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HNC 2030 Scorecard: Onslow County 2021-2024

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Onslow County Health Department (OCHD) and Onslow Memorial Hospital (OMH) are excited to share the Healthy NC 2030 Scorecard for Onslow County.

Healthy NC 2030 Scorecard for Onslow County

In 2021, OCHD and OMH conducted a Community Health Needs Assessment (CHNA) and identified five priorities to address areas of concern within our community. This Community Health Improvement Scorecard describes the work being completed by OCHD, OMH, and community partners to help address the five priorities identified in the 2021 CHNA. 

For each priority, this Scorecard includes: 

  • Results Statements (a description of where we would like to be)
  • Indicators (local or Healthy NC 2030 indicators)
  • Programs (activities or strategies chosen to address priority areas)
  • Performance Measures (measures that show how programs are making an impact)

Instructions: Click anywhere on the Scorecard to learn more about programs and partners working collaboratively to improve the health of Onslow County. The letters below represent key components of the Scorecard. 

Use the + icon to expand items and the paper icon to read more. This Scorecard is not intended to be a complete list of all programs and partners who are working on these issues in Onslow County.

Community Health Assessments
CA
Time Period
Current Actual Value
Current Trend
Baseline % Change
Executive Summary

History of the Community Health Needs Assessment (CHNA)

Local health departments in North Carolina are required to conduct a comprehensive community health assessment every four years. The Affordable Care Act (ACA) requires all tax-exempt hospitals to conduct a community health needs assessment every three years. Two types of data are analyzed for the CHNA: secondary data and primary data. Secondary data is data that was collected from other sources (e.g. N.C. Center for State Health Statistics), while primary data was collected directly from people living in Onslow County via online and paper surveys. Part of the assessment also includes identifying priority areas and developing improvement plans to address priorities.  

In 2015, with permission from the NC Department of Health and Human Services (NCDHHS), Onslow County Health Department (OCHD) and Onslow Memorial Hospital (OMH) joined together to create one Onslow County Community Health Needs Assessment. Three assessments later, OCHD and OMH continue partnering on identifying health concerns within the community and creating plans to improve the overall health of Onslow County. 

Community Health Advisory Team (CHAT) Vision Statement

The CHAT serves as the leadership team that leads, supports, and executes the CHNA and the Community Health Improvement Plans (CHIPs) that are identified from the CHNA results. OCHD and OMH facilitate CHAT, which meets bi-monthly. These CHIPs are placed on the Scorecard to promote awareness, accountability, and transparency of the ongoing work of OCHD, OMH, and community partners. 

Partnerships

The CHAT is a team of stakeholders that meet to discuss public health issues and work collaboratively to improve the health of people living in Onslow County. Stakeholders include representatives from non-profit organizations, healthcare, government, faith leaders, and concerned residents. A comprehensive list of CHAT members can be found in the 2021 CHNA. 

If you are interested in learning more about CHAT or are interested in joining CHAT, please contact the Onslow County Community Relations Team at community_relations@onslowcountync.gov

Priorities

Health Priorities

On December 9, 2021, OCHD and OMH met with the CHAT to review the results of the 2021 CHNA. In comparing the results of the survey with secondary data and available resources, CHAT identified five priorities: 

  1. Data and Evaluation
  2. Mental/Behavioral Health
    • Substance Use and Tobacco Use
    • Adverse Childhood Experiences (ACEs)
  3. Health Equity & Health Disparities
    1. Chronic Disease
    2. Preventative Care
  4. Healthy Living
    1. Women's and Children's Health
    2. Breastfeeding
  5. Physical Activity and Exercise

Next Steps

With the completion of the 2021 CHNA, and health priorities chosen, this Scorecard serves as OCHD's and OMH's Community Health Improvement Plans (CHIPs). To support each health priority, the CHAT developed CHIP teams to help plan, implement, and evaluate programs within each health priority. CHAT members are assigned to specific CHIP teams depending on their personal interests or the agency's needs. CHIP teams will meet regularly in between bi-monthly CHAT meetings to work on program planning, implementation, and evaluation.

Mental and Behavioral Health
R
Time Period
Current Actual Value
Current Trend
Baseline % Change
Why Is This Important?

Adverse Childhood Experiences (ACEs), substance use, and mental/behavioral health problems are major concerns for Onslow County. The prevalence of poor outcomes such as lack of mental/behavioral health treatment, opioid use/death, child abuse, and juvenile crime shows the need of additional support in this area, especially in prevention services. In FY 2021-2022, 1610 child protective cases were assessed and of those, 333 cases of child maltreatment were found. During the April 2021 – March 2022 timeframe, there were 255 children in foster care (Onslow County DSS Data, April 2021 – March 2022). 

Substance use overdoses continue impacting people living in Onslow County. In 2021, 76.5% of drug overdose deaths in Onslow County involved illicit opioids (NCDHHS Opioid Dashboard, 2021). Additionally, in 2021, Onslow County had 111.1 drug overdose emergency department visits per 100,000 residents (NCDHHS Opioid Dashboard, 2021). 

Onslow County has a variety of resources dedicated to address mental/behavioral health and substance abuse across the community. Yet, 47.6% of Onslow County survey respondents chose mental/behavioral health as a top health behavior that people in the community needed more information (2021 CHNA Community Survey). Improving awareness and access to these resources will help ongoing prevention efforts. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Parenting Education Empathy Rapport and Support (PEERS) 

  • Turning Adversity into Success for Children in Onslow (TASCO)

  • Onslow County Health Department (OCHD) 

  • Onslow Memorial Hospital (OMH) 

  • Community Partners

What We Do

Adverse Childhood Experiences (ACEs) can be classified as negative experiences that take place during childhood and/or teenage years such as (but not limited to) neglect, witnessing suicide or violence, abuse, and bullying, in addition to any other traumatic events that may occur (CDC). Children and/or teenagers that experience ACEs can have a greater risk of developing negative health conditions such as chronic health problems or mental illness in their adult years (CDC). Onslow County PEERS Family Development Center and Onslow County TASCO offer training to increase awareness on the impact of Adverse Childhood Experiences (ACEs), and provides support services to help families and children in Onslow County. For more information on Onslow County PEERS Family Development Center, please visit: https://www.onslowcountync.gov/1858/PEERS. For more information on Onslow County TASCO, please visit: https://tasco-onslow.hub.arcgis.com/

Who We Serve

Families and Children

How We Impact

ACEs training helps participants identify children in need, understand the impact of ACEs, identify risk and protective factors, and locate resources to help those impacted by ACEs. Increased awareness of ACEs (and protective factors) will enable participants to better serve their communities and identify opportunities to improve the lives of children in Onslow County.

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Onslow County Department of Social Services (OCDSS) 
  • Methodist Home for Children Prevention Specialists 

  • Onslow County Health Department (OCHD) 

  • Community Partners 

What We Do

OCHD partners with Methodist Home for Children Prevention Specialists to refer patients who are uninsured, and/or do not qualify for OCHD care management services but require additional support. This support may come in many forms, including food pantry services, housing referrals, mental/behavioral health referrals, substance use treatment and recovery referrals, transportation, and affordable health services. 

Who We Serve

OCHD patients who do not qualify for OCHD care management services and/or are uninsured. 

How We Impact

Patients who may be struggling with mental/behavioral health or substance abuse often need additional support. The additional support for OCHD clients that a prevention specialist would offer will bridge the gap to improve accessibility to available community resources when they may not otherwise receive support. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Onslow County Community Paramedics 
  • Healthcare Community Partners 

  • Mental/Behavioral Health Partners 

  • Law Enforcement Partners

  • Onslow County Health Deparatment (OCHD)

  • Onslow Memorial Hospital (OMH)

What We Do

OCHD leads the county’s Overdose Fatality Review (OFR) Team alongside OMH, numerous county, city, and healthcare partners. The OFR Team reviews substance use overdose deaths in Onslow County to determine what services individuals accessed prior to their death. A death review (also referred to as a “case review”) examines a decedent’s life cycle in terms of drug use history, comorbidity, major health events, social-emotional trauma (including adverse childhood experiences), encounters with law enforcement and criminal justice system, treatment history, and other factors including local conditions to facilitate a deeper understanding of the missed opportunities for prevention and intervention that may have prevented an overdose death. Blending input from public health, public safety, providers, and the community, the OFR Team seeks to identify trends in substance use overdose deaths and make recommendations on how to prevent future overdose deaths.  

Who We Serve

Stakeholders and people in Onslow County affected by substance abuse.

How We Impact

OFR Team reviews and identifies trends in substance use overdose deaths. Identification of trends allows the OFR team to make recommendations to other community organizations serving people seeking services and to allow for targeted messaging to at-risk individuals and groups.  

PM
Q2 2024
3
6
-40%
P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Jacksonville Police Department 

  • Onslow Memorial Hospital (OMH)

Why Is This Important?

OMH partners with the Jacksonville Police Department to hold Drug Takeback programs in the community for the public to dispose of unwanted and/or unneeded medications and drugs. All drugs are accepted on a no questions asked policy. 

PM
May 2024
19.95
1
-79%
P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Onslow County Community Paramedics 
  • Onslow Memorial Hospital (OMH)
What We Do

Onslow Memorial Hospital screens every Emergency Department patient for mental health wellness checks and/or substance abuse treatment assistance if needed or desired by the patient.

If a patient with opioid substance use disorder needs and wants assistance, a community paramedic will visit them and dose them with methadone (if indicated) until they can receive treatment in a facility. 

Who We Serve

OMH Emergency Department Patients 

How We Impact

Patients who are struggling with mental health and/or substance related concerns can receive assistance and/or referrals from OMH staff and Community Paramedics. No followup to see if patients make it to the referral is performed at this time.

Health Equity and Health Disparities
R
Time Period
Current Actual Value
Current Trend
Baseline % Change
Why Is This Important?

Health behaviors and the prevalence of risk factors among various subpopulations have major impacts on health outcomes. Risk factors such as tobacco, obesity, poverty, and other factors significantly increase the likelihood of achieving poorer health outcomes.  

The 2022 Robert Wood Johnson (RWJ) County Health Rankings show Onslow County has having an adult smoking rate of 19%. According to the Centers for Disease Control and Prevention, the commercial tobacco industry uses tailored marketing and advertising to target some groups and communities, including people with low socioeconomic status. For example, current tobacco use prevalence is higher among adults who were uninsured, enrolled in Medicaid, or had some other public insurance compared to adults with private insurance or Medicare only. Referrals to QuitlineNC, a free cessation service, from July 2021 through May 2022 came heavily from media commercials (41%) and friends/family (35%). Only 12% of referrals to QuitlineNC came from medical professionals (Optum Inc.).

The Food Bank of Central and Eastern North Carolina estimates in 2018-2019, 14.6% of people living in Onslow County were food insecure and 20.3% of children under the age of 18 in Onslow County experienced food insecurity during this same period. According to the Food Research and Action Center (2022), people experiencing food insecurity are vulnerable to obesity and poor nutrition and many diet-related diseases, such as diabetes and heart disease, have been associated with food insecurity. 

The 2022 RWJ County Health Rankings show Onslow County ranked 76th (1 – best, 100 – worst) in NC for mammography screenings and 86th in NC for flu vaccinations. It is crucial for all people in Onslow County to have access to needed community resources and health services, including preventative care for them to achieve optimal and equitable health outcomes. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Healthcare Providers 

  • QuitlineNC 

  • NC Division of Public Health 

  • Onslow County Health Department (OCHD) 

  • Onslow Memorial Hospital (OMH) 

  • Community Partners 

What We Do

QuitlineNC provides free cessation services to any North Carolina resident who needs help quitting commercial tobacco use, which includes all tobacco products offered for sale, not tobacco used for sacred and traditional ceremonies by many American Indian tribes and communities. Quit Coaching is available in different forms, which can be used separately or together, to help any tobacco user give up tobacco. OCHD will establish agreements with healthcare providers and community partners serving Historically Marginally Populations (HMPs) to refer individuals to QuitlineNC for tobacco cessation.

Who We Serve

Adults who use tobacco products.

How We Impact

By improving QuitlineNC referral networks, healthcare providers and community partners serving HMPs across Onslow County will be able to refer more patients for tobacco cessation services. This will ensure historically marginalized populations have equitable access to resources to reduce tobacco use, especially among high-risk populations.

