyhealthrankingsorg app north - carolina 2016 measure factors 50 data Retrieved 03 01 2017 18 North Carolina State Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - Female Breast http wwwschsstatencus data vital lcd 2015 breastcancerhtml Retrieved 03 01 2014 19 North Carolina Center for Health Statistics Mortality Statistics Summary for 2015 North Carolina Residents Cancer - Female Breast http wwwschsstatencus data vital lcd 2015 breastcancerhtml Retrieved 03 01 2017 20 Johnston County Teen Crash Data 2012 - 2016 Email Communication 2016 February 22 , with Sandy Wood , Johnston County Emergency Services 21 Centers for Disease Control 2015 Sexually Transmitted Diseases Surveillance Chlamydia https wwwcdcgov std stats15 chlamydiahtm - 13 -Page422 Communicable Disease Branch Epidemiology Section North Carolina HIV STD Quarter Surveillance Report Vol 2016 No 4 http epipublichealthncgov cd stds figures vol16no4 pdf 23 County Health Rankings & Roadmaps Adult Obesity North Carolina , Johnston County http wwwcountyhealthrankingsorg app north - carolina 2016 measure factors 11 data 24 County Health Rankings & Roadmaps Physical Activity North Carolina , Johnston County http wwwcountyhealthrankingsorg app north - carolina 2016 measure factors 70 data 25 North Carolina State Center for Health Statistics 2015 BRFSS Survey Results http wwwschsstatencus data brfss 2015 region7 exerany2 html 26 Centers for Disease Control Physical Activity Basics https wwwcdcgov physicalactivity basics indexhtm 27 Eat Smart Move More Holiday Challenge Report 2016 https esmmweighlesscom wp - content uploads 2016 09 2016 - Holiday - Challenge - Wrap - Up - Reportpdf - 14 -Page