Updated: March 30, 2022
The health priorities identified in the 2019 Catawba County Community Health Assessment (CHA) are:
Chronic Disease
Behavioral Health
Healthy Foods & Healthy Weight
The following Community Health Improvement Plan (CHIP) Scorecard as approved on December 22, 2020 by the North Carolina Division of Public Health. The CHIP was developed utilizing the results-based accountability (RBA) framework through the health priority work groups. RBA uses a data-driven, decision-making process to help communities and organizations get beyond talking about problems to taking action to solve problems. RBA starts with the end and works backwards towards the means.
Our CHIP is a long-term, systematic effort to address the health priorities identified in our community health assessment. Our CHIP includes our desired results, indiciators, and strategies to address our health priorities. The CHIP guides the work of Catawba County Public Health, LiveWell Catawba, and our community partners. The three work groups addressing each of the current health priorities include, the Chronic Disease Work Group, Behavioral Health Work Group, and Catawba County Food Council.
The following resources were used and/or reviewed to develop the CHIP:
Clear Impact's Results-Based Accountability Resource Library
Results-Based Accountability Handouts & Guides:
Common Language Key
Icon |
Meaning |
Definition |
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Result |
A population result (or outcome or goal) is a condition of well-being for children, adults, families, and communities in plain language |
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Indicator |
A population indicator or benchmark is a measure that helps quantify the achievement of a result. Indicators answer the question, “How would we recognize this result if we fell over it?” |
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Program/ Strategy |
A strategy is a coherent set of actions that has a reasoned chance of improving results. Strategies are made up of our best thinking of what works, including policy, systems, and environmental changes and programs. Strategies operate at both the population and performance levels. |
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Performance Measure |
A program or service performance measure or indicator is a measure of how well a program, agency, or service system is working. |
Tobacco use is the leading cause of preventable disease, disability, and death in the United States. The use of tobacco harms nearly every organ in the body and causes cancer, heart disease, stroke, lung diseases, type 2 diabetes, and other chronic health conditions. The impacts of smoking extend past the smoker through secondhand smoke (CDC, 2020). Using e-cigarettes also causes health risks. E-cigarettes both contain and emit a number of potentially toxic substances (American Lung Association, 2020).
In Catawba County, chronic lung disease is the third leading cause of death. Chronic lung disease has led to 8,371 years of potential life lost by Catawba County residents. Mortality rates for lung cancer and chronic lower respiratory diseases for Catawba County are also higher than the North Carolina rates. In the 2019 Catawba County Community Health Opinion Survey, 15.5% of the respondents reported having smoked cigarettes or other nicotine products, including e-cigarettes, within the past twelve months; compared to 12.0% in 2015 (Catawba County Public Health, 2020).
If all Catawba County community members lived in communities that supported tobacco free and e-cigarette free lifestyles, Catawba County would potentially have:
Lower rates of lung cancer deaths,
Reduced hospital admissions related to lung cancer,
Increases in life expectancy,
Increases in community members receiving lung cancer screenings,
Decreases in the number of community members using tobacco, and
Increases in the number of tobacco free worksite policies.
Connection to COVID-19 complications?
References:
American Lung Association. (2020). The Impact of E-Cigarettes on the Lung. Retrieved on November 30, 2020 from https://www.lung.org/quit-smoking/e-cigarettes-vaping/impact-of-e-cigarettes-on-lung.
Catawba County Public Health. (2020). 2019 Catawba County Community Health Assessment). Retrieved on November 30, 2020 from https://catawbacountync.gov/site/assets/files/2488/2019_catawba_county_cha.pdf.
Centers for Disease Control and Prevention. (2020). Tobacco Use. Retrieved on November 30, 2020 from https://www.cdc.gov/chronicdisease/resources/publications/factsheets/tobacco.htm.
While Catawba County has seen a decrease in age-adjusted death rates for lung cancer since 2015, chronic lung disease remains one of the leading causes of death. Smoking tobacco is the leading risk factor for lung cancer. The risk of lung cancer for smokers is much higher than for non-smokers and the longer an individual smokes and the more packs a day smoked, the greater the risk. Secondhand smoke, breathing in the smoke of others, can also increase the risk of developing lung cancer (American Cancer Society, 2020). In Catawba County, there is an opportunity to push for tobacco policy adoption, enhancement, and implementation to support tobacco and e-cigarette free lifestyles to decrease lung cancer deaths in the long-term. Lung cancer screenings can increase detection before any symptoms appear. Implementing comprehensive policies is an evidence-based strategy used to reduce tobacco use.