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • NC Division of Public Health 

  • Coordinated Approach to Child Health (CATCH) 

  • Parenting Education Empathy Rapport and Support (PEERS) 

  • Onslow County Health Department (OCHD) 

  • Onslow County Youth Services 

  • Onslow County Learning Center

  • Onslow County Schools

  • Salt and Light Academy

  • Jacksonville Youth Council

  • Sigma Beta Club 

  • Onslow County Teen Court - Mediation Center of Eastern Carolina

  • ZECA

  • Georgetown High School

  • Mediation Center of Eastern Carolina (MCEC)

  • Mentoring Every Neighborhood and Community (MENAC)

  • Methodist Home for Children

  • Community Paramedics

  • Jacksonville Public Safety

  • 4-H

  • Juvenile Justice 

  • Without Limits Counseling

  • Onslow County Public Library

  • Restart Hygiene 

  • Naval Medical Center Camp Lejeune

  • Marine Corps Community Services (MCCS)

What We Do

Catch My Breath is a class developed by Coordinated Approach to Child Health (CATCH) that focuses on youth tobacco use prevention. OCHD will train staff to deliver the class in the community targeting the youth population in Onslow County. 

Who We Serve

Onslow County Youth

How We Impact

Youth tobacco use is a major problem that can lead to continued tobacco use into adulthood and poor health outcomes. Increasing the amount of Catch My Breath trainings will strengthen tobacco prevention efforts, especially for youth in high-risk populations. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • NC Cooperative Extension 
  • Jacksonville/Onslow Chamber of Commerce 

  • Onslow County Health Department (OCHD) 

  • Onslow Memorial Hospital (OMH) 

  • Community Partners - Retail Food Outlets and Businesses

What We Do

Conducting a community food security assessment will measure strengths and weaknesses of the local food system. Completion of the Food Security Assessment will influence the decision-making process for programs and policies that affect food security within Onslow County.

Who We Serve

All people living in Onslow County.

How We Impact

Conducting a food security assessment will allow OCHD to determine the locations and incidence of food deserts in Onslow County and help inform future intervention efforts.

PM
Mar 2023
102
1
73%
PM
Mar 2023
12
1
-48%
P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Caring Community Clinic 

  • Goshen Medical Center 

  • Onslow County Health Department (OCHD) 

  • Onslow Memorial Hospital (OMH) 

  • Community Partners 

What We Do

OCHD and OMH aim to increase awareness of and promote importance of preventative screenings taking place throughout the community via social media platforms.

Who We Serve

All people in Onslow County.

How We Impact

Promoting, sharing, and distributing information regarding affordable preventative screenings to increase accessibility and awareness of services with the goal of identifying chronic diseases and cancers in the beginning stages, and or prevent chronic diseases in general. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Onslow Memorial Hospital (OMH)
What We Do

OMH will develop and share a dashboard to illustrate disparities and health outcomes as they relate to top health issues at OMH. 

Who We Serve

OMH Patients

How We Impact

Sharing data with community partners with assist with knowing what areas in the community need more targeted assistance. 

PM
Q2 2023
594
1
4%
PM
Q2 2023
1,054
1
-4%
Healthy Living
R
Time Period
Current Actual Value
Current Trend
Baseline % Change
Why Is This Important?

Health behaviors and risk factors have a major impact on an individual’s ability to achieve better health outcomes. Onslow County residents should utilize resources available in the community to help increase healthy behaviors and reduce their risk factors. Residents should also have access to needed health services. Onslow County data shows that chronic conditions and other health-related topics such as breastfeeding, nutrition, and access to affordable health services are still priority issues for the county. 

Leading causes of death in Onslow County include: cancer, heart disease, chronic lower respiratory diseases, cerebrovascular diseases, and diabetes (NC State Center for Health Statistics, 2019). Making healthy choices like eating healthy, avoiding too much alcohol, getting regular physical activity, and practicing good sleep habits can help reduce the likelihood of getting a chronic disease.  

Getting a head start on health can help prevent chronic disease and these healthy behaviors are easier to start in childhood and adolescent years. For infants, breastfeeding can help provide short- and long-term protection against illnesses and diseases such as asthma, obesity, type-1 diabetes, and sudden infant death syndrome (SIDS) (CDC, 2021). As of July 2022, Onslow County estimates 35.1% of infants receiving WIC benefits are breastfed with a goal of reaching 40% of infants breastfeeding.  

An area of concern in Onslow County includes the teen birth rate. The 2022 County Health Rankings show Onslow County as 99th for teen birth rate (1 – best, 100 – worst). Teen pregnancies have immediate and long-lasting costs for teen parents and their children. CDC data (2021) links teen pregnancies and births to higher school dropout rates among girls and their children are also at higher risk of lower educational attainment.  

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • American Heart Association 

  • Onslow County Health Department (OCHD) 

  • Onslow Memorial Hospital (OMH) 

  • Community Partners 

 

What We Do

OCHD offers Healthy for Life, an evidence-based nutrition program developed by the American Heart Association (AHA), to individuals and families in the community. The program is offered to anyone in the community in an online format. There is new class topic each month where participants can choose between 2 class times. Participants in the classes learn about heart health, basic nutrition, portion sizes, physical activity, saving money on groceries, and healthy recipes to try. Healthy for Life encourages and empowers Onslow County residents to make healthy food, nutrition, and lifestyle choices. 

Who We Serve

Communities with a moderate to high level of vulnerability as defined by the CDC’s Social Vulnerability Index.

How We Impact

Healthy for Life equips individuals and families with new skills to apply to their life like healthy cooking, shopping tips, increasing well-being tips, gardening and more. These new skills will impact participants as well as individuals around them to change their food and health attitudes as well as behaviors, which will help them develop healthier habits and achieve better health outcomes. 

PM
Jun 2024
1
1
-80%
P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • NC Cooperative Extension 

  • Onslow County Faith-Based Communities

  • Onslow County Health Department (OCHD)

What We Do

Faithful Families is an evidence-based intervention program that connects with faith-based communities to promote healthy living among individuals, families, and local communities. By providing nine sessions consisting of nutrition, meal preparation, food safety, and physical activity education, participants can make informed changes to their health behaviors and improve their overall health. Faith communities and organizations are important health advocates, and through Faithful Families, can support community health improvement and work to decrease health disparities. 

Who We Serve

Faith-based communities and families in Onslow County of any faith or religious tradition. 

How We Impact

Faithful Families provides education and aids in skill development for participants related to improved dietary intake, food safety practices, improved food resource management practices, and increased daily physical activity. This program provides additional support to families and seeks to develop skills and knowledge to enable them to improve health behaviors. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Special Supplemental Nutrition Program for Women, Infants, and Children, Onslow County Health Department
  • Onslow County Health Department  
  • Onslow Memorial Hospital 
  • Realo Drugs
  • Yanas Restaurant
  • Furniture Plus
  • Muttigans Swansboro
  • CRUSH Nutrition
  • Onslow Women's Center Inc
  • Teresa G. Conley DDS, PA
  • Bella Donna Birth & Women's Health, PLLC
  • Children's Museum of Jacksonville, Zing Zumm
  • Milk Road Coffee
  • Paris Bahn Mi
  • One Place
  • Dini's Martinis
  • Montesorri Children's School
  • Lil' Bean Cafe
  • Huffman Vineyards
  • Caring Community Clinic
  • Caring Community Dental Clinic
What We Do

OCHD is working toward increasing the number of facilities that are awarded and/or designated as breastfeeding friendly.  In turn, these actions will promote and support breastfeeding in our community.

Who We Serve

Women and children who breastfeed in Onslow County.

How We Impact

Breastfeeding improves the likelihood of infants achieving better health outcomes and provides a host of health benefits for mother and baby. OCHD will collaborate with community partners to improve breastfeeding rates through improving community access and support for nursing mothers and babies. By increasing the number of local businesses and partners who are designated as being breastfeeding friendly, more mothers will have access to supportive environments and be encouraged to breastfeed. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Special Supplemental Nutrition Program for Women, Infants, and Children (WIC, OCHD) 

  • Onslow County Health Department Clinical Services 

  • Goshen Medical Center

  • Onslow County Department of Social Services (DSS) 

  • Onslow Memorial Hospital (OMH)

What We Do

OCHD offers a wide variety of preventative health services for the community. Services pertaining to women’s and children’s health include Maternal Health, WIC, Family Planning, Child Health, Immunizations, and Breast and Cervical Cancer Control Program (BCCCP). Services are offered to individuals with private insurance, Medicaid, and those who are uninsured, and a sliding-fee scale helps to ensure that health services are low-cost. OMH offers a variety of services and community support to improve Women’s and Children’s Health, including monthly “Understanding Breastfeeding Classes” to expectant families looking for more information regarding breastfeeding and interaction with an International Board-Certified Lactation Consultant (IBCLC), which helps to support breastfeeding in the community. The OMH Foundation also collaborates with radiology to provide screening 3D mammograms for the underinsured and uninsured through “Julie’s Pink Warrior Project.” 

Who We Serve

Women and children in Onslow County.

How We Impact

Improved awareness and utilization of OCHD preventative services to support women’s and children’s health and improved awareness and utilization of OMH Breastfeeding Support Services will improve population health, especially the health of women and children. Increased utilization of preventative services will improve health outcomes and lower health risks. 

PM
Mar 2024
6,822
3
-8%
P
Time Period
Current Actual Value
Current Trend
Baseline % Change
What We Do

The Julie's Pink Warrior Project is in honor of Julie Zerkle, a breast cancer warrior who was passionate about supporting individuals with the same disease. The proceeds of Julie’s Pink Warrior Project will help provide screening 3D mammograms for the underinsured and the uninsured.

Who We Serve

Julie's Pink Warrior Project serves uninsured and underinsured women seeking screening mammograms.

How We Impact
PM
2024
1,538
1
13882%
P
Time Period
Current Actual Value
Current Trend
Baseline % Change
What We Do

Understanding Breastfeeding is an introductory class intended for expectant families looking for more information regarding breastfeeding. Topics covered will include a brief overview of breastfeeding, its benefits, and how to be successful with breastfeeding. This class will allow expectant families the opportunity to interact with our IBCLC (International Board Certified Lactation Consultant) prior to delivery.

Who We Serve

This program serves expectant families. Participants may be at any point in their pregnancy.

How We Impact
PM
2024
5
3
-85%
Physical Activity and Exercise
R
Time Period
Current Actual Value
Current Trend
Baseline % Change
Why Is This Important?

Physical activity and the availability of spaces/opportunities to be physically active can have a huge impact on the health of a community. Physical activity reduces the risk of chronic conditions such as cardiovascular disease, type 2 diabetes, many types of cancer, depression/anxiety, and dementia. By promoting and developing events and programs that encourage physical activity, Onslow County will increase physical activity opportunities for residents to improve their health. 

According to 2022 County Health Rankings, Onslow County is ranked 47th out of 100 counties (1 – best, 100 – worst) for adult obesity. 35% of adults ages 18 and older report a body mass index (BMI) equal to or greater than 30km/m^2 (age-adjusted). In 2019, 32.5% of males and 34% of females were considered obese in Onslow County (CDC, US Diabetes Surveillance System).  

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Centers of Disease Control (CDC) 

  • Faith-Based Communities 

  • Onslow County Health Department (OCHD)

  • Community Partners

What We Do

OCHD offers a CDC-accredited Diabetes Prevention Program to individuals who are at risk for developing type 2 diabetes prediabetic range, have had gestational diabetes, or scores a 5 or higher on the CDC risk test. The focus of this 1-year, evidence-based lifestyle change program is to provide nutrition and physical activity centered lessons. DPP encourages individuals to develop skills in achieving healthier lifestyles to decrease the risk of type 2 diabetes by losing 5-7% of their body weight and engaging in an average of 150 minutes of weekly physical activity.

Who We Serve

Adults who are at risk of developing type 2 diabetes.

How We Impact

Obesity and type 2 diabetes increase the risk for a variety of health complications and poor health outcomes. Delivering DPP for individuals at risk of developing type 2 diabetes will improve their overall health by encouraging healthy lifestyle changes and decrease their risk. OCHD will promote DPP in various ways to increase awareness of its benefits and recruit people living in Onslow to participate. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Onslow County Parks and Recreation 

  • Jacksonville Recreation and Parks 

  • Senior Services 

  • Onslow County Health Department (OCHD) 

  • Onslow Memorial Hospital (OMH) 

  • Community Partners

What We Do

OCHD and OMH will partner with Onslow Parks and Rec, Onslow Senior Services, and other community partners to promote affordable physical activity opportunities throughout the county via social media. By increasing the awareness of affordable physical activity opportunities, more residents will be likely to take advantage of accessible ways to engage in healthy behaviors and improve their health. 

Who We Serve

All people in Onslow County.

How We Impact

Increasing awareness of affordable physical activity opportunities will increase knowledge and participation in the programs that are available to the people of Onslow County. Engaging with the community in this way will increase utilization of available resources and help community members achieve better health outcomes through increased physical activity. 

P
Time Period
Current Actual Value
Current Trend
Baseline % Change
Partners
  • Onslow Memorial Hospital (OMH)
What We Do

OMH will provide education on safe physical therapy/exercise practices at community events.

