Chronic Disease

• During 2021, the Chronic Disease Work Group focused on tobacco policy and lung cancer screenings.
• Work Group members contacted over 100 businesses in 28601 about their tobacco free policies, tobacco quit benefits, and adopting and/or enhancing their tobacco policies. Priority businesses included those in automotive, construction & contractors, entertainment, faith-based organizations, food & dining, manufacturing/ wholesale/ distribution, and real estate. 
• In contacting businesses in 28601, the Chronic Disease Work Group identified the following barriers to worksites enhancing and/or adopting comprehensive tobacco free policies. In 2022, the work group will explore alternatives to engaging worksites and employees. 
  • Labor shortage and need for businesses to focus on hiring more people
  • Concern about putting policies in place that would potentially cause more employees to leave
  • Employees voicing that they would leave if a tobacco policy was enforced where tobacco use was not permitted anywhere onsite
• On November 18, 2021, on the Great American Smokeout, the work group partnered with LiveWell Catawba, Tobacco-Free Alliance Region 4, American Heart Association, and the Catawba County Chamber of Commerce to provide training on pathways to tobacco-free workplace policies. Over 30 businesses and community organizations attended the training.
• Work group members from Catawba Valley Health System and Frye Regional Medical Center provided ongoing presentations to medical providers on lung cancer screenings for those eligible. 
• In 2021, new recommendations for annual screening for lung cancer with low-dose computed tomography (LDCT) were released. In February 2022, Centers for Medicare & Medicaid Services (CMS) announced the expansion of lung cancer screening for at-risk populations that meet the following criteria:
  • Age 50-77 years
  • Asymptomatic (no signs or symptoms of lung cancer)
  • Tobacco smoking history of at least 20 pack-years
  • Current smoker or one who has quit smoking within the last 15 years
  • Receives an order for lung cancer screening with LDCT

Behavioral Health

• During 2021, the Behavioral Health Work Group has three overarching strategies, whole person care, technology supported care, and community engagement.
  • Whole Person Integrated Care is the integration of medical, behavioral, and public health approaches to care for the whole person. The model expands integrated care beyond the health care sector to include the social determinants of health, or the conditions in the places where people live, learn, work, and play. Social determinants of health are factors that can greatly influence the health and quality of life of individuals, populations, and communities (including food, housing, transportation, employment, access to care, medication access, etc.).
  • Technology supported care refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance.
  • Community engagement includes education for the community on anxiety, mood, and psychotic disorders and resources available for behavioral health care.
• The Whole Person Care and Technology Support Care Subgroups did deep dives into emergency room, Medicaid, and uninsured data to identify providers serving community members from the 28609 area. In March 2022, the Subgroups plan to conduct a practice survey to collect information on telehealth and integrated care services practices provide to increase telehealth awareness, access, and consistent engagement with whole person centered care services.
• The Community Engagement Subgroup actively worked with Partners Behavioral Health Management to train work group and Coalition members on the Community Resiliency Model (CRM). The Community Resiliency Model teaches participants about the impact of trauma and chronic stress on the nervous system, behavior, and long-term health. Participants learn how to reset the nervous system with easy to learn, concrete, coping skills. One of the goals of CRM is to create trauma-informed and resilient communities. The Community Engagement Subgroup plans to use CRM during part of the community groups’ education sessions.
• The Community Engagement Subgroup worked to engage community leaders from 28609 and the Town of Catawba in support of a community group. Participants in the community group would learn practical ways to make positive changes and find resources to support mental health. Professional facilitators would lead small peer counseling sessions. The community group plans to tentatively start in 2022. 

