This 2022 State of the County’s Health Report shares progress on Guilford County Division of Public Health’s Community Health Improvement Plans (CHIP) to address two priorities identified in the 2019 Guilford County Community Health Assessment (CHA): 

• Maternal and Child Health and 
• Behavioral Health and Opioid Misuse.  

We also highlight changes in mortality and morbidity since Guilford County Division of Public Health's (GCDPH) last CHA, emerging issues are impacting our community, and other select community initiatives that are underway to address our community’s health.  

Maternal and Child Health

Family Connects Guilford, Care Management for High-Risk Pregnancy, and Care Management for At Risk Children

Family Connects Guilford (FCG), Care Management for High-Risk Pregnancy (CMHRP), and Care Management for At Risk Children (CMARC) continue to provide invaluable community-based services to support pregnant women and their families in Guilford County. Following the Family Connects International evidence-based model for implementation, the FCG program offers nurse home/telehealth visits and follow up contacts to all Guilford County residents following the birth of a baby, providing support, education, and early identification and referral of health and safety concerns. The CMHRP program provides free case management services to high-risk pregnant women enrolled in NC Medicaid and a limited number of low-income or uninsured pregnant women. CMARC is free case management for children up to five years of age who are born with chronic conditions, at risk for developmental delays or have been impacted by social determinants of health and toxic stress or trauma. Staff from all three programs continue to have a significant impact on the lives of expectant mothers and their children as we all continue to adapt to the challenges of the COVID pandemic. For more information about these programs, click here.

Family Connects Guilford (FCG):  On April 1, 2022, FCG staff transitioned back to in-person in- home visits. For the 2022 calendar year, FCG staff engaged 4,664 families with new infants and completed 2,606 home visits or supportive calls with these families (56% of those engaged). For those families who declined the in-home in-person visit, supportive calls continued to be offered per Family Connects model guidelines. FCG nursing staff continued to serve all families in Guilford County including the 27260 and 27262 zip codes, where low birth weight and infant deaths are more concentrated. Of the home visits or supportive calls provided, 867 families had an identified risk, and 3,152 referrals were made to assist these families. Identified risks may include needed supports for health care, caring for an infant, a safe home, and supports for parents.

To support program development, FCG worked with Coastal Cloud in developing a new internal database on the Salesforce platform in 2022 and successfully implemented the new Family Connects Management Information System (FCMIS) on September 13, 2022. We also continue to recruit and interview applicants for our open positions. During 2022, several nurses completed the NC Lactation Education Training Program.  Two nurses graduated in December from UNC Wilmington with their Master’s in Nursing Education (MSN-NE).  One nurse received Lactation Consultant Certification (IBCLC) in January 2022, and one nurse is currently participating in the NC A & T Human Lactation Pathway 2 Program.

CMHRP: During 2022, CMHRP case managers successfully engaged 1,220 high risk pregnant women. Case managers completed 3,428 face-to-face visits at the OB office or in the home. Over 6,127 patient-centered interactions were completed, including phone calls, videoconferences, texts, and emails. Care Managers are back to meeting with patients face-to-face in the various OB offices within the county and surrounding area, as well as via TeleHealth videoconferencing, to engage and deliver quality care management services to pregnant clients. The strain on the economy found many new mothers lacking resources to purchase personal hygiene items. With the help of a local church, United City Greensboro Church, and a local women’s organization, Women the World Over, case managers were able to assist women in need. The photo to the right shows Melissa Randleman (left), and another one of our care managers, Myrica McCain (right) accepting Unity City Greensboro Church’s donation. Backpack Beginnings continues to support families in Guilford County by supplying food and diapers for the Food Pantries located at the Greensboro and High Point Health Department locations. CMHRP Care Managers continue to deliver these much-needed items to families, along with linking them to sustainable community resources, as added support to families with high-risk pregnancy concerns.  

CMARC: From January through December 2022, CMARC staff enrolled 1,291 new clients and completed 704 socially distanced home visits. At these visits, case managers completed comprehensive needs assessment and developed tailored care plans with goals for families. Case managers also delivered essential supplies such as infant formula, diapers, safe sleep equipment, children’s clothes, and food to entire families. In 2022, CMARC also received 248 Plan of Safe Care-Opioid /Substance Exposed Infant referrals that were assigned for outreach. 

Reproductive Health Services 

In 2022, GCDPH continued to provide quality reproductive health services through its Maternity Clinic, Family Planning/Just Teens clinics and CenteringPregnancy programs. For the 2022 calendar year:

