2019 State of the County's Health Report Scorecard - Swain County

HNC2030 Alignment

Chronic Disease and the related result "Residents of Swain County are healthy, active, and thriving" are aligned with the following Healthy NC 2020 Focus Areas/ Objectives. 

• Physical Activity and Nutrition
• Chronic Disease
   

Experience & Importance

How would we experience residents of Swain County being healthy, active and thriving in our community?

Swain County would be healthier and happier byway of increased physical activity and positive nutritional intake, reducing obesity, chronic disease and food insecurity. According to community listening sessions, community members would experience the following if this result were true: 

• Increase physical activity
• More outdoor activity 
• Increase life span
• Increase healthy food options
• Discount for farm to table in restaurants 
• Decrease clinical access as a result of reduced chronic disease
• Hear about chronic disease 
• Smell less cigarette smoke
• Hear more people communicating about healthy options 
• Increase activity with primary care physicians 

What information led to the selection of this health issue and related result?

The Community Wellness Action Team processed the community health assessment data in September and October of 2018 across several meetings. The Community Wellness Action Team was provided information about the relevance, impact, and fesibility around obesity and chronic disease, specifically looking at obesity, chronic disease, and food insecurity. The community members in attendance then unanimously voted to move forward with the chronic disease priority as a result of evaluating the primary and secondary community health data. 

Known risk factors (Healthy People 2020 website) for this issue are as follows: 

• Built-in Environment
• Socioeconomic Status
• Educational Attainment 

Progress Made in 2019

The following progress was made in 2019 on our action plan interventions for Chronic Disease in Swain County. 

• Swain Summits
  • The Swain Summits committee was formed in the beginning of 2019 to design, implement and maintain the community wide wellness program. The committee worked on all logistics of a wellness program available to the entire community. The logistics would include the following: a program name, logo, facebook page, advertisements, marketing strategies, flyers and postcards made then distributed, equipment purchased for biometric screenings, wellness challenges designed, educational videos created, an electronic platform purchased and created, volunteers gathered for health screenings, health screenings conducted, and maintenance of program. Program was launched in September of 2019 with 225 residents in Swain County participating in a health screening. The health screening included: 
    • Total Cholesterol -- Cholestech LDX Analyzer
    • Total Glucose -- Cholestech LDX Analyzer
    • Body Composition (weight, body fat, body mass, and water) -- Tanita Scale TBF 400 
    • Blood Pressure and Heart Rate 
    • Pre-Diabetes CDC Screening
    • A Health Risk Questionnaire (physical activity, nutrition, tobacco, and alcohol)

• Swain School Nutrition Policy
  • School Health Advisory Counsel (SHAC) meets monthly
  • SHAC has discussed the policy
  • Swain School Nutrition Policy will be reviewed in spring 2020 by the Swain School Board

Additionally, the following progress was made in 2019 on Chronic Disease in Swain County.

• Committee was formed to evaluate and explore options for expanding the Heart Health Fair to an Adult Health Fair to include Cancer Awareness and Screenings
• Community Baby Shower was held in October for all expecting parents in Swain County, provided health information
• The local Pathways and Greenways Committee has formed a sub-committee to plan and implement the second annual walkability study in the county
• The Swain County Health Department was awarded a Breastfeeding Friendly Designation

What Is It?

Many of us in the community are working toward a healthier and happier Swain County. Together, we are trying to reduce chronic disease through our high obesity rates.  Swain County Health Department and Swain Community Hospital aim to increase physical activity, nutrition, and mental health through worksite wellness. Why worksite wellness? We spend over 60% of our time at work. We currently provide an employee wellness program to over 100 employees in the Swain County Public School System, and as of the 2018-2019 school year, saw a total of 371-pounds in weight loss, with an average of 6 pounds per person, and a health score increase of roughly 600 points total, averaging 8 points per person.  We want to expand the program to include businesses and employees of the county alike, 18 and older, helping to work toward a healthier and happier Swain. Would you be interested in participating in the program?

