Based on the 2022 Community Health Assessment, Alexander County's Community Health Improvement Plan focus areas for 2023 remained as Mental Health, Substance Use, Elder Care, Childcare & Parenting, and Healthy Lifestyles. In 2023, Mental Health and Substance Use Disorder were slpit into two seperate priorities. The State of Emergency for the Covid-19 pandemic ended on May 11, 2023. In May of 2023 the Alexander County Health Department discontinued the tracking of COVID-19 numbers apart from deaths.

The Alexander County Health Department provided the community with messaging to support good mental health, promote Lock Your Meds and give away medication lockboxes at approved outdoor events and individually by request, as well as messaging about tobacco/vaping cessation and chronic disease screenings through its Facebook page https://www.facebook.com/alexandercountyhealth and through traditional media such as WBTV and Taylorsville Times. The Alexander County Health Department was able to hire a Licensed Clinical Social Worker in April of 2023 and partner with Alexander County EMS to utilize Opioid Settlement Funds to begin a PORT porgram in Alexander County. Most partner relationships including those with Vaya Health, Alexander County Senior Center, Alexander County Department of Social Services, North Carolina Department of Health and Human Services, and North Carolina Emergency Management were maintained through telecommunications and web-based programs such as Zoom and Microsoft Teams, as well as through in-person meetings and coalitions. 

Additionally, members of our staff trained in Results-Based Accountability (RBA) in 2021 and, as a result, Alexander County Public Health has utilized RBA for its 2021 State of the County Report, 2022 Community Health Assessment, 2023 State of the County Health Report, as well as its Healthy Communities grant activities.  This moves Alexander County's community health initiatives to web-based documents that are easily understood and utilized by our stakeholders and audiences, simplifying work with partner agencies and helping us to better track results of implemented programs.  The priorities and programs are available on our Clear Impact Scorecard and linked with the Healthy North Carolinians 2030 Scorecard for better transparency and to provide our citizens clearer understanding of population accountability. 

Mental Health Needs: Hiring a Licensed Clinical Social Worker to serve as a full time Behavioral Health Specialist at the Alexander County Health Department; Applying for the Rural Health Grant to assist with the provision of primary health care to low-income patients  

Substance Use Disorder Needs: Distributing 152 medication lock boxes to community members through a grant partnership with RHA Prevention Resource Center, and 20 medication lock boxes at community outreach events and free pickup at the Health Department Clinic; Development and implementation of substance use disorder prevention materials to three local churches, Alexander Central High School health classes, and the Alexander County Senior Center; Partnering with AC EMS Community Paramedic to distribute overdose kits which include Narcan, test strips, information on overdose and rehabilitation services, and local resources; Training in Catch My Breath program to Alexander Central High School, West Alexander Middle School, and East Alexander Middle School teachers to implement to all student body; Promoting the campaign which includes, in part, recognition of overdose signs and symptoms, introduction to NC Good Samaritan and Naloxone Access Laws, and resources for additional information, alongside Lock Your Meds & #naloxonesaveslives in our social media, on our website, and Health Department electronic sign

Healthy Living Needs: Promoting nutrient-dense foods, physical activity and tobacco cessation messaging and opportunities via our website and social media; Certifying  our health educator as a trainer for CATCH® My Breath and training nine new community leaders in the program; Improving access to care by providing drive-thru flu vaccinations at the Health Department every Friday the month of October; Collaborating with Cooperative Extension to promote and provide wellness and nutrition classes to the underserved population of the county  

Child Care Needs: Partnering ​​​​​​​with the Child Collaborative to utilize Systems of Care Grant funds for childcare and wellbeing programs; Promoting ​​​​​​​local child care services and partnering with Early Head Start to campaign for parents’ education and rights through social media and promoting an in-person class for the Spanish community

Elder Care Needs: Developing and implementing health education presentations to be displayed at the senior center during Monthly Birthday Lunches

In 2023 in Alexander County, the most significant change in morbidity and mortality shifted from the results of the COVID-19 pandemic back to chronic diseases. In 2023 diseases of the heart was the leading cause of death, closely followed by cancer.  Compared to updated data reflecting the number of positive tests and deaths per week for 2021 and 2022, 2023 showed a significant decline in deaths from coronavirus. The Alexander County Health Department stopped tracking coronavirus apart from deaths in May of 2023 as the Federal government ended the state of emergency.

The impact of climate change on health, specifically vector-borne infectious disease has presented itself as a major issue with pathogens being spread to people from insects like ticks and mosquitos. The warming planet is expanding the range of mosquitos which carry dangerous pathogens like dengue, chikungunya, Zika, and yellow fever.

Mental Health and substance use/abuse issues continue to rise across the nation, and with this the rates of vaping and e-cigarettes in the youth population have drastically increased. The long-term health consequences of e-cigarette usage is still unknown.

In 2023 there was a significant rise in syphilis cases, especially congenital syphilis in North Carolina with a shortage of the antibiotic recommended for treatment.

The State of Emergency for coronavirus ended on May 11, 2023. In May of 2023 the Alexander County Health Department discontinued the tracking of COVID-19 numbers apart from deaths. The calendar year of 2022 saw 26 deaths in Alexander County from COVID-19, and calendar year 2023 saw a total of 7 deaths from the respiratory virus. COVID-19 positive cases listed in the chart run from January of 2022-May of 2023.