• GCDPH’s Maternity Clinic provided comprehensive prenatal care for 543 women with low to medium risk pregnancies. Of the 342 clients who delivered in 2022, 95% had babies that were more than 2,500 grams at birth and 5% of the babies were low birth weight or under 2,500 grams at birth. For more information about the Maternity Care clinic, click here.
• Family Planning and the JustTEENS Clinics provide comprehensive family planning services for women and men (teen and adult) based on current recommendations from the Women and Children’s Division of the NC Department of Public Health. During 2022, Family Planning and the JustTEENS clinics together served 3,178 clients through 5,388 visits. To learn more, go to the following links: Family Planning Services or the JustTEENS clinic.
• CenteringPregnancy is a best-practice group prenatal care program that follows the recommended schedule of 10 prenatal visits, each lasting 90 minutes to two hours long. This gives women ten times more time with their provider. Women engage in their care by recording their own health data followed by private time with their provider for pregnancy care. After that private time, women engage together during interactive activities and facilitated discussion, developing a sense of community and support. The providers cover information on nutrition, common discomforts, stress, management, labor and delivery, breastfeeding, and infant care. Women of different ages, races, and socio-economic backgrounds share the common experience of pregnancy, birth, and family care in these groups. For clients who delivered in 2022 for which data is available, 0% were low birth weight and 0% of the births were pre-term. Ninety-four percent were breastfeeding at discharge. In 2022, Centering groups continued in a virtual format until November, when two in-person groups started up again. Also, Every Baby Guilford received $23,280 from the Duke Endowment to renovate DPH existing CenteringPregnancy program space (see photo), support training for new staff, and purchase educational materials and snacks for programming. For more information, contact Catherine Richardson at 336-641-4718 or go to PH CenteringPregnancy Program.  

Behavioral Health and Opioid Misuse

Guilford County Behavioral Health Crisis Center 2022 Highlights

The Guilford County Behavioral Health Crisis Center (BHCC) in Greensboro offers behavioral health urgent care, facility-based crisis services, and behavioral health outpatient services provided by Cone Health staff 24 hours a day 7 days a week for both adults and adolescents (ages 4-17) who reside in Guilford County. This facility includes two 16-bed facility-based crisis centers, one for adults at the BHCC site and an adjacently one for children and adolescents with treatment provided by the Alexander Youth Network. Staff treat adults, children, and adolescents in crisis and address their physical, mental and substance misuse issues. This holistic approach includes medical care, treatment for substance use and other specialized mental health treatment. This facility also has pharmacy, outpatient and peer counseling services for adults, adolescents, and children. Guilford County funded the design and construction costs of the centers. All services are available to the insured and uninsured.    

The Behavioral Health Crisis Center continues to expand its operations since it began offering Behavioral Health Outpatient and Urgent Care June 1, 2021.  Below is a summary of accomplishments:

• Since opening in 2021, the BHCC has provided 13,478 outpatient clinic visits and 9,686 urgent care visits (91% have been Guilford County residents). Of these urgent care visits, 79% of patients were stabilized and discharged without hospitalization. During this time, Cone Health Emergency Departments in Guilford County have seen a 20% reduction in psychiatric visits.
• In August 2022, the Facility-Based Crisis therapeutic environment opened, offering lower acuity crisis and detoxification for alcohol use disorder and opioid use disorder. These 16 short-term crisis care beds provide an immediate, safe place for observation and care for adults with significant mental and emotional health care needs, enabling the center to serve those who need more than a therapist visit but less than a hospital stay. From August 1, 2022 through December 31, 2002, 280 patients were served with average duration of 3 days.
• In July 2022, BH Outpatient Services added a long-acting injection clinic for patients with schizophrenia, enrolling and following 90 patients through December 31,2022.
• Medical Construction and Design Magazine features how these Centers have adapted to enhance behavioral health care in their July/August 2022 edition.
• In October 2022, Alexander Youth Network celebrated one year of services for the Child and Adolescent Facility-Based Crisis Center. To view a virtual Tour video of this facility, click here.
• In October 2022, the BHCC hosted a gathering for community providers to support networking.
• Within the next 12 months, the BHCC plans to provide medication assisted treatment (MAT) services and a chemical dependency outpatient program for adolescents.

 Supporting and Empowering Formerly Justice-involved Persons in 2022

The Guilford County Formerly Incarcerated Transition (FIT) program continues to connect justice-involved persons (JIP) with chronic medical conditions, mental illness and/or substance use disorder to patient-centered primary care, assisting with additional insurance, medication assistance and medically related services. Administered by Triad Adult and Pediatric Medicine (TAPM), specially trained community health workers build trust and act as a peer navigator for reentry with a special focus on opioid use disorder. GCDPH contracts with TAPM to provide these important services in Guilford County.

To support justice-involved persons upon release, FIT staff have referral relationships with WellPath, the correctional care entity responsible for clinical care in the jails and the Guilford County Re-Entry Council. On January 24, 2022, TAPM also began office based opioid treatment (OBOT). OBOT is a type of medication assisted treatment (MAT) often used in combination with counseling and behavioral therapies. MAT is a clinically effective approach to help clients maintain their recovery and reduce opioid overdose. NC-FIT/TAPM also provides treatment referrals to the GCSTOP program (for patients without insurance) through a limited grant funded program, Eleanor’s Health (for patients with insurance) and other community partners including Alcohol and Drug Services, Caring Services, Inc., Family Services of the Piedmont, Daymark, and Continuum of Care Services.

