2023 SOTCH

NOTE: There have not been any new data releases from the NC State Center for Health Statistics on morbidity and mortality data since the 2021 Community Health Assessment.

Leading Causes of Death- Buncombe County * data updated September 2023

Robert Wood Johnson 2023 County Health Rankings- Buncombe County, NC

In 2023, Buncombe County's health ranking fell to 21 out of 100 NC counties for healthiest outcomes including quality and length of life and other health factors. For Buncombe County, health factors that could improve the quality of life for residents include addressing adult smoking, obesity, and the number of uninsured residents.

North Carolina’s Opioid and Substance Use Action Plan Dashboard- Buncombe County, NC

As of 2023, Buncombe County had a total of 520 emergency room visits related to overdose. Buncombe County had a higher rate (199.1 per 100,000) of residents visiting the emergency room due to overdose in comparison to the State (161.4 per 100,000 residents).

*2023 Overdose death data has not been released

Emerging Issues Since Last CHA

These are the new or emerging issues in our community in 2023 that were not identified as priorities in our CHA.

Child Protective Services Staffing Shortages

In August of 2023, Buncombe County’s Social Services gave County Commissioners a briefing on the current workforce shortages for the Child Protective Services division. The department noted that due to recent resignations and transfers that remaining staff were taking on higher caseloads to keep up with the inflow of new cases. As of July 2023, 35% of the positions within the Investigations team were vacant. In the briefing it was reported that due to the shortage, the division repurposed staff from other programs, expanded job qualifications to include non-traditional degrees, hired contract workers, and increased advertising efforts to recruit more applicants.

The need to coordinate resources:

Community leaders have noted that while Buncombe County has a plethora of organizations and resources for the community to access, there lacks a centralized system which can quickly connect the public to resources such as housing and food assistance. Currently, there are discussions of how to streamline the process of linking residents to vital resources by leveraging NCCARE360.

Childcare Center Closures

In October 2023, seven childcare centers throughout the Western North Carolina Region were closed. The closing of centers has left many families seeking alternative childcare as the seven centers served over 300 children ranging in age from birth to five years old. Many of the families impacted by the closures currently receive childcare subsidies.

Foster Care Home Shortages

In recent years, the number of foster homes have greatly reduced across the State. During the 2019-2023 fiscal years, North Carolina saw an 18% decline in the availability of foster care homes. The decline in the number of potential foster care homes is attributed to a number of families who have decided to no longer foster, and there has been an overall decline in the number of new applicants wishing to foster. The lack of placement options has made it difficult to place children in foster homes and is especially difficult for children who have complex needs. In 2023, for at least 61 nights there were children who slept in Department of Social Services room due to lack of available foster care homes. The lack of foster care homes is also causing an issue within Emergency room departments, as children who are brought in to address mental health issues are without a placement upon discharge. Therefore, many children are placed on pediatric floors until a solution is determined.

Gender Affirming Care Ban

As of August 2023, anyone under the age of 18 can no longer seek gender affirming care within the State of North Carolina as lawmakers overrode the veto of House Bill 808. This ban prevents children from accessing puberty-blocking drugs, hormone therapy, and gender affirmation surgery. For many Trans youth this ruling has greatly restricted their medical autonomy as their options for seeking care has been eliminated. Gender affirming care is a critical resource as it has shown to help in reducing depression and suicides amongst Trans Youth. In response to the ban, Campaign for Southern Inequality has started the Southern Trans Youth Emergency Project (STYEP) which provides assistance to youth and their families as they are navigating the ban. This project has a four-pronged approach including patient navigation which assists families in navigating their options for medical care within or beyond their State. The project also helps to provide $500 grants to help cover any medical related expenses including travel.

New/Paused/Discontinued Initiatives Since Last CHA

The following is information on new/paused/discontinued initiatves or activities in our community in 2023:

New Initiatives

Community-Based Public Health Response to Violence

Buncombe County was awarded $2.5 million to launch a new community-based safety initiative. Five organizations were awarded a three-year grant to coordinate and provide services and resources in an effort to reduce the occurrence of community violence. The program will work to provide community health workers across the County to help with addressing the root causes which result in community violence.

RAPID HIV and HEP C Testing

Buncombe County’s Syringe Exchange Program and the Mobile Unit Team partnered together to provide rapid HIV and HEP C testing at the health department. The public can receive rapid testing during designated walk-in hours, during that time a member of the Mobile Team are able to administer the rapid testing as well as coordinate additional care/resources if needed.

Discontinued

Ramada Inn Supportive Housing Project

In an effort to address homelessness in our community, the City of Asheville entered a partnership with a California-based development company who purchased the Ramada Inn to convert the motel into 113 units of permanent supportive housing. The City of Asheville committed to providing three years of funding upon the completion of the project. Of the 113 units, 50 of those units were designated to serve homeless veterans. Prior to the project, the Ramada Inn operated for a year as a temporary shelter. The project broke ground December 2022 and was slated to be complete by August 2023. The project faced several delays and in January of 2024, the project was halted due to legal issues for the development company.

Clear Impact Suite is an easy-to-use, web-based software platform that helps your staff collaborate with external stakeholders and community partners by utilizing the combination of data collection, performance reporting, and program planning.