HNC 2030 Scorecard: Cabarrus Health Alliance
The 2020 Community Health Needs Assessment (CHNA) conducted in Cabarrus County identified the following priority areas:
- Housing (CHNA pg. 23, 63)
- Mental and Behavioral Health (CHNA pg. 23, 73)
- Early Childhood Education and Development (CHNA pg 23, 52)
The CHNA process is intended to inform community stakeholders, as well as community members on how collectively and individually they all play a role in creating a healthier community for the residents of Cabarrus County. By September 2021, key stakeholders and community members were convened to assist with developing Community Health improvement plans for each identified priority need. As instructed by the Community Planning Council and Healthy Cabarrus Executive Committee, Healthy Cabarrus staff will urge partners and community members to apply an equity lens to all proposed and recommended strategies, ensuring a positive impact among marginalized populations. When necessary or if not already established, community coalitions/task forces will be created to carry out action plans.
The following Community Health Improvement Plans (CHIP) were created and submitted to the North Carolina Department of Health and Human Services (NCDHHS) on Tuesday, September 7, 2021. This document includes CHIPs associated with the top three priorities: housing (Long-Term), mental and behavioral health (Short-Term), and early childhood education (short-term). The housing and behavioral health plans meet the requirements outlined in the NC Local Health Department Accreditation and NC Department of Health and Human Services - Department of Public Health Consolidated Agreement. The CHIPs implementation timeline is September 2021 through September 2024, with quarterly or monthly progress documentation from associated workgroups and task forces.
This Scorecard is a living document and is not intended to be a complete list of all programs or partners working on these issues in Cabarrus County. While Healthy Cabarrus and Cabarrus Health Alliance hope to continue to grow the programs and performance measures included, the initial Scorecards highlight targeted strategies that are focused on moving the needle on the identified indicator. Use the icons to expand items and learn more:
- R = Results we hope to see as our health improves
- I = Indicators are data that concern us and the story behind the data that helps us understand why things are getting better or worse
- O = Organizations that are responsible for overseeing the implementation of specific programs, projects or strategies to address identified community needs.
- P = Programs and partners working together to make things better
- PM = Performance Measures are ways we are measuring success and describe how we are making a difference
Executive Summary
Introduction and Vision
Healthy Cabarrus, housed within the Cabarrus Health Alliance, the public health authority of Cabarrus County, was created in 1997 as a multi-sector initiative designed to work collaboratively with community partners to improve the health of those who live, work, learn, play, pray and utilize services in Cabarrus County. Part of the collaborative responsibilities includes overseeing the Community Health Needs Assessment (CHNA) process every four years. While its mission includes the mobilization of community partners, its vision for conducting the county’s Community Health Needs Assessment (CHNA) is to not only identify the top needs, and develop community health improvement plans with strategies that can effectively address those issues faced by residents.
Healthy Cabarrus Missions: United through partnerships, we commit our time, talents and financial resources to create a health community and hopeful future for all.
With an understanding of social determinants of health, Healthy Cabarrus recognizes that an individual’s health is determined by more than just their physical well-being. According to the Centers for Disease Control and Prevention (CDC), a person’s health is impacted by access to social and economic opportunities; the resources and supports available within their homes, neighborhoods, and communities; the quality of schools; the safety of their workplaces; the cleanliness of their water, food, and air; and the nature of their social interactions and relationships.
Social determinants of health are issues far too complex for one group or agency to solve alone. While Healthy Cabarrus does not provide direct services to the community, they provide ongoing support to community partners by guiding community strategy development, identifying resources, and helping to create evaluation measures.
Leadership, Partnerships and Collaborative Process
Cabarrus Health Alliance, along with Healthy Cabarrus’ five-member Executive Committee, made up of external community stakeholders, oversees the CHNA process and ongoing community collaborative efforts. The 2020 CHNA launched with the development of the Community Planning Council (CPC) on September 19, 2019. The Cabarrus County Community Planning Council is made up of a diverse, multi-sectoral group of representatives including more than 40 individuals. The primary role of CPC members is to support primary and secondary data collection; assist with analyzing data and information collected; and interpret county data and community feedback to identify the top priority issues facing residents of Cabarrus County.
| Healthy Cabarrus Executive Committee | Members |
| Atrium Health Cabarrus | Tri Tang, Chair |
| BCI Investgations and Consulting | Merl Hamilton, Vice Chair |
| Cabarrus County Government | Mike Downs |
| Concord Housing Department | Angela Graham |
| Rowan Cabarrus YMCA | Brent Rockett |
| Community Planning Council | Number of Partners |
| Pubilc Health Agency | 2 |
| Hospital/Health Care System | 2 |
| Healthcare PRovider - other than behavioral Health | 4 |
| Behavioral Health Provider | 1 |
| EMS, Law Enforcement, Court System | 4 |
| Local Government | 7 |
| Non-profit Organizations | 6 |
| Business - employers, not organizations | 4 |
| Education - early childhood, K-12 and high education | 4 |
| Media/Communication Outlets | 1 |
| Public Community Members | 3 |
| City and County Service Systems | 4 |
Contracted Services
Cabarrus Health Alliance established a Memorandum of Understanding (MOU) with North Carolina Central University to receive epidemiological support throughout the CHNA process. This support included review of survey tools, focus group discussion questions, and the collection and analysis of data.
The Healthy Cabarrus Executive Director supervised a University of North Carolina – Gilling’s School of Public Health master’s practicum student who contributed to the CHNA process by analyzing the community member survey responses by race/ethnicity, income and zip code. The practicum student also reviewed data for correlating factors and trends in subpopulation responses.
Theoretical Framework and Model
Healthy Cabarrus uses the North Carolina Division of Public Health’s eight-phase community health assessment process.
1. Establish CHNA Leadership Team: The Healthy Cabarrus Community Planning Council represents a diverse group of community sectors, such as the business sector, social services, community members, faith leaders or representatives, as well as transportation and housing experts.
2. Collect primary data: Community Member Survey, Key Informant Survey, and Focus Groups
3. Collect secondary data: Gather data from local, state and national-level sources, along with data surrounding social determinants of health. CPC members are also responsible for compiling and sharing data that their organizations capture.
4. Analyze and interpret county-level data: Host monthly data review sessions with Community Planning Council and other subject-matter experts.
5. Determine health priorities: Review data and conduct priority ranking with Community Planning Council members and stakeholders from key groups. Include priority ranking questions within Focus Group sessions and Community Member Survey.
6. Create CHNA document.
7. Disseminate CHNA document: Distribute throughout the community by reaching out to media outlets, conduct and participate in community meetings, and share findings with key stakeholders.
8. Develop Community Health Improvement Plans: Plan to address health priorities identified in the CHNA and how progress will be measured in the short- and long-term.
To find previously submitted action plans and progress to date on the 2016 priority needs, please visit
www.healthycabarrus.org and review Cabarrus’ annual State of the County Health Report (SOTCH).
Next Steps
The Healthy Cabarrus Community Planning Council presents this report as a call to action. The CHNA process is intended to inform community stakeholders, as well as community members on how collectively and individually they all play a role in creating a healthier community for the residents of Cabarrus County. The results of this report will be distributed in the community through multiple communication platforms and channels.
By September 2021, key stakeholders and community members will be identified and convened to assist with the development of community health improvement plans for each identified priority need. As instructed by the CPC and Healthy Cabarrus Executive Committee, Healthy Cabarrus staff will urge partners and community members to apply an equity lens to all proposed and recommended strategies, ensuring a positive impact among marginalized populations. When necessary, community coalitions/taskforces will be established to carry out action plans.
Priorities
- Housing (CHNA pg. 23, 63)
- Mental and Behavioral Health (CHNA pg. 23, 73)
- Early Childhood Education and Development (CHNA pg 23, 52)
Overview
State of the County Health Report 2021
Conducting a community health assessment is an ongoing process that engages diverse agencies, providers, and individuals in identifying community assets and strengths, as well as unmet needs. Leadership for this collaborative process is provided by the Cabarrus Health Alliance (CHA) through Healthy Cabarrus. The following State of the County Health (SOTCH) Report, serves as an update and documented progress following the findings of the 2020 Community Needs Assessment. The 2021 Cabarrus County SOTCH was submitted to North Carolina Department of Human Services (NCDHHS) on March 7, 2022.
Information provided within this report is specific to the identified priority health issues: housing, behavioral health, and early childhood education and development. The report also provides updated data and information specific to Cabarrus County mortality and morbidity rates; COVID-19 response, resiliency, and recovery; emerging issues and new initiatives.
Communication with stakeholders and community members regarding the identified community health priorities and progress to-date is vital to community health improvement. Following review by the Cabarrus County Public Health Authority Board of Commissioners and Healthy Cabarrus Executive Committee, copies of the 2021 State of the County Health Report will be disseminated to the Healthy Cabarrus Advisory Board, as well as hard copies to target community locations. Targeted locations include local libraries, community centers, park and recreation departments, federally qualified health centers, in addition to other sites with high community member presence.
