A Community Health Needs Assessment (CHNA) is a process by which community members gain an understanding of the health concerns and health care systems of the community by identifying, collecting, analyzing, and disseminating information on community assets, strengths, resources and needs.  In the Spring of 2022, Robeson County Health Department and UNC Health Southeastern began the implementation of the CHNA for Robeson County.  The effort focused on assessing community health needs, local health resources, barriers to care, gaps in services and trends regarding health and healthy lifestyles.  The results from the CHNA will be utilized to document community needs, and link those needs to community benefit efforts.  This assessment will be utilized to assist the health department and hospital in planning and prioritizing its community outreach and programs through CHIPS and strategic plan.  Robeson County strives for all residents to achieve the highest level of health possible through our identification and reduction of health risks; detection, investigation, and prevention of the spread of disease; promotion of healthy lifestyles and a safe and healthy environment; promotion of the availability and accessibility of health care services through the private sector; and the provision of quality health services to those in need.  Robeson County is ranked as the poorest, unhealthiest, as well as the most racially and culturally diverse county in North Carolina.  No doubt, the consequences of living in a persistently poor county impact everyone.  Higher rates of income inequality correlate with higher crime rates, substance misuse, lack of educational attainment, unemployment, and food insecurity.

Vision Statement

Robeson County strives for all residents to achieve the highest level of health possible through our identification and reduction of health risks; detection, investigation, and prevention of the spread of disease; promotion of healthy lifestyles and a safe and healthy environment; promotion of the availability and accessibility of health care services through the private sector; and the provision of quality health services to those in need.

CHA Leadership

Partnerships/Collaborations 

Regional/Contracted Services the Robeson County Health Department and UNC Health Southeastern didn't contract any services for the development of the CHNA.

Theoretical Framework/Model the Transtheoretical Model provides suggested strategies for public health interventions to address people at various stages of the decision-making process.  Transtheoretical Model (TTM) focuses on the decision-making of the individual and is a model of intentional change. The TTM operates on the assumption that people do not change behaviors quickly and decisively. Rather, change in behavior, especially habitual behavior, occurs continuously through a cyclical process. The TTM posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. 

Collaborative Processes The first step activating Robeson County’s Community Health Needs Assessment Team was to designate the Co-Facilitators. The county’s Health Education Supervisor and the Community Mobilization Specialist with UNC Health Southeastern were selected to fulfill these roles. These two individuals were ultimately responsible for maintaining the overall flow of the community health needs assessment process and ensuring that others participating in the process were kept abreast of progress made as well as tasks yet to be completed. Meetings of the Co-Facilitators began in the Fall of 2022. Initial meetings included the review and re-evaluation of the 2020 community health assessment process and the resulting widely disseminated documentation of findings, priorities and action steps. From there, the CHNA Team was formed with partners from Healthy Robeson, Robeson County Health Department, and UNC Health Southeastern. The Team met for a defined period of time; reviewed the CHNA process materials, statistics and survey data, and served as community advocates for the assessment process, which included identification of resources and support. The CHNA Work Group, comprised of members of Healthy Robeson, planned for collecting, analyzing, and interpreting the data. The Work Group met to discuss survey distribution, as well as data availability, collection and analysis. A wide variety of secondary data was reviewed, including local, state and national. When available, trend data was analyzed. The CHNA Team met with the Work Group in June 2023 to discuss the community’s concerns identified through the survey.

Key Findings the Robeson County Health Needs Assessment is the survey tool used to obtain data from the people of Robeson County. The 2023 survey was streamlined to meet the needs of this assessment’s cycle. The survey was distributed in a hard copy format via partnering agencies. The survey was also available electronically. QR codes and links were shared via websites and social media. These methods proved to be an effective way to reach the whole of the county. Secondary data was obtained from various local and state-level resources. Key public resources of existing data on Robeson County were reviewed and compared to state and national data. These resources were used to compare the determinates of health as well as health outcomes. The determinants or drivers of health reviewed were demographic, social and economic status, education levels and environmental health. Health outcome data in the areas of overall health status, disease trends, mental/behavior health (including substance abuse) and modifiable health risk behaviors were compared against state and national data sources.  According to the North Carolina State Center for Health Statistics 2023 County Health Data Book, the top five leading causes of Robeson County’s deaths in 2023 are, in order: diseases of the heart, total cancer, all other unintentional accidents, COVID-19, and Alzheimer’s disease

Health Priorities

• Obesity
• Substance Misuse/ Mental Health

Next Steps

• The Community Health Needs Assessment (CHNA) document will be posted on UNC Health Southeastern website.
• The Robeson County Health Department will place the CHNA document on its website.
• Presentations will be made to Healthy Robeson, the Robeson County Board of Health and the UNC Health Southeastern Board of Trustees.
• Presentations will be shared in the community.
• Information in the CHNA will be disseminated in the community through use of social media, partners, and availability of hard copies of the survey.
• Action plans/implementation strategies will be evaluated.

• To fight obesity, concentrate on Fruits and Vegetables Access and Education.
• Harm reduction will be the area of focus to combat Substance Use/Mental Health