Who We Serve

All people in Onslow County.

How We Impact

Increasing awareness of safe practices while exercising and how to properly stretch before and after working out. 

PM
2024
700
1
-97%
SOTCH Reports
S
Time Period
Current Actual Value
Current Trend
Baseline % Change
What Is It?

In 2021, the Onslow County Health Department (OCHD) conducted its triannual Community Health Needs Assessment (CHNA) in collaboration with Onslow Memorial Hospital. This CHNA provides data from local, state, and federal levels including community surveys to assess the needs of those in Onslow County.  From the data, a report was created to present an analysis for the health priority needs of the community. This report is the 2021 Community Health Needs Assessment.

Community Health Improvement Plans

Throughout the year, OCHD worked diligently at evaluating the data provided through the CHNA to set strategies and programs addressing the prioritized health needs of the community which include: chronic illnesses, obesity, access to healthcare, substance-use disorder, and preventative health. Through these priorities, the Community Health Improvement Plans (CHIPs) were developed. Each plan is designed with programs to help combat the health priority and work toward a healthier community. The four CHIPs are: Mental & Behavioral Health, Healthy Living, Health Equity & Health Disparities, and Physical Activity & Exercise. 

 

Onslow County at a Glance(U.S. Census Bureau)

Population 2020

204,576

Percent White

76.1%

Percent Change of

Population (2010-2020, Census)

87%

Percent African American

15.6%

Percent Female

44.3%

Percent Hispanic/Latino

13.4%

Percent Male

55.7%

Median Household Income

(2015-2019)

$54,732

Percent Under 18 Years Old

24.3%

Percent of Population that are Veterans (2020)

11.9%

Percent Under 5 Years Old

7.9%

Average Life Expectancy at Birth (2015)

84

Percent 65 Years and Older

9.9%

Median Age (2019)

26.5

Source

Progress on CHIPs

   Health Equity & Health Disparities                                               

Health behaviors and the prevalence of risk factors among various subpopulations have major impacts on health outcomes. Risk factors such as tobacco use, obesity, poverty, and other factors significantly increase the likelihood of worsened health outcomes.  

The 2022 Robert Wood Johnson (RWJ) County Health Rankings shows Onslow County has an adult smoking rate of 19% (University of Wisconsin Population Health Institute, 2022). According to the Centers for Disease Control and Prevention, the commercial tobacco industry uses tailored marketing and advertising to target some groups and communities, including people with low socioeconomic status. For example, current tobacco use prevalence is higher among uninsured adults, enrolled in Medicaid, or who had some other public insurance compared to adults with private insurance or Medicare only. Establishing agreements with healthcare providers and community partners serving Historically Marginally Populations (HMPs) to refer individuals to affordable and accessible tobacco cessation can help increase equitable access to resources and reduce tobacco use.

The Food Bank of Central and Eastern North Carolina estimates, in 2018-2019, 14.6% of people living in Onslow County were food insecure, and 20.3% of children under the age of 18, in Onslow County, experienced food insecurity during this same period. According to the Food Research and Action Center (2022), people experiencing food insecurity are vulnerable to obesity, poor nutrition, and many diet-related diseases, such as diabetes and heart disease; which have been associated with food insecurity (Onslow County Profile, 2023). 

The 2022 RWJ County Health Rankings show Onslow County ranked 76th (1 being the best, 100 being the worst) in NC for mammography screenings and 86th in NC for flu vaccinations (University of Wisconsin Population Health Institute). It is essential for all people in Onslow County to have access to needed community resources and health services, including preventative care for them to achieve optimal and equitable health outcomes. 

The Health Equity & Health Disparities CHIP consists of six programs: QuitlineNC Referrals, Catch My Breath Vaping Prevention, an Onslow County Food Security Assessment, Preventative Screenings Awareness, Onslow Memorial Hospital’s “What’s Your Next 10?” as well as Onslow Memorial Hospital’s Health Disparities Data Dashboard.

QuitlineNC

In 2022, 19% of adults are tobacco users in Onslow County, which is equal to the state of North Carolina (University of Wisconsin Population Health Institute, 2022).  QuitlineNC is a free program offered by the NC Department of Health and Human Services.  This service offers free coaching for tobacco and vaping cessation as well as providing participants with nicotine patches and lozenges.  The program is available to all residents of NC regardless of insurance status. Quitline coaches will provide a tailored “quit plan” to individuals to help them in their goal to quit tobacco and

vape products.

Being an easy, affordable, and accessible resource, OCHD wants to expand the awareness of QuitlineNC—especially to medical providers in the county. In a review of referrals made from July 2021 through May 2022, only 5 Onslow County healthcare provider offices referred a patient to QuitlineNC (Optum Inc., 2022); 42% of people using QuitlineNC services were informed about the resource from media commercials, 35% from family and friends, and only 12% from medical providers (Optum Inc., 2022). Due to this low number of physician referrals, OCHD is offering Lunch and Learn presentations to educate medical staff on the benefits of being a QuitlineNC referral site.

OCHD has partnered with Ernest Watts, Region 8 Tobacco Lead with the North Carolina Tobacco Prevention and Control Branch, to obtain resources and materials for healthcare providers to utilize in-office visits for patients who would like to quit using tobacco and vape products.  While 2022 has consisted of training and obtaining resources and materials, OCHD health educators began promoting the QuitlineNC service to providers in February 2023.

By improving QuitlineNC referral networks, healthcare providers and community partners serving Historically Marginalized Populations (HMPs) across Onslow County will be able to refer more patients to tobacco cessation services. This will ensure HMPs have equitable access to resources to reduce tobacco use, especially among high-risk populations.

  View Performance Measure Progress here:                        

How Much Number of individuals referred to QuitlineNC by healthcare providers and community partners. 

How Much Number of providers and partners who refer patients to QuitlineNC.

Catch My Breath

Vaping devices have gained popularity over the years and continue to be used by individuals of all ages.  As the prevalence of youth vaping grew, OCHD’s strategy to implement a vaping prevention program in the county began in 2022.  This is also a selected strategy in coordination with the Healthy Communities initiative by the North Carolina Division of Public Health.

OCHD Health Educators were trained through the CATCH® My Breath Youth E-Cigarette Prevention Program to teach the four-session course throughout the community.  In January 2023, Onslow County Health Department presented the CATCH® My Breath program to students through Onslow County Youth Services (OCYS) and the Jacksonville Youth Council.  The program offers engaging activities and presentations to help elementary, middle, and high school students understand the dangers of vaping, the chemicals contained in vaping products, as well as exit strategies and refusal tactics when being offered vape products.  Performance measures for this program include the number of students that participate in the program, as well as students who indicate their intention to abstain from vaping.

As of mid-February 2023, health educators have taught a total of 17 CATCH® My Breath classes and reached 27 students between Onslow County Youth Services and the Jacksonville Youth Council. OCYS will be a continual partnership where OCHD will regularly provide CATCH® My Breath classes to steadily enrolling students.  OCHD continues to recruit youth-centered agencies and educational institutions to partner with and provide the CATCH® My Breath Program. For more information, please contact community_relations@onslowcountync.gov.

 

  View Performance Measure Progress here:                        

 How Much Number of participants who have completed Catch My Breath trainings.

 How Much Total number of 5th - 12th graders reached.

Food Security Assessment

The hunger crisis has continued to pose a challenge across the nation. A food security assessment was deemed essential to help identify food deserts and food swamps within Onslow County. A food desert refers to a geographical area that lacks healthy food access within a community, whereas a food swamp is a geographical area where there are little to no healthy food options. According to the Centers for Disease Control and Prevention, food deserts are “associated with chronic conditions including obesity, heart disease, and diabetes.”

In 2022, OCHD started conducting research for the Food Security Assessment as a result of the 2021 Community Health Needs Assessment and Advancing Equity initiative from the North Carolina Division of Public Health.  The initial research consisted of scanning numerous interactive maps and indexes to identify the areas within the county that are vulnerable to low access to healthy foods. Low access includes a lack of public transportation, walkability, and/or nearby food outlets. To provide additional context for the areas with limited access to healthy foods and accurate data on locations, health educators also completed a drive-through analysis of the vulnerable areas identified.

 During the second half of the research phase, health educators and interns surveyed the geographical area of Onslow County to pinpoint all full-service grocery stores, convenience stores, gas stations, and additional outlets that distribute food or groceries to the community.  After the locations were mapped, areas were identified as food deserts or food swamps based on access to healthy foods in specific areas. There are on average 1-3 grocery stores in each of the 18 zip codes in Onslow County, but there are no grocery stores in 9 zip codes.

Fast food outlets varied greatly throughout Onslow County: ranging from some zip codes with 0 fast-food outlets and others with 63 to 80 fast-food outlets.

2022 and 2023 Small DDAs and QCTs | HUD USER. (n.d.). https://www.huduser.gov/portal/sadda/sadda_qct.html. Accessed 25 February 2023.

Once the Onslow County profile was created for the food security assessment, the health department began planning for the next phase: surveying the community and holding focus groups. The health department wrapped up 2022 with the development of a community survey, recruiting focus group participants, and planning survey distribution outreaches. Focus groups and gathering community survey input began in early 2023.

In 2023, OCHD posted the community survey on social media platforms, and distributed surveys at Onslow County Senior Services’ five sites, soup kitchen patrons, church congregations, and Care management clientele.

As of February 2023, OCHD has received 215 surveys from the community. Additionally, four out of the six focus groups have been held. The six focus group types are listed in the table to the right.

  View Performance Measure Progress here:                        

 How Much Number of Community Surveys Received

Preventative Screenings

OCHD and Onslow Memorial Hospital aims to increase awareness of and promote the importance of preventative screenings taking place throughout the community via social media platforms. OCHD has a presence on Facebook, Twitter, Instagram, and LinkedIn; each consisting of tailored content for followers. 

Promoting, sharing, and distributing information regarding affordable preventative screenings to increase accessibility and awareness of services. Breaking the barrier of accessibility will assist in the prevention and early identification of chronic diseases and cancer. In 2022, OCHD created 15 social media posts from April-December 2022 promoting preventative screenings.  These screenings were available through the health department, as well as community agencies. From June to December 2022, OCHD obtained an engagement rate (the number of times followers see the post and engage by reacting or sharing the post) of 4.6% across its four social media channels with a total of 3,849 impressions (the number of times the posts have been seen in a social media feed, but not necessarily engaged with) within a total of 9 posts. The average social media engagement rate is between 1-3 percent. With a great engagement rate, OCHD is working to increase new views and reach more people in Onslow County.

  View Performance Measure Progress here:                        

 how well Percent of engagements with the social media post regarding available prevention screenings.

 how well Percent of Facebook engagements with a post regarding available prevention screenings.
 how well Percent of Instagram engagements with a post regarding available prevention screenings.
 how well Percent of LinkedIn engagements with post regarding available prevention screenings.
 how well Percent of Twitter engagements with post regarding available prevention screenings.

 


   Healthy Living                                                                   

Health behaviors and risk factors have a major impact on an individual’s ability to achieve better health outcomes. Onslow County residents should utilize resources available in the community to help increase healthy behaviors and reduce their risk factors. Residents should also have access to needed health services. Onslow County data shows that chronic conditions and other health-related topics such as breastfeeding, nutrition, and access to affordable health services are still priority issues for the county. Leading causes of death in Onslow County include cancer, heart disease, chronic lower respiratory diseases, cerebrovascular diseases, and diabetes (NC State Center for Health Statistics, 2019).

Making healthy choices like eating healthy, avoiding too much alcohol, getting regular physical activity, and practicing good sleep habits can help reduce the likelihood of getting a chronic disease. Healthy behaviors are easier to form in childhood and adolescent years to prevent chronic diseases. For infants, breastfeeding can help provide short- and long-term protection against illnesses and diseases such as asthma, obesity, type-1 diabetes, and sudden infant death syndrome (SIDS) (CDC, 2021). As of July 2022, Onslow County estimates 35.1% of infants receiving WIC benefits are breastfed to reach 40% of infants breastfeeding. 

Another area of concern in Onslow County includes the teen birth rate. The 2022 County Health Rankings show Onslow County as 99 out of 100 for the teen birth rate (1 – best, 100 – worst). Teen pregnancies have immediate and long-term ramifications for teen parents and their children (University of Wisconsin Population Health Institute, 2022). CDC data (2021) links teen pregnancies and births to higher school dropout rates and risk of lower education attainment among girls and their children. 

The Healthy Living CHIP consists of six programs: Healthy for Life, Faithful Families, Breastfeeding Friendly Designations, Women’s and Children’s Health Services, and Julie’s Pink Warrior Project.