Cabarrus County Profile
Cabarrus County’s population has seen consistent growth since 2000. Between 2010 and 2020, Cabarrus County’s population increased by 26.8% percent or nearly 50,000 people. In comparison, during that same time period, North Carolina’s population only increased by only 9.5%. As documented in previous reports, extreme, rapid growth impacts how agencies and organizations provide services to residents, and often times vulnerable populations such as persons with disabilities, limited English proficiency, children under 5 and persons over 65 are disproportionately affected.
Total Cabarrus County Population: 225,804
Sources
Persons in Poverty, Median Household Income - U.S. Census 2015-2019
Educational Attainment - U.S. Census, American Community Survey 1 Year - 2019
Unemployment Rate - US Bureau of Labor Statistics - December 2021
Progress on Community Health Improvement Plans
Following the 2020 Cabarrus County Community Health Assessment, major strides and strategic decisions were made to impact and improve the wellbeing of Cabarrus County residents. With the support from the Cabarrus County Commissioners, Cabarrus County distributed $33.5 million in American Rescue Plan Recovery Funds to more than 50 agencies, with a priority placed on supporting sustainable initiatives that would address the county’s greatest needs.
- Housing Programs: $14,072,673
- Behavioral and Mental Health Programs: $11,450,785
- Childcare and Afterschool/Summer Programs: $1,781,002
For the full summary of the Cabarrus Recovery Grants allocation, click here.
Housing and Homelessness
Healthy Cabarrus worked with local housing leaders to convene the Cabarrus Housing Collaborative. The newly formed collaborative, includes representation from across the public, private, and non-profit housing sectors, with the goal to create a cross-sector, multi-faceted plan to address housing challenges in Cabarrus County. The group plans to develop its mission, vision, and core values in early 2022, as a foundation for its future work to address needs faced by those experiencing housing crisis; seeking affordable housing; or actively seeking support for necessary critical repairs.
Cooperative Christian Ministry
- Huddle Housing (HH) will be carriage housing units positioned (huddled) around a community building with shared facilities on a site in Kannapolis to provide housing for extremely low-income individuals earning
$9,500 to $15,000/year. Often times this target population are people on disability, working minimum wage, and veterans. They can afford housing costs of about $250 - $375 per month (rent, utilities combine), and currently there is no housing solution in Cabarrus County for these individuals. - Homeless to Housing (H2H) will be a multifamily campus that can serve 48 to 50 households of families, senior adults, and adults with disabilities who are currently homeless or in a housing crisis. Once at full capacity, the facility will serve about half of the current level of need for these populations. CCM is actively working on securing a location for this facility.
The City of Concord launched the Concord Family Enrichment Association, now WeBuild Concord in May of 2021. WeBuild Concord is a as a nonprofit established to develop equitable strategies for affordable housing and merge private, public and social resources for wealth creation and economic mobility for residents. Beginning with the 2020-2021 fiscal budget, the city gave 1 cent of the tax rate to affordable housing. This investment is set to recur each year, equaling $2.8 million for affordable housing: $1.4 million from the recurring tax rate and $1.4 million from the city’s return on investment the previous year.
Future housing projects scheduled for the beginning of 2022, will be developed with resources from WeBuild Concord, the City of Concord, and Cabarrus County. The Lincoln Street Townhomes Project, a 26-unit townhome development, will provide residents earning less than 80 percent of the area median income (AMI) an opportunity to own their homes. The Lincoln Street Project will be in the historic Logan Community. WeBuild Concord also announced a partnership with the City of Concord to provide several single-family homes during the same period.
Salvation Army
In August 2021, the Salvation Army broke ground on a new 16,000 square foot ‘Center of Hope Emergency Shelter’. The new facility will help to address the community’s emergency housing needs for homeless residents and increase local capacity to serve families with nowhere else to turn. The new facility will increase the crisis beds available from 28-bed to 64-bed, including the addition of six living units for families with additional beds for women and men.
- The new Center of Hope will offer six 2-bedroom family living units that include a family room and private bathroom.
- Seclusion of the family unit allows two-parent families to stay intact and allows teenage young men to stay with their families rather than being separated into the men's dorm.
- Privacy and security is increased for families, including a private playground for children, separate dining from individual men and women, and secure access to the family floor.
- Programs and partnerships that help meet the immediate and long-term needs of shelter residents to help them identify and overcome barriers to stable housing.
Additional services and programs that Salvation Army residents will have access to:
- Medical and mental health care;
- Finance and budgeting classes;
- GED and vocational classes;
- Life skills classes;
- Intensive case management.
Behavioral Health
Cabarrus County is a designated Health Professional Shortage Area in mental healthcare. For the last nine years, access to mental healthcare has been identified as a priority need in the Cabarrus County Community Health Assessment. In 2017, the Cabarrus County Commissioners established the Cabarrus County Mental Health Advisory Board, a formal county board, to oversee efforts and advocate for improved access to mental health services.
After years of work and advocacy to improve the mental healthcare system for residents, commissioners made the decision to vote to disengage from Cardinal Innovations Healthcare, the County’s Managed Care Organization (MCO). The disengagement process required approval from the North Carolina Department of Health and Human Services (NC DHHS), and in September 2021, Cabarrus and Union counties were notified that, NC DHHS Secretary Mandy Cohen approved both requests for realignment with Partners Health Management . The realignment was effective September 1, 2021.
To reevaluate efforts due to continued changes within the behavioral health system, Healthy Cabarrus hosted a virtual action planning meeting in January 2021, nearly 4 years after the first retreat in April 2017. The meeting focused on assessing previous efforts of the Mental Health Task Force; identifying current gaps and new challenges; as well as educating partners on Results Based Accountability. The action planning retreat, helped to realign task forces to respond to emerging needs and narrow focus to priority populations.
New focus areas for the Mental Health Task Forces: Trauma Informed Communities, Persons who are Justice Involved, Data and Assessments
Cabarrus County Behavioral Health Facility Expansion
The 2021 North Carolina State Budget allocated $30-million to Cabarrus County for the development and building of a regional behavioral health crisis service center. Leaders from Cabarrus County, Atrium Health, Cabarrus Health Alliance and Partners Behavioral Health have started working to identify best practices to maximize service delivery, and are scheduled to visit Guilford County’s new mental health facilities in early 2022. Tentatively the behavioral health crisis center will include separate adult and child/youth facilities, as well as a behavioral health urgent care (BHUC).
CHA Expand Behavioral Health Services
Prior to 2021, CHA employed two Licensed Clinical Social Workers (LCSWs) for our pediatric and maternal health patients. Grant funds through the Cabarrus Recovery Grants, increased the number of LCSWs to a total of 5 to provide evidence-based treatment and support services. Through this services expansion, individuals eligible to receive services through these grant funds will be limited to Cabarrus County residents who are uninsured, underinsured, or low-to-moderate income. Short-term expected outcomes include:
- Expanded capacity in Cabarrus County to provide mental health treatment services and support for vulnerable residents;
- Decreased impact of COVID-19 on the mental wellness of vulnerable Cabarrus County residents; and,
- Decreased health disparities for Spanish-speaking Cabarrus County residents.
The long-term vision for CHA’s new Behavioral Health Department includes engagement in policy practice at the state and local level, as well as efforts to continue to develop and expand community based behavioral health education.
Early Childhood Education
Cabarrus County Government hired Early Childhood Education Coordinator, Carla Brown, to lead and coordinate efforts to improve the County’s early childhood systems. Ms. Brown works closely with the 15-member Early Childhood Task Force Advisory Board (ECTFAB), which was established to advise the Board of County Commissioners on matters related to the primary development of children in Cabarrus County.
The ECTFAB, expanded to include four primary work groups: Healthy; Basic Needs; Social, Emotional and Nurturing Relationships; Learning and Ready to Succeed. The Task Force and Work Group members are responsible for developing action plans and identifying necessary strategies to impact the NC Early Childhood Action Plan benchmarks, ensuring shared community partner responsibility to improve the lives of the County’s youngest residents.
Lockhart Child Development Center
Partners in the project include:
- All Saints’ Episcopal Church provides the facility and administration of the education center
- Rowan-Cabarrus Community College uses the site to train Rowan-Cabarrus Community College students who wish to pursue a career in early childhood development
- Cabarrus County Government assisted with the initial startup costs and provides tuition assistance to County employees who enroll their children in one of 40 spots dedicated to children of County employees
- The County plans to use the site to inform businesses about the importance and value of helping employees with childcare expenses.
Click to play video above.
Community Health Improvement Plans for housing and behavioral health are available here. Indicator and performance measure data is updated quarterly and annual based on the source.
Mortality and Morbidity Changes
Mortality
Rates of morbidity, mortality, and emergency hospitalizations can be reduced if community members have adequate access to services such as health screenings, routine testing, and vaccinations. Prevention indicators can call attention to a lack of access or knowledge regarding one or more health issues and should inform program interventions.
The data within this section comes from the State Center for Health Statistics 2021 County Health Data Book and the Robert Wood Johnson Foundation – County Health Rankings. The data within the 2021 County Health Data Book spans 5 years, either 2014-2018 or 2015-2019 and is considered current for community health assessments and state of the county health reports due in March 2022.