Swain Summits was identified by the Community Wellness Action Team (C-WAT) as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in obesity as it realtes to chronic disease in our community. This is a brand new program in our community.

The priority population/customers for Swain Summits are all residents in Swain County over the age of 18 years old, and Swain Summits aims to make a difference at the individual and county level. Implementation will take place in September housed by Swain Community Hospital and Swain County Health Department.

This addresses health disparties in the following ways:

• Health assessments aid in connection to healthcare and provide free health screenings to the public that includes cholesterol and glucose
• Lifestyle change program will aid in Diabetes education and awareness to impact diabetes 
• Physical activity education and challenges will be aimed to help obesity, heart disease, and diabetes 
• Nutrition education and challenges will be aimed to help obesity, food insecurity, heart disease, diabetes, and COPD
• Stress management/mental health education and challenges will be aimed to help obesity and heart disease

Partners

The partners for Swain Summits includes:

Work Plan

Evaluation & Sustainability

Evaluation Plan:

We plan to evaluate the impact of Swain Summits through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures.

Our evaluation activities will be tracked through the health screenings, through the following performance measures;

• Weight
• Body Fat Percentage
• Cholesterol
• Glucose
• Health scores 

Sustainability Plan:

The following is our sustainability plan for Swain Summits: 

• Sustainability Component 1:
  • During year 1 of Swain Summits, MountainWise is helping to fund the strategy through an ARC grant for two years. The ARC grant is being used to get the program up and running through assistance with tools needed (i.e. Cholestech LDX, Tanita scale, tablecloths, sandwhich boards, and flyers for promotion); Swain County Health Department will store and maintain the supplies provided by the ARC grant. Further, in-kind is being used for leaders of the program for the first year of the program. Swain Community Hospital is providing the sponsorship funding for incentives in the program. 

• Sustainability Component 2: 
  • Swain Summits will continue after the ARC grant funding has ended. Swain County Health Department and Swain Community Hospital will continue to provide leadership via job responsibilites to the program. Swain Community Hospital will supply materials for the Cholestech LDX moving forward, and continue to sponsor the program for incentives. 

What Is It?

Many of us in the community are working toward a healthier and happier Swain County. Together, we are trying to reduce chronic disease through our high obesity rates.  Swain County Health Department and Swain Community Hospital are working to increase quality nutrition among children in our schools. The School Health Advisory Committee (SHAC) have been advocating for a new sugar policy within the schools but have been unsuccessful thus far. The Community Wellness Action Team wants to assist in passing and implementing the sugar nutrition policy in all Swain County schools, helping to work toward a healthier and happier Swain County. 

Swain Schools Nutrition Policy was identified by the Community Wellness Action Team as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in obesity as it relates to chronic disease in our community. This is a new strategy in our community.

The priority population/customers for this Swain schools nutrition policy are each of the school systems in Swain County, and the nutrition policy aims to make a difference at the individual and community level. Implementation will take place in meetings and presentations.

The strategy impacts obesity as it relates to chronic disease in the following ways:

• Nutrition (i.e. sugar consumption) provided in the school systems among students
• Obesity rates among children up to 18 years of age

Partners

The partners for this Swain Schools Nutrition Policy include:

Work Plan

Evaluation & Sustainability

Evaluation Plan:

We plan to evaluate the impact of Swain Schools Nutrition Policy through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures. Our evaluation activities will be tracked in the Work Plan table, above. 

Sustainability Plan:

The following is our sustainability plan for Swain Schools Nutrition Policy: 

• Sustainability Component 1: 
  • The Swain Schools Nutrition Policy is not being funded nor does it need to be funded. The sustainability will be the continued pursuit of the policy change until it is passed and implemented successfully. 
    • Goal for the policy change will be before the 2020-2021 academic year starts. 

