Haywood County 2021 Community Health Assessment Executive Summary

Community Results Statement

The ultimate goal for Haywood County is to build a healthy and resilient community.

Leadership for the Community Health Assessment Process

A data team of community partners and the public health education team from Haywood County Health and Human Services led the CHA process. Following internal review of both primary and secondary data, the data team received a condensed list. This team provided input to public health staff on which data to review during the prioritization process.

Partnerships                                                                                                                                                                                                       

Regional/Contracted Services

Our county received support from WNC Healthy Impact, a partnership and coordinated process between hospitals, public health agencies, and key regional partners in western North Carolina working towards a vision of improved community health. We work together locally and regionally to assess health needs, develop collaborative plans, take action, and evaluate progress and impact. This innovative regional effort is coordinated and supported by WNC Health Network. WNC Health Network is the alliance of stakeholders working together to improve health and healthcare in western North Carolina. Learn more at www.WNCHN.org.

Theoretical Framework/Model

WNC Health Network provides local hospitals and public health agencies with tools and support to collect, visualize, and respond to complex community health data through Results-Based Accountability™ (RBA). RBA is a disciplined, common-sense approach to thinking and acting with a focus on how people, agencies, and communities are better off for our efforts.

Collaborative Process Summary

Haywood County’s collaborative process is supported on a regional level by WNC Healthy Impact.

Locally, our process began with an internal public health education team reviewing a large list of primary (newly collected) and secondary data (existing). The team narrowed the list before sharing with a data team of community partners. The data team further reviewed the information and arrived at a ‘short list.’  Before and during prioritization meetings, participants received opportunities to review this data. Following a data presentation, participants used a ‘Local Rating and Prioritization’ worksheet to rate the relevance, impact, and feasibility of addressing the key issues presented. After arriving at their top three scores, each participant selected their top three key issues using an online poll. The three top-scoring areas overall are the county’s new health priorities. 
 

Phase 1 of the collaborative process began in January, 2021 with the collection of community health data. For more details on this process see Chapter 1 – Community Health Assessment Process.

Key Findings

Findings that were particularly telling included: 

• Chronic Disease

  • Over 72% of individuals are experiencing overweight or obesity (WNC Health Network, 2021), root causes for many chronic diseases. This was an increase from 2018.

• Substance Use and Mental Health

  • Over 88% reported feeling hopeful, but 23% of individuals experienced more than seven days of poor mental health in the past month, an increase from 2018. In addition, over 18% were unable to get necessary mental health care in the past year, also an increase from 2018 (WNC Health Network, 2021).

  • A decrease in all opioid use (prescription and non-prescription) was reported: 15.3% vs. 12.4% (WNC Health Network, 2021).

  • Alcohol continues to be a widely misused substance, with over 12% of adults reporting  past-month binge drinking, an increase from 2018  This was defined as five or more drinks for a man or four or more for a woman during any occasion (WNC Health Network, 2021). In addition, Haywood County residents made over 500 emergency department visits in 2021 for ‘alcohol abuse and dependence,’ a decrease from over 600 visits in 2018 (North Carolina Disease Event Tracking and Epidemiologic Detection Tool*, 2022). **NC DETECT is a statewide public health syndromic surveillance system, funded by the NC Division of Public Health (NC DPH) Federal Public Health Emergency Preparedness Grant and managed through collaboration between NC DPH and UNC-CH Department of Emergency Medicine’s Carolina Center for Health Informatics. The NC DETECT Data Oversight Committee does not take responsibility for the scientific validity or accuracy of methodology, results, statistical analyses, or conclusions presented.

• Violent Crime

  • A larger number of survivors were served by domestic violence shelters: 413 vs 320 (NC Department of Administration, 2021).

  • The community has experienced an increase in violent crime: 342.7 vs 326.8 per 100,000 (NC Department of Justice, 2021).

• Social Determinants of Health

  • Over 12% reported a loss of health Insurance during the pandemic, with 24% losing work hours or wages (WNCHN, 2021), affecting access to care. This is a point-in-time figure.  

  • In spite of a pandemic, fewer people reported experiencing food insecurity: 3.4% vs. 18.9% (WNC Health Network, 2021).

  • While over 13% of residents live below the poverty level, this figure sharply increases to 33% for those under age 5. This data point is unchanged, as we reviewed a 2015-2019 estimate (U.S. Census, 2021).

• The top three health priorities identified through the Online Key Informant Survey were the same as those emerging from health prioritization meetings.

Health Priorities

1. Mental Health

2. Obesity

3. Substance Use

      *Obesity and substance use received an equal number of votes during prioritization meetings.

Next Steps

• Monthly action team meetings based on each health priority;

• Engage existing and new partners in health priority action teams;

• Select priority strategies and performances measures to help us evaluate community health improvement progress;

• The evidence-based strategy, Results-based Accountability (RBA), will be utilized to guide decision-making to create swift and effective health improvements;

• The county’s health action teams will hold ‘Getting to Strategies’ meetings during spring 2022. These meetings will include discussing the quality of life conditions desired for the county, the county’s progress on related data points, partners with a role to play, and possible evidence-based strategies.

• Following completion of strategy development for each priority area, the Community Health Improvement Plan (CHIP) will be published using electronic scorecard software. The scorecard allows anyone to monitor progress of the CHIP, the current plan shown here. A CHIP, built from evidence-based strategies, is submitted to the North Carolina Division of Public Health.

• To access the full data set(s) (primary and secondary data), community members are encouraged to contact megan.hauser@haywoodcountync.gov.

1. Mental Health
2. Obesity
3. Substance Use

      *Obesity and substance use received an equal number of votes during prioritization meetings.