The Executive Summary can be found on pages 6-10 of the 2021 Mitchell County Community Health Assessment. 

Mitchell County 2021 Community Health Assessment Executive Summary

Community Results Statement

Our mission is to partner with local agencies to not only identify health needs of our community, but to also explore and develop possible solutions to address health concerns in order to work toward improving health for all residents.

Leadership for the Community Health Assessment Process

Many local organizations assisted the local health department with the creation of this document. Among those were community leaders, public health agencies, businesses, medical community, school systems, and local faith-based organizations and churches. This team worked to identify, collect, analyze, and disseminate information on community assets, strengths, resources, and needs.  This document is the result of collaboration between Toe River Health District, WNC Healthy Impact, and the Mitchell County Health Partnership.

Partnerships

A health department-led comprehensive Community Health Assessment (CHA) provides community insight into the health status of the county. Through the use of surveys, focus groups, interviews, community members, local government and business leaders, and health professionals came together to identify and prioritize health issues. Participating in the assessment process put the county in a position to take the next steps in developing policy, environment, and system changes that support their concerns. Currently in Mitchell County there is a coalition to bring together all the organizations and individuals that are committed to improving health in the county. This group consists of motivated individuals who are advocates on behalf of a broad range of community members and can represent appropriately the concerns of various populations within the county. The limited resources available in the county demonstrates a need for a coalition who will take responsibility and provide leadership for promoting and supporting policy, systems and environmental change that support healthy eating, and increase physical activity and prevent tobacco use throughout the county to combat most chronic disease conditions.

Membership Mitchell County Health Partnership

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

Collaborative Process Summary

Mitchell County’s collaborative process is supported on a regional level by WNC Healthy Impact (WNCHI).  The Community Health Assessment outlines the community’s current health status.   Based upon findings, steps have been developed to implement interventions, as well as community resources to address these health issues.

The collaborative process includes input from the community as an important element of the community health assessment process. Our county included community input and engagement in a number of ways: (1) Partnership on conducting the health assessment process; (2) Through primary data collection efforts; (3) In the identification and prioritization of health issues. Community engagement is an ongoing focus for our CHA Leadership Team as we move forward to the collaborative action planning phase of the community health improvement process.  Partners and stakeholders with current efforts or interest related to priority health issues will continue to be engaged. We also plan to work together with our partners to help assure programs and strategies in our community are developed and implemented with community members and partners.

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

A community wide 76-questionnaire was conducted to give residents an opportunity to express concerns and opinions about the quality of life in Mitchell County. This included questions about the quality of life, economy, education, health, housing, physical activity, social issues, transportation, and COVID. Surveys were conducted by telephone by a trained interviewer and efforts were made to reach a representative sample of the population.   Self-administered surveys were also available online. A total of 244 Mitchell County surveys were analyzed: 200 via telephone interview and 44 via the publicly available weblink.   

Some of the major findings that the Mitchell Community Health Partnership discussed in the prioritization process included that 54% of respondents stated that their life has been negatively influenced by substance abuse. An increasing proportion of participants have had more than seven days or poor mental health in the past year and 15% of respondents did not get needed mental health care or counseling in the past year.  Three quarters of Mitchell County survey respondents had a Body Mass Index in the overweight or obese range; 39% had been diagnosed with high blood pressure. 

In additional to secondary data and survey collection, nine (9) community stakeholders participated in an online key informant survey.  Individuals were asked to consider specific health issues, provide comments about social determinants of health, and evaluate the strengths and opportunities of the Mitchell County community. The graphic displays a summary of their ranking of health topics in the community.

During monthly meetings, standards for the Community Health Assessment Process and Accreditation were discussed and reviewed for publication in the 2021 Community Health Assessment. Each member reviewed and approved of the Community Health Assessment Survey and Community Resource Directory included in the assessment. After the analysis was completed, qualitative and quantitative data findings were presented to the Community Health Assessment team. The team reviewed the data and developed the top ten major health issues based upon statistical data and community survey results.

Based on findings from the community survey combined with secondary health data, in November 2021, Mitchell County Health Partnership members identified ten (10) chief health concerns for the county.

Health Priorities

In November 2021, the CHA Team members participated in a prioritization activity to determine the three leading health concerns to be addressed during this cycle. The worksheet asked that each of the ten concerns be ranked, as to find a top three concerns to take action. The results from the prioritization process are reviewed and discussed at the meeting. The final health concerns are named as the focus for the next four-year cycle. Results of these worksheets were calculated to come up with the top three priorities, which are as follows:

1. Mental Health/ Substance Abuse/Domestic Violence 
2. Access to Care/ Use of Services 
3. Chronic Disease/Obesity/Healthy Lifestyles

Next Steps

The 2021 CHA will be disseminated in a variety of ways. To begin, the document will be made available online at http://www.toeriverhealth.org.  Hard copies will also be available at the Health Department, local library, and printed upon request. The CHA Facilitator will present the CHA data during a Board of Health Meeting, Health Partnership meetings, Mitchell County Health Department staff meeting, and upon request.

Further steps will be taken including the development of a community health improvement plan based on the findings from the CHA. The CHA Facilitator will convene community members and partners interested in moving forward on the selected health priorities. Action teams will emerge from the selected health priorities and the teams will begin brainstorming evidence-based strategies.

Collaborative action planning with hospitals and other community partners will result in the creation of a community-wide plan that outlines what will be aligned, supported and/or implemented to address the priority health issues identified through this assessment process.  The next steps will be to formulate action plans regarding these three prioritized health concerns, starting with determining what is currently going on regarding the top health concerns, and what we would like to see going on regarding these health concerns.

The health partnership will create subcommittees for each health concern and these committees will work on creating collaborative action planning and implementation efforts. Upcoming meetings will be scheduled, and partners will be notified.  We will conduct a root cause analyzes and identify possible evidence-based strategies to tackle the health concerns during the action planning process. 

While much work has already been done to improve the health of our community’s residents, more work is left to do to ensure that Mitchell County is the healthiest place to live, learn, work, and play.

The 2021 Mitchell County Community Health Priorities are: 

1. Mental Health/ Substance Abuse/ Domestic Violence

2. Access to Care/ Use of Services

3. Chronic Disease/ Obesity/ Healthy Lifestyles