The data available for leading cause of death shows that diseases of the heart has surpassed cancer – all sites, as the number one leading causes of death among Cabarrus County residents. Although state and county data are not yet available for leading causes of death for 2020 and 2021, the Centers for Disease Control and Prevention reports COVID-19 as the third leading causes of death in 2020, proceeding heart disease and cancer. Diabetes dropped from the 8th leading cause of death to the 9th.
2015-2019 NC Resident Race/Ethnicity and Sex-Specific Age-Adjusted Death Rate Disparities
- African Americans, both males and females, have higher rates of death associated with Disease of the Heart and two-times higher rate for nephritis/nephrosis (kidney disease)
- African American females consistently have the highest rates of death caused for Breast Cancer and three-times higher rate for Diabetes
- Females, both African American and White, have a much higher rate of Alzheimer’s disease than their male counterparts
- Suicide is highest among white males. All other races, sexes are too small a number to calculate a county-wide rate
It is important to point out that like the leading cause of death data, the life expectancy data available is prior to the COVID-19 pandemic. According to the Proceedings of the National Academy of Sciences (PNAS) COVID-19 has generated a huge mortality toll in the United States, with a disproportionate number of deaths occurring among the Black and Latino populations. Experts anticipate that COVID-19 will reduce US life expectancy by 1.13 years, with estimated reductions for the Black and Latino populations being 3 to 4 times that for Whites. Disparities in life expectancy between race and ethnicities existed prior to the pandemic. In 2019, data showed a two year life expectancy difference between white and African American Cabarrus residents, 78.9 and 76.9 respectively.
Morbidity
Morbidity is another term for illness or medical condition. and often times refers to having a disease or a symptom of disease, or the assessment of the amount of disease within a population. Some examples of common morbidities are heart disease, diabetes, and obesity, but morbidities can range from Alzheimer's disease to cancer to traumatic brain injury. When a person has more than one morbidity at a time, it is referred to as co-morbidity. Morbidities are NOT deaths. Prevalence is also used as a measure to determine the level of morbidity in a population.
2021 Robert Wood Johnson County Health Rankings: Quality of Life, Health Behaviors and Clinic Care Measures
*Items shaded in yellow indicate that Cabarrus County is doing better than or the same as the state of North Carolina, but not has good as Benchmark Counties or Top Performers in the U.S.
*Items shaded in red indicated that Cabarrus County is doing worse than the state of North Carolina and Top Performers
To learn more about the County Health Rankings or to see how other counties across North Carolina are performing, click here.
Sources
NC State Center for Health Statistics
Robert Wood Johnson Foundation - County Health Rankings
Emerging Issues
COVID-19
The COVID-19 pandemic remains an emerging and on-going issue as variants cause rapid increases in case counts and deaths.Cabarrus County experienced the first COVID-19 related death in North Carolina in early March 2020, placing the county in a state of emergency. The Public Health Authority of Cabarrus County d.b.a Cabarrus Health Alliance (CHA) has been responsible for supporting the multi-sector and cross jurisdictional response to COVID-19. As the local health department, CHA, is responsible for overseeing contact tracing, contact investigation, and public education on mitigation strategies.
On January 6, 2021, CHA began administering the COVID-19 Pfizer vaccine at the Cabarrus Arena and Events Center. More than 1,000 people were vaccinated the first day and tens of thousands more were vaccinated through similar large scale drive-thru clinics operated by the health alliance. Understanding capacity issues and the challenges of rapid mobilization, CHA partnered with school systems, nonprofits and private sector companies to meet testing and vaccine demands as public requests increased. CHA continues to monitor and make local and state COVID-19 data easily accessible to the public. County health officials are preparing to move from response to recovery and plan to engage individuals from across the county, including traditional and non-traditional leaders, in hopes of creating a Recovery Coalition, which will make recommendations for how to move forward from pandemic to endemic.
Racism declared a Public Health Crisis
In late 2020, the Cabarrus County Public Health Authority Board of Commissioners, the governing body of the Cabarrus Health Alliance, joined a growing number of U.S. cities, counties and public health departments in declaring racism a Public Health Crisis. Throughout 2021, CHA staff, departments and leadership worked diligently to implement efforts and advocate for systems and policy changes, to accomplish the 13 items outlined within the proclamation. Racism has created a health divide negatively impacting black and brown residents. Minorities in Cabarrus County have lower life expectancies when compared to their white counterparts, meaning they are more likely to die before age 75. Data also shows that black residents are more likely to die from heart disease and diabetes, than white residents. To view the entire proclamation, as well as the internal and external strategies outlined, click here.
Smoking and Tobacco use
The NC Tobacco Prevention and Control Branch (NC TPCB) reports that tobacco use is the leading cause of preventable disease and death in North Carolina and the United States. In Cabarrus County, the highest rate of death due to cancer, is caused by cancer of the trachea, bronchus and lung. Studies have shown that smoke-free laws can not only protect people from secondhand smoke, but
Every day, about 1,600 young people under 18 try their first cigarette, and nearly 200 become daily cigarette smokers (CDC). For many years in Cabarrus County smoking and tobacco use data showed decreases in reported use by youth. In recent years, smokeless tobacco products and electronic vaping have been the primary products of tobacco use for middle and high school students. According to the 2021 Cabarrus Youth Substance Use Survey, only 2% of middle and high school students reported current cigarette use, while 6% reporting current vape use (10.6% High School, 2.1% Middle School). Cabarrus County students also reported highest perceived risk associated with cigarette use, even when compared to prescription drugs, alcohol and marijuana use.
The Rescue Agency, shined a light on some shifts in tobacco trends associated with teen vaping behavior data due to the COVID-19 pandemic. Data showed decreased vaping use by experimenting teens due fewer peer interactions and less access, while regular users reported increasing their vape use due to boredom and coping with stress from being home. The Healthy Cabarrus Substance Use Coalition and community partners are working to identify strategies to change youth perception and decrease the number of youth who report first time tobacco use, either through use of cigarettes or electronic vaping devices.
New, Paused or Discontinued Initiatives
Office of Rural Health - Dental Grant Service Expansion
With funding from the Office of Rural Health, Cabarrus Health Alliance (CHA) will increase access to evidence-based dental care that prevents and reduces the incidence of oral disease through targeted recruitment, patient education, and comprehensive treatment; reaching at least 1,000 low-income, underinsured, or uninsured residents patients annually. Care will be provided at CHA’s two dental offices, and by leveraging existing infrastructure, staff, and community relationships to institute a systems-change that brings pop-up dental services to vulnerable residents at trusted locations that already serve them.
Through these funds, the dental program will provide each patient will be afforded up to $500 of free dental services. If completing their treatment plan extends beyond that value, the patient will be automatically enrolled in a 60% discount using our sliding fee scale. Partner pop-up locations:
- Cooperative Christian Ministry
- El Puente Hispano
- Local churches – through Atrium Health’s Faith Community Health Ministry
Community Health Workers
Cabarrus Health Alliance Community Health Worker
CHA has hired and began training six (6) racially and linguistically diverse CHWs who come from the culture and community they intend to serve. CHW’s will be deployed to the following agencies/locations:
- El Puente Hispano
- Cooperative Christian Ministry
- Cabarrus County Department of Health and Human Services
- Community Free Clinic
- Cabarrus Health Alliance – Communicable Disease Department
- Cabarrus Health Alliance – Women’s Health Clinic
Public–private partnerships (PPPs) have been placed at the forefront of many conversations, as they have become a popular way to get major infrastructure projects built and develop a shared responsibility for improving resident/employee well-being. Compared with traditional solutions, which can strain government and non-profit resources, these public-private arrangements are intended to boost efficiency and effectiveness.
The involvement of large employers during workforce housing discussions has been a focus of the Cabarrus Housing Collaborative. When companies like Amazon launch a $2 billion Housing Equity Fund to preserve and create over 20,000 affordable homes across the country, it is imperative that they have a seat at the local table to strategize future housing growth and development.
The public and non-profit sectors are encouraged and challenged to engage the private sector with education and advocacy of how for-profit companies are a vital part of the community. From large corporations to small businesses, these entities should have the opportunity to contribute far beyond just jobs, salaries, and wages. They are members of the community and should have a space to share their concerns and be active in supporting solutions.
Overview
State of the County Health Report 2022
Conducting a community health assessment is an ongoing process that engages diverse agencies, providers, and individuals in identifying community assets and strengths, as well as unmet needs. Leadership for this collaborative process is provided by the Cabarrus Health Alliance (CHA) through Healthy Cabarrus. The following State of the County Health (SOTCH) Report, serves as an update and documented progress following the findings of the 2020 Community Health Needs Assessment. The 2022 Cabarrus County SOTCH was submitted to North Carolina Department of Human Services (NCDHHS) on March 6, 2023.
Information provided within this report is specific to the identified priority health issues: housing, behavioral health, and early childhood education and development. The report also provides updated data and information specific to Cabarrus County mortality and morbidity rates; emerging issues; new, paused and discontinued initiatives.