During the six-month period from March 1, 2022 through August 31,2022, the FIT program staff:

• Served 147 JIP through 704 contacts.
• Provided 117 social determinant of health referrals, including referrals for food, housing, transportation, employment, education, legal services, job training and other needs, that are vital to a JIP's successful reentry.
• Continued naloxone kit distribution and began fentanyl test strip distribution in 2022 to support harm reduction and distributed 22 naloxone kits and 16 test strips to clients.
• Connected 62 JIP to community health insurance programs during the enrollment period to support their care.
• Greatly increased their community presence through 50 community partner contacts and utilizing TAPM’s mobile unit for events, including blood pressure screenings, food pantries, job fairs, and COVID test kit giveaways.
• Participated in opioid-based and Mental Health First Aid trainings.

For more information about NC FIT, click here.

Collaborative Opioid Efforts in 2022

Guilford County Solution to the Opioid Problem (GCSTOP), a partnership between the University of North Carolina at Greensboro (UNCG) Department of Social Work and Guilford County EMS, continues to work together to reduce overdoses and opioid related deaths and empower clients to enter treatment for persistent substance use and utilize evidence-based harm reduction practices. The Post-Overdose Response Team (PORT) provides case management, counseling, service linkage and harm reduction for those who have experienced an overdose. GCSTOP also provides syringe exchange services, support for those involved with the justice system, and free Hepatitis C testing and linkage to medical care.

From January 1,2022 to December 31, 2022, GCSTOP:

• Had 1,981 contacts with participants.
• Tracked 656 community overdose reversals that originated with GCSTOP.
• Distributed 7,843 naloxone kits.
• Dispensed 332,727 syringes.
• Provided referral and linkages to care. For example, from October 1, 2022 to December 31, 2022, 80% of the 56 individuals who requested referral for substance use treatment attended their appointment and successfully engaged in services.

Collaborative Opioid efforts in 2022 include:

• GCSTOP’s location in High Point is now co-located with Caring Services at 2638 Willard Dairy Road. This location now has an office-based opioid treatment clinic with physician staffing on Friday as well as pharmacy and phlebotomy services. This empowers GCSTOP to connect with individuals through outreach and then refer them to this clinic to get a Medication Assisted Treatment (MAT) prescription within a few days.
• GCSTOP will receive $379,330 in funding from the Carolina Collaboratory Opioid Abatement and Recovery Research Program to increase awareness and decrease later overdoses among the opioid-naïve population through psychoeducation, peer counseling, and safer use supplies such as fentanyl strips and naloxone training. Opioid naïve describes an individual who has not used opioids consistently and may have larger reactions because their bodies are not used to them. Melissa Floyd-Pickard, Ph.D., is the academic partner at UNC Greensboro. This is one of five new research projects through the Carolina Collaboratory focused on community and local government engagement to assist opioid abatement and recovery efforts.  For more information, click here. 
• Kaitlyn’s House, a transitional and sober living home house in High Point is now transitioning under Caring Services in High Point. Caring Services offers a holistic continuum of care to individuals who are ready to make a commitment to their recovery. Kaitlyn’s House is named in honor of Kaitlyn Drake, a Greensboro resident who lost her life to an overdose to heroin laced with fentanyl. Click here for more information about Caring Services. 
• GCSTOP has: 
  • Significantly increased its weekly outreach presence at many Guilford County locations, such as Walgreens, Compare Foods, and others, providing education and naloxone distribution as needed. Click here to see a GCSTOP Weekly Schedule.
  • Provided harm reduction education and naloxone training to the Guilford Community Care Network, North Carolina A&T State University, High Point University, and Family Services of the Piedmont. GCSTOP also partnered with Sandhills Center to train 48 first responders from Greensboro and High Point Police, the Guilford Sheriff’s Office, EMS and Metro 911 on substance use and harm reduction.
  • Continued grant collaborations with the Cone Health Foundation, the Gilead Foundation to support Hepatitis C testing and linkage to medical care, and the Health Resources & Service Administration for Opioid Workforce Expansion.
• Partners GCDPH, GCSTOP, TAPM, the NC FIT program, and UNC Greensboro continue to support the Save a Life Guilford Campaign/savealifeguilford.com website (see photo). This effort seeks to reduce the stigma around substance use disorder that can be a significant barrier to treatment and promote harm reduction strategies such as the uses of Naloxone and where it can be obtained for free in the community.
• These partners also participated in Guilford County’s special opioid settlement meeting on October 31, 2022.
• Partners are also increasing availability of lifesaving medication Naloxone.
  • Free naloxone kits and training on its use are now available at the GCDPH pharmacies and TAPM locations in Greensboro and High Point. For more information, go to: https://savealifeguilford.com/#get-naloxone.  
  • A Naloxone vending machine has also been installed at the Greensboro Detention Center. Research shows that justice-involved individuals are at much greater risk of dying of an opioid overdose shortly after release. This National Center for State Courts provided this vending machine to Guilford and six other North Carolina counties at no cost and GCSTOP works to stock with nasal Narcan (GCSTOP's Kianna Cuascut, Justice Involved Coordinator and Emily Motsinger, JMSW intern pictured stocking the vending machine below).