References:
American Cancer Society. (2020). Lung Cancer Risk Factors. Retrieved on December 2, 2020 from https://www.cancer.org/cancer/lung-cancer/causes-risks-prevention/risk-factors.html.
In June 2020, Catawba County Public Health and LiveWell Catawba convened work groups for each of the 2020 to 2023 health priorities: chronic disease, behavioral health, and healthy foods & healthy weight. The Chronic Disease Work Group narrowed their focus from all chronic diseases to lung cancer specifically. As the work group moved through the results-based accountability process to develop the community health improvement plan (CHIP), they discussed on an ongoing basis who are partners and community members that are not involved that should be involved.
The Chronic Disease Work Group is continuously expanding to include a diverse group of community members, agencies, and sectors. A current list of Chronic Disease Work Group members is available here.
The Chronic Disease Work Group through the strategy selection process discussed best practices that work to support tobacco and e-cigarette free lifestyles, potential low cost and no cost ideas, and data needed to better inform the work.
Strategy Selection Process
In 2020, the Chronic Disease Work Group selected the overarching strategies of tobacco policy and lung cancer screening to support tobacco-free lifestyles. The strategy selection process included the work group members rating each strategy idea as high, medium, or low on the criteria of leverage (short-term: 3 years, intermediate: 3 to 5 years, and long-term: 10 years), feasibility, values, and specificity. The work group then reviewed the rating survey results, discussed each strategy, identified the overarching strategies based on related themes of the strategies selected, and determined, based on the criteria and rankings, which strategies should not be included in the community health improvement plan. The work group continued to update their strategies and action steps throughout 2021 and 2022.
What are the programs and/or interventions recognized as best practices?
Comprehensive tobacco-free policies
Leveraging health insurance for preventive screenings
Onsite screenings at worksites
What are potential low cost and/or no cost ideas for immediate improvements?
Education for worksites
Media campaigns
Promoting available resources (American Cancer Society, NC Quitline, Tobacco Support Specialists)
What data is needed to better inform the work?
The Chronic Disease Work Group has discussed the following data needs and/or additional data to consider if available.
Age-adjusted lung cancer rates at the census tract level (currently is available at the zip code level)
Hospital admission data related to lung cancer at the county level
Number of health professional referrals to tobacco treatment resources
Number of people receiving lung cancer screenings at the county level
Number of worksites currently with tobacco-free policies
Tobacco use (including e-cigarette use) data at the county level collected regularly for adults and children
At the Chronic Disease Work Group meeting on January 24, 2022, work group members reviewed and updated their current strategies based on what was working well, what was not working well and/or could be removed or changed, and how these strategies impact health disparities in Catawba County. The work group’s action plan was updated to include the following strategies. Action steps related to the followling strategies are discussed and updated during monthly work group meetings.
Strategies: Tobacco Policy
Workplaces adopt or enhance comprehensive tobacco-free policies.
Indoor and outdoor public places adopt or enhance tobacco policies.
Media education campaign on tobacco policies to educate the public and have workplaces become more involved in setting tobacco policies.
Strategies: Lung Cancer Screening
Screening education for the community and public about why lung cancer screening is a beneficial choice.
Promotion and education of lung cancer screenings for providers.
Tobacco free policies are public-sector regulations and private-sector rules that prohibit smoking in indoor spaces and designated public areas. State and local ordinances establish smoke-free standards for all, or for designated, indoor workplaces, indoor spaces, and outdoor public places. Private-sector smoke-free policies may ban all tobacco use on private property or restrict smoking to designated outdoor locations. Tobacco free policies are highly effective in decreasing tobacco use and reducing secondhand smoke exposure (The Community Guide, 2020). The Chronic Disease work group has selected to address tobacco policies in indoor public places, worksites, and adoption of tobacco-free/ comprehensive policies.
A comprehensive tobacco-free policy prohibits smoking and the use of tobacco products in the city, town, or county buildings, grounds (including parks), and in vehicles owned, leased, or occupied by the city or county. A comprehensive tobacco-fee policy also includes all enclosed or indoor areas of public places within the city, town, and/or county, excluding those places identified in NCGS 130A-498(b1) as being exempt from smoking restrictions. Exclusions include certain tobacco shops, premises of tobacco manufacturers and growers, smoking guest rooms in lodging establishments, certain cigar bars, private clubs, and live production sets (North Carolina Department of Health and Human Services, 2020).
A 100% tobacco-free policy for local governments and worksites applies to all of the property under the program's control that is rented or owned and all of that property, including the buildings, grounds, and vehicles, are tobacco-free. Tobacco includes the use of combustible, electronic, heated, and smokeless tobacco products. Under a 100% tobacco-free policy there are no designated areas for tobacco use indoors or outdoors. Programs do not purchase, accept as donations, or distribute any tobacco products. The gold standard is 100% tobacco-free, plus smoke-free and tobacco-free for enclosed or indoor public places for local governments (NCDHHS, 2020).
References:
The Community Guide. (2020). Tobacco Use: Smoke-Free Policies. Retrieved on November 30, 2020 from https://www.thecommunityguide.org/findings/tobacco-use-smoke-free-policies.
The Community Guide. (2020). Tobacco Use: Comprehensive Tobacco Control Programs. Retrieved on November 30, 2020 from https://www.thecommunityguide.org/findings/tobacco-use-comprehensive-tobacco-control-programs#:~:text=Comprehensive%20tobacco%20control%20programs%20are%20coordinated%20efforts%20to%20implement%20population,tobacco%20use%20among%20young%20people.
North Carolina Department of Health and Human Services- Tobacco Prevention and Control Branch. (2020). North Carolina Gold Standard for Comprehensive Tobacco Policy. Received on December 1, 2020 from Carleen Crawford, Region 4 Tobacco Control Specialist.
The Chronic Disease Work Group’s strategies for tobacco policy and lung cancer screenings target adults ages 45 to 64 in the 28601 zip code. Community members age 45 to 64 in the 28601 zip code had higher rates of lung cancer deaths, emergency department visits for chronic lower respiratory disease, and tobacco use.
The Chronic Disease Work Group’s action plan includes the following strategies related to tobacco policies. The work group recognizes the importance of focusing on evidence-based strategies to lower tobacco use. Action steps related to the following strategies are discussed and updated during monthly work group meetings.
Strategies: Tobacco Policy
Workplaces adopt or enhance comprehensive tobacco-free policies.
Indoor and outdoor public places adopt or enhance tobacco policies.
Media education campaign on tobacco policies to educate the public and have workplaces become more involved in setting tobacco policies.
Policy Agenda: Tobacco and E-cigarette Free Lifestyles
In the fall of 2021, the Chronic Disease Work Group crafted the following policy statement as part of LiveWell Catawba's overall policy agenda supporting health and wellness in Catawba County.
Lung cancer screening is a test used to detect lung cancer before any symptoms appear. People who currently smoke or formerly smoked are at higher risk for lung cancer. The American Cancer Society recommends yearly lung cancer screening with a low-dose CT scan (LDCT) for some of these people (American Lung Association, 2022).
The American Cancer Society advises that health care providers, and people at increased risk for lung cancer, follow the recently updated recommendations for annual lung cancer screening from the US Preventive Services Task Force (USPSTF), the American Academy of Family Physicians (AAFP), or the American College of Chest Physicians.
These organizations recommend yearly lung cancer screening with LDCT scans for people who:
In addition, it’s important that people who are going to be screened:
References:
American Cancer Society. (2022). Lung Cancer Screening Guidelines and Screening Criteria. Retrieved on March 29, 2022 from https://www.cancer.org/health-care-professionals/american-cancer-society-prevention-early-detection-guidelines/lung-cancer-screening-guidelines.html.
The Chronic Disease Work Group’s strategies for tobacco policy and lung cancer screenings target adults ages 45 to 64 in the 28601 zip code. Community members age 45 to 64 in the 28601 zip code had higher rates of lung cancer deaths, emergency department visits for chronic lower respiratory disease, and tobacco use.
The Chronic Disease Work Group’s action plan includes the following strategies related to lung cancer screenings. Action steps related to the following strategies are discussed and updated during monthly work group meetings.
Strategies: Lung Cancer Screening
Screening education for the community and public about why lung cancer screening is a beneficial choice.
Promotion and education of lung cancer screenings for providers.
Policy Agenda: Tobacco and E-cigarette Free Lifestyles
In the fall of 2021, the Chronic Disease Work Group crafted the following policy statement as part of LiveWell Catawba's overall policy agenda supporting health and wellness in Catawba County.
Behavioral health is an important part of overall health and includes emotional, psychological, and social well-being (CDC, 2020). An individual’s behavioral health can affect many aspects of their life including their ability to cope with stress, resiliency levels, build sustaining relationships, and make healthy choices. Integrated behavioral health care incorporates primary medical care with behavioral healthcare. Integrated behavioral health care includes whole person wellness with the individual as part of the team and care includes both the individual and their support system. The movement towards integrated behavioral health emphasizes the importance of whole person health.
During the community listening sessions for health priority selection in 2019, 34.2% of participating community members identified a need for increased access to behavioral health services, resources, social supports, and behavioral health professionals (Catawba County Public Health, 2020). From 2016 to 2019, 13.2% of all emergency department visits by Catawba County residents were for anxiety, mood, and psychotic disorders (The University of North Carolina at Chapel Hill, 2020). Access to equitable and affordable primary care that incorporates behavioral is both an applicable and realistic need as Catawba County continues to move forward and cope with the unintended consequences of COVID-19.
References:
Catawba County Public Health. (2020). 2019 Catawba County Community Health Assessment. Retrieved on November 30, 2020 from https://catawbacountync.gov/site/assets/files/2488/2019_catawba_county_cha.pdf.
Centers for Disease Control and Prevention. (2020). Learn about Mental Health. Retrieved on November 30, 2020 from https://www.cdc.gov/mentalhealth/learn/index.htm.
The University of North Carolina at Chapel Hill. (2020). NCDETECT- Emergency Department Data for Catawba County for Anxiety, Mood, and Psychotic Disorders from 1/1/2019 to 11/30/2020. Retrieved on December 1, 2020 from https://ncdetect.org/.
As Catawba County continues to move forward and cope with the unintended consequences of COVID-19, access to equitable and affordable primary care that incorporates behavioral is both an applicable and realistic need. In 2019, 15.5% of all emergency department visits were for anxiety, mood, and psychotic disorders. From January 1 to November 30, 2020, 15.8% of all emergency department visits have been for anxiety, mood, and psychotic disorders (The University of North Carolina at Chapel Hill, 2020).
Behavioral health conditions, such as anxiety, mood, and psychotic disorders, affect a person’s thinking, feeling, mood, or behavior in a way that influences their ability to relate to others and function each day. These conditions may be situational, short-term, or long-lasting, chronic (Centers for Disease Control and Prevention, 2020). Emergency department visits are categorized by ICD-10-CM codes and anxiety, mood, and psychotic disorders are defined as follows:
The Behavioral Health Work Group continues to consider if they have a full understanding of root causes and continue to discuss equity, stigma, non-medical drivers/ social determinants of health, case management and lack of wrap around services.
References:
Centers for Disease Control and Prevention. (2020). Coronavirus Disease 2019: Coping with Stress. Retrieved on December 3, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html.
The University of North Carolina at Chapel Hill. (2020). NCDETECT- Emergency Department Data for Catawba County for Anxiety, Mood, and Psychotic Disorders from 1/1/2019 to 11/30/2020. Retrieved on December 1, 2020 from https://ncdetect.org/.
In June 2020, Catawba County Public Health and LiveWell Catawba convened work groups for each of the 2020 to 2023 health priorities: chronic disease, behavioral health, and healthy foods & healthy weight. The Behavioral Health Work Group narrowed their focus from behavioral health prevention to the prevention of anxiety, mood, and psychotic disorder relapses. As the work group moved through the results-based accountability process to develop the community health improvement plan (CHIP), they discussed on an ongoing basis who are partners and community members that are not involved that should be involved.
The Behavioral Health Work Group is continuously expanding to include a diverse group of community members, subject matter experts, agencies, and sectors. A current list of Behavioral Health Work Group members is available here.
The Behavioral Health Work Group through the strategy selection process discussed best practices that work to support access to equitable and affordable primary care that incorporates behavioral health, potential low cost and no cost ideas, and data needed to better inform the work.
Strategy Selection Process
In 2020, the Behavioral Health Work Group Group selected the overarching strategies of whole person care, technology supported care, and community education to support access to equitable and affordable primary care that incorporates behavioral health. The strategy selection process included the work group members rating each strategy idea as high, medium, or low on the criteria of leverage (short-term: 3 years, intermediate: 3 to 5 years, and long-term: 10 years), feasibility, values, and specificity. The work group then reviewed the rating survey results, discussed each strategy, identified the overarching strategies based on related themes of the strategies selected, and determined, based on the criteria and rankings, which strategies should not be included in the community health improvement plan. The work group continued to update their strategies and action steps throughout 2021 and 2022. In 2021, the Whole Person Care Subgroup and Technology Supported Care Subgroup merged into one subgroup for Whole Person Care & Telehealth.
What are the programs and/or interventions recognized as best practices?
What are potential low cost and/or no cost ideas for immediate improvements?
What data is needed to better inform the work?
The Behavioral Health Work Group has discussed the following data needs and/or additional data to consider if available.
At the Behavioral Health Work Group meeting on January 19, 2022, work group members reviewed and updated their current strategies based on what was working well, what was not working well and/or could be removed or changed, and how these strategies impact health disparities in Catawba County. The work group’s action plan was updated to include the following strategies. Action steps related to the followling strategies are discussed and updated during monthly work group meetings.
Strategies: Whole Person Care & Technology Supported Care
Strategies: Community Engagement
Integrated behavioral health care includes whole person wellness with the individual as part of the team and care includes both the individual and their support system. The movement towards integrated behavioral health emphasizes the importance of whole person health. Holistic care refers to caring for the whole person.
Technology supported care includes telehealth (phone conversations) and virtual health (provider can see the client) for behavioral health care. Before the COVID-19 pandemic, trends show some increased interest in use of telehealth services by both health care providers and clients. However, recent policy changes during the COVID-19 pandemic have reduced barriers to telehealth access and have promoted the use of telehealth as a way to deliver acute, chronic, primary and specialty care. Telehealth can also improve patient health outcomes (Centers for Disease Control and Prevention, 2020).
Reference:
Centers for Disease Control and Prevention. (2020). Using Telehealth to Expand Access to Essential Health Services during the COVID-19 Pandemic. Retrieved on December 2, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html#:~:text=%2D%20Screen%20patients%20who%20may,%2C%20and%20refer%20as%20appropriate.
The Behavioral Health Work Group’s strategies target adults ages 19 to 44 in the 28609 zip code (Town of Catawba) and surrounding area, with focus on the rural community and working with churches. Of emergency department visits for anxiety, mood, and psychotic disorders, 39.7% were for adults ages 19 to 44. Community members age 19 to 44 in the 28609 zip code had a higher number of emergency department visits for anxiety, mood, and psychotic disorders compared to other zip codes and age groups in Catawba County.
The Behavioral Health Work Group's action plan includes the following strategies related to whole person care and telehealth. The work group recognizes the importance of focusing on evidence-based strategies. Action steps related to the following strategies are discussed and updated during monthly work group meetings.
Strategies: Whole Person Care & Technology Supported Care
Policy Agenda: Equitable Access to Whole Person Care
Community engagement may include and is not limited to, education on resources available in the community, reducing stigma, mental health first aid training, community groups, etc.
The Behavioral Health Work Group’s strategies will target adults ages 19 to 44 in the 28609 zip code (Town of Catawba), with focus on the rural community and working with churches. Of emergency department visits for anxiety, mood, and psychotic disorders, 39.7% were for adults ages 19 to 44. Community members age 19 to 44 in the 28609 zip code had a higher number of emergency department visits for anxiety, mood, and psychotic disorders compared to other zip codes and age groups in Catawba County.
The Behavioral Health Work Group's action plan includes the following strategies related to community engagement. The work group recognizes the importance of focusing on evidence-based strategies. The following strategies were discussed during the whole distance exercise completed by the Behavioral Health Work Group in December 2021 and January 2022. Action steps related to the following strategies are discussed and updated during monthly work group meetings.
Strategies: Community Engagement
Food is a basic building block of health that affects both behavioral and physical health. Where someone lives strongly influences access to healthy foods. Limited access to healthy foods links to obesity, cardiovascular conditions, nutritional deficiencies, diabetes, and chronic kidney disease (North Carolina Institute of Medicine, 2020). Limited access to healthy foods is defined as living more than ½ a mile in urban areas or more than 10 miles in rural areas from the nearest supermarket, supercenter, or large grocery store. Census tracts where a significant number of residents have limited access to healthy foods are considered food deserts (United States Department of Agriculture, 2019). Low-income neighborhoods and those with large minority populations are less likely to have supermarkets and the available stores often have more limited healthy options and may have higher prices than their counterparts in wealthier communities (NCIOM, 2020).
In Catawba County, 8 of 31 census tracts (25.8%) have limited access to healthy foods with 14,151 community members living more than a ½ mile (urban) or 10 miles (rural) from the nearest supermarket. Nearly 1 in 3 adults (31.3%) age 20 and over report a body mass index (BMI) of greater than or equal to 30 (obese). In the 2019 Catawba County Community Health Opinion Survey, 42.6% of the respondents reported eating at least 5 servings of fruits and vegetables a day; compared to 51.6% in 2015 (Catawba County Public Health, 2020). Respondents were asked in follow-up why they felt they were not eating 5 servings of fruits or vegetables a day, 23.5% responded they were too expensive and 7.2% selected it was not convenient for them to buy fruits and vegetables 2015 (Catawba County Public Health, 2020). Improving access to healthy food is a critical component of creating an equitable and sustainable food system and a healthier community. (The Food Trust, 2010).
References:
Catawba County Public Health. (2020). 2019 Catawba County Community Health Assessment. Retrieved on November 30, 2020 from https://catawbacountync.gov/site/assets/files/2488/2019_catawba_county_cha.pdf.
North Carolina Institute of Medicine. (2020). Healthy North Carolina 2030: A Path Toward Health. Retrieved on December 1, 2020 from https://nciom.org/healthy-north-carolina-2030/.
The Food Trust. (2010). The Grocery Gap: Who Has Access to Healthy Food and Why It Matters. Retrieved on December 1, 2020 from http://thefoodtrust.org/uploads/media_items/grocerygap.original.pdf.
United States Department of Agriculture. (2019). Food Access Research Atlas. Retrieved on December 1, 2020 from https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas/.
United States Department of Agriculture. (2019). Food Access Research Atlas Definitions. Retrieved on December 1, 2020 from https://www.ers.usda.gov/data-products/food-access-research-atlas/documentation/.
Food insecurity refers to a lack of access, at times, to enough food for an active, healthy life for all household members and limited or uncertain availability of nutritionally adequate foods. Food-insecure households are not necessarily food insecure all the time. Food security may reflect a household's need to make trade-offs between important basic needs, such as housing or medical bills, and purchasing nutritionally adequate foods (Feeding America, 2020).
Low-income census tracts where a significant number or share of residents are more than ½ or 1 mile (urban) or 10 miles (rural) from the nearest supermarket, also referred to as food deserts, are included in the Food Access Research Atlas map below.
References:
Feeding America. (2022). 2019 Overall County Food Insecurity In North Carolina, Catawba County. Retrieved on March 30, 2022 from https://map.feedingamerica.org/county/2019/overall/north-carolina/county/catawba.
United States Department of Agriculture. (2022). Food Access Research Atlas. Retrieved on March 30, 2022 from https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas/.
In June 2020, Catawba County Public Health and LiveWell Catawba convened work groups for each of the 2020 to 2023 health priorities: chronic disease, behavioral health, and healthy foods & healthy weight. The Catawba County Food Council, formerly the Healthy Foods & Healthy Weight Work Group, narrowed their focus to reducing food deserts in Catawba County. As the work group moved through the results-based accountability process to develop the community health improvement plan (CHIP), they discussed on an ongoing basis who are partners and community members that are not involved that should be involved.
The Catawba County Food Council is continuously expanding to include a diverse group of community members, agencies, and sectors. A current list of Catawba County Food Council members is available here.
The Catawba County Food Council through the strategy selection process discussed best practices that work to support equitable access to health foods and culturally appropriate resources, potential low cost and no cost ideas, and data needed to better inform the work.
Strategy Selection Process
In 2020, the Catawba County Food Council selected the overarching strategies of community gardens and farmers markets to support equitable access to health foods and culturally appropriate resources. The strategy selection process included the work group members rating each strategy idea as high, medium, or low on the criteria of leverage (short-term: 3 years, intermediate: 3 to 5 years, and long-term: 10 years), feasibility, values, and specificity. The work group then reviewed the rating survey results, discussed each strategy, identified the overarching strategies based on related themes of the strategies selected, and determined, based on the criteria and rankings, which strategies should not be included in the community health improvement plan.
In 2021, the Catawba County Food Council updated their overarching strategies to target food pantries and farmers markets. The Food Council had met with volunteers with community gardens and found that the majority of gardens were already donating produce within the community and were accessible to local community members. The Food Council met with the two largest food pantries, Greater Hickory Cooperative Christian Ministry (GHCCM) and Eastern Catawba Cooperative Christian Ministry (ECCCM) to assess culturally appropriate foods and resources and identify education needs for community members.
What are the programs and/or interventions recognized as best practices?
What are potential low cost and/or no cost ideas for immediate improvements?
What data is needed to better inform the work?
At the Catawba County Food Council meeting on January 24, 2022, work group members reviewed and updated their current strategies based on what was working well, what was not working well and/or could be removed or changed, and how these strategies impact health disparities in Catawba County.
Strategies: Food Pantries
Strategies: Farmers Markets
Limited access to healthy foods
Percentage of population who are low-income and do not live close to a grocery store.
The 2020 County Health Rankings used data from 2015 for this measure.
A food pantry is a distribution center where hungry families can receive food. Supplied with food from a food bank, pantries feed hundreds of people per week. Because every community is different, there are many different types of pantries (Feeding America, 2022).
The Catawba County Food Council has partnered with Greater Hickory Cooperative Christian Ministry (CCM) and Eastern Catawba Cooperative Christian Ministry (ECCCM) for cooking videos, recipes, accessing culturally appropriate resources, and continues to work directly with both food pantries to provide education on topics they have identified.
References:
Feeding America. (2022). What is the difference between a food bank and food pantry. Retrieved on March 30, 2022 from https://www.feedingamerica.org/hunger-blog/what-difference-between-food-bank-and-food-pantry.
The Catawba County Food Council’s strategies will target the the census tracts of 103.03, 104.2, 106, 107, 109, 110, 112 and 113, which are low-income census tracts where a significant number or share of residents are more than ½ or 1 mile (urban) or 10 miles (rural) from the nearest supermarket. At this time the census tracts targeted are based on the 2015 data from the USDA's Food Access Research Atlas. The Food Council had also planned to target parents and/or caregivers of children ages 2 to middle school within the low income and low access census tracts.
The Catawba County Food Council's action plan includes the following strategies related to food pantries The work group recognizes the importance of focusing on evidence-based strategies. Action steps related to the following strategies are discussed and updated during monthly work group meetings.
Strategies: Food Pantries
Policy Agenda: Equitable Access to Healthy Foods
A farmers market is a public and recurring assembly of farmers or their representatives selling food that they produced directly to consumers (Farmers Market Coalition, 2020). Catawba County currently has five farmers markets; Catawba County Public Health Farmers Market, Conover Farmers Market, Downtown Hickory Farmers Market, Murray's Mill Farmers Market, and Farmers Market at Center United Methodist Church. Market seasons for all the farmers markets vary slightly year to year.
For SNAP Double Bucks, for every $1.00 spent at the farmers market, $1.00 will be matched from funding. This will allow customers who utilize SNAP (Supplemental Nutrition Assistance Program) to purchase a greater quantity of fresh produce.