Communication with stakeholders and community members regarding the identified community health priorities and progress to-date is vital to community health improvement. Following review by the Cabarrus County Public Health Authority Board of Commissioners and Healthy Cabarrus Executive Committee, copies and/or the shared link of the 2022 State of the County Health Report will be disseminated to the Healthy Cabarrus Advisory Board. The Advisory Board will also be asked to identified ways that they can assist with public and partner awareness of the report and its findings. Hard copies will be distributed to target community locations, which include local libraries, community centers, park and recreation departments, federally qualified health centers, in addition to other sites with high community member presence.
Cabarrus County Profile
Cabarrus County has experienced a 2% or higher annual population growth since at least 2010. The population of Cabarrus County, North Carolina in 2021 (ACS 1 Year Estimate) was 231,278, an increase of 29.5% from the 178,564 residents who lived in the county in 2010. For comparison, the US population grew 7.3% and North Carolina's population grew 10.2% during that same time period.
Rapid population growth will not only impact how agencies and organizations serve residents, due to capacity and staff challenges, but communities can also experience lack of housing and schools, increased pollution, insufficient water availability and waste-disposal problems.
Often times vulnerable populations, such as persons with disabilities, limited English proficiency, children under 5 and persons over 65 are disproportionately affected.
Total Cabarrus County Population: 231,278
Sources:
U.S. Census, American Community Survey 1-Year 2021 Estimate
US Bureau of Labor Statistics - December 2022
Progress on Community Health Improvement Plans
For data updates and progress specific to additional strategies outlined in the Community Health Improvement Plan for the Mental and Behavioral Health (Short Term) and Housing (Long Term) priorities, please visit each respective Scorecard here.
Housing and Homelessness
Cooperative Christian Ministry
Rebuilders College and Brown Mill Commons – The Rebuilders College at Brown Mill Commons will initially provide 48 transitional, stable housing units, as well as nutritional support, resources for adult and child education, healthy habits and activities, connection to vital resources, access to public and other transportation, job training, career coaching and employment opportunities. Participants who complete the program will have achieved: debt elimination, credit improvement, financial budgeting and savings, increased income and financial stability, established child care supports, reliable transportation strategy, academic achievement, successful parenting practices, healthy lifestyles, and household stability.
Grace Place – Grace Place is an asset-based program, designed to provide the basic needs of food, housing and community for extremely low-income senior individuals in an environment that allows them to establish stability and connect with vital resources while promoting personal responsibility and community engagement. Serving extremely low income, seniors, Veterans, or those on disability (12-14 units), the campus will have multiple units strategically positioned around a community center which provides access to prepared meals, laundry facilities, transportation services, counseling, activities, educational opportunities, and life skills training.
HelpwithHousing.net – This site provides a selective referral for the homeless or those in housing crisis in Cabarrus County to a local entity that best serves their specific needs or condition. The site also aggregates data to provide community leaders with insight into the real housing need in our community. This site is a readily available digital platform for the homeless population or those serving others in housing crisis in our community to be CONNECTED to the appropriate resource that bests fit his/her needs. www.helpwithhousing.net
Unsheltered Impact Report – The Unsheltered Impact Report is the product of a multi-agency focus group chartered by local Law Enforcement and Emergency Services to compile the working knowledge of the agencies working hand on with the unsheltered homeless in Cabarrus County. The resulting report gives insight to quantifying the population, understanding the circumstances of the unsheltered and identifying potential corrective actions or solutions to improve the plight of the homeless in our cities. The report has been presented to numerous local initiatives who address populations which are integrated with the unsheltered, in order to ensure appropriate considerations in all future corrective measures.
WeBuild Concord
WeBuild Concord expanded its mission in 2022 to provide housing opportunities through public and private partnerships for residents, including the building and development of homes, a community land trust, and advocacy for equitable housing and community development.
On November 30, WeBuild hosted a ground breaking for the Lincoln Street Townhome Project, a 26-unit townhome development designed to increase affordable housing and homeownership in the Logan Community. The Lincoln Street Project is a collaboration with the City of Concord, Cabarrus County Government and other community partners. The project will begin the most significant homeownership effort in the historic Logan Community. Currently, less than 35% of residents in the Logan Community own their homes, which is extremely low. The City of Concord and Cabarrus County support the effort with funding from the American Rescue Plan Act (ARPA) and the City’s affordable housing revolving fund. The Lincoln Street Townhome Project is the first of a more than $12 million investment in affordable and equitable housing projects by WeBuild Concord over the next several years.
Behavioral Health
The Cabarrus Healthcare Foundation received a $3.5 million grant from Cabarrus County Government – American Rescue Plan Act funding to build and upfit a Behavioral Health Holding Unit (BHHU) at Atrium Health Cabarrus. The 3,623 square-foot locked space will be located just outside the hospital’s existing emergency department (ED) and include eight beds which will be designated for behavioral health patients seeking crisis care through the ED. The addition of the BHHU will allow for traditional ED beds, that were repurposed for behavioral health patients, to again be used for those needing emergency medical services.
The BHHU will provide a safe space that maintains the dignity and respect for mental health patients who are seeking care during crisis. The hospital will maintain five beds within the traditional ED, ensuring a total of 13 beds for patients in behavioral health crisis. The renovated space will have a dedicated tele-psych room, shower and activity space.
In spring 2022, Cabarrus County released an initial Request for Proposals (RFP) from for-profit and not-for-profit providers, to operate a newly constructed regional behavioral health facility in Kannapolis. The facility is expected to begin operations in early 2025. The County is seeking to enhance existing crisis response service systems in the community and to divert individuals from hospitalization and emergency departments when appropriate.
Although design concepts will be finalized in 2023, the County does anticipate one building with a single floor. The combination of Behavioral Health Urgent Care (BHUC) and traditional treatment beds, for adults, children and adolescents, is intended to provide a “no wrong door” center to receive walk-in and drop-off patients experiencing a behavioral health crisis. The goal of the facility is to provide initial treatment and stabilization leading to diversion of appropriate patients to less restrictive levels of care with only those who require 24-hour treatment being referred to the Facility Based Crisis (FBC), Substance Use Disorder (SUD), Psychiatric Residential Treatment Facility (PRTF), or other beds in the region. The treatment spaces (FBC, SUD, PRTF) within the facility will be designed to comply with the Facility Guidelines Institute (FGI) guidelines for inpatient treatment spaces to allow for flexibility in adjusting licensure and program types as the needs of the local population shift during the lifespan of the facility.
Cabarrus County - NC Department of Health and Human Services, Mental Health Town Hall
North Carolina Department of Health and Human Services Secretary (NCDHHS) Kody H. Kinsley — alongside N.C. State Senators Jim Burgin and Paul Newton and State House Representatives Kristin Baker, and Wayne Sasser — hosted a town hall in Kannapolis on November 29, to discuss mental health in North Carolina. NCDHHS leadership and Cabarrus County Commissioners are committed to advancing behavioral health and resilience, as more than three million people in the state have mental health or substance use disorders. Members of the public from Cabarrus and surrounding counties were able to attend, ask questions and contribute to the conversation. State officials offered comments on key policy issues, such as Medicaid Expansion, access challenges related to behavioral health and state legislation that restricts staff and billable services.
Click here to watch the full Mental Health Town Hall hosted in Cabarrus County.
Cabarrus Health Alliance (CHA) School Nurse Program - Mental Health and Social Emotional Learning Supports
CHA's School Health Department, which manages all school nurses in Cabarrus County and Kannapolis City Schools, was able to use state funds to provide school based mental health and social emotional learning interventions. The funds were approved to be used for hiring mental health providers to provide population-based mental health support, wrap around, non-clinical mental and behavioral health services for students, teachers, and staff as well as training and education in addition to the COVID testing services provided in 2021.
Through a collaborative approach with CCS and KCS, the School Health team identified and have been able to support the following activities:
- Train school health support staff in Question, Persuade, Refer (QPR) and Reconnect for Resilience
- Train all school nurses in QPR and Reconnect for Resilience
- Support Reconnect for Resilience Training for KCS and CCS staff
- Provide QPR Trainer Training and Reconnect Trainer Training to some KCS & CCS staff members, as well as the School Health Admin Team – This approach now allows these trainings to be incorporated into new school nurse orientation, creating sustainability for continued education and interventions.
- Hire nearly 10 additional Behavioral and Mental Health Support positions for KCS
- Make and distribute grade-level appropriate “Coping Skills Toolboxes” that can be used in classrooms, nurses’ offices, and by guidance counselors and social workers
Early Childhood Education
Cabarrus Partnership for Children
The Cabarrus Partnership for Children continues to lead the way by identifying and addressing needs of local childcare providers and families with children birth to five years old.
The Cabarrus Partnership for Children provides education-based salary supplements to low-paid teachers, directors and family child care educators working with children ages birth to five years old through the Child Care WAGE$ Program. The program was created in response to research-based evidence that shows that the quality-of-care children receive is lowered by high turnover rates and inadequate teacher education. In November, the Partnership’s board voted to fully fund WAGE$ participants at a Tier II stipend.
Lack of resources and an effort to maintain affordability for parents often make it difficult for individual child care programs to reward or encourage teacher education through salaries. As a result, many teachers leave the field or never even consider the profession an option. WAGE$ is designed to provide preschool children more stable relationships with better-educated teachers by rewarding teacher education and continuity of care.
Early Education Liaison Program
In partnership with Rowan Cabarrus Community College (RCCC), the Cabarrus Partnership for Children created the Early Education Teacher Liaisons and Early Education Business Administrator Liaisons programs to address the needs of child care centers and strengthen the workforce within Cabarrus County.
The program addresses teacher education and business administration education for educators in child care facilities. The liaisons serve as a bridge between the college and local child care centers, offering academic support such as referrals for tutoring and scholarships for further education. Additionally, they place an emphasis on early education recruitment and business knowledge.
The Chamber, Leading Business in Cabarrus - Legislative Agenda
The Chamber has incorporated five items within its Legislative Agenda to address increased access to childcare for workers:
• Providing tax credits to businesses that provide childcare support for their employees.
• Expanding the current Opportunity Scholarship* program to include Pre-Kindergarten education.
• Revising existing childcare subsidy income limits to phase out subsidies rather than provide a hard income ceiling in order to encourage workers to seek higher paying opportunities.
• Investing in additional childcare subsidies to help address the current worker shortage until long term solutions can be implemented.
• Invest in pilot programs that seek innovative solutions to the current childcare shortage.
Mortality and Morbidity Changes
Mortality and Morbidity Data
Two measures commonly used for public health surveillance are mortality and morbidity. These measures can help describe and understand the progression and severity of a health event. Monitoring causes of death or rates of illnesses help public health professionals and epidemiologist to recognize cases or clusters of cases, to trigger interventions to prevent transmission or reduce morbidity and mortality. Both are useful tools to learn about risk factors of diseases and compare and contrast health events between different populations, and identify appropriate health interventions.
The data within this section comes from the State Center for Health Statistics 2022 County Health Data Book and the Robert Wood Johnson Foundation – County Health Rankings. The data within the 2022 County Health Data Book spans 5 years, either 2016-2020 and is considered current for community health assessments and state of the county health reports due the March 2022.
Source: https://schs.dph.ncdhhs.gov/data/databook/
Mortality
Disparity ratios are calculated by dividing the rate for a population by the best rate for a selected health indicator to determine how much more likely a particular event is to occur in a population compared to another population. In the table above, infant mortality disparity for both the state and Cabarrus County compares the death rates of white and African American babies. In Cabarrus County, African American babies are 1.66 times more likely to die before 1 year of age when compared to white babies.
The red arrow indicates the data is worse than the previous reporting period. The green arrow indicates health improvements since the previous reporting period.
Leading Causes of Death
Data available for leading cause of death, shows that diseases of the heart has surpassed cancer – all sites as the number one leading causes of death among Cabarrus County residents. It is also important to know that data from 2016-2020 is the first reporting period where deaths caused by COVID-19 are reported. COVID-19 did rank as the 10th leading cause of death, replacing suicide from the previous report. It should be noted that although suicide has fallen out of the top 10, it remains the 3rd leading cause of death for residents Ages 20-39.
Other Unintentional Injuries also moved up one place from 5th to 4th. The most common unintentional injuries result from motor vehicle crashes, falls, fires and burns, drowning, poisonings and aspirations. Falls are the second leading cause of unintentional injury death for North Carolinians of all ages, and in every year from 1999 to 2019. Diabetes has jumped from 9th leading cause of death to 7th, which is an indicator that Cabarrus County consistently sees disparities among the demographic populations most frequently diagnosed.
The only change in Leading Cause of Death by Age (2016-2020) among Cabarrus County residents was within the 0-19 age category. Congenital anomalies (birth defects) actually switched rankings with Other Unintentional Injuries, going from 2nd to 4th leading cause of death.
2016-2020 NC Resident Race/Ethnicity and Sex-Specific Age-Adjusted Death Rate Disparities
- African Americans, both males and females, have higher rates of death associated with Disease of the Heart compared to White, non-Hispanic residents and two times higher rate for nephritis/nephrosis (kidney disease)
- African American females consistently have the highest rates of death caused by Breast Cancer and three times rate for Diabetes
- African American males have two times the rate of Diabetes
- Females, both African American and White, have a much higher rate of Alzheimer’s disease than their male counterparts
- Suicide is highest among white males. All other races, sexes are too small a number to calculate rate
Cabarrus County saw a small drop in life expectancy (0.2 years), a similar decline was seen throughout the region and state. Two counties maintained a consistent life expectancy, Iredell and Union. It will be important for this data to continue to be monitored as it is anticipated to continue to be altered by pandemic impacts.
Morbidity
Morbidity is another term for illness, medical condition or being unhealthy from a disease. Morbidity often times refers to having a disease or a symptom of disease, or the amount of disease within a population. Public health professionals are able to estimate morbidity among a population by using prevalence or incidence of the disease or illness. Some examples of common morbidities are heart disease, diabetes, and obesity, but morbidities can range from Alzheimer's disease to cancer to traumatic brain injury. When a person has more than one morbidity at a time, it is referred to as co-morbidity. Morbidities are NOT deaths.
Terms:
- Prevalence describes the proportion of the population with a given symptom or quality.
- Incidence shows the frequency at which individuals within a specific population develop a given symptom or quality.
*Items shaded in yellow indicate that Cabarrus County is doing better than or the same as the state of North Carolina, but not has good as Benchmark Counties or Top Performers in the U.S.
*Items shaded in red indicated that Cabarrus County is doing worse than the state of North Carolina and Top Performers
To learn more about the County Health Rankings or to see how other counties across North Carolina are performing, click here.
Emerging Issues
CHA’s Community Dental Program is designed to visit each elementary, middle and high school in Cabarrus County and Kannapolis City Schools twice per school year. As the program relaunched this school year, the team has been challenged to achieve this goal because patients are presenting with such higher rates of decay, requiring additional time at each school or the need to refer patients to a pediatric specialist. During the 22-23 School Year, 32% of Kindergarten children were reported to have untreated tooth decay. Oral Health Scorecard
CHA Dental staff are responsible for conducting decay screenings of the NC Pre-Kindergarten classes and the Head Start classes throughout the county. Public Health Hygienists have also done two days of education at preschools for children and caregivers while sending home education information. Staff also made themselves available to patients and families at childcare centers if a child does have a dental concern.
CHA recently hired a dental patient navigator; this position is a bilingual staff who will focus on the highest need patients and helping to close the loop on their dental care needs. Priority will be focused on patients with no insurance, missed appointments, and transportation barriers to their appointment.
Sexually Transmitted Infections and Sexually Transmitted Disease Rates
According to 2021 Centers for Disease Control preliminary surveillance data, Chlamydia and Gonorrhea cases continue to increase with no signs of slowing. Cabarrus County has also experienced a steady increase in Chlamydia and Gonorrhea
Red line represents Chlamydia cases. Blue line represents Gonorrhea cases.
Workforce Shortages
The pandemic caused a major disruption in our day-to-day lives, including our workforce. This impact and continued ripple effect has been referred to by many as The Great Resignation. Many sectors have become increasingly affected by growing workforce shortages over the last several years, and while COVID-19 left its impact, these shortages were already on the rise. According to an article from University of North Carolina - Chapel Hill's School of Government, North Carolina was already projected to face a shortage of around 12,500 nurses by 2033 before the pandemic and is now set to face projected shortages of up to 21,000 nurses in the coming decade due to burnout. Another profession heavily affected by shortages is teachers and school staff. A national survey indicated that nearly half of all teachers considered switching positions or professions. It February 2022, it was reported that 130 teachers left Cabarrus County Schools so far during the 22-23 School Year. The district reported that many teachers left to teach elsewhere or got out of the profession completely.
The leisure and hospitality industry, which includes restaurants and hotels, are still missing 7.2 percent of jobs. This reflects 1.2 million jobs statewide that haven’t been filled compared to job numbers before the pandemic, which has led restaurants to close, operate with alternative hours, or work with a smaller staff. Prior to the pandemic, stores and restaurants associated with Concord Mills Mall collectively represented 4,000 jobs in the county.
New, Paused or Discontinued Initiatives
Public Health Surveillance Data Dashboards
According to the field of epidemiology, public health surveillance is the ongoing, systematic collection, analysis, and interpretation of health-related data essential to planning, implementation, and evaluation of public health practice. Data monitoring and surveillance has long since been a role of public health, but during COVID-19 the public became much more aware and interested in their ability to monitor population health data. State and local dashboards were created to allow citizens to see the COVID-19 spread in their community, allowing them to consider their own health risk and adopt mitigation strategies that they believe necessary. Cabarrus Health Alliance has launched three public health surveillance dashboards, with plans for more, all of which are publicly accessible and monitor both health and other social determinants which impact individuals' health and well-being.
• Influenza Like Illness
• Housing
• American Community Survey Dashboard
Cabarrus County Emergency Rental Assistance
Cabarrus County Government closed the Emergency Rental Assistance Program (ERAP) in late 2022. ERAP was funded through various state and federal COVID-19 relief programs and provided payments on behalf of residents for overdue rent and
Cabarrus Recovery and Resilience Coalition
Priority focus groups included adolescents, seniors, first responders and frontline workers, teachers, childcare providers, and Latinx community members. The coalition identified recovery needs and acknowledged constructive feedback from each group to improve responses to future emergencies (regardless of scale, public health, and non-public health incidents).