2020 Guilford County Leading Causes of Death

As in years past, the two leading causes of death in Guilford County in 2020 were cancer (891 deaths) and heart disease (867 deaths), comprising about 34% of all deaths. Following a national pattern, COVID-19 became the third leading cause of death in Guilford County in 2020, causing 346 deaths. Dementia followed closely behind with 341 deaths. Unintentional injuries (295 deaths), comprised primarily of unintentional poisonings (158 deaths), falls (96 deaths), and other external causes of death (excluding motor vehicle crashes), ranked as the fifth leading cause of death, followed by stroke (266). Lung cancer was the leading type of cancer death, followed by colorectal and breast cancers. 

Males had more deaths due to cancer, heart disease, unintentional injuries, chronic liver disease, Parkinson’s Disease, suicide, and homicide. Females had more deaths due to dementia, Alzheimer’s Disease, and strokes. African Americans had higher age-adjusted death rates than Whites for heart disease, cancers, stroke, diabetes, and homicide, while Whites had higher age-adjusted death rates due to chronic lower respiratory disease, chronic liver disease, and cirrhosis, and unintentional injuries.  The following chart highlights trends in leading causes of death in Guilford County between 2018 and 2020.

 *2020 is the most recent year for which these data are available. The processing requirements for birth and death certificate records result in a delay in public availability of the data.

For more detail on other leading causes of death and injuries, go to the 2022 Leading Causes of Death Data Brief and the 2022 Injuries Data Brief.  

Guilford County COVID-19 Confirmed Cases and Deaths

According to the Guilford County COVID-19 Dashboard, Guilford County has reported 155,266 total cases from March 14, 2020 through February 15, 2023 and has had 1,142 COVID-19 deaths during that time.  For continuously updated county data go to the Guilford County COVID-19 Data Dashboard. 

Please note: COVID-19 cases are reported by clinicians and laboratories by the date a person was tested. Total cases do not include all people with COVID-19 as some people do not get tested and many people use at-home tests of which results (positive or negative) are not reported to the State. COVID-19 mortality data for 2021 and 2022 is preliminary as the processing requirements of death certificate records results in a delay in public availability of the data. Please interpret with caution as these data need to be vetted when the final detailed 2021 and 2022 mortality data is released from the state.

Guilford County COVID-19 Hospitalizations

The chart below illustrates Guilford County COVID-19 hospitalizations from March 15, 2020 through December 31,2022. In 2020, hospitalizations reached their highest in late December at 229 (12/31/20) and this wave peaked at 275 hospitalizations on 1/11/21. In late summer 2021, we had another peak in hospitalizations with 171 on 8/26/21. Hospitalization then gradually declined until early November 2021 when they began to rise again. The highest number of Guilford County hospitalizations during this surge occurred on 1/26/22 with 313 hospitalizations. There were two smaller peaks in 2022, one on 8/19/22 with 83 hospitalizations and a second on 12/22/22 with 86 hospitalizations. 

Select Sexually Transmitted Infections Cases and Rates per 100,000, Guilford County, 2018-2021

Sexually transmitted infections continue to have a significant impact on the community’s health. While reported cases for chlamydia, gonorrhea, early syphilis, and HIV decreased from 2019 to 2020, this is likely due to the reduced availability of STI testing due to COVID-19, stay at home mandates, and quarantine procedures in place during the COVID-19 pandemic (see table below). In 2021, rates of newly diagnosed chlamydia, gonorrhea, syphilis, and HIV have all increased.  According to the 2021 NC HIV Surveillance Report, Guilford County ranked fifth in the state for newly diagnosed HIV among adults and adolescents with a three-year rate of 25.4 per 100,000 population (2019-2021), just behind Martin, Scotland, Mecklenburg, and Cumberland counties. Guilford County also ranked fourth for newly diagnosed cases of early syphilis, with a three-year rate of 40.4 per 100,000 population (2019-2021), behind Durham, Mecklenburg, and Vance counties. Significant racial disparities exist with respect to STIs. African American residents account for a disproportionate percentage of the cases as compared to Whites.

Opioid Overdose Deaths

In 2020, the overall leading cause of injury deaths was unintentional poisoning. Unintentional poisoning deaths—which increased from 131 deaths in 2019 to 158 in 2020 - were due primarily to adverse reactions to prescription and nonprescription use of opioid drugs.  The following chart which shows the breakdown of overdose deaths by drug type from 2014 to 2020 highlights the role of opioids and synthetic opioids.

Violence Related Deaths

As the chart below illustrates, violence-related deaths increased from 2019 to 2020 in Guilford County. In 2020, there were 73 homicide deaths in Guilford County, up from 62 the previous year. Males (82%) and African Americans (76%) were disproportionately impacted. That same year, suicide deaths also increased from 58 in 2019 to 65 in 2020. 85% of suicide deaths were among males and Whites (85%). Firearms were used in 86.7% of the homicides and 63% of the suicides.