Healthy for Life

OCHD began the American Heart Association’s Healthy For Life® program in November 2022 to promote healthy living, wellness, nutrition, and smart choices.  The Healthy for Life® program is a  quarterly series consisting of monthly topics ranging from healthy cooking and recipes to smart shopping and budget-friendly grocery lists.

The Healthy For Life® program is held twice a month at different times to give the community the opportunity to attend.  The program is conducted by the Lead Public Health Educator and a WIC nutritionist.  Participants join via Zoom and complete a pre- and post- survey to gauge increased knowledge and awareness of food, nutrition, and healthy habits.

From November 2022 through January 2023, OCHD had a total of 13 Healthy For Life® participants. Given the holidays being a busy time of year, OCHD anticipates an increase in class participation as 2023. OCHD plans to hold satellite classes with the library, offer lunch and learn classes with the Department of Social Services employees, and continue promoting the monthly Healthy For Life® classes on social media and at community outreaches to boost awareness and participation.

  View Performance Measure Progress here:                        

How Much Number of HFL Participants

How Much Number of participants indicating increased confidence in making healthier behavior changes (pre/post-tests).

Faithful Families

Faithful Families is an evidence-based intervention program that connects with faith-based communities to promote healthy living among individuals, families, and local communities. By providing nine sessions consisting of nutrition, meal preparation, food safety, and physical activity education, participants can make informed changes to their health behaviors and improve their overall health. Faith communities and organizations are important health advocates, and through Faithful Families, can support community health improvement work to decrease health disparities. In these nine sessions, health educators from OCHD implement the health and nutrition aspect of the program, while a lay leader from the partnering organization conducts the spiritual component of the program.  During 2022, the Community Relations Team health educators completed the training for Faithful Families and began researching local faith-based organizations throughout Onslow County as potential partners.  In January 2023, the Health Department began Faithful Families with the Sandy Run Missionary Baptist Church in Jacksonville.  

  View Performance Measure Progress here:                        

 How Much Number of participants in the program that went to 50% or more of the sessions.

 How Much Number of participants indicating increased healthy behaviors (pre/post-tests).

Breastfeeding Friendly Designations

OCHD is working toward increasing the number of facilities that are awarded and/or designated as breastfeeding-friendly.  In turn, these actions will promote and support breastfeeding in the community. Breastfeeding improves the likelihood of infants achieving better health outcomes and provides a host of health benefits for mothers and babies. OCHD will collaborate with community partners to improve breastfeeding rates by improving community access and support for nursing mothers and babies. By increasing the number of local businesses and partners who are designated as being breastfeeding-friendly, more mothers will have access to supportive environments and be encouraged to breastfeed. 

In 2022, The Health Department’s Community Relations Team connected with businesses and employers to educate on the benefits of being a breastfeeding friendly designation and if interested, supplying the business with the application to submit to the North Carolina Breastfeeding Coalition. In 2022, 24 Onslow County organizations submitted applications to become breastfeeding friendly designations. The North Carolina Breastfeeding Coalition website updates the list of awardees twice a year, in March and August.

  View Performance Measure Progress here:                        

 How Much Number of businesses and organizations submitting applications for breastfeeding friendly designation.

 How Much Number of businesses and organizations to obtain breastfeeding friendly designation award.

 Women’s and Children’s Health Services

OCHD offers a wide variety of preventative health services for the community. Services pertaining to women’s and children’s health include Maternal Health, Women, Infants, and Children (WIC), Family Planning, Child Health, Immunizations, and Breast and Cervical Cancer Control Program. Services are offered to individuals with private insurance, Medicaid, and those who are uninsured. OCHD utilizes a sliding-fee scale to ensure that health services are accessible and affordable. Onslow Memorial Hospital offers a variety of services and community support to improve Women’s and Children’s Health, including monthly “Understanding Breastfeeding Classes” to expectant families looking for more information regarding breastfeeding and interaction with an International Board-Certified Lactation Consultant, which helps to support breastfeeding in the community. The Onslow Memorial Hospital Foundation also collaborates with radiology to provide screening 3D mammograms for the underinsured and uninsured through Julie’s Pink Warrior Project.

Improved awareness and utilization of OCHD preventative services and Onslow Memorial Hospital's Breastfeeding Support Services will improve population health, especially the health of women and children. Increased utilization of preventative services will improve health outcomes and lower health risks. 

The Women’s and Children’s Health Services program is tracked by three performance measures: WIC participation, referrals to Parents, Education, Empathy, Rapport and Support (PEERS) Family Development, and social media posts for services offered by the county.  In October 2022, the WIC program’s target goal for enrollment was 6,435.  The actual number of participants in the program was 7,812.  From September to December 2022, OCHD referred 20 individuals to PEERs Family Development for education and/or services.

Onslow Memorial Hospital Julie’s Pink Warrior Project offers free mammograms to women in need.  OCHD refers their clients who need mammograms to Onslow Memorial Hospital.  In 2022, Onslow Memorial Hospital held their annual “Miles for Mammos” 5K to raise money for Julie’s Pink Warrior Project.  The event had 166 participants and raised over $19,000.

  View Performance Measure Progress here:                        

 How Much Number of OCHD referrals to PEERS Family Development.

 how well WIC Participation Numbers

 how well Percent of engagements with the social media post regarding Women's & Children's Services


   Mental and Behavioral Health                                                      

Adverse Childhood Experiences (ACEs), substance use, and mental and behavioral health problems are major priorities for Onslow County. The prevalence of poor outcomes such as lack of mental and behavioral health treatment, opioid use and/or death, child abuse, and juvenile crime show the need for additional support in this area, especially in prevention of overdose death services. In FY 2021 to 2022, 1610 child protective cases were assessed and of those, 333 cases of child maltreatment were found. During the April 2021 to March 2022 timeframe, there were 255 children in foster care (Onslow County DSS Data, April 2021 to March 2022).

Substance use overdoses are continuing to impact people living in Onslow County. In 2021, 76.5% of drug overdose deaths in Onslow County involved illicit opioids (NCDHHS Opioid Dashboard, 2021). Additionally, in 2021, 111.1 drug overdose emergency department visits per 100,000 residents occurred in Onslow County (NCDHHS Opioid Dashboard, 2021).

Onslow County has a variety of resources dedicated to addressing mental and behavioral health and substance abuse across the community. Despite of this, 47.6% of Onslow County survey respondents chose mental and behavioral health as a top health behavior that people in the community need more information about (2021 CHNA Community Survey). Improving awareness and access to these resources will help ongoing prevention efforts.

The Mental and Behavioral Health CHIP consists of five programs: ACEs Trainings, Prevention Specialist Referrals, Overdose Fatality Review, Operation Medicine Drop, and Mental Health/Substance Use Disorder Screening and Referral.

Overdose Fatality Review

The Overdose Fatality Review (OFR) Team consists of numerous city, county, and healthcare partners that meet quarterly to review substance use overdose deaths in Onslow County to determine what services individuals accessed prior to their death. Ultimately, the mission of the team is to facilitate a deeper understanding of the missed opportunities for prevention and intervention that may have prevented an overdose death.

OCHD created a charter for the OFR team that contains confidentiality and affiliation agreements. Once signed, these agreements are valid from 2022 through the end of 2023. To inform new members about OFR, the charter also includes an overview of OFR, its mission, background, scope, team objectives, and requirements of the team's participants. As Onslow County's team is in the stage of developing the best route to propose recommendations on how to prevent future overdose deaths, multiple team members attended the 2023 National Forum on OFR to learn how other teams across the country develop their recommendations.

  View Performance Measure Progress here:                        

 How Much Number of recommendations proposed to reduce substance use overdose deaths.

 How Much Number of overdose fatalities reviewed

Adverse Childhood Experiences Training

Adverse Childhood Experiences (ACEs) can be classified as negative experiences that take place during childhood and/or teenage years such as, but are not limited to: neglect, witnessing suicide or violence, abuse, bullying, and other traumatic events that may occur (CDC, 2021). Youth that experiences ACEs can have a greater risk of developing negative health conditions such as chronic health problems or mental illness in their adult years (CDC, 2021). Onslow County PEERS Family Development Center and Onslow County TASCO (Turning Adversity into Success for Children in Onslow) offer training to increase awareness of the impact of ACEs and provide support services to help families and children in Onslow County.  

ACEs training helps participants identify children in need, understand the impact of ACEs, identify risk and protective factors, and locate resources to help those impacted by ACEs. Increased awareness of ACEs and protective factors will enable participants to better serve their communities and identify opportunities to improve the lives of children in Onslow County.

From August to December 2022, 138 individuals around the community were trained on Resiliency and ACEs awareness.  To further the efforts of ACEs awareness and TASCO's mission, OCHD’s Health Educators were trained to conduct resiliency and ACEs Awareness training.

  View Performance Measure Progress here:                        

 how well Percent of training participants with increased knowledge on ACEs (pre/post test).

 How Much Numbered of participants trained in Adverse Childhood Experiences.

Prevention Specialist Referrals

OCHD partners with Methodist Home for Children Prevention Specialists to refer patients who are uninsured, and/or do not qualify for OCHD care management services to receive additional support. This support may come in many forms, including food pantry services, housing referrals, mental/behavioral health referrals, substance use treatment and recovery referrals, transportation, and affordable health services. 

Patients who may be struggling with mental/behavioral health or substance abuse often need additional resources. The additional support for OCHD clients, offered by the prevention specialist, will bridge the gap to improve accessibility to available community resources when they may not otherwise receive support. 

Onslow County began prevention specialist referrals to the Methodist Home for Children in August 2022.  From August to December 2022, 63 referrals have been made.

  View Performance Measure Progress here:                        

 How Much Number of patients referred to the Methodist Home for Children’s prevention specialist. 

Operation Medicine Drop

Onslow Memorial Hospital partners with the Jacksonville Police Department to hold Drug Takeback programs in the community for the public to dispose of unwanted and/or unneeded medications. All medications are accepted on a no questions asked policy. Along with drug takeback events, there are also designated locations through the community that the public can drop off unused medications. In 2022, the Jacksonville Police Department collected 539.4 pounds of unwanted medications.

  View Performance Measure Progress here:                        

 How Much Number (in pounds) of drugs collected.


 

 

   Physical Activity & Exercise                                                  

Physical activity and the availability of spaces and/or opportunities to be physically active can have a significant impact on the health of a community. Physical activity reduces the risk of chronic conditions such as cardiovascular disease, type 2 diabetes, many types of cancer, depression/anxiety, and dementia. By promoting and developing events and programs that encourage physical activity, Onslow County will increase physical activity opportunities for residents to improve their health.

According to 2022 County Health Rankings, Onslow County is ranked 47th out of 100 counties (1 being the best, 100 being the worst) for adult obesity. Of adults aged 18 and older, 35% report a body mass index equal to or greater than 30km/m2 (age-adjusted). In 2020, 9.3% of males and 9.2% of females, in Onslow County, aged 20 years and over, were diagnosed with diabetes. (CDC, US Diabetes Surveillance System, 2022). 

The Physical Activity and Exercise CHIP consists of 3 programs: Prevent T2 - Diabetes Prevention Program, Physical Activity Opportunities, and Health Education at Community Events.

Diabetes Prevention Program

The CDC’s Prevent T2 Diabetes Prevention Program (DPP) is a year-long lifestyle change program for individuals who have screened positive for prediabetes. The goal of the program is to delay or prevent the onset of type 2 diabetes. Throughout the annual program, participants track their food, activity, and weight each week as they form new habits and stay accountable to their behavior change. By the end of the program, the goal is for participants to lose and maintain at least 5-7% of their body weight and maintain at least 150 minutes of physical activity each week. The program is designed to provide regular education on nutritious eating to prevent the onset of type 2 diabetes Participants find ways to increase their daily activity, set goals, learn stress managements skills, and discover strategies for working through their barriers and setbacks. The program starts with three months of weekly, hour-long classes, then moves to biweekly classes for three months. In the last 6 months the program transitions to monthly classes, which is considered the “maintenance phase”.

In February 2022, a new, year-long Prevent T2 DPP cohort began. Since beginning the program, seven individuals have successfully completed DPP. All seven participants have reported getting at least 150 minutes of physical activity each week. Four of the participants have reached and maintained at least a 5% weight loss of their overall body weight. The greatest body weight loss for a single participant, during 2022, was 20%. While it is not required for all participants to report their A1C, two of the participants reported a lower A1C level throughout the duration of the program. As a cohort, the participants lost a total of 75 pounds and participated in a collective 34,900 minutes of activity throughout the year.

  View Performance Measure Progress here:                        

 How Much Number of participants that average 150 minutes of physical activity a week.

 How Much Number of participants enrolled in the program annually.

