Gaston County completed its most recent Community Health Assessment in 2021 and created the Community Health Improvement Plan immediately following the publication of the Community Health Assessment.  The three priorities chosen for the CHIP at that time:

1. Infant and Maternal Health
2. Substance Use Disorder with an emphasis on opioid use
3. Access to Healthcare – focusing on the Mountainview Neighborhood

Gaston County Public Health is actively addressing each of the priority areas with significant activities and programming in each area.

Access to Healthcare and Neighborhood Health 

Gaston County is a diverse community that shares its eastern border with Mecklenburg County.  This geographic positioning drives many of the socio-economic factors in the community with nearly 30% of Gaston County workers commuting to Mecklenburg County.  This commuting pattern creates a pattern of wealth in the eastern part of the county with large areas of poverty and inadequate access to care predominately in the western part of the county.  There is roughly a 20 difference in life expectancy between the impoverished areas of the county and the areas of high wealth.  The following map illustrates the areas of higher risk in the county.

Access to Care – Activities

After reviewing the pertinent data and working with community partners, Gaston County determined that the best approach to Access to Care was to target a specific census tract / neighborhood to address access to care issues.  The Mountainview neighborhood, which is physically located in the same census tract as the primary location of the health department has high rates of poverty, including a public housing complex, heart disease, diabetes, and uninsured individuals.  Additionally, the FQHC serving Gaston County has identified this neighborhood has an area of high need and is providing targeted services as well.

Gaston County began by convening a workgroup of representatives from various government and nonprofit Initial activities to engage the Mountainview community have included a health fair, a survey of residents and an event that allowed participants to have a conversation about health care with one of the public health providers over dinner.

Infant and Maternal Health

There were several factors that drove the decision to focus on Infant and Maternal Health, but one statistic that created the most impact in the county was the infant mortality rate in the African American population during 2020. 

The chart below shows that the infant mortality rate in Gaston County was 11.4/1,000 live births in 2020, however there was a  rate of 25/1,000 live births in the African American population.  During this same time, the overall rate for North Carolina was 6.9/1,000 live births, and the rate for the African American population was 12.8/1,000 live births.

In 2021, these statistics improved considerably, while racial comparisons are not possible, the overall rate for Infant Mortality in Gaston County dropped 24.6% to 8.6/1,000 live births.  This is still somewhat higher than the 6.8/1,000 live birth rate experienced at the state level, but a significant improvement for Gaston County.  Preliminary data provided by the State Center for Health Statistics shows continued improvement for 2022, however data for North Carolina was not available at this time.

Source: NC State Center for Health Statistics, Rate/1,000 live births

Infant and Maternal Health - Activities

Gaston County Public Health has partnered with the local Perinatal Equity Coalition to examine racial bias in Infant and Maternal Health.  This coalition was developed and supported by a grant from the NC Maternal Health Innovation program in cooperation with Atrium Health.  Working cooperatively with this coalition Gaston County Public Health will be hosting a Health Equity Summit focusing on Black Maternal Health in April of 2024.  CEU’s will be available for nurses, social workers and other professionals.

The Gaston Healthy Beginnings Program is a free program that was developed for pregnant and post-partum African American women and Latinos between the age of 13 to 22 who live in Gaston County. The program provides case management services, educational group sessions, support services, resource and referrals, and community outreach.

The Healthy Beginnings program has served 40 clients with a total of 33 live births.  The program has shown a number of significant outcomes, including improvement in the number of infants sleeping on their backs, and a steady rate of participants who received postpartum care.

Gaston County Public Health also hosts the Women Infants and Children (WIC) Program which provides access to nutritious foods, information on healthy eating, including breastfeeding promotion and support, and referrals to health care and community resources for moms-to-be, new moms, and families with young children.  Like most of the counties in North Carolina the Gaston WIC program remains below it’s baseline participation level, but between August and October of 2023 (most recent data available) the program saw a 7.5% increase in participation rates, and 33.6% of the infants in the programs were fully or partially breastfed.

Substance Use and Misuse 

Gaston County has seen an increase in overdoses including opioid overdoses in recent years.  This issue extends well beyond the effect on the individual experiencing Substance Use Disorder and affects the entire population with its impact on healthcare, the economy, and even foster care.

Gaston County has an active coalition involved in the distribution of the Opioid Settlement Funds.  One of the early projects funded by the coalition was the Community Paramedic program.  This program extends the conventional first responder model and integrates aspects of public health, primary care, public safety, and prevention in its service delivery model. 

The community paramedics in this program offer essential support by supplying fentanyl and xylazine test strips, distributing naloxone to reverse opiate overdoses, and, for those who qualify, providing suboxone—a medication designed to treat opiate withdrawal.

Based upon the early success of this program the Gaston County Board of County Commissioners has recently approved expansion of the Community Paramedic program to a 24-hour service.

Morbidity -  Using Cancer as an indicator of Morbidity, it is clear that Gaston County has a higher rate of all cancers than the state of North Carolina, and this rate has increased over the past six years whereas the state rates have declined over the same period.

Gaston County Mortality statistics remain relatively unchanged and somewhat higher than the state rates for comparable causes of death.

Source:  North Carolina State Center for Health Statistics, Death Counts and Crude Death Rates per 100,000 Population for Leading Causes of Death, by Age Groups 

Gaston County, much like the rest of the state, and nation has seen an increase in syphilis cases over the past four years.   The disease is primarily affecting men in the 25 to 49 age group.

Gaston County has been experiencing an influx of patients whose primary language is not English.  Most notably this increase has been seen in both the Spanish-speaking, and Haitian-French Creole languages.  To improve services to these communities Gaston County Public Health has increased the number of Spanish-speaking interpreters and added a Haitian- French Creole interpreter.