The Impact of COVID-19

Like 2020 and 2021, COVID-19 continued to be a pressing concern impacting the health of our Guilford County community in 2022. According to the Guilford County COVID-19 Dashboard, Guilford County has reported 155,266 total cases from March 14, 2020 through February 15, 2023 and has lost an estimated 1,142 valued community members to COVID-19. To continue to reduce the negative impact on the community’s health and to address existing inequities intensified by COVID-19, Public Health continues to utilize partnerships to support our COVID-19 community response. These innovative partnerships focused on surveillance, COVID-19 testing and vaccination, communications, and issues around equity. For more information on these COVID-19 efforts are detailed in the section below (New/Paused/Continuing/Discontinued Initiatives Since Last CHA).

Increasing Awareness of Equity 

In Fall 2021, GCDPH received grant funding from North Carolina Department of Health and Human Services (DHSS) through the CDC’s Advancing Equity effort to support our equity work. Health equity recognizes the history of systemic oppression and necessitates the creation and strengthening of policies, practices, and organizational structures that produce fair outcomes and eliminate disparities based on social factors.

At GCDPH, we serve individuals and families from vastly diverse backgrounds with unique histories, cultures, identities, and lived experiences. While we strive to improve our community’s health and address health disparities, there is evidence that links significant differences in health outcomes to race and other marginalized identities, neighborhood of residency, educational attainment, income, language, and other social factors. Because of these disparities, it is critical that we continually assess our department’s ability to address the health inequities that many individuals we serve may face. It is equally important to operationalize our commitment to equity in all dimensions of our institution by developing and implementing strategies to advance health equity across all areas of work within Public Health.

Major accomplishments made by GCDPH in the 2022 calendar year include: 

• The formation of the Health Equity Core Team in early 2022. The Core Team meets monthly, and their purpose is to design, coordinate, and organize racial and health equity plans and activities across GCDPH.
• The Health Equity Staff Assessment. The Health Equity Core Team distributed the Staff Assessment in Spring 2022. These survey responses are informing the operational strategies within the organizational equity action plan, which includes policy review, employee trainings, department focus groups, and much more!
• The addition of a new Health Equity Coordinator position. Jacob French, MPH (he/they) assumed this role at GCDPH in July 2022, and they are serving as one of the leaders in ensuring equitable structures for both employees and community members.
• The adoption of the Equity Corner column in GCDPH’s The PULSE newsletter. The goal of this column is to make employees aware of the equity-work happening internally so they can feel empowered to advance equity in their inter-departmental work or inter-personal work relationships.

The American Rescue Plan Act– Coronavirus State and Local Fiscal Recovery Funds 

In July 2021, the Guilford County Board of Commissioners accepted $104 million allocated by the U.S. Department of Treasury under the American Rescue Plan Act. These funds are intended to lessen the impact of the COVID pandemic. They can be used to assist households, small businesses, and nonprofits; offset County revenue losses, improve infrastructure and support impacted industries, such as tourism and hospitality.  

From September 2021 to March 2022, Guilford County led a four-phase public engagement process to inform local allocation decisions. This process included resident surveys, community conversations, a Broadband survey, economic analysis, and a digital inclusion analysis. Guilford County issued a Growth and Recovery Request for Ideas process (RFI) in early 2022. This process invited collaborative project proposals to assist the community with short and long-term growth, our response to COVID-19 and its negative economic impacts. Guilford County used Federal guidance, the Board’s core values, and community survey priorities to guide this effort. For more information about this RFI process, click here. 

As of December 31, 2022, Guilford County has budgeted $104.3 million of the APRA Funds.  is a breakdown of funded projects in the following strategic priority areas:

For more information about the funded projects and their progress, click here.

Local Impact of the North Carolina Opioid Settlement 

In July 2021, to lessen the harm caused by the opioid epidemic and bring vital resources to local communities, Attorney General Josh Stein negotiated a $26 billion settlement for the State of North Carolina. This settlement resolves opioid litigation with three drug distributors, McKesson, Cardinal Health, and AmerisourceBergen, and one manufacturer, Janssen Pharmaceuticals, Inc., and its parent company Johnson & Johnson. 

As a result of the settlement, our local county and municipalities will receive the following settlements over an 18-year period:

• Guilford County - $21,735,653
• City of High Point – $1,329,849
• City of Greensboro – $3,397,546

Local governments may choose one of two options to use these funds. With Option A, they may fund one or more strategies from a shorter list of high-impact strategies. With Option B, they engage in a collaborative strategic planning process to choose from the list of Option A and Option B strategies or a longer list of strategies from the national settlements. The Guilford County Board of Commissioners voted for Option B.  This Option B approach recognizes the complex nature of opioid use disorders and how they often interact with other substance use and mental health challenges. It will also allow the county to build partnerships with community stakeholders to create solutions. A link to the strategies under Option B is here.

On October 31, 2022, Guilford County hosted a special meeting to share updates on the opioid settlement funding to be received by Guilford County from the state of North Carolina. In January 2023, the Division of Public Health named Amanda Clark as Drug and Injury Prevention Manager, who will facilitate the development and implementation of the County’s opioid recovery strategies to reduce community prevalence in opioid-related injury and death. For more information or to get involved in the next steps of the Guilford County response, go to Guilford County’s Opioid Settlement webpage. For more information the state settlement, click here.

If you or someone you know is struggling with opioid addiction, seek help by visiting the link for the Guilford County Behavioral Health Centers or calling (336) 890-2700. Guilford County also offers free naloxone kits (overdose reversal kits) and instructions/training on its use. For more information about why Naloxone is important and where you can pick up a free kit, go to: https://savealifeguilford.com/#get-

Public Health's Education, Testing, and Vaccination Efforts to Address Mpox  

Mpox (formerly known Monkey Pox) is a rare disease caused by infection with the mpox virus. Anyone can contract mpox through direct contact with infectious rashes, scabs, or body fluids. It can also be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex.

In May 2022, due to a global outbreak in many countries without a history of mpox, the Centers of Disease Control and Prevention (CDC) and partners began efforts to reduce the spread of mpox in the United States. North Carolina’s first case was identified in June 2022. 

To prevent and mitigate the impact of mpox locally, GCDPH has partnered with local health and medical providers to ensure they are informed on the symptoms, risk factors, and could make referrals for testing if they do not have the ability to test at their locations. Based upon data through January 31, 2023, Guilford County has 21 confirmed and 49 probable cases. Probable cases must be confirmed by the CDC. GCDPH also offered community education and collaborated with local non-profit organizations and universities to provide tailored outreach and vaccination clinics to specifically reach populations at higher risk. Through December 7, 2022, GCDPH has administered 514 doses of JYNNEOS vaccination to eligible individuals. Example graphics highlight special events and samples from a social media campaign with COMMANDO Advertising to assist us in engaging with the LGBTQ⁺ audience on the most relevant social, web, and dating platforms.  For more information about mpox, go to click here.

Guilford County's Resolution on Gun Violence

On June 2, 2022, Guilford County Commissioners issued a resolution declaring gun violence a public health crisis. This resolution demonstrates Guilford County will partner with local municipalities, community partners and community members to support evidence based public health efforts to address the underlying social, economic and systemic factors that promote gun violence.  Click here to read the resolution. 

In November 2022, GCDPH added a Social Determinants of Health Coordinator position. Alexis Powell, MPH (she/her) accepted this role and will provide leadership and support efforts to enhance activities related to the elimination of health disparities and inequities to address systemic issues. For more information about the impact of violent deaths in North Carolina and in Guilford County, go to the NC-Violent Death Reporting System (NC-VDRS) Data Dashboard.

COVID-19 Related Initiatives Continue 

In 2022, Guilford County Division of Public Health (GCDPH) continued to:

• Provide local COVID-19 surveillance,
• Ensure accurate, timely information is communicated to the public,
• Support access to testing and vaccinations, and
• Actively reach out to underserved communities to increase COVID-19 vaccinations.

Local COVID-19 Surveillance

As of February 15, 2023, GCDPH continues to track COVID-19 metrics through its COVID-19 Data Dashboard to regularly inform the media, community leaders, partners and community members. This dashboard tracks key metrics, including number of cases, hospitalizations, deaths and tests, positivity rates and demographic data for cases and deaths by age, race, and ethnicity.

GCDPH also continued its COVID-19 Wastewater Testing partnership with North Carolina A & T State University that began in August 2021. Wastewater testing is an affordable, accurate, rapid, and effective method to track COVID-19 trends in underserved and vulnerable communities. GCDPH highlighted this innovative collaboration at two national conferences, the 2022 National Association of County and City Health Officials (NACCHO) 360 Annual Conference in July 2022 in Atlanta and the American Public Health Association in November 2022 in Boston. Charley Naney, Public Health Epidemiologist, received a scholarship to attend the American Geophysical Union (AGU) Science Conference in Chicago in December 2022 as a guest of the Thriving Earth Exchange. GCDPH has been partnering with Thriving Earth to develop a community consortium for exploring the Wastewater Water Surveillance process with residents and decision makers in Guilford County during the COVID-19 Pandemic. GCDPH looks forward to continuing their empowering work with AGU Thriving Earth and NCAT in 2023.

Emergency Declarations

On March 13, 2020, the Guilford County Board of Commissioners, acting as the Board of Health (BOH), issued a countywide emergency COVID-19 declaration to mitigate the threat of COVID-19 transmission in Guilford County. Guilford County terminated its local emergency COVID-19 declaration on August 15, 2022. As of February 15, 2023, the federal government declared its intention to end the COVID-19 national and public health emergencies on May 11, 2023.

County Mask Mandates

The Guilford County Board of Commissioners put in place the first county wide mask mandate on August 27, 2021, due to the emergence of the Delta COVID-19 variant. This rule required that all Guilford County residents wear a mask within all indoor public spaces regardless of vaccination status. This rule was rescinded on November 15, 2021, after a data review confirmed that County positivity rate was at or below 5% for three consecutive weeks. Because of a significant surge in 14-day positivity rates from 7.4% to 26.8% impacted hospital capacity and medical supplies as well as the County’s ability to effectively respond to needs in December 2021, the Board reissued a BOH Indoor Mask Rule on January 13, 2022. This rule stayed in effect until February 18, 2022, when it was repealed. To offer support, GCDPH held two drive thru N95 mask distribution events in January 2022, one at the Roy B. Culler Senior Center in High Point and one at the Greensboro Coliseum in Greensboro.

Communication 

GCDPH continues to maintain the www.healthyguilford.com website launched in March 2020 to address the need for factual COVID-19 information in our community. This website is the local “go to” site for accurate, up-to-date COVID-19 information from reputable sources, links to COVID-19 testing, vaccinations, and local COVID-19 metrics tracking.

To address disparities and connect to the least vaccinated groups in the county, GCDPH Health Education staff collaborated with VitaLink to develop and launch the “My Why” Campaign. This campaign included tailored messages to reach African American and Latino community members to ensure they had accurate information to protect their health and the health of their families.  Below are some examples of these messages:

COVID-19 Testing

Access to testing continues to be an important tool to reduce the spread of COVID-19. In 2022, GCDPH:

• Continued to support availability of local testing at Piedmont Hall, Four Seasons, and GCDPH in High Point by partnering with vendors.
• Promoted the free at-home COVID-19 rapid test give away launched by the Biden Administration in January 2022 to empower individuals to secure tests through COVIDtest.gov.
• Launched the state supported Community Access Points (CAP) program in August 2022 to increase access to free home COVID-19 tests. This program expands access to free at-home tests by making them available at 12 community-based locations in the county like local libraries, community-based organizations, and others. From August 2022 through December 31, 2022, GCDPH and partners have distributed 38,907 tests. For more information on free testing locations and testing kit information, click here.

   

Outreach and Vaccinations

Since the initial release of COVID-19 vaccines in late December 2020, GCDPH has engaged in partnerships and outreach to vaccinate community members to reduce COVID-19 illness, hospitalizations, and deaths. This effort began with larger mass vaccination sites and subsequently shifted to community-based and mobile clinics. GCDPH has followed the NC Department of Health and Human Services guidance and partnered with numerous organizations, faith communities and community-based groups to ensure equity in vaccine distribution and address systemic barriers.

Recognizing the need to be flexible, reduce access barriers, and meet community members where they are, in spring and summer of 2021, GCDPH shifted to a community and mobile model in delivering COVID-19 vaccines and boosters. From July to December 31, 2021, GCDPH held more than 100 community and mobile COVID-19 vaccine clinics by collaborating with over 70 community partners. In 2022, GCDPH offered vaccinations at both Greensboro and High Point GCDPH clinic locations daily. We also held 50 community and mobile vaccine clinics with 32 community partners. Partners included faith communities, businesses, schools, congregate living sites, and other community sites. Three mobile units increased our capacity to host pop-up vaccine events. Because COVID-19 worsened issues like food insecurity, GCDPH built collaborations with groups like Definition Church and One Step Further’s Community Food Market to host vaccine clinics during market hours.

GCDPH partnered with the YWCA High Point’s VaxConnects program that engages individuals to serve as vaccine connectors in vulnerable communities with lower vaccination rates in High Point and Greensboro. These vaccine connectors conduct door to door outreach to talk with individuals and families. Connectors listen to community members’ concerns, answer questions, and help them make appointments if needed. In May 2022, VaxConnects received an Achievement Award from the National Association of Counties (NACo), which honors innovative, effective county government programs that strengthen services for residents.

As of February 1, 2023, out of all people in Guilford County, 66% have been vaccinated with at least one dose, and 63% have completed an initial series (see charts below). Out of those who have finished their initial vaccines in Guilford County, 60% have been vaccinated with at least one booster, and 20% with an updated Omicron booster.

Public Health is Going More Mobile

With three new mobile units to support our community work, GCDPH continues to pilot new ways to use these resources. In addition to using the mobile units to support COVID-19 vaccination clinics with community partners, these units are now being piloted to support the following Public Health services:

• The Community Access Points (CAP) program to increase access to free home COVID-19 tests at our two health department clinic locations.
• Integrated Targeted Testing Services (ITTS), offering education and testing for sexually transmitted infections and HIV (see photo to the right with health educators, DeVontee' Tanner, Kristy Brown, Jordan WIlson, and Kaleigh Rhodes).
• Mpox community education and vaccinations to high-risk individuals.
• Seasonal flu shots.
• Required immunizations at select schools through our School Health and Clinical Services programs.

GCPDH will continue to explore other uses such as diabetes screening and referrals to primary care in the future.

Primary Care Services at Public Health in 2022 

In June 2021, the Guilford County Division of Public Health began offering traditional primary care services for adults, including preventive services, diagnosis, and treatment of acute sicknesses like urinary tract infections and management of chronic conditions like diabetes. These services also support patients in making healthy choices to maintain good health and increase access to regular health screenings for prevention and early detection. These services are available at both 1100 East Wendover in Greensboro and 501 E. Green Street in High Point. In the 2022 calendar year, GCDPH provided primary care to 593 patients, up from 215 patients from June to December 2021.

