EXECUTIVE SUMMARY
Purpose of the Community Health Needs Assessment

The purpose of a community health needs assessment (CHNA) is to collect and use data to identify community assets and priorities that can improve community health and wellbeing. By identifying these priorities with broad community input, local leaders can collaborate and leverage shared resources and expertise to act.

This assessment process was led by Live Well Wake working to fulfill the vision:

            Every Wake County resident, regardless of background or neighborhood, deserves an equal opportunity to achieve optimal health and well-being. 1

Participation and Community Engagement

Members of the Live Well Wake collaborative and CHNA Steering Committee represent community leaders in public, private, and nonprofit sectors. Participating members and affiliations are listed in the acknowledgements section. Throughout the 2022 process the Live Well Wake team made collaborative decisions related to assessment methods, data interpretation, and prioritization. Wake County residents who are not members of the collaborative participated in the process through the community health opinion survey, focus groups, and individual prioritization voting. Live Well Wake will continue building collaboration through improvement planning.

Live Well Wake contracted with the North Carolina Institute for Public Health (NCIPH) to lead data collection, analysis, and written report components of the assessment. NCIPH created a data dashboard to display on the Live Well Wake website (www.livewellwake.org) to transparently share data that informed the CHNA process.

Process

The Live Well Wake team worked from June 2021 through April of 2022 to plan, collect and analyze data, prioritize, and finalize this report. The 2022 Wake CHNAfollowed an eight-phase process developed by NCIPH and informed by the County Health Rankings Model, emphasizing how policies and programs influence a variety of health factors which lead to health outcomes.2 The process included collecting new data through a community health opinion survey and focus groups and reviewing existing, secondary data. Secondary data was collected on national (U.S. Census Bureaus) and state (NC Center for Health Statistics) levels. The COVID-19 pandemic required some data collection methods to be adapted.

Comparisons and Findings

New and existing data were analyzed and presented in an interactive dashboard alongside peer county and state data for comparison. Data were presented to and discussed by the LWWAT on January 21, 2022 and February 18, 2022 and to the Steering Committee on March 15, 2022 prior to determining priorities.

People living in Wake County, on average, experience better health outcomes and living conditions than in peer counties and the state on many indicators. The improvements that have been made in the areas of health insurance access (uninsured dropped from 15.5% in 2010 to 10.1% in 2019),3 cancer mortality (rate decreased from 153.4 to 134.6 per 100,000 population for the five-year periods ending 2014 and 2019 respectively),4 and incarceration (decreased 46% from 2000 to 2020)5 can be celebrated.

However, concerning trends and disparities in outcomes highlight work that is yet to be done. Affordable housing remains a challenge with 43.2% of renters paying more than 30% of their income on rent in 2019,2 and data from the Community Health Opinion Survey and focus groups suggests that the problem has only increased in the past three years. African American/Black community members experience homelessness at a rate that is more than seventeen times that of the White community members, and women have a higher rate than men.6 African American/Black people in Wake County have higher mortality rates than their White and Asian counterparts,4 and the disparity in infant mortality increased between 2018 and 2019. In 2019, African American babies died at a rate of 13 out of every 1,000 live births compared to 2.5 White babies.6 While most racial groups’ cancer mortality has been decreasing in recent years, it has been increasing for Hispanic/Latinx community members.4 In both the Community Health Opinion Survey and the focus groups, participants highlighted mental health as a top area of community concern, and that mental health resources are not accessible to everyone in Wake County.

PRIORITIZATION

Community members were invited to review the data dashboard and vote on priorities online. Voting was open from February 25 through March 9, 2022, and 950 people participated. The Steering Committee then met to review data alongside community prioritization voting results, discuss, and decide through a collective voting process which topics to prioritize for 2022-2025. The selected priorities match the top priorities from the community voting process and include:

Next Steps

The next and final step in the CHNA process is to develop community-based health improvement strategies and action plans to address the three priorities identified for Wake County in this assessment. The CHNA partners will be reaching out to invite members of the community and community organizations to a community action planning meeting to discuss the best ways to address these priorities. The most effective strategies will be those that have the collaborative support of community organizations and residents.

We strongly encourage you to get involved! Ways to get involved include:

• Checking the http://www.livewellwake.org website for the date, time, and location of CHNA strategy and action planning meetings.
• Plan to attend the community action planning meetings
• Encourage your family, neighbors, co-workers, and community organizations to read the CHNA and get involved in the planning process as well.

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1 About Us. Live Well Wake. Retrieved from https://livewellwake.org/

2 County Health Rankings Model. County Health Rankings and Roadmaps. Retrieved from https://www.countyhealthrankings.org/explore-health-rankings/measures-data-sources/county-health- rankings-model

3 U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE).

4 NC Department of Health and Human Services, North Carolina State Center for Health Statistics, County Health Data Book: Table CD12B, 5-year data.

5 NC Department of Health and Human Services, Department of Health and Human Services, Division of Public Health, Injury and Violence Prevention Branch, The NC Opioid Data Dashboard. Sourced from Department of Public Safety, Research and Planning, Automated System Query, Prison Population, 2000 - present.

6 NC Department of Health and Human Services, North Carolina State Center for Health Statistics, 1 year data.

Access to Healthcare

Mental Health

Affordable Housing and Homelessness