Physical Activity Opportunities

OCHD and Onslow Memorial Hospital will partner with Onslow Parks and Recreation, Onslow Senior Services, and other community partners to promote affordable physical activity opportunities throughout the county via social media. By increasing the awareness of affordable physical activity opportunities, more residents will be likely to take advantage of accessible ways to engage in healthy behaviors and improve their health. 

Increasing awareness of affordable physical activity opportunities will increase knowledge and participation in the programs that are available to the people of Onslow County. Engaging with the community in this way will increase the utilization of available resources and help community members achieve better health outcomes through increased physical activity. 

From June to December 2022, OCHD created 16 posts promoting social media throughout the community.  OCHD maintains a steady 3% engagement rate with the post, remaining at the top of the 1-3% average.

  View Performance Measure Progress here:                        

 how well Percentage of engagements that the social media physical activity posts receive.

 

 

 

Sources

Morbidity and Mortality Changes Since Last CHNA

Onslow County has seen additional changes in morbidity and mortality rates since the 2021 CHNA has been released. Details on updated data as well as contributing factors and analysis of these changes are listed below.

County Health Rankings

County Health Rankings & Roadmaps is a program of the University of Wisconsin Population Health Institute. County-level data, which is collected from different sources, on health behaviors, clinical care, social and economic factors as well as the physical environment are provided in their profile reports. Physical inactivity has increased from 20% in 2021 to 29% in 2022 according to the County Health Rankings data.

Figure 8 shows each county’s ranking based on the length and quality of life. Onslow County is shaded in the lightest green with a rank of 23 out of 100 (1 being the best, 100 being the worst) in North Carolina counties.

(The green arrows depict areas of health improvements since the last reporting period. The red arrows represent data that has worsened since the last reporting period.)

Some of the factors and categories that contribute to Onslow County's ranking by County Health Rankings & Roadmaps can be seen in the table above. Alcohol-impaired driving deaths have decreased by 7% since the previous reporting period. In 2019, the number of newly diagnosed chlamydia cases (per 100,000) rose to 1,175, which continues to climb higher than the state’s number of cases (per 100,000). New social media awareness and community presentations are planned for 2023 to address this concern (University of Wisconsin Population Health Institute, 2023).

Although Onslow County had 45 teen births (per 1,000) among 15 to 19-year-olds, it has declined by three since the 2021 CHNA. (University of Wisconsin Population Health Institute, 2022) Efforts to inform teens in the county of the family planning services we offer include adding resource cards to our outreach events.

 

2022 County Health Rankings & Roadmaps: Health Outcomes & Factors (University of Wisconsin Population Health Institute, 2023)

 

Onslow County

North Carolina

Years of Data Used

Health Outcomes

Length of Life

Premature Death (Years of potential life lost before age 75 per 100,000 population, age-adjusted.)

8,800

p

8,000

p

2018 - 2020

Health Factors

Health Behaviors

Alcohol-Impaired Driving Deaths

28%

q

26%

q

2016 & 2020

Sexually Transmitted Infections (newly diagnosed chlamydia cases per 100,000)

1,175.6

p

669.9

q

2019

Teen Births (number of births per 1,000 females, 15-19yo)

45

q

21

q

2014-2020

Clinical Care

Uninsured (% of pop-under age 65 without health insurance)

11%

p

13%

=

2019

Primary Care Physicians (ratio of pop to primary care physicians)

2,950:1

q

1,400:1

=

2019

Dentists (ratio of population to dentists)

990:1

p

1,710:1

q

2020

Social & Economic Factors

Unemployment (% 16 and older unemployed but seeking work)

7.2%

p

7.3%

p

2020

Income Inequality (Ratio household income at the 80th percentile to income at the 20th percentile)

3.6

q

4.7

=

2016-2020

Injury Deaths (Deaths due to injury per 100,000 pop)

74

p

82

p

2016-2020

Physical Environment

Air Pollution – Particulate Matter (particulate matter – avg. daily density of fine PM 2.5 mg cubic meter)

6.1

q

7.5

q

2018


COVID-19

The most recent data on the leading causes of death in Onslow County shows that chronic lower respiratory deaths declined by 27% from 2019 to 2020.  One of the possible factors includes the beginning of the COVID-19 pandemic.  With quarantines in place across the nation, in 2020, the transmission rate of common respiratory infections made a significant drop.  The decrease in the number of lung infections could have contributed to the 27% decline in chronic lower respiratory deaths. Another contributing factor could be the coding methods used to categorize the cause of death. Individuals with chronic lower respiratory disease, who contracted COVID-19, were at a higher risk of dying.

As of February 8, 2023, 61% of Onslow County residents have completed their initial COVID-19 vaccination series (NCDHHS, 2023).

Suicides

The number of suicides in the previous four years has fluctuated very little causing them to remain at a rate that is greater than North Carolina (13.2 per 100,000, in 2020) (CDC, 2022).

(Onslow County Register of Deeds)

Sources

  • NCDHHS; COVID-19 Vaccination Progress for Onslow County. (2023, February 8). In North Carolina Department of Health and Human Services. Retrieved February 10, 2023, from https://covid19.ncdhhs.gov/dashboard/vaccinations
  • NCEDSS; North Carolina Electronic Disease Surveillance System. (n.d.). In North Carolina Electronic Disease Surveillance System. Retrieved February 8, 2023, from https://nccovid.dph.ncdhhs.gov/login.do
  • Onslow County Deaths. (n.d.). Onslow County Register of Deeds. Retrieved February 13, 2023.
  • Suicide Rates by State. (2022, March 17). www.cdc.gov. https://www.cdc.gov/suicide/suicide-rates-by-state.html
  • University of Wisconsin Population Health Institute (n.d.). Onslow, NC. Www.Countyhealthrankings.org. Retrieved January 9, 2023, from https://www.countyhealthrankings.org/explore-health-rankings/north-carolina/onslow?year=2022
 
Emerging Issues Since Last CHNA

Mental Health Impacts

The COVID-19 pandemic caused various mental health impacts on the United States population. From January to June 2019, four in ten adults, in the United States, reported anxiety or depressive disorders during the pandemic (Kaiser Family Foundation, 2021). With the impact COVID-19 had on mental health, overdose deaths increased by 72% between 2019 and 2020 (NCDHHS, 2021). Other adverse outcomes in the mental health of adults, in the United States, in 2020, include difficulty sleeping or eating and worsening chronic conditions (Suicide Rates by State, CDC).

Unemployment can have a negative impact on mental health, increasing the likelihood of depression in adults (CDC, 2015). The unemployment rate in Jacksonville, North Carolina in June of 2018 was 5% and increased to 6% in June of  2021 (U.S. Bureau of Labor Statistics). The North Carolina Department of Commerce stated that Onslow County moved from Tier Two in 2022 to Tier One in 2023, with Tier One being the most distressed and Tier Three being the least distressed. Tiers are determined by four main factors: average unemployment rate, median household income, percentage of population growth, and adjusted property tax base per capita. The county’s recent increase in the unemployment ranks heavily influenced the shift in tiers (NC Department of Commerce, 2022).

One in five Americans will experience a mental illness each year (CDC, 2021). Factors such as Adverse Child Experiences (ACEs) and/or substance use can impact an individual’s mental health (National Library of Medicine, 2020). Long-term health risks such as depression and/or anxiety can result from drinking alcohol over time or excessively (CDC, 2022). Each year, counties are ranked on a scale of 1 to 100 in North Carolina with rank number one considered the best ranking for various health factors and outcomes. Onslow County was ranked 86 out of 100 for excessive drinking and 71 out of 100 for alcohol-impaired deaths in 2022 (County Health Rankings, 2022).

Drug Epidemic

The Kaiser Family Foundation stated that 12% of adults, in 2020, reported an increase in alcohol consumption or substance use. There were 4,041 drug overdose deaths in North Carolina in 2021; over 700 more compared to 2020.

Illicitly manufactured fentanyl could have contributed to more than 77% of overdose deaths in North Carolina, in 2021 (Kaiser Family Foundation, 2021). According to the NC Office of the Chief Medical Examiner toxicology data, there were 258 fentanyl-positive deaths in September 2021 compared to 298 fentanyl-positive deaths in September of 2022. Drug overdose mortality in North Carolina continues to climb yearly, with the most recent increase in data from 2,266 drug overdose deaths in North Carolina in 2019 to 3,146 drug overdose deaths in North Carolina in 2020.

To help combat the drug epidemic in Onslow County, the Onslow County Board of Commissioners passed Resolution 21-019 regarding the Opioid Settlement at a regular meeting in September of 2021. A Memorandum of Agreement was also signed outlining the guidelines for tracking and using the funds. The agreement allowed counties to choose services from an approved list to address the opioid epidemic in their communities. Onslow County gathered a group of stakeholders to meet, review data, and make recommendations on the services needed. On February 6, 2023, the Onslow County Commissioners passed resolution 23-002 outlining the spending plan for Onslow County for the remainder of the fiscal year 2022-2023 regarding the Opioid Settlement funds. These activities are all included in those authorized in the original agreement and are priorities from the stakeholder's group. This plan will be updated annually based on recommendations of the stakeholder group as they consider the needs of our community.

In addition, The Healing Place of New Hanover County is an evidence-based program that provides detox and long-term residential services to adults with a substance abuse diagnosis. This contract secures up to 10 beds for Onslow County residents to receive services at The Healing Place. Payment is a daily per diem based on actual usage. The Healing Place began taking residents on February 1, 2023 and is the first in Eastern North Carolina. The need for access to long-term treatment beds was identified as a priority by the SOAR Sub-Group in the Onslow County Settlement Funds Report 2022 (Onslow County Board of Commissioners, 2023).

Sources

New/Paused/Discontinued Initiatives Since Last CHNA

New

Med-South

The Med-South Lifestyle Program is an evidence-based behavior change intervention incorporating a Mediterranean dietary pattern for the southeastern population and guides participants through making lifestyle changes in eating and physical behaviors. The program is delivered in four monthly, individual counseling sessions that last roughly 45 to 60 minutes each, in addition to a brief 15-minute phone call in-between sessions to check on the participant’s goals and progress with the program. After four monthly 1:1 sessions are completed with the phone call check-ins occurring in-between the monthly sessions, there is a phone call check-in at months six and eight of the program, and the participants will come in person at month 10 of the program to complete their last blood pressure and weigh in. The program utilizes REDCap to track participants’ weight, blood pressure, and goals the participants as well as the percentage of the goal that is reached at different checkpoints throughout the program.

In July 2022, OCHD recruited Health Department staff to pilot the Med-South program. Eligibility requirements include: must be aged 18 to 80, be able to make decisions about dietary intake, and not have advanced kidney disease or diagnosis of malignancy or cancer. Those interested in the program provided their contact information, which was then forwarded to the UNC Team for the screening and enrollment process. The Med-South Lifestyle Program kicked off its first counseling session in September 2022, with a total of 18 participants fully enrolled in the program. As of February 2023, 17 out of 18 participants are still enrolled in the program, and 13 out of the 17 enrolled participants have completed all 4 of the 1:1 counseling sessions and have entered the maintenance phase of the program.

 

Discontinued

Diabetes Self-Management Education

Onslow County WIC and Nutrition Services discontinued the Diabetes Self-Management Education Support Program due to internal and external factors.  In response to this, OCHD began the American Heart Association’s Healthy For Life® program.  The program is held twice per month by a Health Department Nutritionist and Health Educator. Different series from the curriculum are implemented quarterly and various topics are offered monthly. The program is held virtually and is free for the public to attend with no registration necessary (more details can be found at https://bit.ly/ochdhealthyforlife).

Data/Evaluation CHIP

The Data and Evaluation CHIP was established to support the four CHIPs developed by OCHD, Onslow Memorial Hospital, and community partners. Originally, the Data and Evaluation CHIP was designed to serve a supportive role to enhance the efficacy of other CHIPs and provide a strategy for transparency with community partners to access statistics and data regarding the county.  Since this CHIP was regarded as supportive and played a passive role to the Health Department and its community agency partners, the Data & Evaluation CHIP was removed from the scorecard but work on the programs continues to meet the goals of the data and evaluation programs including a shared data dashboard.

 

 

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Time Period
Current Actual Value
Current Trend
Baseline % Change
What Is It?

Introduction

In 2021, the Onslow County Health Department (OCHD) conducted its triennial Community Health Needs Assessment (CHNA) in collaboration with Onslow Memorial Hospital.  The CHNA provides data from local, state, and federal levels, including a community survey, to assess the needs of those in Onslow County.  A report was created to present an analysis of findings and establish the health priorities for the community.  

The 2021 Community Health Needs Assessment can be found on the health department website. In the years where the CHNA is not conducted, the Health Department issues a State of the County Health (SOTCH) report. This 2023 SOTCH report provides updates on progress made on health priorities outlined in the Community Health Improvement Plans. 

