VISION STATEMENT

PURPOSE OF THE COMMUNITY HEALTH ASESSMENT

The purpose of a community health assessment (CHA) is to collect and analyze data to determine the needs of a community, as well as identify community resources and assets that can improve the community’s health and wellbeing. Assessment priorities are identified with community input. The process and final report promote collaboration between local leaders to leverage shared resources and expertise to act on these community priorities.

PARTICIPATION & COMMUNITY ENGAGEMENT

Granville Vance Public Health (GVPH) consulted with NCIPH to facilitate the assessment process. In addition to the GVPH leadership team, a steering committee comprised of representatives from various health and human service organizations in both counties met regularly to plan, review and analyze data, and discuss priorities. Community input is a crucial part of an assessment, and GVPH engaged community members throughout the process. The Community Health Opinion Survey (CHOS), conducted in both Granville and Vance Counties, engaged 226 community members to learn more about their personal health status and concerns, as well as their concerns for the community as a whole. Additionally, community members in Granville and Vance were invited to participate in focus groups to share their experiences living and working in both counties. The focus group topics and populations were identified by the GVPH leadership team to ensure a diverse set of voices and experiences were represented; they included youth, youth service-providers, the Latinx community, residents in public housing, and residents in Henderson. Finally, community members were invited to vote on a set of priorities for the CHA cycle based on the information gathered during the assessment.  

LEADERSHIP

Community Health Assessment Team

The Community Health Assessment (CHA) team and Granville Vance Public Health (GVPH) met monthly from August 2021 to May 2022 coordinate the work of the CHA. The team was led by Ashton Johnson and Lisa Harrison and included consultants from the North Carolina Institute for Public Health (NCIPH; see section below for full list of NCIPH contributors). This team focused on managing the CHA data collection and timeline and coordinating with the Steering Committee for strategic direction.

Steering Committee

The Steering Committee met bimonthly throughout the assessment process to provide input on survey questions, determine focus group populations and topics, promote participation in CHA activities, review assessment data, and prioritize topics.

PARTNERSHIPS

REGIONAL CONTRACTED SERVICES

Granville Vance Public Health contracted with NCIPH at the University of North Carolina-Chapel Hill to facilitate the Community Health Assessment process and report-writing. The following report was drafted by the NCIPH team and reviewed by the CHA Team and Steering Committee members. NCIP members contributing to this report include:

PROCESS

The CHA Team worked from August 2021 to May 2022 to collect and analyze data, present it for discussion to the steering committee and community members, and set priorities that represent the counties’ needs and concerns. The data collection process included primary data – data collected directly from the community through the community health opinion survey and focus groups – as well as secondary, or existing, data. The secondary data sources included the North Carolina Center for Health Statistics, the United States Census Bureau, and local government, among others.

COMPARISONS AND TARGETS

Throughout the data collection and analysis process, the CHA team compared data from Granville and Vance Counties to two peer counties, Franklin and Warren, which were chosen for their similarity to the district in geography, demographics, and economic indicators. Data was also compared to the state of North Carolina, as well as targets from the Healthy North Carolina 2030 objectives, which serve as a health improvement plan for the state.

ASSESSMENT FINDINGS

Key takeaways from this assessment include greater awareness of health disparities, such as cancer incidence and mortality. Cancer is the leading cause of death in Granville (170.3 per 100,000) and Vance (199.2 per 100,000) Counties. Cancer mortality is higher for Black/African American community members than for white community members and higher among males than females. Cancer Incidence of newly-diagnosed cancer is greater in Granville (529.6 per 100,000) than Vance (482.8 per 100,000). Although cancer incidence is higher in Granville, Vance has higher mortality due to cancer. ¹ This disparity suggests that residents in Vance may experience barriers to accessing screening and diagnostic services and receiving treatment.

Mental health and substance use continued to be community priorities in this cycle of health assessment. Mental health services ranked high as a needed health service among Community Health Opinion Survey (CHOS) respondents. Focus group discussions identified the need for mental health support among youth and adults. Focus group participants highlighted the following factors as contributing to poor mental health among youth: the stressors and isolation associated with the COVID-19 pandemic, bullying, excessive screen time, and limited opportunities for socialization and physical activity. Barriers to assistance included lack of insurance, the stigma around mental health, and insufficient numbers of providers, including providers representative of the community. Community assets through which residents strengthen their mental health include recreation, cultural events, and education.

Among respondents to the CHOS, substance use disorder ranked as the second most important health and safety issue in both counties. Opioid overdose visits to the emergency room were higher in Granville and Vance than in their peer counties, and across both counties, males have experienced a larger burden of unintentional medication and drug overdose death, 40.1 per 100,000 male population in Granville and 75.8 per 100,000 male population in Vance. Community members participating in focus groups identified substance use as both a personal health and community challenge. They drew specific connections between substance use and community violence.

Before the COVID-19 pandemic, the top three communicable diseases were Chlamydia, Gonorrhea, and Hepatitis C. Vance had a higher rate of diagnosed Chlamydia and Gonorrhea cases than Granville and peers in the 2016-2020 period reviewed for this assessment. ¹ Focus group participants cited concerns related to stigma and confidentiality as barriers to using existing testing and treatment services. In 2020, the COVID-19 pandemic profoundly shaped the daily lives and health of people across the world and in Granville and Vance Counties. COVID-19 became the leading communicable disease spreading among community members. As of March 1, 2022, 111 deaths in Granville and 112 in Vance have been attributed to COVID-19. ² By March 9, 2022, 66% of Granville community members and 62.1% in Vance had received at least one dose of the COVID-19 vaccine, and 62% in Granville and 56.8% in Vance had received the full series of vaccinations. Fewer community members have received a booster dose in both counties.³

This assessment identified many bright spots, strengths, and assets in addition to community challenges. A notable achievement in Vance is the continuous positive trend in high school graduation rates since 2014. In 2020, Vance County reached a 90% graduation rate for all students, exceeding the state average. In addition, graduation rates have increased by over 15% for economically disadvantaged students and almost 25% among male students. Successes in Granville include meeting or exceeding the state's community health improvement goals, such as a low percent of households with a severe housing problem, exceeding the goal for the provider to population ratio, and reporting a lower number of deaths than the goal for drug overdose deaths.

PRIORITIZATION

The NCIPH team conducted a series of three virtual data walks to provide an overview of the findings from the data collection and analysis and facilitate open discussion among community leaders. Following the data walks, an online prioritization survey was distributed to community members, and five priority areas received the most votes by community respondents: mental health and substance use, access to healthcare, youth well-being, community safety, and access to healthy food and physical activity. From this list of five, the GVPH leadership team selected mental health and substance use disorder, access to healthcare, and engaging youth to advance community health and safety as the top three priorities for the 2021-2024 CHA period. Health equity is central to all community health improvement work, as the community cannot become healthier if disparities are not addressed. Therefore, the goal of working to achieve health equity among all community members runs within each of the prioritization areas.   

Mental Health and Substance Use

Engaged Youth for Community Health and Safety

Access to Health Care