Vision Statement 

The 2019 Community Health Assessment (CHA) vision is to conduct a “deeper dive” to develop greater understanding of the health focus areas of Maternal and Child Health, Healthy Living and Active Living, Behavioral Health, and Social Determinants of Health. CHA goals are to identify key actionable issues, potential points of leverage and services or program gaps to inform efforts to eliminate health disparities and improve population health. Click on the image to view the full report. 

Leadership

The 2019 CHA leadership is bi-sectoral. The Guilford County Department of Health and Human Services Public Health Division and local hospitals (Cone Health, Wake Forest Baptist Health-High Point Medical Center and Fellowship Hall) are accountable to the NC Local Health Department Accreditation Board and the Internal Revenue Service, respectively, for successful completion of the CHA every three years.

Partnerships   

The CHA Team included the following partner types:

Theoretical Framework/Model   Social-Ecological Model

Collaborative Process Summary

Primary data on the four focus areas were collected through a series of online Key Informant Surveys and workshops attended by persons known as subject matter experts or otherwise knowledgeable regarding the focus areas. The survey included questions about key challenges to making improvements in the priority focus areas, as well as disparities and population subgroups impacted, gaps and needs in existing services and programs, existing programs and policies that are perceived to be effective and ideas for needed programs and policies. At a series of half-day workshops, participants engaged in facilitated discussion to consider both quantitative data and data from the Key Informant Surveys to identify key issues and recommendations for improvements.

Key Findings

Maternal and Child Health (MCH)

Poor birth outcomes are a significant problem, with rates of low birthweight, preterm birth, and infant mortality substantially higher than national benchmarks, NC, and peer counties, with African American women experiencing consistently poorer birth outcomes than Whites. Much of the racial disparity in infant mortality can be explained by the disproportionate number of very low birthweight births among African American women. The biggest challenges to improving pregnancy outcomes identified by MCH Key Informants were reductions in inequalities in the social determinants of health, issues of toxic stress and improvements in preconceptional health.

Healthy Eating/Active Living (HEAL)

The county has 26 “food desert” census tracts with limited access to healthy food outlets and limited resources to purchase healthy foods, as well as high rates of obesity and persons not engaging in leisure time physical activity. The crucial issues are access to healthy food, the cost of healthy food and lack of access to healthy food outlets. The most important challenge to increasing physical activity noted by Key Informants was safety issues of crime and traffic, followed by cost of exercise facilities and lack of sidewalks. Improvement approaches include targeting areas with fewer resources, support for a living wage, equity-oriented policies and transformation of policies that previously led to inequality of access to resources.

Social Determinants of Health

Life expectancy in Guilford County varies by up to 20 years depending on the census tract in which one lives. Low life expectancy, low educational attainment, high poverty areas of the county are also areas with higher concentrations of African Americans and other racial/ethnic minorities, creating areas of concentrated disadvantage that have negative impacts on population health. African Americans living in areas of concentrated disadvantages are living with the legacy of segregation, housing redlining and governmental policies that have perpetuated segregation and social inequality for decade. Improvement will require targeted development coordinated across systems.

Behavioral Health (Mental Health and Opioid Misuse and Overdose)

County suicide rates show an increasing trend, while mortality rates from unintentional drug poisoning are higher than in peer counties. Emergency Department visits due to opioids showed a small improvement in 2018. The most crucial behavioral health issues identified were access to mental health services and the important role of the social determinants of health.  Critical challenges to improving the problem of opioid misuse are access to dependency treatment services, cost and knowledge of available treatment services and limited availability of medication-assisted treatment.

Guilford County Priority Health Issues

• Maternal and Child Health
• Healthy Eating and Active Living
• Behavioral Health (Mental Health and Opioid Misuse and Overdose)
• Social Determinants of Health