Community Health Improvement Plans

In 2022, OCHD worked diligently at evaluating the data provided through the CHNA to set strategies and programs addressing health priorities identified in the assessment. These include chronic illnesses, obesity, access to healthcare, substance use disorder, and preventative health.  To address these priorities, Community Health Improvement Plans (CHIPs) were developed. Each plan is designed with programs to help address the health priority and work toward a healthier community.  The four CHIPs are Mental & Behavioral Health, Healthy Living, Health Equity & Health Disparities, and Physical Activity & Exercise. 

Onslow County at a Glance1 

Population Estimates (2022)

207,298

Percent White

76.3%

Percent Change of

Population (2010-2020, Census)

15.1%

Percent African American

15.3%

Percent Female

44.9%

Percent Hispanic/Latino

13.6%

Percent Male

55.1%

Median Household Income

(2015-2019)

$59,976

Percent Under 18 Years Old

24.6%

Percent of the Population that are Veterans (2018-2022)

12.15%

Percent Under 5 Years Old

8%

Percent 65 Years and Older

10.4%

 

 

 

 

 

 

 

 

[1] “Onslow County, North Carolina.” U.S. Census Bureau Quickfacts, US Census Bureau, www.census.gov/quickfacts/fact/table/onslowcountynorthcarolina/PST045222. Accessed 26 Jan. 2024.

Progress on CHIPs

Health Equity & Health Disparities

Health behaviors and the prevalence of risk factors among various subpopulations have major impacts on health outcomes. Risk factors such as tobacco use, obesity, poverty, and other factors significantly increase the likelihood of worsened health outcomes. Health disparities are “preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups, and communities.”2

Programs around tobacco use, preventative screenings, and food security were priorities in the Health Equity and Health Disparities CHIP. According to the Centers for Disease Control and Prevention, the commercial tobacco industry uses tailored marketing and advertising to target some groups and communities, including people with low socioeconomic status. For example, current tobacco use prevalence is higher among uninsured adults, enrolled in Medicaid, or other public insurance compared to adults with private insurance or Medicare only. While tobacco use is prevalent in Onslow County, food insecurity also ranks higher than in the state and nation. According to the Food Research and Action Center (2022), people experiencing food insecurity are vulnerable to obesity, poor nutrition, and many diet-related diseases, such as diabetes and heart disease, which have been associated with food insecurity.3

In addition, The Health Department wants to ensure individuals access and take advantage of preventative care and screenings. Improving access to community resources and health services, including preventative care, is vital for all residents of Onslow County to attain optimal and equitable health outcomes. 

The Health Equity & Health Disparities CHIP consists of five programs: QuitlineNC Referrals, Catch My Breath Vaping Prevention, an Onslow County Food Security Assessment, Preventative Screenings Awareness, and Onslow Memorial Hospital’s Health Disparities Data Dashboard.

QuitlineNC

How Much Number of individuals referred to QuitlineNC by healthcare providers and community partners. 

How Much Number of providers and partners who refer patients to QuitlineNC.

In 2023, 20% of adults were tobacco users in Onslow County, which is higher than the 17% reported for the state of North Carolina.4    QuitlineNC is a free program offered by the NC Department of Health and Human Services.  This service offers free coaching for tobacco and vaping cessation as well as providing participants with nicotine patches and lozenges.  The program is available to all residents of NC regardless of insurance status. Quitline coaches provide a tailored “quit plan” to individuals and help them in their goal to quit tobacco and vape products. Different programs are available for a variety of priority populations, such as pregnant women and Hispanic/Latinx individuals. Residents throughout North Carolina can access the free tobacco cessation resource by a provider referral or through a self-referral by contacting QuitlineNC via call, text, or visiting their website.

In 2022-2023, OCHD health educators worked to raise awareness of QuitlineNC among healthcare professionals in Onslow County. Health educators connected with counselors, pediatric specialists, and family providers. OCHD also actively engaged with established referral sites in Onslow County, ensuring these providers were equipped with the latest information about QuitlineNC and reinforcing the opportunity to refer patients. Alongside these efforts, health educators also presented vaping information to bring awareness to the health effects associated with the rising vaping epidemic among youth.

In Spring, 2023, OCHD with Vitalink Marketing introduced a campaign to promote QuitlineNC and referrals to the free service. This campaign included YouTube, radio, and social media advertisements.

Establishing agreements with healthcare providers and community partners serving Historically Marginally Populations (HMPs) to refer individuals to affordable and accessible tobacco cessation can help increase equitable access to resources and reduce tobacco use.

Catch My Breath

How Much Number of Catch My Breath trainings held.

How Much Number of Participants Who Have Completed Catch My Breath Trainings.

OCHD health educators began implementing the evidence-based, CATCH® My Breath Youth E-Cigarette Prevention Program to the community in January 2023 as a part of the Community Health Improvement Plan and the Healthy Communities strategy by the North Carolina Division of Public Health. 

In 2023, 200 classes were taught with a total of 997 youth participants. Data collection is done based on a school calendar year. From January 2023 to June 2023, health educators taught a total of 112 CATCH® My Breath classes and reached 385 students.  From July 2023 to December 2023, health educators taught a total of 88 classes, reaching 612 students. 

Onslow County Youth Services has been a continuous partner through 2023 where OCHD has provided 80 CATCH® My Breath classes to steadily enrolled students.  OCHD has gained partnerships with 12 other youth-centered agencies and educational institutions to implement the CATCH® My Breath Program and continues to look for new opportunities to reach additional youth populations. For more information, please contact community_relations@onslowcountync.gov.

Food Security Assessment

How Much Number of Community Surveys Received

How Much Number of Focus Group Participants

In 2023, the Onslow County Health Department completed a Food Security Assessment (FSA) for Onslow County. This assessment aimed to measure the strengths and weaknesses of the local food system and identify strategies to help increase access to healthy foods around the county.  

As of 2021, Feeding America’s Map the Meal Gap study concluded that 13.4% of adults and children are considered food insecure in Onslow County.5  While food insecurity itself is a major concern, it is also linked to chronic health conditions like obesity, diabetes, cardiovascular disease, and kidney disease.6  These conditions raise annual healthcare costs by an estimated $1,800 per person.7  However, these conditions are preventable, and the FSA was a first step to preventing these compounding health effects in our county.

The research involved analyzing interactive maps, mapping locations of food outlets, distributing community surveys, and conducting focus groups. OCHD collected a total of 374 community surveys and conducted six focus groups. The questions asked in the survey and focus groups included health status, transportation, accessing information, and social support. The surveys were distributed to individuals throughout the county with a focus on reaching high-risk populations. 

Transportation was highlighted as a dominant barrier to accessing food. Almost 40% of the people surveyed do not have access to a personal vehicle when they need to go grocery shopping. Instead, 20% of people reported finding a ride with someone else. While having this social support in times of need is beneficial, this means they can only access food according to another person’s schedule. The other top responses included 12% walking to the store and 7% relying on public transportation. These methods of getting to the grocery store or food pantry do not allow these individuals to carry many food items with them, especially as shelf-stable foods like cans are heavy. Additionally, information from the focus groups suggested that people may be scared to use the bus system by themselves or not know how to use public transit.

Nine key themes emerged from the primary and secondary data of the assessment. Within these nine themes, a total of 20 strategic recommendations for improvement were made. These recommendations will be considered in future work to improve access to healthy foods. One recommendation that has been put into action is the expanded distribution of the Health Department’s Community Resource Guide to community organizations in all corners of the county.

Implementing this strategy improves access to information and awareness of free and affordable resources available to county residents. The resource guide contains a variety of health-related resources, including a master list of food distribution sites throughout Onslow County.

Preventative Screenings

How Much Number of social media posts that OCHD publishes to announce prevention screenings in the community. 

How Much Number of social media posts that OMH publishes to announce prevention screenings in the community.

OCHD and Onslow Memorial Hospital aim to increase awareness and promote the importance of preventative screenings taking place throughout the community via social media platforms.

The 2023 RWJ County Health Rankings show in 2020, 38% of Onslow County female Medicare enrollees ages 65-74 received an annual mammography screening. In comparison, peer counties Craven, NC, and Alamance, NC had annual mammography screening ratings of 53% and 39% respectively. Similarly, flu vaccination efficacy trended lower with only 48% of Medicare fee-for-service enrollees having received a flu vaccine; while Craven County, NC, and Alamance County, NC saw 59% and 54% adherence respectively.4

OCHD has a presence on Facebook, Twitter (X), Instagram, and LinkedIn each consisting of tailored content for followers. Promoting, sharing, and distributing information regarding affordable preventative screenings to increase accessibility and awareness of services. Breaking the accessibility barrier will assist in the prevention and early detection of chronic diseases and cancer. In 2023, OCHD created 18 social mediaposts promoting preventative screenings.  These screenings were available through the health department and community agencies. OCHD obtained an engagement rate (the number of times followers see the post and engage by reacting or sharing the post) of 2.9% across its four social media channels with a total of 4,382 impressions (the number of times the posts have been seen in a social media feed, but not necessarily engaged with) within a total of 15 posts. The average social media engagement rate falls between 1-5%. OCHD continues to increase its online presence and promote preventative screenings on its social platforms. 


Healthy Living

Health behaviors and risk factors have a major impact on an individual’s ability to achieve better health outcomes. Onslow County residents should utilize resources available in the community to help increase healthy behaviors and reduce their risk factors. Residents should also have access to needed health services. Onslow County data shows that chronic conditions and other health-related topics such as breastfeeding, nutrition, and access to affordable health services are still priority issues for the county. Leading causes of death in Onslow County include cancer, heart disease, chronic lower respiratory diseases, cerebrovascular diseases, and diabetes.8 

Eating healthy, avoiding excess alcohol, regular physical activity, and practicing good sleep habits can help reduce the likelihood of chronic diseases. Healthy behaviors are easier to form in childhood and adolescent years to prevent chronic diseases. For infants, breastfeeding can help provide short- and long-term protection against illnesses and diseases such as asthma, obesity, type-1 diabetes, and sudden infant death syndrome (SIDS).9  As of October 2023, Onslow County estimates 46.9% of infants receiving WIC benefits are breastfed. 

Onslow County continues to promote Women’s and Children’s Health services to promote healthy living and decrease areas of concern such as the Onslow County is the teen birth rate. The NC State Center for Health Statistics reported for 2020 that Onslow County ranked 90 out of 100 for the teen birth rate (1 – best, 100 – worst). Teen pregnancies have immediate and long-term results for teen parents and their children.10  CDC data links teen pregnancies and births to high school dropout rates and the risk of lower educational attainment among girls and their children.11  
The Healthy Living CHIP consists of six programs: Healthy for Life, Faithful Families, Breastfeeding Friendly Designations, Women’s and Children’s Health Services, and Julie’s Pink Warrior Project.

Healthy for Life

How Much Number of Healthy For Life Participants

How Much Number of participants indicating increased confidence in making healthier behavior changes (pre/post-tests).

OCHD teaches the American Heart Association’s Healthy For Life® program each month to promote healthy living, wellness, nutrition, and smart choices. The Healthy for Life® program consists of monthly topics ranging from healthy cooking and recipes to smart shopping and budget-friendly grocery lists. 

The Healthy For Life® program is taught monthly by a Public Health Educator. Participants join via Zoom and complete a pre- and post-survey to gauge increased knowledge and awareness of food, nutrition, and healthy habits.

OCHD held satellite classes with the Onslow County Main Branch Library to extend the reach to community members across the county and provide opportunities for individuals to come in person and learn together. In 2023, 89 participants attended Healthy For Life Classes.

Faithful Families

How Much Number of Participants in the Faithful Families Program That Went to 50% or More of the Sessions.

how well Percentage of participants indicating increased regular physical activity (pre/post-tests).

Faithful Families is an evidence-based intervention program that connects with faith-based communities to promote healthy living among individuals, families, and local communities. By providing nine sessions consisting of nutrition, meal preparation, food safety, and physical activity education, participants can make informed changes to their health behaviors and improve their overall health. Faith communities and organizations are important health advocates, and Faithful Families can support community health improvement work to decrease health disparities. In these nine sessions, health educators from OCHD implement the health and nutrition aspect of the program, while a lay leader from the partnering organization conducts the spiritual component of the program.

In January 2023, the Health Department began Faithful Families with the Sandy Run Missionary Baptist Church in Jacksonville, NC. The first cohort at Sandy Run Missionary Baptist implemented a policy/environmental change that each member would drink a bottle of water during each church meeting. In June 2023, the Community Relations Division began the second cohort of the Faithful Families program with Sandy Run Missionary Baptist Church. The second cohort averaged 15 participants who attended 50% or more of the sessions. In September 2023, a new cohort began with River of Life Church in Jacksonville. The River of Life cohort averaged 22 participants who attended at least 50% of the program’s sessions. 