HNC2030 Alignment

Substance use and the related result "Residents of Swain County are healthy, safe, and thriving" are aligned with the following Healthy NC 2020 Focus Areas/ Objectives. 

• Subtance Abuse
• Tobacco Use

Experience & Importance

How would we experience residents of Swain County being healthy, safe and thriving in our community?

Swain County would be healthier and happier byway of deduction of substance abuse/misuse. According to community listening sessions, community members would experience the following: 

• No needles
• More physical activity
• More treatment 
• More participation in commuity 
• Happier 
• No cigarette butts 
• Less funds being used 
• Empowered by discussion 
• Less smoke pollution 
• Not holding breath to go in buildings
• Not hearing about overdoses
• More communication 

What information led to the selection of this health issue and related result?

The Community Wellness Action Team and the Coalition for a Safe and Drug Free Swain County processed the community health assessment data in September and October of 2018 across several meetings. Both groups were provided information about the relevance, impact, and fesibility around substance abuse/misuse, specifically looking at opioid, tobacco, and alcohol data. The community members in attendance then unianimously voted to move forward with the substance abuse priority as a result of evaluating the primary and secondary community health data. 

Known risk factors for this issue are as follows: 

• Family
• Social Networks
• Peer Pressure 
• Income Level
• Educational Attainment 

For results 2018 Swain County CHA, Chapter 8, pg. 36-38

Progress Made in 2019

The following progress was made in 2019 on our action plan interventions for Substance Use in Swain County. 

• Narcan Distribution 
  • Applied for the Highlands Cashiers Health Foundation grant in 2019 for Narcan kits, training, and campaigns. 
• Swain Summits
  • Please see listed items for Swain Summit progress under the Chronic Disease priority result. For the Substance Use priority and result, Swain Summits has included question items in relation to tobacco and alcohol usage within the Health Risk Questionnaire. There was also quitline information provided in the packets distribtued during the health screening. 
• Lockbox and Dropbox Campaign
  • Applied and received funding from the Great Smokies Health Foundation in 2019 for purchasing of lockboxes and promoting dropboxes through campaigns. Previously established two separate dropboxes within the community during the last CHA cycle. 
  • Distribution of lockboxes to community members. 
  • Distributed lockboxes during four separate events -- Medicine Takeback in October of 2019, two Community Baby Showers in 2019, and a Child Health Fair in 2019. 
  • Facebook, newspaper and radio education on the importance of using a lockboxes as well as where to obtain a lockbox if needed or wanted. 
• Quitline
  • Distributed quitline information during four separate events in 2019 -- Medicine Takeback in October, two Community Baby Showers, and a Child Health Fair. 
  • All patients at the health department and WIC office are provided quitline information as pertinent. 
• Tobacco Free Spaces
  • Swain County adopted new tobacco free parks and recreation ordinance prohibiting all tobacco products on campuses. 
  • Swain County Health Department became a tobacco free campus, including the purchasing of new signs that include e-cigarettes and vape products. 
  • Public Health Educator presented on the benefits of becoming a tobacco free campus to the Department of Social Services, working toward adding another location to tobacco free spaces in Swain County. 

Additionally, the following progress was made in 2019 on Substance Use in Swain County.

• Alcohol -- prom campaign in April 

What Is It?

Lock Box and Drop Box Campaign was identified by the Community Wellness Action Team and the Coalition for a Safe and Drug Free Swain County as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in substance misuse in our community. This is an ongoing program in our community.

This program is ongoing as it is currently effective in Swain County and needs to be expanded to reach more of the population.

The priority population/customers for this Lock Box and Drop Box Campaign are organizations that are willing to establish a Drop Box and community members interested in a Lock Box, and the Lock Box and Drop Box Campaign aims to make a difference at the community level. Implementation will take place in the community.

Misuse often impacts rates of violence, injuries and certain diseases so people who are using substances are at a disadvantage when it comes to overall health.  

