A Community Health Needs Assessment (CHNA) helps health leaders evaluate the health and wellness of the community they serve and identify gaps and challenges that should be addressed through new programs, services and policy changes. This report was created in compliance with North Carolina Local Health Department Accreditation standards, as well as Internal Revenue Service requirements for not-for-profit hospitals.
Several local health organizations came together to help develop this CHNA, including Lenoir County Health Department and UNC Health Lenoir.

Secondary (existing) data is an important piece of the CHNA process. Key sources for secondary data included information provided by the Steering Committee and a variety of public data sources related to demographics, social and economic determinants of health, environmental health, health status and disease trends, mental/behavioral health trends, and individual health behaviors. Each data measure was also compared to state or national benchmarks to identify areas of specific concern for Lenoir County. Top community needs identified through secondary data analysis included health concerns related to physical and behavioral health, and social or environmental concerns such as education, employment and income, food access and security, and housing and homelessness, among others.

Primary (new) data were collected through focus groups and a web-based survey for community members, and included feedback from 647 people who live, work or receive healthcare in Lenoir County. A total of three in-person focus groups were conducted, with a variety of community members from different backgrounds, age groups and life experiences. Primary data identified behavioral health (including mental health and substance use), community safety, employment and income, healthcare quality and access, housing and homelessness, and physical health (chronic diseases, cancer, obesity) as top needs that impact the health and well-being of people living in Lenoir County.

Representatives from Lenoir County worked together to identify the priorities the county should focus on over the following three-year period. Leaders evaluated the primary and secondary data collected throughout the process to identify needs based on the size and scope, severity, the ability for hospitals or health departments to make an impact, associated health disparities, and importance to the community. Although it was not possible for every single area of potential need to be identified as a priority, Lenoir County selected three top priority health needs (Behavioral Health, Physical Health and Healthcare Access and Quality, and Transportation and Transit).

Lenoir County also compiled a Health Resources Inventory, which describes a variety of resources available to help Lenoir County residents meet their health and social needs.
Following completion of this report, health leaders throughout Lenoir County will use its findings to collaborate with community organizations and local residents to develop effective health strategies, new implementation plans and interventions, and action plans to improve the communities they serve.

The process of identifying the priority health needs for the 2023-2024 CHNA began with the collection and analysis of hundreds of new and existing data measures. In order to create more easily discussable categories, all individual data measures were then grouped into six categories and 20 corresponding focus areas based on “common themes” that correspond to the Population Health Model.

Since a large number of individual data measures were collected and analyzed to develop these 20 focus areas, it was not reasonable to make each of them a priority. The Steering Committee considered which focus areas had data measures of high need or worsening performance, priorities from the primary data, and how possible it is for health departments or hospitals to impact the given need to help determine which health needs should be prioritized.

The Steering Committee utilized the multi-voting technique to determine Lenoir County’s priority need areas, while considering the following factors:

• Size and scope of the health need;
• Severity and intensity of the health need;
• Whether possible interventions would be possible and effective;
• Health disparities associated with the need; and
• Importance the community places on addressing the need.

Specifically, ten potential priority need areas were identified based on the primary and secondary data. These ten potential priority needs were displayed on large sticky notes. On each of the ten sticky notes, the following questions were listed: “What will we do?”, “How?”, and “Who is responsible?”. Each participant was given three stickers and asked to vote on three of the ten priorities using the stickers. Participants were also asked to answer the questions listed on the large sticky notes. During the first round of voting, four priority need areas emerged. Two priorities were tied in the number of votes, and an open discussion was conducted to determine the possibility of combining priorities to achieve attainable goals. Another vote via a show of hands occurred related to combining priorities. This vote determined it was best for Transportation & Transit to remain a single priority and Physical Health (Chronic Diseases, Cancer, Obesity) and Healthcare Access & Quality to be combined into one priority.

The final priority need areas were not ranked in any particular order of importance, and each will be addressed by the Steering Committee. The following three focus areas (Mental Health, Physical Health/ Healthcare Access & Quality, and Transportation & Transit) were identified as Lenoir County’s top priority health needs to be addressed over the next three years, as seen in Figure 1.4 below:

                                                                                                        Figure 1.4: Priority Health Needs, 2024