Breastfeeding Friendly Designations

How Much Number of businesses and organizations submitting applications for breastfeeding friendly designation.

How Much Number of businesses and organizations to obtain breastfeeding friendly designation award.

OCHD has continued to work toward increasing the awareness of breastfeeding-friendly designations offered through both the North Carolina Breast Feeding Coalition (NCBC) and the North Carolina Department of Health and Human Services (NCDHHS). Consequently, fostering these initiatives will encourage and improve breastfeeding within the community. Breastfeeding enhances the prospects of infants attaining improved health outcomes and provides a myriad of health benefits to both mothers and babies. OCHD aims to work in conjunction with community collaborators to enhance breastfeeding rates. By expanding the roster of local businesses and partners recognized as breastfeeding-friendly, there will be an increase in the availability of nurturing environments, motivating more mothers to embrace breastfeeding.

In 2023, The Health Department's Community Relations Division connected with businesses and employers to educate them on the benefits of being a breastfeeding-friendly designation site and if interested, supplied the business with the application to submit to the NCBC and/or NCDHHS. In 2023, 67 Onslow County organizations were educated on breastfeeding-friendly designation opportunities. The NCBC’s website updates the list of awardees biannually, in March and August. As of August, 18 new organizations were awarded the NCBF Coalition’s designation in 2023.

Women’s and Children’s Health Services

How Much Number of OCHD referrals to PEERS Family Development. 

how well WIC Participation Numbers

how well Percent of engagements with the social media post regarding Women's & Children's Services

OCHD offers a wide variety of preventative health services for the community. Services for women's and children's health include Maternal Health, WIC, Family Planning, Child Health, Immunizations, and the Breast and Cervical Cancer Control Program. Services are offered to individuals with private insurance, Medicaid, and those who are uninsured. OCHD utilizes a sliding fee scale to ensure that health services are accessible and affordable. Onslow Memorial Hospital offers a variety of services and community support to improve Women's and Children's Health, including monthly "Understanding Breastfeeding Classes" to expectant families looking for more information regarding breastfeeding and interaction with an International Board-Certified Lactation Consultant, which helps to support breastfeeding in the community. The Onslow Memorial Hospital Foundation also collaborates with radiology to provide screening 3D mammograms for the underinsured and uninsured through "Julie's Pink Warrior Project." 
Improved awareness and utilization of OCHD preventative services and Onslow Memorial Hospital's Breastfeeding Support Services will improve population health, specifically for women and children. Increased utilization of preventative services will improve health outcomes and lower health risks. 

The Women's and Children's Health Services program is tracked by three performance measures: Women, Infants and Children (WIC) program participation, referrals to Parents, Education, Empathy, Rapport, and Support (PEERS) Family Development, and social media posts for services offered by the county. 

In 2023, WIC had a monthly average of 7,360 individuals participating in the program. OCHD also made 54 referrals to PEERS Family Development for education and/or services.
Onslow Memorial Hospital Julie's Pink Warrior Project offers free mammograms to women in need.  OCHD refers their clients who need mammograms to Onslow Memorial Hospital.  In 2023, Onslow Memorial Hospital held its annual "Miles for Mammos" 5K to raise money for Julie's Pink Warrior Project. In 2023, OMH provided 2,212 mammograms.


Mental and Behavioral Health

Adverse Childhood Experiences (ACEs), substance use, and mental and behavioral health are priorities for Onslow County. The prevalence of poor outcomes such as lack of mental and behavioral health treatment, opioid use and death, child abuse, and juvenile crime show the need for additional support in this area. From July 2022 to June 2023, Child Protective Services received 3,620 reports and assessed 1,942 of those.  651 of those assessed were found to have child maltreatment involved. During that same time, 166 children were in foster care12 echoing the need for additional support services for adults who use drugs and suffer from mental and behavioral health conditions. 

Drug overdose deaths are continuing to impact people living in Onslow County. In 2022, 81% of drug overdose deaths in Onslow County involved illicit opioids.13  Additionally, in 2023, there were 151 opioid overdose emergency department visits in Onslow County.14 

Overdose Fatality Review

  How Much Number of recommendations proposed to reduce substance use overdose deaths.

  How Much Number of overdose fatalities reviewed

The Overdose Fatality Review (OFR) Team consists of numerous city, county, and healthcare partners that meet quarterly to review substance use overdose deaths in Onslow County to determine what services individuals accessed before their death. Ultimately, the mission of the team is to facilitate a deeper understanding of the missed opportunities for prevention and intervention that may have prevented an overdose death.

Adverse Childhood Experiences Training

how well Percent of training participants with increased knowledge on ACEs (pre/post test). 

How Much Number of participants trained in Adverse Childhood Experiences.

Adverse Childhood Experiences (ACEs) can be classified as negative experiences that take place during childhood and/or teenage years such as, but are not limited to neglect, witnessing suicide or violence, abuse, bullying, and other traumatic events that may occur. Youth who experience ACEs can have a greater risk of developing negative health conditions such as chronic health problems or mental illness in their adult years.15  Onslow County PEERS Family Development Center and Onslow County TASCO (Turning Adversity into Success for Children in Onslow) offer training to increase awareness of the impact of ACEs and provide support services to help families and children in Onslow County.  

ACEs training helps participants identify children in need, understand the impact of ACEs, identify risk and protective factors, and locate resources to help those impacted by ACEs. Increased awareness of ACEs and protective factors will enable participants to better serve their communities and identify opportunities to improve the lives of children in Onslow County.
In 2023, 366 individuals throughout the community were trained in Resiliency and ACEs. 

Prevention Specialist Referrals

How Much Number of patients referred to the Methodist Home for Children’s prevention specialist.

OCHD partners with Methodist Home for Children Prevention Specialists to refer uninsured patients and those who do not qualify for OCHD care management services to receive additional support. This support may come in many forms and aims to address several social determinants of health including food pantry services, housing referrals, mental/behavioral health referrals, substance use treatment and recovery referrals, transportation, and affordable health services. 

Patients who may be struggling with mental/behavioral health or substance abuse often need additional resources. The additional support for OCHD clients, offered by the prevention specialist, will bridge the gap to improve accessibility to available community resources when they may not otherwise receive support. 
From January to November 2023, 112 client referrals were made from OCHD to the Methodist Home for Children for these additional support services.  

Operation Medicine Drop

How Much Number (in pounds) of drugs collected.

Onslow Memorial Hospital partners with the Jacksonville Police Department to hold Drug Takeback programs in the community for the public to dispose of unwanted and/or unneeded medications. All medications are accepted on a no-questions-asked policy. Along with drug takeback events, there are also designated locations in the community where the public can drop off unused medications. In 2023, the Jacksonville Police Department collected 303 pounds of unwanted medications.


Physical Activity & Exercise

Physical activity and the availability of spaces and/or opportunities to be physically active can have a significant impact on the health of a community. Physical activity reduces the risk of chronic conditions such as cardiovascular disease, type 2 diabetes, many types of cancer, depression/anxiety, and dementia. By promoting and developing events and programs that encourage physical activity, Onslow County will increase physical activity opportunities for residents to improve their health.

According to 2023 County Health Rankings, Onslow County is ranked 39 out of 100 counties (1 being the best, 100 being the worst) for adult obesity. Of adults aged 18 and older, 34% report a body mass index equal to or greater than 30km/m^2 (age-adjusted). In 2020, 9.3% of males and 9.2% of females, in Onslow County, aged 20 years and over, were diagnosed with diabetes. (CDC, US Diabetes Surveillance System, 2022). 

The Physical Activity and Exercise CHIP consists of 3 programs: Prevent T2 - Diabetes Prevention Program, Physical Activity Opportunities, and Health Education at Community Events.

Diabetes Prevention Program

How Much Number of Participants Enrolled in the Diabetes Prevention Program Annually. 

How Much Number of participants that average 150 minutes of physical activity a week.

The CDC's Prevent T2 Diabetes Prevention Program (DPP) is a year-long lifestyle change program for individuals who have screened positive for prediabetes. The goal of the program is to delay or prevent the onset of type 2 diabetes. Throughout the annual program, participants track their food, activity, and weight each week as they form new habits and stay accountable for their behavior change. By the end of the program, the goal is for participants to lose and maintain at least 5-7% of their body weight and maintain at least 150 minutes of physical activity each week.

In July 2023, a new, year-long Prevent T2 DPP cohort began. There are nine individuals enrolled in the program and all nine have seen success between lower body weight, increased physical activity, lower blood sugar numbers, and non-scale victories such as clothes fitting better, feeling more energized, and decreasing daily sugar intake. All nine participants have reported getting at least 150 minutes of physical activity each week.

While it is not required for all participants to report their A1C, three of the participants reported a lower A1C level within the first 18 weeks of the program. As a cohort, the participants lost a total of 116 pounds and participated in a collective 28,000 minutes of activity as of December 2023.

Physical Activity Opportunities

How Much Number of participants in physical activity programs presented by the health department.

how well Percentage of engagements that the social media physical activity posts receive.

OCHD and OMH partner with Onslow Parks and Recreation, Onslow Senior Services, and other community partners to promote affordable physical activity opportunities throughout the county via social media. By increasing the awareness of affordable physical activity opportunities, more residents are likely to take advantage of accessible ways to engage in healthy behaviors and improve their health. 

In 2023, OCHD created 18 posts promoting social media throughout the community.  OCHD maintains a steady 2.85% engagement rate with the post, remaining at the top of the 1-3% average.

OCHD also partnered with Onslow County Parks & Recreation and Onslow County GIS to develop a physical activity map that show all available parks and outdoor trails and recreation to promote physical activity.  The map can be filtered for specific activities such as sports, kayaking, trail, and more. Interested residents may view the map on the health department's website under the Community Health Living tab.OCHD also has partnered with community organizations for physical activity classes throughout 2023.

 


 

 


Footnotes/Sources

[2] “Health Disparities.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 31 Jan. 2017, www.cdc.gov/aging/disparities/index.htm.

[3] “Onslow, North Carolina.” County Health Rankings & Roadmaps, University of Wisconsin Population Health Institute, Robert Wood Johnson Foundation, www.countyhealthrankings.org/explore-health-rankings/north-carolina/onslow?year=2023. Accessed 15 Jan. 2024.

[4] “Onslow, North Carolina.” County Health Rankings & Roadmaps, University of Wisconsin Population Health Institute, Robert Wood Johnson Foundation, www.countyhealthrankings.org/explore-health-rankings/north-carolina/onslow?year=2023. Accessed 15 Jan. 2024.

[5] Feeding America Research. (2019, July 17).

[6] Berkowitz SA, Basu S, Gundersen C, Seligman HK. State-Level and County-Level Estimates of Health Care Costs Associated with Food Insecurity. Prev Chronic Dis 2019;16:180549. DOI: http://dx.doi.org/10.5888/pcd16.180549

[7] Feeding America Research. (2019, July 17). The healthcare costs of food insecurity. https://public.tableau.com/app/profile/feeding.america.research/viz/TheHealthcareCostsofFoodInsecurity/HealthcareCosts

[8] NC State Center for Health Statistics. “Detailed Mortality Statistics Report, 2021 Onslow County Deaths.” Https://Schs.Dph.Ncdhhs.Gov/Data/Vital/Dms/2021/OnslowCounty.Pdf.

[9] “Why It Matters.” Breastfeeding, Centers for Disease Control and Prevention, 31 July 2023, www.cdc.gov/breastfeeding/about-breastfeeding/why-it-matters.html.

[10] NC Department of Health and Human Services, NC State Center for Health Statistics. “2020 NC Resident Pregnancy Rates.” Https://Schs.Dph.Ncdhhs.Gov/Data/Vital/Pregnancies/2020/Table2B-2020-Pregpubrates-1519Preg-v2.Pdf, 2020.

[11] “About Teen Pregnancy.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 Nov. 2021, www.cdc.gov/teenpregnancy/about/index.htm.

[12] Onslow County Department of Social Services. “Onslow County DSS Foster Child Statistics.” 15 Dec. 2023.

[13] “Drug Overdose Deaths.” Opioid and Substance Use Action Plan Data Dashboard, NCDHHS, www.ncdhhs.gov/opioid-and-substance-use-action-plan-data-dashboard. Accessed 5 Feb. 2024.

[14] “Drug Overdose ED Visits.” Opioid and Substance Use Action Plan Data Dashboard, NCDHHS, www.ncdhhs.gov/opioid-and-substance-use-action-plan-data-dashboard. Accessed 5 Feb. 2024.

