The 2022 State of the County Health (SOTCH) Report presents an update on the current health status of Clay County residents. The SOTCH provides health information that is intended to augment the 2021 Community Health Assessment (CHA) that is conducted every four years and includes a more comprehensive analysis of the overall health status of the county. The main priorities identified from the 2021 Community Health Assessment were:

1. Chronic Disease Control and Prevention
2. Prevention and Management of Acute Respiratory Infections
3. Prevention and Screening of Cancer

This report demonstrates progress made in the last year as it relates to these health priorities, recent health statistics, new initiatives and emerging issues that may impact the health status of residents in Clay County. The 2021 CHA and previous SOTCH reports may be found at the county library, the health department, or online at https://www.health.claync.us/community-health-assessment                              

(U.S Census Bureau, 2021 Quick Facts; N.C Institute of Medicine)

Progress on Community Health Improvement PLAn

Priority One: Chronic Disease Control and Prevention

Healthy Initiative-Clay County BeFit

The Clay County Health Department decided to create a program that provided information to the public through lunch and learns along with healthy lifestyle posts on social media. To better understand what our community would like to learn more about, Clay County Health Department decided to create a survey asking clients what they would like to learn about health wise. Unfortunately, the responses have been very minimal and the majority of individuals would prefer to not have an in-class environment but more of a virtual learning. Since the use of social media to educate individuals about healthier lifestyles, we have seen an increase in individuals being reached with this information.

Worksite Wellness

Clay County Health Department found an opportunity to write for a grant to help improve the lives of our county employees. With this grant, our hope was to bring in incentives to motivate individuals in becoming healthier. However, the grant that the Health Department was writing for was not granted to us. Even though, we have encountered this small bump in the road, we are still exploring other avenues to get this program started for a healthier future for our employees.

Community Health Project

The community health project was initiated due to a mini-grant being awarded to the Clay County Health Department. This grant was used to buy blood pressure monitors, incentive spirometers, pulse oximetry monitors, and blood glucose machines. Since this purchase, we have helped several individuals who could not afford these items on their own. We have seen an improvement with patients’ self-care. Patients are taking the initiative to be proactive in their care and learn the importance of proper monitoring when dealing with both acute and chronic conditions. Our goal is to continue to work with these individuals and hopefully see improvements overall within their health.

Priority Two: Prevention and Management of Acute Respiratory Infections

Immunization Program

Clay County Health Department offers an immunization program that encourages patients to receive vaccines to help eliminate vaccine-preventable diseases, especially those that can cause respiratory infections. Through promotions within our media outlets, Clay County Health Department is determined to bring awareness to vaccines and how they can be beneficial. In the year 2022 alone, we have given 434 Influenza vaccines, 75 Pneumonia vaccines, and 1,082 COVID-19 vaccines. Many of these vaccines were given through off-site outreach clinics and even in-home services.

Monoclonal Antibody Therapy Program

Monoclonal Antibody Therapy helps those individuals who are at a greater risk of being hospitalized with COVID-19 build their immune system up to fight off this infection. The program started in September 2021 and was completed in March 2022. During that time, we treated 344 individuals with Monoclonal Antibodies and only 8 reported hospitalizations post treatment. To our knowledge, there were no deaths involving those who were hospitalized after receiving the Monoclonal Antibody treatment. As the year continued and more research was discovered, it was determined that oral antiviral medications were the best practice for patients versus Monoclonal antibody treatment. Sadly, due to this change, Clay County Health Department decided to stop the program until Monoclonal Antibodies were needed again.  

Priority Three: Prevention and Screening of Cancer

Breast and Cervical Cancer Control Program          

Breast and Cervical Cancer Control Program helps screen or identify abnormalities within a patients breast tissue or cervix. This program is aimed to help those individuals who do not have insurance and has very little income. Within 2021-2022, Clay County Health Department has set up 59 individuals with breast and/or cervical screenings, and 9 of those individuals needed to have further testing to help rule out cancer. This current program will continue until June 2023.

Promotion and Referral to Quitline NC

Quitline NC is a program that helps individuals receive counseling and techniques to stop smoking. Within our clinic, each patient is asked about their smoking status and asked if they desired to stop smoking. Unfortunately, we have had only four individuals that requested to be referred to the Quitline NC. Clay County Health Department is continuing to figure out a more appealing way to get individuals encouraged to quit and seek out the Quitline NC.

Relay for Life-Festival of Hope

Relay for Life is an event that the Clay County Health Department hoped would bring awareness back to the community regarding cancer and the importance of early screenings. Overall, we have raised 646.97 in funds to go towards American Cancer Society and continue to find avenues to raise more money.

On December 3, 2022, Clay County Health Department had our very first kick-off for Relay for Life. At this event, we provided individuals with information on what Relay for Life involved and how to become a team member. This outreach helped share the excitement for this event and let them know when the main event would take place.  Monthly meetings are being held to monitor progress and brainstorm more ideas to make our festival of Hope a success.

Morbidity and Mortality Changes

Current reports from the North Carolina State Center for Health Statistics continues to show that Clay County has high rates of chronic diseases, but are showing some mild improvements within the disease process. In 2016-2020, cancer had made a small improvement with 148 total deaths from 158 total deaths in 2015-2019. Unfortunately, in 2016-2020, diseases of the heart increased to 170 deaths from 163 deaths in 2015-2019.  We have also discovered that since COVID-19 erupted in 2020, the number of deaths related to respiratory illnesses has increase to 24 total deaths with 8 of those being COVID-19 related. To show a comparison, Table 1 is the most recent statistical data, and Table 2 is the statistical data that the Community Health Assessment was based off of in 2021. Even though these numbers can be discouraging, Clay County Health Department is determined to continue to improve these numbers and continue to increase our life expectancy. Our progress towards these community improvement activities can be found within this document. One main challenge noted, is making sure that residents understand the importance of assessing their own personal choices and behaviors, and how their decisions may impact their health outcomes.

Table 1 - Leading Causes of Death 2016-2020.

Table 2 - Leading Causes of Death 2015-2019.

 North Carolina State Center for Health Statistics (NC SCHS). (2020). Causes of Death. [Data tables]. Available from https://schs.dph.ncdhhs.gov/data/

Emerging Issues since last community health assessment

• COVID-19 testing, antivirals, and vaccinations have become a new normal within the health department.
• An emerging issue with teenagers vaping within the local school system.
• Mental Health concerns are an ongoing issue within the community and has gotten worse since the start of the pandemic.
• Social determinates of health continue to be a challenge for our residents along with the lack of access to healthcare.
• In 2022, Influenza continues to spread rapidly with more patients ending up at the hospital.
• Within the last six months, Clay County Health Department has seen 5-10 initial Herpes cases throughout the community.
• Within the last year, Clay County Health Department has treated 5-10 cases of Syphilis from individuals within our community or those residing surrounding counties.

New/ Paused/ Discontinued initiatives since last community health assessment

• Clay County Health Department has decided to discontinue the Monoclonal Antibody Therapy due to new research and recommendations involving better treatment for COVID-19.
• The worksite wellness program has been paused until a grant is found to help support program implementation.