Healthy Foods & Healthy Weight

• During 2021, the Catawba County Food Council focused on strategies for food pantries and farmers markets.
• The Food Council partnered with Catawba County Cooperative Extension, Greater Hickory Cooperative Christian Ministry, (GHCCM), and Eastern Catawba Cooperative Christian Ministry (ECCCM) to do cooking videos using recipes with ingredients frequently available in the food pantries. Funding for the videos and recipes was provided by Community Food Strategies.
• Food Council members did tours of the food pantries at CCM and ECCCM and are evaluated the availability of culturally appropriate foods. The Food Council provided WIC cookbooks to both food pantries to distribute to their clients in addition to the cooking video recipes. Recipes and cookbooks were provided in English and Spanish.
• SNAP (Supplemental Nutrition Assistance Program) Double Bucks were piloted at Catawba County Public Health’s Farmers Market for the 2021 market season; $1,447.00 SNAP Double Bucks were redeemed at the market for fresh fruits and vegetables. LiveWell Catawba also supported WIC Bonus Bucks for WIC participants to use to purchase fresh fruits and vegetables; $1,580.00 WIC Bonus Bucks were redeemed.
  • For SNAP Double Bucks, for every $1.00 spent at the farmers market, $1.00 was matched from funding. This allows customers who utilize SNAP (Supplemental Nutrition Assistance Program) to purchase a greater quantity of fresh produce.
  • For WIC Bonus Bucks, each eligible WIC (Women, Infants, and Children) participant could receive $5.00 Bonus Bucks in addition to their WIC vouchers. 
• The Food Council worked with the Hickory Farmers Market in the fall of 2021 to implement a SNAP Double Bucks program starting in January 2022. LiveWell Catawba was able to support this program with funding from Healthy People, Healthy Carolinas and Community Food Strategies. The Food Council is continuing in 2022 to work with the Hickory Farmers Market for sustainable long-term funding.
• The Food Council is currently working with the Hickory Farmers Market to hire a community health worker (CHW) to provide community outreach and education on SNAP and WIC. The CHW would provide outreach and education at farmers markets in Catawba County and within the community, specifically targeting food deserts.
• In 2022, the Food Council plans to begin environmental scans of the 8 food deserts in Catawba County. The Food Council worked with County GIS to map convenience stores and grocery stores within the food deserts.
• LiveWell also provided funding to Morning Star First Baptist Church to support their community garden and snack for seniors program. Funding was also provided to Catawba County Cooperative Extensions Juntos program for healthy meals and snack for their participants.

Morbidity and mortality changes for Catawba County for 2021 are focused on the impact of COVID-19 on the community and the leading causes of death from the 2021 County Health Data Book for 2015 to 2019. Local COVID-19 data is available on the NC DHHS COVID-19 North Carolina Dashboard. COVID-19 surveillance is continuously changing, as key metrics, such as testing positivity rates and total case counts, have become more difficult to quantify due to at-home testing. CCPH has linked to the state dashboard in order to remain consistent with new metrics the state is using to track COVID-19.

In 2021, COVID-19 reports accounted for 92.2% of Catawba County’s Communicable Disease case investigations. This includes a prolonged period of elevated case numbers early in the year, the Delta wave and part of the Omicron wave at the end of the year.

COVID-19 Case Data (March 2020 to March 30, 2022)

While many cases are no longer reported due to at-home testing, the overall trends of cases reported can still be informative. Trends in reported cases help understand the spread of disease in the community and in specific groups and locations over time.

 COVID-19 Vaccinations:

2015-2019 Leading Causes of Death

2015-2019 Leading Causes of Death by Age for Catawba County

• Ages 0 to 19
  1. Conditions originating in the perinatal period
  2. Congenital anomalies (birth defects)
  3. Motor vehicle injuries
• Ages 20 to 39
  1. Other Unintentional injuries
  2. Suicide
  3. Motor vehicle injuries
• Ages 40 to 64
  1. Cancer - All Sites
  2. Diseases of the heart
  3. Chronic lower respiratory diseases
• Ages 65 to 84
  1. Cancer - All Sites
  2. Diseases of the heart
  3. Chronic lower respiratory diseases
• Ages 85 and Over
  • Diseases of the heart
  • Alzheimer's disease
  • Cancer - All Sites

References: 

North Carolina Department of Health and Human Services. (2022). NC COVID-19 Dashboard- Cases and Deaths. Retrieved on March 30, 2022 from https://covid19.ncdhhs.gov/dashboard/cases-and-deaths.  

