Vision Statement

The Nash County Community Health Needs Assessment (CHNA) is a broadly-inclusive and collaborative effort that is conducted every three years to identify and prioritize health needs that are significant for those who live in the county. This exercise provides current-state insight regarding health concerns in the county to inform strategic planning for the improvement and creation of impactful programs and policies for eliminating health disparities and improving health outcomes.

Leadership

The 2021-2022 CHNA leadership is a bi-sectoral effort supported by various community organizations. Nash County Health Department and Nash UNC Health Care are the partner organizations leading the Community Health Assessment (CHA) process. Both organizations have designated staff working in collaboration for the planning and coordination of CHA efforts under the leadership of:

• William W. Hill, Jr., Health and Human Services Director - Nash County Health Department
• L. Lee Isley, President and Chief Executive Officer - Nash UNC Health Care

Partnership/Collaborations

Establishing partnerships is critical to improving the health and well-being of citizens in Nash County. The Nash County Health Department and Nash UNC Health Care contacted approximately 100 individuals, currently providing community services for children and adults, to engage them in the CHNA process. Over half of the individuals responded and committed to participate in a seven-month process of planning, survey promotion/distribution/collection, and stakeholder meetings. The partners consisted of various community sectors engaging in activities focused on physical and mental health, emergency services, environmental health, education, housing, research, food access, economic development, planning, transportation, organizational board members, etc. See the following categorized table for the number of partners involved in the 2021-2022 CHNA process.

The categorized sectors and partners involved in the CHNA process include:

Regional/Contracted Services

The health department and hospital established an agreement with Health ENC to provide technical assistance in the CHNA planning process for data collection and analysis. Health ENC is a program of the Foundation for Health Leadership and Innovation (FHLI) focused on improving health in North Carolina. Through FHLI, the Health ENC program helps build coalitions and partnerships that will address health issues identified in the regional CHNA process.

Theoretical Framework/Model

The Community Health Needs Assessment Planning Team adopted the North Carolina Division of Public Health’s eight-phase approach as the theoretical framework/model to establish collective impact. This approach allows partners to engage the community in meaningful conversations about health and better positions partners to address priorities to make a collective impact. We also used the Collective Impact Model throughout the CHA process. Collective impact aims to shift organizations working from isolation to collective impact and encourage more collaboration and public-private partnerships. It allows partners to focus on the organization's relationship and the progress toward shared objectives. The five Collective Impact steps used to align the CHNA include:

Collaborative Process Summary

The collaborative process included monthly meetings that occurred in a seven-month process between Nash County Health Department, Nash UNC Health Care and various community partners. A Community Assessment Planning Team was established to formalize the planning process, engage community partners, and host community stakeholder meetings to determine health priorities. The planning team coordinated bi-monthly meetings to develop the assessment plan with technical assistance from Health ENC. In addition, Nash County Health Department and Nash UNC Health Care attended various regional community action planning meetings held by Health ENC to gather insight for developing the county plan. From April 2021 to November 2021, the planning team collected surveys, analyzed data, and held two stakeholders' meetings. A total of eleven key community partners lead survey distribution and collected approximately 1,076 English and 46 Spanish surveys. The surveys were distributed through various community sites (online, Covid-19 vaccination sites, health fairs, worksites, organizations, businesses, and schools).

Key Findings

Key findings for Nash County from the Community Health Assessment survey samples found:

• Senior population (ages 55 and older) has been steadily increasing and exceeds the state’s average rate of growth. 
• Adult obesity continues to be a concern among residents. 
• Racial and ethnic disparities exist across nearly all health outcomes.
• Black residents have higher poverty rates than any other racial categories.
• High poverty rates are linked to drug and alcohol abuse, violent crimes, housing issues, access to care and food insecurity issues.
• Top ways to better support communities include transportation access, crime reduction, physical activity infrastructure, affordable housing, access to healthcare, education system improvements, and community outreach to improve quality of life and address health concerns.
• Majority of residents feel that Nash County is a safe place to live, work, and play.

Health Priorities 

The top three 2021-2022 Nash County health priorities include: