Yancey 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 Healthy Yancey Health Partnership.

Partnerships

The Community Health Assessment team is comprised of many participants representing area agencies in Yancey County, North Carolina. A health department-led comprehensive Community Health Assessment (CHA) provides community insight into the health status of the county. Using surveys, focus groups, and interviews, community members, local government and business leaders, and health professionals came together to identify and prioritize health issues. Participating in the assessment process puts the county in a position to take the next steps in developing policy, environment, and system changes that support their concerns. Currently in Yancey 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 of Healthy Yancey Health Partnership

• Jessica Farley, Yancey County Health Department 
• Diane Creek, Yancey County Health Department
• Schell McCall, Partners Aligned Toward Health
• Jessica Zucchino, Partners Aligned Toward Health
• Lila Sheon, Partners Aligned Toward Health
• Sylvia Buchanan, Blue Ridge Partnership for Children 
• Jennifer Simpson, Blue Ridge Partnership for Children
• Colby Boston, Blue Ridge Regional Hospital
• Amber Dillinger, Mountain Community Health Partnership
• Amy Earnheart, Mountain Community Health Partnership
• Casie Ledford, Mountain Community Health Partnership 
• Cassie Burleson, Mountain Community Health Partnership
• Jessica Hensley, Yancey County Health Department 
• Katherine Savage, Blue Ridge Partnership for Children
• Nickey Stamey, Blue Ridge Healthy Families
• Pam Snyder, Headstart/Intermountain Children Services Inc.
• Hannah Robinson, Partners Aligned Toward Health
• Lisa Pitman, Local Children’s Developmental Services Agencies
• Amanda North, Health-e Schools/Center for Rural Health Innovation
• Angela Garner, VAYA Health
• Brian Buchanan, Burnsville Police Department
• Mike Sink, WKYK Radio Station
• Rick Tipton, Yancey DSS
• Peirce Bingham, Yancey County Cooperative Extention
• Jim Haaga, Retired Physician
• Shane Hilliard, Yancey County Sheriff’s Office
• Niki Maness, Yancey County Cooperative Extension
• Patrick Bradford, Toe River Project Access
• Daniel Barron, Community Volunteer/ Substance Abuse Task Force

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

Yancey County’s collaborative process is supported on a regional level by WNC Healthy Impact (WNCHI). Locally, our process is a community-wide and multi-faceted approach to completing the community health assessment and giving this information to the community.

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 9 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 75-questionnaire was conducted to give residents an opportunity to express concerns and opinions about the quality of life in Yancey 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 264 Yancey County surveys were analyzed: 200 via telephone interview and 64 via the publicly available weblink.

Some of the major findings that the Healthy Yancey Health Partnership discussed in the prioritization process included the increasing proportion of respondents with more than seven days of poor mental health in the past month. Nearly 11% of respondents have considered suicide in the past year and 28% were taking medication or receiving treatment for mental health. A growing percentage of respondents have been diagnosed with heart disease and more than 15% have been diagnosed with diabetes or borderline diabetes. Seventy percent of Yancey County respondents had calculated BMIs in the overweight or obese range. A decreasing proportion of respondents eat the recommended servings of fruits and vegetables, approximately 19% reported food insecurity, and 20% got no leisure-time physical activity in the last month. Approximately 45% of respondents were current drinkers,15% engaged in binge drinking, and 19% were classified as excessive drinkers. Twenty percent of respondents reported using opioids in the past year, with or without a prescription and 43% said their life had been negatively impacted by the own, or someone else’s, substance use.

In addition to secondary data and survey collection, seven (7) 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 Yancey County community. The graphic below 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 CHA 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, Healthy Yancey members identified the chief health concerns for the county.

• Substance abuse/misuse/prevention
• Housing
• Mental Health
• Economic opportunities
• Food insecurity
• Aging/dementia/fall prevention
• Transportation
• Adverse Childhood Experiences
• Equity/Spanish translation
• Social Determinants of Health
• Chronic disease prevention/healthy lifestyles
• Oral Health
• Community resilience
• Cancer
• Domestic Violence
• Birth outcomes/infant mortality

Health Priorities

In November 2021, Healthy Yancey members along with 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 concerns be ranked. The results from the prioritization process were 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. Behavioral Health: Mental health, substance abuse, Adverse Childhood Experiences, domestic violence, and community resiliency
2. Healthy Living Across the Lifespan: Chronic disease prevention and management, healthy lifestyles, oral health, cancer, aging, dementia, fall prevention, and birth outcomes/infant mortality
3. Food Insecurity and Access to Food

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, Healthy Yancey meeting, Yancey 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. A key step in action planning will be to determine what is currently going on regarding the top health concerns, and what we would like to see going on regarding these health concerns.

The Healthy Yancey 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 Yancey County is the healthiest place to live, learn, work, and play.

The 2021 Yancey County Community Health Assessment priorities are:

1. Behavioral Health: Mental health, substance abuse, Adverse Childhood Experiences, domestic violence, and community resiliency
2. Healthy Living Across the Lifespan: Chronic disease prevention and management, healthy lifestyles, oral health, cancer, aging, dementia, fall prevention, and birth outcomes/infant mortality
3. Food Insecurity and Access to Food