Vision Statement

Franklin County Health Department promotes healthy lifestyles and disease prevention activities in order to enhance the quality of life for the citizens of Franklin County. Health Department programs provide a holistic approach to healthcare, emphasizing physical, intellectual, and emotional health to protect against public health threats. These programs include: Women’s Health, Maternity Care, Child Health, WIC, Communicable Disease, STD, Adult Health, Home Health, Environmental Health, and Community and Health Education.

Leadership

The Community Health Needs Assessment has been a collaborative process with leadership across stakeholder and partner organizations.  These leadership groups include:

Community Health Assessment Management Team

• Scott LaVigne - Franklin County Health Department Health Director
• Betsy Hunt - Chairperson of the Franklin County Board of Health and Chief Nursing Officer Maria Parham Health
• Graham Bundy - Franklin County Health Department Public Health Education Supervisor

Steering Committee

• Loftin Wrenn - Franklin County Health Department Nursing Supervisor
• Lauren Pace - Franklin County Health Department Director of Nursing
• Mary Jo Michalski - Franklin County Home Health Nursing Supervisor
• Whitney Holmes - Franklin County Health Department Health Equity Coordinator
• Lana Cooper - Franklin County Health Department Women’s Health Provider
• Chastity West - Impact Healthcare Practice Manager
• Brittany Newell - Impact Healthcare Nurse Practitioner
• Jennifer Clement - Maria Parham Director Growth and Outreach
• Monica Kearney- SafeSpace Executive Director
• Traci Dunston - SafeSpace
• Dawn Goodwin - NC DHHS Central Region Pharmacist
• Katie Taggett - Franklin County Emergency Management
• Lisa Pursell-Morris - Franklin County Schools Lead Nurse
• Meg Wyatt - Franklin County Cooperative Extension Agent
• Dominque Simon - Franklin County Cooperative Extension Area Agent
• Virginia Campbell - Franklin County Emergency Services
• Christy Southall - Franklinton Senior Center Program Supervisor

Community Health Assessment Team

• Elane Edwards - Franklin County Health Department Triple P Coordinator
• Roxie Packer -Franklin County Health Department Health Education
• Antrel Branch -Franklin County Health Department (Health Education Supervisor 2019-2021)

Partnerships/Collaborations

Collaborative Process Summary

Community Health Needs Assessments are required to be completed every three years. These health assessments involve identifying and prioritizing the health needs of the county and creating strategies to address those needs. This process is collaborative including agencies and stakeholders from across public health and social services.  This process included the direct involvement of the county’s residents through surveys and public engagement.  Each of these collaborations allowed the department to identify those health priorities of greatest need and importance to the county.  The CHA is an ongoing continuous improvement process that remains community centered and focused on improving the overall health and well-being of Franklin County.

Key Findings and Health Priorities

Based on analysis of the secondary data and the input gathered from community residents and partnering agencies, the following significant health needs were identified for Franklin County:

• Access to Primary Care
• Adult Obesity
• COVID-19
• Suicide
• Substance Abuse
• Adult Tobacco Use
• Cancer
• Exercise, Nutrition, and Weight
• Heart Disease
• Health Outcome Disparities for Communities of Color

Details of the process used to prioritize these health needs is included later in this report.  In short, the steering committee met to discuss the preliminary 2021 CHNA report, primary and secondary data sources, and the community input surveys.  After discussion and input, the committee evaluated the needs and determined the following four health priorities for the community as described in the 2021 CHNA.

• Access to Care
• Heart Disease
• Exercise, Nutrition, and Weight
• Health Outcome Disparities in Communities of Color

Access to Care

Define issue:  Access to care priority includes data pertaining to how and why people use or do not (cannot) use healthcare.  How many primary care and specialty providers are in the county?  How many people have health insurance?  How much healthcare, across specialty, is there in the community?  How much information is there about healthcare and are residents able to easily access that information?

