A Community health needs assessment (CHNA) is the foundation for improving and promoting the health of community members. The role of a CHNA is to identify factors that affect the health of a population and determine the availability of resources within the community to address those factors adequately.  

During the two years between each CHNA, local health departments are responsible for providing a State Of The County Health (SOTCH) Report. This document highlights current statistical information in addition to actions and interventions taken to address the top health priorities identified in the 2019 CHNA. This report can assist with community health action planning, influence policy development, and engage community members in public health strategies.

The top three (3) priorities referenced below are:

                                  1.  Mental Health/Behavioral Health

                                  2.  Healthy Eating/Active Living

                                  3.  Substance Misuse

The original 2023 SOTCH Report presented to the Wilson County Board of Health on May 14, 2024 can be accessed here: 2023SOTCHBOHSnapshot_1719359608.pdf                                                                

Priority 1: Mental & Behavioral Health

Mental health continues to be a growing concern both locally and across the state. In North Carolina, the age-adjusted suicide death rate increased from 13.3 per 100,000 in 2021 to 14.8 per 100,000 in 2023. Suicide is closely linked to mental health, with contributing factors such as trauma, financial insecurity, housing instability, and physical illness. Wilson County's rate is even higher, but community-wide trainings in Mental Health First Aid and trauma-informed care continue to support public awareness and response to mental health needs. Strengthening access to services and reducing stigma remain top priorities.

Suicide Death Rate in NC (per 100,000, Age-Adjusted)

Wilson County continues to face challenges in mental health provider access. While the ratio of mental health providers to population has improved slightly, it remains worse than the state average. Suicide rates have also shown concerning trends.

Mental Health Provider Ratio

Suicide Rate in Wilson County (per 100,000, Age-adjusted)

The suicide rate in Wilson County has shown a concerning upward trend, increasing from 10.1 per 100,000 in 2019 to 19.8 per 100,000 in 2023, which is significantly higher than the state average.

Program Highlights

Mental Health First Aid Training In 2023, Wilson County significantly expanded Mental Health First Aid (MHFA) training, a program that teaches community members how to identify, understand, and respond to signs of mental illnesses and substance use disorders.

While there was a decrease in training activities from 2022 to 2023, this followed a significant increase from 2021, and the program has still maintained substantial reach. The decrease can be attributed to organizational consolidations as Eastpointe merged with Sandhills Center in 2023.

Adverse Childhood Experiences (ACEs) Training The county expanded education on childhood trauma through ACEs training, which helps participants understand how early life adversity affects long-term health outcomes.

Wilson Area School Health Program (WASH) The WASH program provides healthcare services directly in schools, helping to address both physical and mental health needs for students.

In 2023, a fourth WASH center was added at Fike High School, expanding access to healthcare services for students.

Progress and Challenges

While progress has been made in expanding mental health awareness and training programs, Wilson County continues to face challenges in provider availability and addressing the rising suicide rate. The consolidation of Managed Care Organizations impacted service delivery in 2023, but community partnerships have helped maintain critical programming.

Priority 2: Healthy Eating & Active Living

Healthy eating and active living continue to be major health concerns in Wilson County, with adult obesity rising to 42% and physical inactivity increasing since 2019. Despite these trends, there are signs of progress. The county’s healthy food environment score has shown modest improvement, and access to exercise opportunities increased from 68% in 2022 to 75% in 2023. This measure reflects proximity to parks, gyms, and recreational areas, though it does not account for other community resources such as sidewalks or school-based facilities. At the same time, 7.4% of residents still face limited access to healthy foods. These mixed trends highlight the importance of improving access to healthier lifestyles to reduce chronic disease. Expanding partnerships that support nutrition education and physical activity is helping create more opportunities for families to engage in healthy behaviors, even as significant challenges remain.

*A higher score indicates better access to healthy foods based on proximity and income.

Program Highlights

Eat Smart Move More (ESMM) The ESMM program promotes wellness through education and community engagement. In 2023, the program saw growth in both offerings and participation.

Since 2016, Eat Smart Move More has helped promote wellness among Wilson County employees through education and community engagement. The increase in sessions and participants reflects improved planning and a broader commitment to making wellness part of the workplace culture. Funding from the Healthcare Foundation of Wilson has supported this growth by prioritizing healthy eating and active living as community health goals.

Progress and Challenges

While there have been positive trends in access to exercise opportunities and the food environment score, the obesity rate and physical inactivity continue to present significant challenges. Rural areas in particular face barriers to accessing affordable, healthy food and safe places for physical activity. Economic factors also impact families' ability to make healthy choices.

Priority 3: Substance Misuse

The substance misuse crisis continues to impact Wilson County deeply. In 2023, the age-adjusted drug poisoning death rate reached 66.3 per 100,000, significantly higher than the state rate of 42.1 per 100,000. This steep increase has been driven by fentanyl and polydrug use. In response, Wilson County expanded naloxone access, peer recovery coaching, and community education through initiatives like the Post Overdose Response Team (PORT). These coordinated strategies aim to prevent overdose deaths, increase access to treatment, and help individuals recover from substance use disorders.

Key Metrics

Drug Overdose Death Rate (per 100,000, Age-adjusted)

Program Highlights

Naloxone Distribution Program This program trains community members to administer naloxone and distributes kits to reverse opioid overdoses.

Harm Reduction Services The county has expanded testing for infectious diseases among individuals with substance use disorders.

Post Overdose Response Team (PORT) PORT provides follow-up services to individuals who have experienced non-fatal overdoses.

Lock Your Meds Campaign This campaign aims to prevent prescription medication misuse through secure storage and proper disposal.

Opioid Settlement Funds Allocation

On April 3, 2023, Wilson County Commissioners unanimously approved key initiatives for the use of opioid settlement funds, including:

• Treatment & Naloxone: $200,000 for expanded access to treatment and life-saving naloxone
• Youth Programs: $125,000 for trauma-informed programs in schools to address risk factors
• Recovery Support: $100,000 for syringe services, housing support, and a public data dashboard
• Community Efforts: $125,000 for flexible funding to support local organizations

Progress and Challenges

While substance misuse remains a critical issue with overdose deaths continuing to rise, Wilson County has significantly expanded its response capabilities. The naloxone distribution program in particular has shown substantial growth, and the allocation of opioid settlement funds provides resources for comprehensive approaches. However, the increasing overdose death rate indicates ongoing challenges that require sustained and expanded efforts.

Starting December 1st, 2023, Medicaid coverage expanded to include adults aged 19-64 with higher incomes. In Wilson County alone, over 2,735 residents enrolled within the first 30 days, with enrollment expected to grow. This expansion presents opportunities to improve healthcare access for many residents, including those seeking mental health and substance use disorder treatment.

Conclusion

Wilson County has made progress in addressing its health priorities through 2023, with expanded programming and community engagement across all three priority areas. However, challenges remain, particularly with mental health provider shortages, increasing obesity rates, and the ongoing substance misuse crisis. The county continues to adapt its approaches through collaborative partnerships and data-driven strategies to improve health outcomes for all residents.

Wilson County Allocates Opioid Settlement Funds

On April 3, 2023, County Commissioners unanimously approved key initiatives for the use of opioid settlement funds. This plan lead by the Wilson Substance Prevention Coalition tackles the opioid crisis by expanding treatment, harm reduction, and recovery support.

• Treatment & Naloxone: $200,000 for expanded access to treatment and life-saving naloxone.
• Youth Programs: $125,000 for trauma-informed programs in schools to address risk factors.
• Recovery Support: $100,000 for syringe services, housing support, and a public data dashboard.
• Community Efforts: $125,000 for flexible funding to support local organizations.