The coalition highly encourages all Cabarrus County leaders to consider these recommendations as response measures for future emergencies in their own organizations.
Overview
State of the County Health Report 2023
Conducting a community health assessment is an ongoing and collaborative effort engaging various agencies, providers, and individuals to identify community assets, strengths, and unmet needs. The Cabarrus Health Alliance (CHA) provides leadership for this collaborative process through Healthy Cabarrus. The following State of the County Health (SOTCH) Report provides updates and documents progress following the 2020 Community Health Needs Assessment findings. The 2023 Cabarrus County SOTCH was submitted to the North Carolina Department of Human Services (NCDHHS) on March 4, 2024.
This report provides information specific to the identified priority health issues, including housing, behavioral health, and early childhood education and development. The report also offers updated data and information regarding mortality and morbidity rates in Cabarrus County, along with updates on emerging issues, new initiatives, paused initiatives, and discontinued initiatives.
Keeping stakeholders and community members informed about the identified community health priorities and progress to date is a crucial element of community health improvement. After the Cabarrus County Public Health Authority Board of Commissioners and Healthy Cabarrus Executive Committee review the report, the 2023 State of the County Health Report will be sent to the Healthy Cabarrus Advisory Board. The Advisory Board will be requested to identify ways that they can assist with public and partner awareness of the report and its findings. In addition, hard copies of the report will be distributed to various community locations, including local libraries, community centers, park and recreation departments, federally qualified health centers, and other sites with high community member presence. The 2023 State of the County Health Report will also be translated into Spanish to inform our Hispanic neighbors about the progress made since the previous Community Health Assessment.
Cabarrus County Profile
Cabarrus County has been experiencing a consistent annual population growth of 2% or more since 2010. Based on the 2022 ACS 1 Year Estimate, Cabarrus County's population has increased significantly to 235,797, indicating a 32.1% boost from the 178,564 residents recorded in 2010. The US population grew by 7.7% during the same period, while North Carolina's population grew by 11.9%.
Concord, the largest city and county seat of Cabarrus County, is now the tenth-largest city in North Carolina and is one of the fastest-growing cities in the state and region. Rapid population growth poses significant challenges to agencies and organizations that serve their communities. These challenges can be attributed to limitations in capacity and staffing, which can result in inadequate resources and support. Furthermore, communities may experience a shortage of housing and schools, increased levels of pollution, insufficient water availability, and waste-disposal problems.
Often, these challenges can disproportionately affect vulnerable populations, including persons with disabilities, those with limited English proficiency, children under 5, and persons over 65.
Total Cabarrus County Population: 235,797
Progress on Community Health Improvement Plans
For data updates and progress specific to additional strategies outlined in the Community Health Improvement Plan for the Mental and Behavioral Health (Short Term) and Housing (Long Term) priorities, please visit each respective Scorecard here.
Housing and Homelessness
Cooperative Christian Ministry
The Rebuilders College @ Brown Mill Commons – This project aims to create new transitional housing capacity to help individuals and families experiencing homelessness and housing crises achieve stable housing. In addition to the 48 initial transitional housing units, the project will provide nutritional support and access to resources that support positive outcomes such as adult and child education, healthy habits and activities, connection to vital resources, access to public and other transportation, job training, career coaching, and employment opportunities.
In June 2023, CCM acquired the property and launched a community-wide capital fundraising campaign. Following the completion of the engineering and architectural design stages, the construction of the initial phase has commenced, while design and fundraising efforts remain underway. Cabarrus Health Alliance has committed to establishing a significant presence on the campus.
Grace Place @ Caremoor - Grace Place is an asset-based program originally designed to meet the basic needs of food, housing, and community for senior individuals experiencing extreme poverty. The program aims to create an environment that enables these individuals to establish stability while simultaneously promoting personal responsibility and community engagement.
In December 2023 CCM purchased Caremoor Retirement Community with the help of ARP funding from the city of Kannapolis. The recent purchase will greatly increase the capacity for transitional housing and expand the population to include families with children.
My Father’s House Annex @ Memorial Baptist Church -The program's facilities were renovated in 2023 and will open early in 2024. The program will offer support to expectant mothers in MAT care (Medication-Assisted Treatment for women with substance use disorders), as well as other single mothers through CCM's Path to
Stability model. The transitional housing program is a joint effort between CCM, Cabarrus Health Alliance-SUN Clinic, and Memorial Baptist Church of Kannapolis.
HelpwithHousing.net - HelpwithHousing.net is a digital platform readily available to assist the homeless population or those serving others who need housing in our community. The platform connects people in need to the appropriate resources that best fit their needs. Additionally, the site aggregates data to provide community leaders with insight into the real housing needs in our community. Since its launch in November 2022, the site has received over three hundred inquiries, providing significant insight into our local population in a housing crisis.
WeBuild Concord
WeBuild Concord is a collective impact and advocacy model for accessible housing and community development. It builds permanent homes through public and private partnerships. They provide residents ownership and rental opportunities in single-family, multi-family, and mixed-use developments. The organization uses deed restrictions, a community land trust, and donated equity strategies to ensure long-term affordability, neighborhood stability, and wealth creation.
In 2023, WeBuild built and rehabilitated eleven (11) homes. An additional seventy-one (71) permanent dwellings are under construction or in the development phases in neighborhoods with less than forty percent (40%) ownership rates and low affordability as of December 31, 2023. These projects include multi-family developments targeting low to moderate-income homebuyers, mature adults, and other opportunity populations such as veterans and returning residents. WeBuild developments such as the Lincoln Street Townhomes (26 units), Corban Street Village for 55+ (11 units), Malvern Townhomes (8-10 units), and new mixed-income developments are part of the total.
WeBuild projects account for approximately $15 million in permanent housing development in collaboration with the City of Concord, Cabarrus County, U.S. Housing and Urban Development, 12th District Congressional Office, and private foundations such as the Atrium Health Foundation, Wells Fargo Foundation, Z. Smith Reynolds Foundation, and dozens of individual donors and industry representatives.
AYA House
AYA House provides transitional housing with holistic, wrap-around services to the Cabarrus County Community Reentry Program participants. Their focus is on individuals who are justice-involved, in recovery from substance use, or experiencing chronic homelessness. The goal of AYA House is to remove the barriers and root causes that prevent our participants from advancing to independent, stable housing and help them become healthy, productive citizens of Cabarrus County by providing them with all the necessary resources.
AYA is able to carry out its mission effectively thanks to the extensive partnerships it has established within the community. Cabarrus Health Alliance provides mental health counselling, wellness education, and resources, as well as grants for dental care. Assurance Life Learning Center offers outpatient substance use treatment, while the Community Free Clinic provides primary care for those who are uninsured. Genesis-A New Beginning provides mental health and life skills groups, and the Lions Club provides vouchers for vision care. Rowan Cabarrus Community College (RCCC) is a valuable partner, providing vocational certification courses and employment services. Cooperative Christian Ministries offers educational and housing support, while CK Rider Transit provides transportation assistance. Finally, Concord Housing Department, WeBuild Concord, Prosperity Unlimited, and Habitat for Humanity are housing assistance partners.
In 2023, AYA House and the Reentry Program received 177 new referrals, and a total of 254 individuals were seen throughout the year. The Peer Support Specialist worked with 29 individuals from correctional facilities, 124 from CCDC, 14 from Probation, 27 from chronic homelessness, 39 from treatment, 2 from self-referrals, and 19 from other sources (such as hospitals, outpatient treatments, friends, etc.) They provided assistance to 40 individuals in identifying documents, 15 with connecting to the Social Security office for benefits, 48 with obtaining Food and Nutrition Services, 14 with obtaining government phone services, 60 with services from Rowan Cabarrus Community College, 17 with housing resources or placement, and 35 with connection to NC Works/employment. Additionally, we made 133 referrals to medical care, 63 to mental health, 40 to inpatient or outpatient SU treatment, 41 to vision care, and 41 to dental care.
Behavioral Health
Regional Mental Health Facilities
In 2023, Cabarrus County continued to make progress toward opening a regional behavioral health center. The center is designed to expand the crisis continuum in the community and to divert individuals from hospitalization and emergency departments when appropriate. As noted previously, the facility will be newly constructed and located in Cabarrus County, serving Cabarrus residents and residents in surrounding areas. One major development in 2023 was the selection of the operator for the center: Monarch. Monarch is a non-profit organization with a longstanding history of providing an array of publicly funded behavioral health services to NC residents. Cabarrus County also created an internal Behavioral Health Department (BHD). The BHD will work alongside Monarch to ensure the center provides evidence-based care in a trauma-informed setting.