[15] “Adverse Childhood Experiences (ACEs).” Violence Prevention, Centers for Disease Control and Prevention, 29 June 2023, www.cdc.gov/violenceprevention/aces/index.html.

Morbidity and Mortality Changes Since Last CHNA

Onslow County has experienced few fluctuations in morbidity and mortality rates following the 2022 SOTCH. The information below includes updated data. 

County Health Rankings

County Health Rankings & Roadmaps (see Table 3) is a program of the University of Wisconsin Population Health Institute. County-level data, which is collected from different sources, on health behaviors, clinical care, social and economic factors as well as the physical environment are provided in their profile reports. 

Figure 1 shows each county's ranking based on the length and quality of life. Onslow County fell from 23 to 29 in ranking; however, the county is still in the higher middle range (Higher 50% - 75%). Onslow County is shaded in the second lightest green with a rank of 29 out of 100 (1 being the best, 100 being the worst) in North Carolina counties.
Some of the factors and categories that contribute to Onslow County's ranking by County Health Rankings & Roadmaps can be seen in Table 3. Details for the state are provided along with the red and green arrows indicating whether the county’s status is better or worse comparatively.  

The rate of sexually transmitted infections (number of newly diagnosed chlamydia cases per 100,000) in Onslow County remains greater than that of the state, as of 2022. Although the county rate has remained high, there has been a steady decline since 2019, which peaked at a rate of 1,180 cases per 100,000, as seen in Graph 5.17 In 2023 health educators worked to educate teens and young adults in the county about the family planning services offered at the health department by incorporating resource cards at outreach events and adding QR codes to the back of youth tobacco cessation cards. OCHD distributed 1,730 condoms at outreaches throughout 2023 and posted 23 family planning social media posts to spread awareness and education to the community.

Table 3: County Health Rankings and Roadmaps16
2023 County Health Rankings & Roadmaps: Health Outcomes & Factors 
   
Onslow County
Compared to State
North Carolina
Years of Data Used
Health Outcomes
Length Of Life

Premature Death (Years of potential life lost before age 75 per 100,000 population, age adjusted.) 

8,800

p

8,000

2018 - 2020

Health Factors
Health Behaviors Alcohol-Impaired Driving Deaths

28%

p

26%

2016 - 2020

Teen Births (number of births per 1,000 females, 15-19yo)

45

p

21

2014-2020

Clinical Care Uninsured (% of pop-under age 65 without health insurance)

11%

q

13%

2020

Primary Care Physicians (ratio of population to primary care physicians)

3,090:1

p

1,410:1

2020

Dentists (ratio of population to dentists)

980:1

q

1,660:1

2021

Social & Economic Factors Unemployment (% 16 and older unemployed but seeking work)

5.1%

p

4.8%

2021

Income Inequality (Ratio household income at the 80th percentile to income at the 20th percentile)

3.8

q

4.7

2017-2021

Injury Deaths (Deaths due to injury per 100,000 pop)

74

q

82

2016-2020

Physical Environment Air Pollution – Particulate Matter (particulate matter – avg. daily density of fine PM 2.5 mg cubic meter)

6.3

q

7.8

2019

Suicides  

In 2020 Onslow County had a suicide rate of 28.3 per 100,000 individuals whereas the state rate was 15.3 per 100,000 individuals. Of those suicides, 67.3% were inflicted by a firearm in Onslow County compared to 60.7% by firearms statewide.18 In 2021, 81% of firearm deaths in Onslow County were identified as suicides.  OCHD has received gun locks from NCDHHS which are distributed at outreaches and events to individuals that have firearms in their homes. Lethal Means Safety, an evidence-based practice, makes suicide methods less available or more difficult to immediately access (i.e. gun locks and safes). According to SAMHSA, the time between thinking and acting on a suicide is often less than 10 minutes.  Increasing Lethal Means Safety can allow for intervention or for the individual to seek help.19 

Mortality

The most recent data from NCDHHS shows a consistent report for the top five causes of death in Onslow County, from 2020 – 2021, with the exception of a spike in COVID-19 deaths.20  The top five causes of death include cancer, heart disease, chronic lower respiratory diseases, accidents, and COVID-19. North Carolina’s reported leading causes of death are comparable with the exception of stroke outnumbering chronic lower respiratory diseases.21 

The cancer mortality rates in Onslow County compared to the state from 2017 – 2021 show discrepancies. The age-adjusted mortality rate per 100,000 for lung cancer in Onslow County was 62, whereas the state was 39. In the United States, approximately 80% to 90% of lung cancer fatalities are attributed to cigarette smoking.22  To increase the awareness of free cessation resources to North Carolina citizens, health educators informed local providers about the benefits of becoming referral sites for QuitlineNC. Health educators also taught 200 classes surrounding vaping prevention and education in an effort to prevent new tobacco users. The age-adjusted mortality rate per 100,000 for all cancers combined was 199 for Onslow County and 155 for the state. In an effort to combat these differences, OCHD promotes known free and low-cost screenings offered to the community.


Footnotes/Sources

[16] “Onslow, North Carolina.” County Health Rankings & Roadmaps, University of Wisconsin Population Health Institute, Robert Wood Johnson Foundation, www.countyhealthrankings.org/explore-health-rankings/north-carolina/onslow?year=2023. Accessed 15 Jan. 2024.

[17] “NCD3: North Carolina Disease Data Dashboard.” Facts & Figures: N.C. Communicable Disease Reports, NCDDHS, Dept. of Public Health, 24 Jan. 2024, https://epi.dph.ncdhhs.gov/cd/figures.html. Accessed 6 Feb. 2024.

[18] “Suicide Trends and Demographics.” NC Injury and Violence Prevention Branch: NC Violent Death Reporting System, NCDHHS, dashboards.ncdhhs.gov/t/DPH/views/NCVDRSDashboard/NC-VDRSDashboard?%3AshowAppBanner=false&%3Adisplay_count=n&%3AshowVizHome=n&%3Aorigin=viz_share_link&%3AisGuestRedirectFromVizportal=y&%3Aembed=y. Accessed 5 Feb. 2024.

[19] Delphin-Rittmon, Miriam  E. “Lethal Means Safety for Suicide Prevention.” SAMHSA, Substance Abuse and Mental Health Services Administration, 29 Sept. 2023, www.samhsa.gov/blog/lethal-means-safety-suicide-prevention.

[20] NC State Center for Health Statistics. “Detailed Mortality Statistics Report, 2021 Onslow County Deaths.” Https://Schs.Dph.Ncdhhs.Gov/Data/Vital/Dms/2021/OnslowCounty.Pdf.

[21] “North Carolina.” National Center for Health Statistics, Centers for Disease Control and Prevention, 12 Sept. 2023, www.cdc.gov/nchs/pressroom/states/northcarolina/nc.htm#lcod.

[22] “What Are the Risk Factors for Lung Cancer?” Lung Cancer, Centers for Disease Control and Prevention, 31 July 2023, www.cdc.gov/cancer/lung/basic_info/risk_factors.htm#:~:text=In%20the%20United%20States%2C%20cigarette,Many%20are%20poisons.

Emerging Issues Since Last CHNA

Housing

Onslow County continues to explore ways to meet the needs of its citizens who are in search of affordable and accessible housing. According to the North Carolina Housing Coalition, 33% of Onslow County are cost-burdened (families that spend 30% or more of their income on housing) compared to state at 28%.23 24   

The HUD Fair Market Rent Documentation System states the Fair Market Rent values in Onslow County for 2023 are $1,352 for a three-bedroom residence.25  That amounts to 27.1% of the median annual income for Onslow County over a 12-month period. Although Fair Market Rentals are not above the cost-burdened threshold of 30%, many rental properties throughout Onslow County are between $1,200 and $1,750 per month for a three-bedroom dwelling.26  

New & Emerging Drugs

Fentanyl, methamphetamine, and cocaine remained the drugs most frequently found in deaths caused by overdoses in Onslow County in 2022-2023 (Onslow County Register of Deeds Data, 2023).  While continuing to address these trends is a priority, OCHD has analyzed data and worked with community partners to identify new and emerging drug trends.  

Previously used as homeopathic treatment, mitragynine (commonly known and sold as kratom), has significantly increased in Onslow County as a drug found in illicit overdose cases and commonly used with these drugs.  Though it has not been found as a primary cause of death in Onslow County, the presence of xylazine in the drug supply was detected in late 2023 in the county by law enforcement.  Law enforcement also reported concerning reports of two new synthetic drugs, niatezene and bromazolam.  While these drugs have yet to appear in Onslow County, the UNC Street Drug Analysis Lab has identified their presence in the northeastern section of the state as late as October 2023.27   

As a bright spot in the battle against opioid use, Community Paramedics in Onslow County are investigating the use of a new nasal spray opioid antagonist, nalmefene (sold as Opvee).  This drug was approved for use in late spring 2023.  While somewhat more cost-prohibitive, the treatment is intended to target the emerging array of synthetic opioids presenting in the drug supply and has a longer effective period than traditional opioid antagonists.


Footnotes/Sources

[23] “The 2024 Housing Need in Onslow County.” Onslow County Profile, North Carolina Housing Coalition, nchousing.org/wp-content/uploads/2017/01/NCH-CountyProfile-Onslow.pdf. Accessed 13 Feb. 2024.

[24] “The 2024 Housing Need in North Carolina.” North Carolina Profile, North Carolina Housing Coalition, nchousing.org/wp-content/uploads/2017/01/NCH-CountyProfile-NC.pdf. Accessed 13 Feb. 2024.

[25] HUD Economic and Market Analysis Division. “FY 2023 Fair Market Rent Documentation System.” FY2023 FMR Documentation System 3-Bedroom Rent Calculation, HUD, www.huduser.gov/portal/datasets/fmr/fmrs/FY2023_code/2023bdrm_rent.odn?year=2023&cbsasub=METRO27340M27340&br_size=3. Accessed 13 Feb. 2024.

[26] “Onslow County 3 Bedrooms Rentals.” Microsoft Bing Real Estate, Microsoft, www.bing.com/homes/map?q=onslow+county+rentals+3+bedroom&form=000074. Accessed 13 Feb. 2024.

[27] UNC Street Drug Analysis Lab data. University of North Carolina. 2024.

New/Paused/Discontinued Initiatives Since Last CHNA

New Programs

CATCH Vaping Prevention Train the Trainer

To complement the CATCH My Breath Vaping Prevention program the Community Relations Division had two health educators complete Train the Trainer Training. The county is home to 40 public schools28, seven Department of Defense schools29, and close to 20 private schools, which serve more than 34,000 children aged 5–18 years old.30 Providing the training to community partners allows for a larger educational reach and supports the sustainability of the CATCH My Breath program. 

From July 2023–December 2023, the health educators taught 35 community partners from multiple disciplines, ranging from teachers to dental hygienists. Each partner is given the opportunity to shadow an OCHD Health Educator or to have one present when teaching their first CATCH My Breath program. Eight of the trained community partners were public health and tobacco treatment specialists from Naval Medical Center Camp Lejeune and Marine Corps Community Services. These individuals have a plan to deliver the vaping prevention program among the seven Department of Defense schools in 2024. 

Data is collected on programs taught by community partners through an online post-class survey. Southwest High School was the first trained location to report their attendance of 126 ninth-grade health and physical education students, in December 2023. 

Overdose Fatality Review (OFR) Program Restructure

In 2023, a new Standard Work Plan was developed for the Onslow County Overdose Fatality Review (OFR) to improve practices and lead the county in adherence to national best practices.  The Standard Work Plan is an 18-step outline of work that begins twelve weeks prior to the quarterly OFR.  The outlined and descriptive steps serve to keep both the facilitator and moderator on track with timing and gathering data pertinent to each upcoming review. 

This plan not only engages OFR community partners with face-to-face interaction to obtain case information but also implements a new recommendation meeting the month following the general review.  The recommendation meeting will work with agency partners to execute recommendations suggested during the OFR.  Collaboration for community change is key in this newly developed practice.

Agencies involved in Onslow County’s OFR are genuinely more engaged and collaborate more effectively using this new Standard Work Plan.  Through this new process, the OFR meetings have transitioned to in-person meetings to promote engagement.

 

Footnotes/Sources

[28] District Detail for Onslow County Schools, National Center for Education Statistics (NCES), nces.ed.gov/ccd/districtsearch/district_detail.asp?ID2=3703450. Accessed 29 Jan. 2024.

[29] Camp Lejeune Schools, Department of Defense, 17 Mar. 2021, www.dodea.edu/americas/mid-atlantic/camp-lejeune-schools.

[30] Bureau, US Census. “Quickfacts, Onslow County, North Carolina.” Census.Gov, 8 Oct. 2021, www.census.gov/programs-surveys/sis/resources/data-tools/quickfacts.html.

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