The 2023 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.

Clay County, nORTH cAROLINA

(U.S Census Bureau, 2023 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

Unfortunately, the healthy lifestyle in-class environment was not able to be successfully completed. However, we have received several responses to our educational information that is shared through our social media accounts. We will continue to work on different avenues to engage our community towards a healthier lifestyle.

In the meantime, the Clay County Health Department decided to have our Healthcare Providers become educated through lunch and learns regarding new weight loss medications available.

Worksite Wellness

Clay County Health Department was unable to receive grant money to implement the worksite wellness program for our county employees, but we were able to help another facility with their worksite program. Clay County Health Department teamed up with the Clay County School System to help them implement a wellness event for all teachers. During our event, we performed blood draws (CBC, CMP, LIPID, HgbA1C, Thyroid Panel, and Uric Acid), hearing screenings, blood pressure checks, vision screenings, and weight/ BMI checks. In total, we were able to perform 20 blood draws and several other screenings.  Since the wellness event was a big success, Clay County Health Department plans to continue to work with Clay County School System again this year.

Community Health Project

The community health project was initiated due to a mini-grant being awarded to the Clay County Health Department through the WNC Healthy Impact partnership. 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 their willingness to do self-care. Since the beginning of the Community Health Project, Clay County Health Department has given out 63 blood pressure cuffs, 33 incentive spirometers, 18 glucose monitors, and 10 pulse oximeters. Unfortunately, our supplies of blood pressure monitors and incentive spirometers have come to an end. However, our goal is to find another mini-grant to help purchase more blood pressure monitors and incentive spirometers since it made a big impact on managing these chronic and acute conditions.

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 2023 alone, we have given 313 Influenza vaccines, 93 Pneumonia vaccines, and 212 COVID-19 vaccines. Many of these vaccines were given through off-site outreach clinics and even in-home services. Starting in December 2023, Clay County Health Department will be administering RSV vaccines (Abrysvo) to those who are 60 years of age or who are currently pregnant within their 32 to 36 weeks gestational age. Administration will be provided seasonally with a one-time dose of the vaccine.

 Monoclonal Antibody Therapy Program

The monoclonal antibody therapy was completed in March 2022 and is no longer being done at Clay County Health Department. However, Clay County Health Department is still working with their patients to prescribe antiviral therapy to those who become positive for COVID-19 and would like to receive the antiviral treatment.

Priority Three: Prevention and Screening of Cancer

Breast and Cervical Cancer Control (BCCCP) Program

Breast and Cervical Cancer Control Program helps screen or identify abnormalities within a patient’s breast tissue or cervix. This program is aimed to help those individuals who do not have insurance and has very little income. Within 2022-2023, Clay County Health Department has set up 46 individuals with breast and/or cervical screenings, and 9 of those individuals needed to have further testing to help rule out cancer. Since June 2023, Clay County Health Department is assuring BCCCP services through an alternative practice. Therefore, if any clients are in need of these services, they are being referred to Haywood County (Blue Ridge Health).

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. Clay County Health Department has had a total of 11 people who were willing to have our clinic fax a referral to the Quitline NC. Even though, many patients do not want to be referred at the time of their visit, we still provide them with the resources to the Quitline in hopes they will decide to call. 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. The Relay for Life event took place on May 20^th 2023.  Overall, we have raised 700.00 in funds to go towards American Cancer Society.

Morbidity and Mortality Changes

Current reports from the North Carolina State Center for Health Statistics shows that Clay County has high rates of chronic diseases that have increased over the past few years. In 2017-2021, cancer had increased with 151 total deaths from 148 total deaths in 2016-2020. In 2017-2021, diseases of the heart increased to 180 deaths from 170 deaths in 2016-2020.  We have also discovered that since COVID-19 erupted in 2020, the number of deaths related to respiratory illnesses has increase to 67 total deaths with 51 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 State of the County Health Report was based off of in 2022. 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 2017-2021.

 Table 2 - Leading Causes of Death 2016-2020.

Emerging Issues since last community health assessment

• An emerging issue with teenagers vaping within the local school system.
• Mental Health continues to be a concern as there are limited providers/resources available.
• Social determinates of health continue to be a challenge for our residents along with the lack of access to healthcare.
• Increase interest in new weight loss medication (Wegovy) but lack of funding for patients to have access to the medication.
• Homeless population has increased.
• Workforce recruitment and retention.
• Substance use disorder continues to be a concern.
• Affordable housing
• Childcare (limited related to closing of southwestern child development centers).

New/ Paused/ Discontinued initiatives since last community health assessment

• Clay County Health Department has decided to discontinue the BCCCP program as of June 2023.
• Relay for Life was completed on March 20^th 2023. The year 2024 has been placed on pause for any future plans of another Relay for Life.
• The administration of the new RSV vaccine to those individuals who are 60 years of age or are 32-36 weeks pregnant started in December 2023.
• Clay County Health Department will continue to work closely with Clay County School System with their staff wellness project.
• Smoky Mountain Pregnancy Center offers services to pregnant woman here at Clay County Health Department with their mobile unit.
• Community Paramedic Increasing opportunities for telehealth.