The Richmond County Health Department is pleased to present its 2022 Community Health Assessment. This report provides an overview of the methods used to identify and prioritize significant health needs in Richmond County.

I. Vision Statement

We commit, through personal and organizational excellence, to be an agent of change dedicated to achieving a healthier Richmond County.

II. Mission Statement

The mission of the Richmond County Health Department is to help prevent disease, promote health, and protect the environment for all citizens of Richmond County and to continually assess and respond to the health needs of the community.

III. Leadership

The Richmond County Community Health Assessment Team (CHAT) consists of individuals from a diversified cross-sectional group of a wide variety of organizations and collaborations with the Richmond County Health and Human Services at the forefront, along with the local hospital system, FirstHealth of the Carolinas. Those individuals are listed under the acknowledgments heading of this document. This report provides an overview of the methods and processes used to identify and prioritize significant health needs in Richmond County. First-in-Health Richmond County 2020 Taskforce, Richmond County Health, and Human Services, and FirstHealth of the Carolinas medical system collaborated to complete one comprehensive assessment. The CHAT gathered in March 2023, to determine current or emerging health issues as well as identify future health priorities. It was during the meeting that the final draft version of the CHA was presented and approved. Distribution was also discussed, and plans were made for hardcopy dispersal and digital copy availability for download.

IV. Partnerships

The following agencies include some of the many collaborations and partnerships within the Richmond County community. This list should be considered a partial list of all possible organizations and associations.

 Healthy People, Healthy Carolinas

The Healthy People Healthy Carolinas established the Montgomery/Richmond Coalition under the Duke Endowment to incorporate evidence-based interventions known to improve health in the community. The goals of this collaboration are promoting healthy eating, physical activity, prevention of obesity, and education about chronic diseases. First-in-Health Richmond County 2020 Task Force, now called the First-in-Health Richmond County Impact Team, was formed to develop best practices for organizing, planning, and implementing community programs tailored for Richmond County. Such programs are designed to increase the availability of fresh foods and produce and increase the areas open to exercise.

Improving Community Outcomes for Maternal and Child Health Improving Community

Outcomes for Maternal and Child Health or ICO4MCH is a collaboration of Richmond County, Cumberland County, Hoke County, and Montgomery County called the Sandhills Collaborative. The overall goal is to improve birth outcomes, reduce infant mortality, and improve the health status of children ages birth to five. These goals are accomplished through evidence-based programs such as breastfeeding promotion, the Triple P Parenting Program, and the Mothers and Baby Program.

Tobacco Prevention and Control Branch

Tobacco Prevention and Control Branch Region Six works with the Richmond County Health Department Public Health Education Division to provide resources to support the community to avoid the new onset of smoking/vaping or other tobacco use, the elimination of second-hand smoke exposure, and offer cessation products for those who want to quit. Together, we identify and address tobacco-related health disparities among Richmond County residents.

Healthy Communities

North Carolina Department of Health and Human Services Healthy Communities program works with the Richmond County Health Department Public Health Education Division to assist in preventing chronic disease and injury in Richmond County. Richmond County Health Department chose to implement evidence-based media messaging campaigns approved by the Tobacco Prevention and Control Branch. The goal is to prevent the use of tobacco products by young adults and teens, which includes cigarettes, e-cigarettes, cigars, little cigars, smokeless tobacco, and hookahs.

Drug Endangered Family Task Force

Richmond County Drug Endangered Family Task Force (DEFT) collaborates with many local agencies to counter the opioid crisis in Richmond County. The Richmond County Department of Social Services heads DEFT. These local agencies include Richmond County Health Department, FirstHealth Emergency Medical Services, FirstHealth Outreach Department, Sandhills Behavior Center, Daymark Recovery Services, Samaritan Colony, Alcohol and Drug Services of Richmond County, Guardian Ad Litem, several local faith-based organizations, Juvenile Crime Prevention Council members, Compassionate Counseling, and advocates from Connections Family Support and Community Collaboration Program. DEFT runs and promotes many programs, such as Lock Your Meds (LYM), Naloxone distribution, and Bedroom Project, as well as dispensing information through social media and local media advertisements concerning the opioid crisis and how to find help. The focus of DEFT is to reduce the oversupply of prescription opioids, increase community awareness and prevention, measure our impact, and revise strategies based on results.

Juvenile Crime Prevention Council

Juvenile Crime Prevention Council (JCPC) addresses the issues of delinquent juveniles, juveniles most likely to become delinquent, and the family issues surrounding delinquent behavior. The organization is a collaboration of the Richmond County Sheriff’s Department, Richmond School System, United Way, Faith-based community, Richmond County business owners, Richmond County Sheriff’s Department, Richmond County Court System, Richmond County Health and Human Services, Rockingham Police Department, Alcohol and Drug Services of Richmond County, Richmond County Court Counselors, and the Richmond County Commissioners. The goals of the JCPC are to strengthen youth and families, delinquency prevention, and intervene immediately and effectively when delinquent behavior occurs. JCPC concentrates on programs such as Project Focus, Parenting Wisely, Restitution and Community Services, DASH (Develop Adolescents and Strengthen Homes), and Teen Court.