North Carolina State Center for Health Statistics. (2022). County Health Data Book: Death Counts and Crude Death Rates per 100,000 Population for Leading Causes of Death, by Age Groups NC 2015-2019- CD11A. Retrieved on March 29, 2022 from https://schs.dph.ncdhhs.gov/data/databook/. 

Catawba County Heptatis Coalition

• In 2021, the Heptatis C Coalition expanded to include hepatitis A, B, and C and is now known as the Catawba County Heptatis Coalition. The Catawba County Hepatitis Coalition continues to focus on providing seamless, coordinated care for those with hepatitis of all types. Because the population most affected by Hepatitis in recent years tends to cross county lines, the coalition is expanding across those lines as well, and has begun collaborating with surrounding counties to ensure continuity of care. This also comes in response to an increase in hepatitis throughout the region. By adopting a regional approach, the Hepatitis Coalition can leverage resources in multiple counties, and address spread across county lines, and have consistent messaging for these individuals, no matter where they live.
• Based on the continued success of Catawba County’s Hepatitis Coalition, Public Health was invited to speak at the NC Viral Hepatitis Task Force meeting and at the United States Conference on HIV/ AIDS to share best practices with other coalitions.
• In response to an outbreak of Hepatitis A that began in 2020 and expanded in 2021, the outreach efforts among people who use drugs and people who are experiencing homelessness have increased, as these two populations have been affected the most by this ongoing outbreak. To do this, partnerships with organizations that serve the homeless population and organizations that provide harm reduction services were strengthened, including ALFA, Olive Branch Ministry, Hickory Soup Kitchen and Open Door Homeless Ministry and have offered Hepatitis A and B vaccinations to at-risk individuals at off-site events sponsored by these trusted organizations.

COVID-19

• In 2021, COVID-19 reports accounted for 92.2% of Catawba County’s Communicable Disease case investigations. This includes a prolonged period of elevated case numbers early in the year, the Delta wave and part of the Omicron wave at the end of the year. Catawba County Public Health (CCPH) administered more than 64,000 COVID-19 vaccines in 2021, beginning at the Hickory Metro Convention Center, then moving to the Public Health building. At times, CCPH vaccinated more than1,000 people per day.

Equipping Local Health Departments to Build COVID-19 Vaccine Confidence (COVIED) Project

• Catawba County Public Health (CCPH) has been selected to participate in the Equipping Local Health Departments to Build COVID-19 Vaccine Confidence (COVIED) project. Through this grant-funded project, CCPH will partner with NACCHO to address vaccine hesitancy and increase COVID-19 vaccine confidence and uptake among priority populations disproportionately impacted by COVID-19 disease and complications.
• Because Catawba County’s African-American community has the lowest vaccination rate among the county’s major historically marginalized populations, and based on the number of individuals falling into that group, focusing on the African-American community is a priority for this grant.
• CCPH plans to hire a part-time vaccine coordinator who will coordinate vaccine education and outreach events, and who will develop a team of vaccine ambassadors who are well-respected within the African-American community. Those ambassadors will work alongside the vaccine coordinator to share messages about the vaccine’s safety and effectiveness, and address misinformation that has led to a lower vaccination rate among this population.
• CCPH  will couple these efforts with strategic advertising opportunities to amplify the message. CCPH will recieve $75,000 over the grant period, which lasts through December 31, 2022.

Health Priority Work Groups

• In January and February 2021, the Chronic Disease Work Group, Behavioral Health Work Group, and Catawba County Food Council paused to allow Catawba County Public Health and our healthcare partners to focus all of their efforts to supporting the COVID-19 vaccine rollout. All three health priority work groups picked back up with action planning in March 2021. 
• In December 2021 and January 2022, the three health priority work groups completed whole distance exercises to update the community health improvement plan (CHIP). The whole distance exercises included each work group reviewing, discussing, and updating their results statement, indicators, story (why is this important and the story behind the curve), partners involved and/or that should be involved in the work group, and what works, including their strategies and action plans.