The design concepts and programming of the center were finalized in 2023. Specifically, the center will include a Behavioral Health Urgent Care (BHUC), a pediatric Facility-Based Crisis (FBC), and psychiatric residential treatment services for children and adolescents. The combination of programs is intended to provide an umbrella of services and supports in one setting to ensure residents receive appropriate assessments, stabilization, and treatment services. The BHUC will provide triage, crisis risk assessment, evaluation, and intervention to individuals with urgent or emergent crisis needs. The BHUC will serve children/adolescents and adults. The FBC will provide intensive, short-term, medically supervised services to children and adolescents who require treatment in a facility. The typical FBC stay will be less than two weeks. The psychiatric residential treatment services will provide inpatient psychiatric care to children and adolescents. The shift toward a center primarily serving children and adolescents is due to the severity and magnitude of behavioral health conditions affecting children and adolescents, as reported by local healthcare systems, social services, and other community partners.
Jail-Based Integrated Behavioral Health Services
During FY23, Cabarrus Health Alliance partnered with the Cabarrus County Sheriff's Office to expand behavioral health services for incarcerated individuals in Cabarrus County. The program was designed to align with the Stepping Up Program and expand its services. It now includes Licensed Clinical Social Workers (LCSW) who provide crisis assessments, comprehensive clinical assessments, and ongoing therapy. Coordinated Certified Peer Support Specialist services and case management during and after incarceration are also available. The program is fully integrated within the detention facility and serves clients seven days a week. The collaboration aims to further the vision of CHA's Behavioral Health Division, which is to ensure that all residents of Cabarrus County have access to high-quality behavioral health services. The program focuses on three core pillars: stabilization, treatment, and connection to services, with the ultimate goal of improving the quality of life for patients and reducing recidivism rates.
From July 1 to January 31, there were 632 referrals for clinical behavioral health services, resulting in 631 assessments. One hundred and thirteen clients have received ongoing behavioral health services. One-hundred and seventy-five case management intakes were completed, resulting in 90 individuals receiving case management follow-up. One-hundred and sixty-eight Peer Support services were provided.
ARPA Funding Behavioral Health Services
Cabarrus County has made a noteworthy commitment to addressing the issue of behavioral health within its jurisdiction. To this end, in 2021, $11,393,731 was awarded to twelve organizations that provide mental health services to residents of Cabarrus County.
The following organizations are part of this effort: Amazing Grace Advocacy, Cabarrus Healthcare Foundation, Cabarrus Public Health Interest, Clarkinetics & Associates, Camino Health Center, Cano Family Services, Genesis A New Beginning, Rise 2 Thrive Family Resource Center, Kannapolis Head Start, Vida Wellness Center, Mental Health America, and Silver Linings for Seniors. Each of these organizations offers a variety of services and caters to a diverse clientele.
These funds have enabled various organizations to provide mental health treatment to an average of 572 clients per month, with an average of 26 mental health providers receiving funding. The client demographics indicate a growing number of African-American clients, while Hispanic and white clients continue to make up the majority. It is worth noting that mental health treatment has a higher proportion of recurring clients (75%) than new ones, indicating that providers can continue to provide care to their patients.
United Way Mental Health Collaborative
In 2023, the United Way of Greater Charlotte invested $354,901 towards promoting mental wellness in Cabarrus County. The agency disbursed grants to six local organizations that join forces to form a Mental Wellness Collaborative. The goal of this collaborative is to reduce the stigma that surrounds discussions about mental health and to shift the focus to promoting mental wellness.
A key factor in United Way's selection of the Cabarrus agencies was their strong relationships with young people, particularly those in African American and Latino communities.
Members of the collaborative include Big Brothers Big Sisters of Central Carolinas, El Puente Hispano, Firm Foundations, Girl Scouts Hornets' Nest Council, Mental Health America of Central Carolinas, and The S.T.U.D.I.O. Each of these organizations offers unique services related to mental wellness. As a group, one of their primary focuses was to provide QPR training. They organized a total of seven training sessions and trained 80 community members.
Early Childhood Education
Cabarrus Partnership for Children
The Cabarrus Partnership for Children continues to lead the way by identifying and addressing needs of local childcare providers and families with children from birth to five years old.
Childcare Wage$ Program
Individual childcare programs often face challenges in rewarding or encouraging teacher education through salaries due to the lack of resources and the need to maintain affordability for parents. As a result, many teachers leave the field or never even consider the profession an option.
The Cabarrus County Partnership for Children (CCPC) offers the WAGE$ program to address this issue. The program provides education-based salary supplements to low-paid teachers and family childcare educators working with children aged birth to five. Previously, the Partnership's board had decided to provide full funding to WAGE$ participants at a Tier II stipend. However, in January, the board also voted to fund WAGE$ participants at a Tier III stipend to reduce the waiting list in childcare programs as much as possible. The goal of WAGE$ is to provide preschool children with more stable relationships with better-educated teachers by rewarding teacher education and continuity of care.
Early Education Liaison Program
In partnership with Rowan Cabarrus Community College (RCCC), the Cabarrus Partnership for Children created the Early Education Teacher Liaisons program to address childcare centers' needs and strengthen Cabarrus County's workforce. The liaisons serve as a bridge between the college and local childcare centers, offering academic support such as referrals for tutoring and scholarships for further education.
In 2023, The Partnership continued collaborating with RCCC and supported the Early Education Teacher Liaisons in teaching the introductory course on early childhood education (EDU 119) in Spanish. This initiative aimed to extend the course material to the Latino community, enabling them to become teachers in childcare facilities.
Reach Out and Read & Dolly Parton Imagination Library
In FY 22-23, the Partnership distributed 100,269 books to children in Cabarrus County through the Reach Out and Read & Dolly Parton Imagination Library programs.
The Read Out and Read is a book gifting program that gives free books to children when they attend a Well Child Check at Cabarrus County Pediatrics/Family Practice Clinics. The Dolly Parton Imagination Library is a book-giving program that mails books to children’s homes every month until they are five years old and ready for kindergarten.
NC General Assembly allocation of $2 million
The North Carolina General Assembly granted the Cabarrus Partnership for Children a $2 million allowance in July 2023 for early childhood programs, particularly for child care.
The Early Childhood Task Force and the Cabarrus County Partnership for Children Board of Directors have approved a list of programs to be funded using the allocated budget. The Partnership aims to fund all the approved programs, but the funding may vary depending on the implementation cost.
Below are the top priority programs that the Partnership plans to fund:
− Child Care Wage$ Program: The program provides education-based salary supplements to low-paid teachers and family childcare educators working with children aged birth to five.
− Conscious Discipline: An evidence-based, trauma-informed approach that emphasizes self-regulation, empathy, and problem-solving skills for both educators and students. The approach aims to create a safe, connected environment where children can develop emotional intelligence, resilience, and positive relationships.
− Cabarrus Teacher On-Call (Childcare Substitute Service): A program designed to create a pool of qualified substitute teachers who are available to work with childcare centers in Cabarrus County. The program will recruit, train, and equip these substitute teachers to ensure that childcare facilities have adequate staff to cover staff absences.
− Tri Share in Cabarrus County: Tri-Share aims to provide affordable and accessible high-quality childcare to working families. It is a public/private partnership in which the cost of childcare is shared equally between employers, eligible employees, and the Partnership. This program also helps employers retain and attract employees while stabilizing the childcare businesses.
− Parent As Teachers (PAT): PAT is a voluntary early childhood development home visiting program offering research-based curricula that help families raise children to be healthy, safe, and ready to learn in school.
The Chamber, Leading Business in Cabarrus - Legislative Agenda
The Chamber, Leading Business in Cabarrus, is committed to promoting legislative action that supports the development and welfare of the workforce. Over the years, The Chamber has collaborated with legislators and local and state partners to address the issue of affordable, available, and high-quality childcare. They understand that this is crucial to the workforce and that the high costs of childcare are deterring potential workers from participating in the labor force.
The Chamber continues working on the following items within its Legislative Agenda to address increased access to childcare for workers:
• Providing tax credits to businesses that provide childcare support for their employees.
• Expanding the current Opportunity Scholarship program to include early childhood education.
• Revising existing childcare subsidy income limits to phase out subsidies rather than provide a hard income ceiling in order to encourage workers to seek higher-paying opportunities.
• Investing in additional childcare subsidies to help address the current worker shortage until long-term solutions can be implemented.
• Invest in pilot programs that seek innovative solutions to the current childcare shortage.
Mortality and Morbidity Changes
Mortality and Morbidity Data
Two measures commonly used for public health surveillance are mortality and morbidity. These measures can help describe and understand the progression and severity of a health event. Monitoring causes of death or rates of illnesses helps public health professionals and epidemiologists recognize cases or clusters of cases to trigger interventions to prevent transmission or reduce morbidity and mortality. Both are useful tools to learn about disease risk factors, compare and contrast health events between different populations, and identify appropriate health interventions.
The data within this section comes from the State Center for Health Statistics 2023 County Health Data Book and the Robert Wood Johnson Foundation – County Health Rankings. The 2023 County Health Data Book data spans 5 years, either 2017-2021, and is considered current for community health assessments and state of the county health reports due March 2023.
