McDowell’s collaborative process is supported on a regional level by WNC Healthy Impact. Locally, our process begins with the collection of data that is completed through a partnership with WNC Healthy Impact to conduct this assessment from January 2021 through December 2021. In working with WNC Healthy Impact, the CHA Advisory Committee had the opportunity to assist with collecting primary data, which included telephone surveys of 233 residents and 16 key informant surveys completed by community key leaders. Team members also accessed the WNC Healthy Impact Secondary Data Workbook including a comprehensive set of secondary data from the NC State Center for Health Statistics, US Census Bureau, CDC’s Behavioral Risk
Factor Surveillance System, and other sources, and maps from Community Commons. All collected data, which is not only specific to the health status of McDowell County, but also demonstrates how it relates to the Western North Carolina region, was then analyzed and prioritized with the input of a preliminary data team. This initial data team, Foothills Health District, chose the top 4 health priorities utilizing a prioritization process based on the Rating/Ranking Key Health Issues (Health Resources in Action) worksheet. These were narrowed down to the top two health priorities again utilizing a process based on the Rating/Ranking Key Health Issues (Health Resources in Action) worksheet. The top three health priorities and data will then be presented to stakeholders in McDowell County after CHA submission. Phase 1 of the collaborative process began in January 2021 with the collection of community health data. For more details on this process see Chapter 1 – Community Health Assessment Process.

Key Findings
In 2020 the total population of McDowell County was 44,578 (US Census Bureau, 2021). The majority of residents are White (9.32%) with minorities represented as follows: Black or African American (4.2%), Hispanic or Latino (6.4%), Asian and Pacific Islander (1.2%), and American Indian/Alaska Native (0.8%) (Us Census Bureau, 2021). In 2018 the Health Priorities included: Mental Health and Suicide Prevention, and Substance Abuse including Tobacco. In mental health from 2018 to 2021 there was a 1.9% decrease in the number of individuals who had more than seven days of poor mental health in the past month. As for tobacco use the percent of current smokers decreased from 21.9% to 17.7%. (WNC Health Network, 2021) In other findings cancer is still the leading cause of deaths within the county, COVID-19 impacted the CHA priorities and the percent of obesity in the county has risen by 8.1% in the last 4 years. It is also important to note the percent of individuals who experienced overall “fair” or “poor” health dropped from 26.6% to 19.3%. (WNC Health Network, 2021)

Health Priorities
• Lack of Health Insurance
• Unintentional Injuries
• Obesity

Next Steps
Foothills Health District will share the CHA findings with the Health Coalition and members of Mission Hospital McDowell. An electronic copy will be made available on the Foothills Health District website at http://www.foothillshd.org/ and printed copies will be made available at the Health Department, the local library, and printed upon request.

In partnership with community leaders and existing work groups, the Foothills Health District will support planning and taking action around the health priorities. We will better understand the story and root causes behind the priority issues and will engage with existing and new partners to help improve these issues and move the needle in the right direction towards the common goal of making McDowell County a healthier place to live, work, and play.

• Lack of Health Insurance
• Unintentional Injuries
• Obesity