In April 2022, Guilford County Public Health received the 2021 North Carolina Public Health Association (NCPHA) Dr. Sarah Taylor Morrow Health Department of the Year. This award, which is given to health departments who have demonstrated outstanding and exemplary health initiatives like those highlighted in this State of the County’s Health Report. It is named in honor of Guilford County’s very first female Public Health Director, Dr. Sarah T. Morrow. 

2022 Every Baby Guilford Accomplishments

In 2020, Every Baby Guilford went through a redesign and strategic planning process to envision bold goals and collective action strategies to disrupt longstanding racial disparities in birth outcomes and infant mortality in Guilford County. Using a racial equity lens, EBG continues to build an inclusive collective action movement that began in 2021 by:

• Advancing health equity,
• Creating collaborative solutions with radically inclusive community engagement,
• Strengthening the continuum of care of reproductive life planning for equitable access to quality care, and
• Promoting infant wellness and positive child development.

Every Baby Guilford 2022 highlights include:

• Hosting Crucial Conversations: The State of Infant Mortality in Guilford County, a Virtual Leadership Breakfast on February 24, 2022. Representative Alma Adams shared a national message of Black maternal health as keynote speaker with the 2021 Momnibus Act. The 2021 Momnibus Act directs multi-agency efforts to improve maternal health, particularly among racial and ethnic minority groups.
• Hosting Racial Equity trainings to disrupt longstanding health outcomes and racial disparities in Guilford County. From November 2021 – December 2022:
  • 431 community leaders, health care systems, allied health professionals, social support partners, and community members attended Racial Equity Institute (REI)) Groundwater trainings.
  • 86 participated in REI’s 2-day workshop, Phase 1.
  • 118 took part in the Dismantling Bias in Maternal and Infant Healthcare™ Awareness to Action workshop in partnership with March of Dimes.
• Amplifying Every Voice, a community storytelling project to learn about and share pregnant and birthing people's experiences in Guilford County is wrapping up year one and will be unveiling these stories in 2023.

• Continuing to connect 231 uninsured birthing people to prenatal care through the Adopt-A-Mom (AAM) program. This program provides access to health care, health education, counseling, and information on needed resources for vulnerable populations.

• Launching EBG Preconception Health Ambassador program by recruiting community members to serve as social influencers to perinatal health. In summer 2022, Ambassadors created and shared relatable prenatal health messaging and social media content with over 290 Guilford County residents to increase understanding of reproductive health and local resources. Topics included connecting with a doctor, the importance of taking vitamins (folic acid), and eating well. EBG recruited new 15 Ambassadors for fall 2022. 
• Implementing EBG’s Fetal and Infant Mortality Review (FIMR) program, which was inducted into the National Center for Fatality Review and Prevention Institute. FIMR is a community-owned, action-oriented process to improve service systems and resources for birthing people, infants, and families.
• Promoting Baby Steps for a Healthy Future and Family. With this walking campaign, families collectively walked 34 million steps (15,000 miles) and accessed health messaging for families of child-bearing age through Baby Steps with EBG podcasts hosted by Danielle Deshazor, Perinatal Health Coordinator. Click here to listen to the podcast.
• Hosting Pregnancy and Infant Loss Remembrance Day 2022 and the wrap up of the Baby Steps Campaign on October 15, 2022, at Center City Park in Greensboro.
• Collaborating to expand CenteringPregnancy, a group-based model of prenatal care with Duke Endowment funding. Through this expansion, GCDPH renovated their CenteringPregnancy space in 2022 and resumed in-person sessions in the fall of 2022. Cone Health’s MedCenter for Women trained staff and prepared space to launch its first CenteringPregnancy cohort in January 2023. 
• Partnering with Children's Home Society of North Carolina to expand the Triple P – Positive Parenting Program and Cone Health's MedCenter for Women to implement a Mothers and Babies curriculum to reduce maternal stress and postpartum depression.  
• Promoting breastfeeding friendly businesses through the Making It Work Toolkit to ensure employees have access and opportunity to continue lactation upon their return to work. 
• Implementing the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) project, which supports evidence-based efforts to address three Aims: Improve Birth Outcomes; Reduce Infant Morality; and Improve the Health Status of Children Ages 0-5. This grant effort is coordinated by new EBG Grant Coordinator, Tairra Booth and is funded by NC Department of Health and Human Services, Division of Public Health.
• Promoting Perinatal Health Education: In December 2022, Jada Rogers and Rebecca Eliassaint joined EBG as Community Health Workers to help connect community members to information and education, services, and resources in high impact communities in our county.

Coming up in 2023!  New Reducing Infant Mortality in Communities (RIMC) Grant!

Beginning June 1, 2023, the Guilford County Division of Public Health will receive $225,000 annually during the next 3 years. This grant will support a community-based Doula program, Reproductive Life Planning, and a Diabetes Management program in our DPH clinical services. After a year-long process of designing a program engaging maternal health stakeholders invested in this work, GCDPH will hire a Doula Coordinator and contract with 5 Community Doulas to be matched with patients served from home visiting programs serving birthing people prenatally.  This grant award comes from the NC Department of Health and Human Services, Division of Public Health.

To learn more or to get involved go to: www.everybabyguilford.org.