Partners

The partners for this strategy include:

Work Plan

Evaluation & Sustainability

Evaluation Plan:

We plan to evaluate the impact of Lock Box and Drop Box Campaigns through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures. 

Sustainability Plan:

The following is our sustainability plan for [insert program type]: 

• Sustainability Component 1:
  • Establishing consistent funding through grants for a financial base to consistently have Lock Boxes available to the public as well as Drop Boxes in the community.
  • Increasing community awareness on the issue and demonstrating the value of the program to the public as well as keystakeholders. 

What Is It?

Quitline was identified by the Community Wellness Action Team and the Coalition for a Safe and Drug Free Swain County as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in substance misuse in our community. This is an ongoing program in our community.

The quitline is an ongoing strategy that is effective in probing people to stop smoking. The strategy will hopefully reach more people within the community to reduce tobacco usage. 

The priority population/customers for Quitline are individuals who use tobacco products within the community, and Quitline aims to make a difference at the individual and commuity level. Implementation will take place in the community.

Misuse often impacts rates of violence, injuries and certain diseases so people who are using substances are at a disadvantage when it comes to overall health.  

Partners

The partners for this strategy include:

Work Plan

Evaluation & Sustainability

Evaluation Plan:

We plan to evaluate the impact of Quitline through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures. 

Sustainability Plan:

The following is our sustainability plan for Quitline: 

• Sustainability Component 1:
  • It is a free program provided by the state, all funding for the program is state funding, meaning we do not need to establish consistent funding to sustain.
  • We will be able to sustain the use of the strategy by utilizing it more via referrals. 

What Is It?

Narcan Community Distribution was identified by the Community Wellness Action Team and the Coalition for a Safe and Drug Free Swain County as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in substance misuse in our community. This is an ongoing program in our community.

The current narcan community distribution is effective within Swain County and needs to be expanded to a new target population reaching more community members and saving more lives. 

The priority population/customers for the narcan community distribution are select community members who want to be trained in narcan use, and the community narcan distribution aims to make a difference at the community level. Implementation will take place in the community.

Misuse often impacts rates of violence, injuries and certain diseases so people who are using substances are at a disadvantage when it comes to overall health.  

Partners

The partners for this strategy include:

Work Plan

Evaluation & Sustainability

Evaluation Plan:

We plan to evaluate the impact of community narcan distribution through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures.  

Sustainability Plan:

The following is our sustainability plan for community narcan distribution: 

• Sustainability Component 1:
  • Establishing a consistent financial base for the program via grant funding -- working toward a full-time staff member to adequately address narcan distribution and training as well as funding for the narcan itself to distribute. 
    • Using program measures to ensure continued effectiveness within the community and demonstrate success to funders and other key stakeholders

What Is It?

Tobacco Free Spaces was identified by the Community Wellness Action Team and the Coalition for a Safe and Drug Free Swain County as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in substance misuse in our community. This is an ongoing program in our community.

This program is ongoing and needs to be expanded into all policy across the county.

The priority population/customers for this Tobacco Free Spaces are community members in Swain County, and the Tobacco Free Spaces aims to make a difference at the individual and community level.

Misuse often impacts rates of violence, injuries and certain diseases so people who are using substances are at a disadvantage when it comes to overall health.  

Partners

The partners for this Tobacco Free Spaces include:

Work Plan

Evaluation & Sustainability

Evaluation Plan:

We plan to evaluate the impact of Tobacco Free Spaces through the use of Results-Based AccountabilityTM to monitor specific performance measures. We will be monitoring How Much, How Well and/or Better Off Performance Measures. 

Sustainability Plan:

The following is our sustainability plan for Tobacco Free Spaces: 

• Sustainability Component 1:
  • Identifying champions who strongly support the program 
  • Demonstrating success to key stakeholders, communicating and engaging community leaders and organizations
  • Establishing a grant to help with Tobacco Free Space signage across the city and county

What Is It?

Please see our Chronic Disease Priority