Key themes from primary and secondary sources:

There is a clear need for primary care providers since the ratio for Franklin County is 1 provider per 13,510 people compared to the NC ratio of 1 per 1,400 (County Health Rankings, 2018).  Franklin County does not meet the NC Institute of Medicine’s target ratio of 1 primary care provider to every 1,500 people (Center for Health Services Research UNC, 2017).  Rates of uninsured persons in the county are higher than the state average.

Heart Disease

Define issue: This health care priority includes data pertaining to key risk factors and outcomes of heart disease. Heart disease refers to a group of conditions that affect the heart and blood vessels, such as coronary artery disease, heart failure, stroke, and cerebrovascular disease. Outcomes of heart disease can result in poor quality of life, disability, and death – but can be prevented by controlling key risk factors like high blood pressure, smoking, unhealthy diet, and obesity.

Key themes from primary and secondary data:

Heart disease is the leading cause of death in Franklin County with a mortality rate of 206.64 per 100,000 population in 2019 (NC-DHHS State Center for Health Statistics, 2019).  Also, Franklin County’s mortality rate for heart disease was higher than the state rate of 187.00 per 100,000 population in 2019 (NC-DHHS State Center for Health Statistics, 2019).

Exercise, Nutrition, and Weight

Define issue: This health care priority includes data pertaining to key risk factors (obesity) and modifiable behaviors (exercise & nutrition) that contribute to chronic diseases. Healthy eating and physical activity can help individuals reach and maintain a healthy weight. Also, obesity can increase the risk of serious health problems such as heart disease, cancer, and diabetes.

Key themes from primary and secondary data:

There is an increased rate of adult obesity at 41% among Franklin County residents compared to the state rate of 32% for 2017 (County Health Rankings, 2017). Also, the top three leading causes of death in Franklin County are respectively heart disease, cancer, and cerebrovascular disease (NC-DHHS State Center for Health Statistics, 2019). These are chronic diseases that can be prevented through healthy lifestyle changes like exercise and nutrition.

Health Outcome Disparities for Communities of Color

Define issue:  Health outcome disparity priority includes data pertaining to differences in health outcomes that adversely affect specific, potentially disadvantaged, racial, or ethnic populations.  Outcomes could include:

• Higher incidence and/or prevalence and earlier onset of disease

• Higher prevalence of risk factors, unhealthy behaviors, or clinical measures in the causal pathway of a disease outcome

• Higher rates of condition-specific symptoms, reduced global daily functioning, or self-reported health-related quality of life using standardized measures

• Premature and/or excessive mortality from diseases where population rates differ

• Greater global burden of disease using a standardized metric

Key themes from primary and secondary sources:

Overall, there are health disparities present in Franklin County among racial/ethnic groups. Specifically, when examining the top three leading causes of death in Franklin County – heart disease, cancer, and cerebrovascular disease – the mortality rate for African Americans or Blacks is higher than the White population for each health outcome. For heart disease, the mortality rate for African Americans was 252.9 per 100,000, while the rate for Whites was lower at 210.6 per 100,000 in 2019 (NC-DHHS State Center for Health Statistics, 2019).  For cancer, the death rate for African Americans was 211.8 per 100,000 and 197.9 per 100,000 for Whites. Also, for cerebrovascular disease, the mortality rate was higher for African Americans at 88.2 per 100,000 compared to Whites at 55.3 per 100,000 (NC-DHHS State Center for Health Statistics, 2019).  

Conclusion and Next Steps

This report describes the process and findings of a comprehensive community health needs assessment for the residents of Franklin County.  The final steps in the CHNA process is to develop community-based health improvement strategies and action plans to address the four priorities identified in this assessment.  The strategies identified in the CHNA will be implemented through use of the Community Health Improvement Plan (CHIP), which will include targeted measurable efforts of the Health Department, partnering agencies, and community stakeholders. 

Franklin County Priority Health Issues

• Access to Care
• Heart Disease
• Exercise, Nutrition, and Weight
• Health Outcome Disparities in Communities of Color