Source: https://schs.dph.ncdhhs.gov/data/databook/
Mortality
Infant and Child Death
Disparity ratios are used to assess the likelihood of a particular event occurring in one population compared to another. To calculate the disparity ratio, the rate for a population is divided by the best rate for a selected health indicator. The table above compares the infant mortality rates of white and African American babies in the state and Cabarrus County. In Cabarrus County, African American babies are 2.09 times more likely to die before turning one year old when compared to white babies.
The red arrow indicates the data is worse than the previous reporting period. The green arrow indicates health improvements since the previous reporting period.
Leading Causes of Death
Data available for leading cause of death shows that diseases of the heart have remained the number one leading cause of death among Cabarrus County residents. It is also important to note that data from 2017-2021 is the second reporting period where deaths caused by COVID-19 are reported. As a result, COVID-19 has jumped from being the 10th to the 7th leading cause of death, surpassing Diabetes mellitus in the previous reporting period.
Other unintentional injuries remain in fourth place. The most common unintentional injuries result from motor vehicle crashes, falls, fires and burns, drowning, poisonings, and aspirations. Falls have been identified as the second leading cause of unintentional injury-related deaths among North Carolinians of all ages from 1999 to 2019. Cerebrovascular disease has moved up from sixth place to fifth. This may indicate the impact of heart disease not only as a leading cause of death but also as a significant risk factor for cerebrovascular disease.
Leading Causes of Death by Age
There have been two changes in the top three Leading Causes of Death by Age (2017-2021) among Cabarrus County residents. The first is within the 0-19 age category. Homicide now replaces Suicide/Motor vehicle injuries as the third leading cause of death. Within the 20-39 age category, suicide is now the third leading cause of death, replaced by Motor vehicle injuries, which is now second.
2017-2021 NC Resident Race/Ethnicity and Sex-Specific Age-Adjusted Death Rate Disparities
• African Americans, both males and females, have higher rates of death associated with Disease of the Heart compared to White, non-Hispanic residents and two times higher rate for nephritis/nephrosis (kidney disease)
• African American females consistently have the highest rates of death caused by Breast Cancer and close to two times rate for Diabetes
• African American males have over two times the rate of Diabetes
• Females, both African American and White, have a much higher rate of Alzheimer’s disease than their male counterparts
• Suicide is highest among white males. All other races, and sexes are too small a number to calculate the rate
Life Expectancy
Morbidity
Morbidity is a term used to describe illness, medical conditions, or being unhealthy as a result of a disease. It is often used to refer to the presence of a disease or a symptom of a disease within a population. Public health professionals can estimate morbidity by using the prevalence or incidence of a disease or illness. Common examples of morbidities include heart disease, diabetes, and obesity, but they can range from Alzheimer's disease to cancer to traumatic brain injury. When a person has more than one morbidity at the same time, it is referred to as co-morbidity. It's important to note that morbidity does not refer to deaths but rather to the presence of illness or disease.
Terms:
• Prevalence describes the proportion of the population with a given symptom or quality.
• Incidence shows the frequency at which individuals within a specific population develop a given symptom or quality
To learn more about the County Health Rankings or to see how other counties across North Carolina are performing click here:
Emerging Issues
Aging and Older Adults
It is projected that by the year 2030, 90% of the 100 counties in NC will have a larger population of older adults than young individuals. As a result, it is crucial for policymakers and healthcare professionals to take proactive measures to develop sustainable, systems-level solutions that will help avoid adverse outcomes in terms of social, financial, and health issues among this aging population. Healthy aging requires interdisciplinary efforts that promote physical activity, proper nutrition, safe housing, regular social interaction, and mental well-being.
Atrium Health Cabarrus has been experiencing a large number of octogenarians and Medicare discharges with limited post-acute care options for people aged 50 and above. As a result, they have developed a Roadmap for Advancing Acute Age-Friendly Care. This roadmap includes a geriatric pharmacist, a geriatric cohort unit, and the first Atrium geriatric designation in the southeast. Additionally, they are working towards obtaining a geriatric ED designation while emphasizing the importance of continuity of care, which means having a doctor who knows your medical history and health, resulting in better overall health outcomes.
Human Sex and Labor Trafficking
The North Carolina State Bureau of Investigation has reported that North Carolina ranks ninth in the United States in terms of the prevalence of human trafficking. Neighboring Charlotte is considered a hotspot for activity, and that puts Cabarrus at a much higher risk for incidents to occur, according to Cabarrus County Sheriff Van Shaw.
In North Carolina, the Human Trafficking Hotline has received 8,875 reports since its launch in 2007. Out of these reports, the program has been able to identify 2,050 cases of human trafficking, and as a result, 5,896 victims have been identified. In Cabarrus County, 275 cases of sexual assault were reported to the Sheriff's Office, Concord, and Kannapolis Police Departments in 2022.
In January 2023, the Cabarrus County Sheriff's Office received a $1 million grant from the State to address Human Sex and Labor Trafficking. This grant will be used to create and equip two positions within the Criminal Investigations Division with the sole purpose of combating human trafficking and sexual exploitation of children. The individuals in these positions underwent more than 150 hours of specialized training in North Carolina and Florida, specifically in conducting this type of investigations. They also trained additional detectives to assist in the investigations.
During 2023, the Sheriff's office conducted several human trafficking investigations of groups operating in multiple southeastern states. One human trafficking organization based in Charlotte was traveling weekly to Atlanta and transporting young females to the Cabarrus County region. Several arrests have been made this year involving this group, and this investigation is still ongoing.
The detectives, funded through this grant, have arrested over 25 men traveling to and from Cabarrus County to meet what they believed to be children, both male and female, between the ages of 11-15, for sex. These investigations included hours of chats online by these detectives in undercover communications with these predators. More than 45 search warrants have been issued in 2023 from social media accounts to cellular devices. Thanks to the work of the Sheriff's Office, six victims were rescued from their traffickers and reunited with their families.
New, Paused or Discontinued Initiatives
Community Free Clinic Raising Service to 300% Federal Poverty Level
In July 2023, the Community Free Clinic's Board of Directors voted unanimously to increase the Clinic's income threshold to 300% of the Federal Poverty Level (FPL). With this change, adults in Cabarrus County without insurance and earning less than $43,740 are eligible for free healthcare and medication at the Clinic. The FPL is calculated based on the number of people in the household and their total income. The goal is to reduce barriers to vulnerable populations' access to healthcare.
The Community Free Clinic has provided free care and medications to adults suffering from acute and chronic illnesses in Cabarrus County since 1994. The Clinic is the Cabarrus County Healthnet hub and serves over 900 patients every year. In 2023, the Clinic provided services worth $8 for every $1 received and saved the area's emergency rooms $1.96 million in costs.
Increased Narcan Access
The Behavioral Health- Prevention & Education Department at Cabarrus Health Alliance now provides nasal Narcan to the public, at no cost, through a vending machine located in the Cabarrus County Detention Center at 30 Corban Ave. The vending machine is located in the hallway across from the magistrate's office and is accessible 24/7 to the general public. Since August 2023, more than 450 kits have been distributed to the public through this vending machine. Part of the Naloxone Distribution Plan under the Prevent Drug Overdose Grant is to provide Cabarrus County residents with free nasal Narcan & decrease the number of Emergency Department visits. While Naloxone/Narcan has been available for residents and community partners at the Cabarrus Health Alliance for several years, the addition of the vending machine is assisting with increasing access across the county.
As part of the Naloxone Education Plan aimed at preventing overdoses and reducing the number of Emergency Department visits, Naloxone/Narcan training is offered along with a distribution plan. Anyone in the community can request training for themselves or a group, either in-person or virtually. Each attendee is given the opportunity to create their own "Community Wellness Kit" consisting of various prevention supplies, including nasal Narcan, medication lock boxes, Rx Destroyer, locking pill bottles, locking pouches, alcohol bottle locks, and more.
Expanded Funding for Residents in Crisis
In 2023, Cabarrus County launched an initiative aimed at preventing eviction, utility disconnection, and other short-term crises. This initiative provides up to $1,000 to assist families experiencing non-recurring crises or episodes of need. The program, known as Work First Emergency Assistance, is designed to help families resolve their situation and prevent dependence on ongoing Work First cash assistance. The Cabarrus County Department of Human Services (DHS) administers the funds.
The program guidelines state that short-term services and benefits must be “preventative or transitional in nature.” The Cabarrus County Department of Human Services (DHS) administers the funds.
The application requires information such as household occupants, landlord, on-hand resources (cash), checking/savings account balances, income, and monthly expenses, and it is available online or on paper. To date, this program has approved 52 applications and provided over $46,000 in funding for rent, utilities, and car repairs.
New Online Food Pantry Resource
Members of the Cabarrus County Hunger Task Force envisioned the idea and provided support for the development of a Food Resource Map. The map, housed on the Cooperative Christian Ministry website, was made available to our community on October 26, 2023.
This platform features resources from Cabarrus community partners that provide any form of food relief for the community. It serves as a one-stop informational hub that identifies where an individual can access food pantries, mobile and/or open market offerings, meal delivery options, prepared meal possibilities, and blessing box locations. Additionally, for residents who may face transportation challenges in getting to or from these resources, a link within the platform will help with public or ride transit opportunities. The platform also has a built-in translating tool for the Spanish-speaking population.
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