Tri-County Child Advocacy Center

Richmond, Anson, and Scotland County have worked together to establish our area's Children's Advocacy Center (CAC), appropriately named Tri-County "Our House" CAC, which aims to provide, in one location, child protective services investigators, law enforcement, forensic interviewers, prosecutors, family advocates, and medical and mental health professionals to provide a coordinated, comprehensive response to victims and their caregivers. This multidisciplinary team approach results in better outcomes for child abuse investigations and minimizes trauma to the child. In addition, CACs have successfully provided a safe, neutral environment for children and their families where the child's well-being is a priority.

Table 1

Number and Type of Partnerships

V. Methods

The Community Health Assessment uses two types of data: primary data and secondary data. FirstHealth of the Carolinas collected primary data directly as a part of this report. At the same time, secondary data was obtained from other sources. Local statistics for Richmond County were compared with state statistics, as well as the neighboring counties. The adjacent counties were identified as Montgomery, Anson, and Scotland. These counties were chosen due to similar demographics, social issues, and those residents who work and shop in Richmond County and work collaboratively on community health projects.

A. Primary Data The regional health system, FirstHealth of the Carolinas, conducted countywide surveys in 2022. The confidential 86-question survey was conducted via an internet link and was distributed to people during doctor visits, local community events, and social media. Limitations of the study included a small sample size of 427 responses which were 80% women, 48% aged 45 to 64, 77% White or Caucasian, and 96% non-Hispanic. Additionally, the response completion rate was approximately less than 50%. FirstHealth shared the data with the First-in-Health Richmond Impact Team, which analyzed the data in September, October, and November 2022 during the monthly meetings. These meetings were well attended and representative of the partnerships in Richmond County. An area of opportunity was identified as access to behavioral health due to mental health issues of stress, increasing responsibilities, and low income.

B. Secondary Data The public health education department compiled secondary data from sources listed below from October 2022 to March 2023, which the CHAT analyzed during December 2022 and January 2023. The Richmond County 2022 Community Health Assessment shares secondary data and resources from the Richmond County Health Department (RCHD)Patagonia electronic health records, N.C. State Center for Health Statistics (NCSCHS), Center for Disease Control and Prevention (CDC), U.S. Census Bureau (U.S. Census), N.C. Department of Public Instruction (NCDPI), Cape Fear Collective, Kids Count Data Center, Cecil G. Sheps Center for Health Services Research, and many other agencies.

V. Key Findings

In summary of all collected primary and secondary data, the CHAT determined that the health problems with the most significant impact on Richmond County residents are obesity, aging, diabetes, cardio/cerebrovascular disease, and cancer. The most significant impact on the quality of life of Richmond County residents is substance misuse, adolescent health, and chronic health conditions. The unhealthy behaviors with the most impact and the most problematic are substance misuse, poor eating habits, and a lack of exercise.

VI. Priority 

See the Priorities tab under the 2022 Community Health Assessment. 

VII. Next Steps

Richmond County Health Department and other local education and human service agencies will use the Richmond County Community Health Assessment to set priorities and coordinate and target resources in collaboration with community partners.

1. Submission

The North Carolina Local Health Department Accreditation Program and the North Carolina Department of Health and Human Services (NC DHHS) Consolidated Agreement require local health departments to conduct a Community Health Assessment (CHA) at least every 48 months.

2. Community Health Improvement Plans

The development and implementation of strategies with collaboration from partners towards action and accountability using the Clear Impact Scorecard.

3. Distribution 

Presentations will be made to various local government and community stakeholders. In addition, hard copies will be located in multiple county agencies. Please take a look at Appendix D for more details.

VI. Priority

The primary and secondary data were analyzed, and three areas of concern were identified. These priority areas will focus on developing the Community Health Improvement Plans (CHIPs), Richmond County Health Department Strategic Plans 2023-2026, and Community Action Plans for the next three to five years. These plans will assist Richmond County residents, programs, and organizations in reaching the goals of HNC 2030, as well as improve the overall health of Richmond County residents.

1. Health Behaviors: Substance Use

Option A in the North Carolina Opioid Settlement Strategy 6: Early intervention Early identification and intervention for children or adolescents struggling with problematic use of drugs or mental health conditions, including Youth Mental Health First Aid, peer-based programs, or similar approaches.

2. Health Equity

Provide at least one training opportunity for health department staff to learn about health equity and social determinants of health. Implement at least one internal organizational policy/practice/system change that supports advancing health and/or racial equity

3. Chronic Conditions

Investigate funding and partnerships to create a chronic disease self-management program as an interactive workshop for people with all chronic conditions.