Reference:
Farmers Market Coalition. (2020). What is a Farmers Market. Retrieved December 2, 2020 from https://farmersmarketcoalition.org/education/qanda/.
The Catawba County Food Council’s strategies will target the the census tracts of 103.03, 104.2, 106, 107, 109, 110, 112 and 113, which are low-income census tracts where a significant number or share of residents are more than ½ or 1 mile (urban) or 10 miles (rural) from the nearest supermarket. At this time the census tracts targeted are based on the 2015 data from the USDA's Food Access Research Atlas. The Food Council had also planned to target parents and/or caregivers of children ages 2 to middle school within the low income and low access census tracts.
The Catawba County Food Council's action plan includes the following strategies related to farmers markets. The work group recognizes the importance of focusing on evidence-based strategies. Action steps related to the following strategies are discussed and updated during monthly work group meetings.
Strategies: Farmers Markets
Policy Agenda: Equitable Access to Healthy Foods
Despite the challenges due to COVID-19 in 2020, Catawba County Public Health and our partners were able to:
Catawba County declared a state of emergency due to the COVID-19 pandemic on March 18, 2020. Catawba County has had over 19,000 confirmed cases of COVID-19 and 300 deaths. Catawba County Public Health updates our COVID-19 dashboard daily at https://www.catawbacountync.gov/county-services/public-health/coronavirus-19/.
Catawba County COVID-19 Case Update: 5/27/2021
Cases | |
Number of total cases | 19,186 |
Number of deaths | 305 |
Number recovered | 18,712 |
Retrieved on 5/27/2021 from https://covid19.ncdhhs.gov/dashboard/cases-demographics.
Catawba County Vaccination Update: 5/27/2021
Vaccinations | |
People Fully Vaccinated | 56,107 |
Percent of Population Fully Vaccinated | 35.2% |
Retrieved on 5/27/2021 from https://covid19.ncdhhs.gov/dashboard/vaccinations.
Community Health Advocates
Throughout 2020, the Chronic Disease Work Group, Behavioral Health Work Group, and the Catawba County Food Council met monthly to develop Community Health Improvement Plans (CHIPS). The planning process was extended to the end of 2020 and by the end of the year all three work groups had started action planning and preparing for the upcoming year. The work groups anticipate new strategies will begin implementation in 2021.
In January and February 2021, all three work groups paused to allow Catawba County Public Health and our healthcare partners to focus all of their efforts to supporting the COVID-19 vaccine rollout. The work groups picked back up with action planning in March 2021. Action plans for the Chronic Disease Work Group, Behavioral Health Work Group, and Catawba County Food Council are available in the Work Group Action Plan folder. The work groups' action plans are fluid and are being updated monthly as the work group and/or subgroups meet.
Chronic Disease
Behavioral Health
Healthy Foods & Healthy Weight
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
Leading Causes of Death (Unadjusted Death Rates per 100,000 Population, Ranking by Geographic Area) |
Catawba |
North Carolina |
||
Total Deaths- All Causes |
1078.0 |
901.7 |
||
|
|
|
|
|
Cause of Death |
Rate |
Rank |
Rate |
Rank |
Cancer - All Sites |
211.8 |
1 |
190.9 |
1 |
Diseases of the heart |
201.1 |
2 |
184.1 |
2 |
Chronic lower respiratory diseases |
87.4 |
3 |
52.3 |
3 |
Alzheimer's disease |
73.6 |
4 |
41.4 |
5 |
Cerebrovascular disease |
51.0 |
5 |
49.4 |
4 |
Other Unintentional injuries |
40.6 |
6 |
41.1 |
6 |
Diabetes mellitus |
28.9 |
7 |
28.5 |
7 |
Pneumonia & influenza |
27.4 |
8 |
19.3 |
9 |
Nephritis, nephrotic syndrome, & nephrosis |
25.9 |
9 |
19.3 |
8 |
Chronic liver disease & cirrhosis |
18.5 |
10 |
- |
- |
2015-2019 Leading Causes of Death by Age for Catawba County
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
COVID-19
Equipping Local Health Departments to Build COVID-19 Vaccine Confidence (COVIED) Project
Health Priority Work Groups