HNC 2030 Scorecard: Wilkes County (2021-2024)
HNC 2030 Scorecard: Wilkes County
The Wilkes County Health Department is excited to share the Healthy NC 2030 Scorecard for Wilkes County. This Community Health Improvement Scorecard is an easy way to learn about some of the efforts currently underway in Wilkes County to address three health priorities identified in the 2021 Wilkes County Community Health Assessment (CHA):
- Obesity/Chronic Disease
- Substance Abuse
- Tobacco
While the COVID-19 pandemic has adversely impacted our community since March 2020, Wilkes County and our community partners are united in our efforts to support community health improvements to address these priorities. This Scorecard also serves as Wilks County’s Community Health Improvement Plans (CHIPs), fulfilling the NC Local Health Department Accreditation requirement that local health departments submit two CHIPs following the CHA submission.
For each priority, this Scorecard spotlights:
- A Result Statement, a picture of where we would like to be,
- Indicators or measures are local indicators of how we are doing linked to Healthy NC2030 indicators and
- Select Programs or activities and
- Key Performance Measures that show how those programs are making an impact.
The Scorecard also contains the annual Wilkes County State of the County Health reports (SOTCH).
Instructions: Click anywhere on the scorecard to learn more about programs and partners working together to improve the health of Wilkes County. The letters below represent key components of the Scorecard.
Use the icons to expand items and the
icons to read more. This scorecard is not intended to be a complete list of all the programs and partners working on these issues in Wilkes County.
Progress on CHIPs
Substance Abuse and Mental Health Progress:
A task force focused on mental health and substance abuse been meeting since early 2010, eventually leading to the founding of Project Lazarus. The focus is on prevention and access to services. Goals include: community education, integration of physical and mental health, training in preventive mental health interventions, access to care, and drug overdose prevention. With partnering with local agencies and non-profits, the collaborative works to identify gaps in service in mental health care in Wilkes County. Project Lazarus employees Youth Mentor/Youth Services Advocates. Youth Mentor/Youth Service Advocates are teaching the Botvin Life Skills Curriculum for Youth Advocates and is working on creating prevention clubs in North Wilkes Middle and High Schools as well as Central Wilkes Middle and High School. The Botvin curriculum focuses on self-improvement, decision making, alcohol, marijuana, vaping, cigarette, media and advertising, violence, coping with anxiety, anger management, communication, social skills, and how to resolve conflict. The Youth Mentor/Youth Service Advocates are working on establishing connections with East and West districts. Youth Mentor/Youth Service Advocates are working with students who have been affected by opioids or substance abuse in some way. The Youth Mentors/Youth Services Advocates work with the juvenile justice system primarily because of a grant from the Office of Juvenile Justice and Delinquency Prevention (OJJDP).
Another collaborative in Wilkes formed to help combat the opioid crisis. The Community Opioid Prevention and Education (COPE) Team consists of over forty members who work or live in our Community. Each organization involved implements different activities in their workplace to help solve the opioid problem in Wilkes. Due to COPE, Wilkes Recovery Revolution has worked with 12 businesses within Wilkes to designate them as “Recovery Friendly” as part of their workplace initiative. The hospital has peer support specialists visit patients at bedside, providing support and immediate resources. Project Lazarus is distributing Naloxone kits through community partners, and established a community Naloxone vending machine in the lobby of the county jail.
Wilkes Community Health Center continues to receive additional funding to tackle Mental Health and Substance Abuse. The center has a Licensed Professional Counselor to work with our patients and community. These opportunities have been made possible in part through a HRSA Rural Communities Opioid Response Grant.
Change in Data: According to NC Region 3 Behavioral Risk Factor Surveillance System, in 2021, 92.3% of the residents reported having good, very good, or excellent health compared to 93.6 in 2020. Upgrades and improvements in
NC DETECT was able to capture more complete and accurate diagnosis codes. An increase was seen in unintentional overdoses from 2020 (102 cases) to 2021 (152 cases) and 159 cases reported in 2022
Obesity and Chronic Disease Action Plan Progress:
Wilkes County has worked on multiple initiatives in the past year to help reduce chronic disease and obesity in our community. With the return of students full time in Wilkes County Schools Wilkes County Safe Kids was able to work with C.B. Eller Elementary, Roaring River Elementary, and Mulberry Elementary Schools this spring to offer Bicycle and Pedestrian Safety Days at their Schools. Each Fourth Grader at their respected school completed a bicycle and pedestrian safety and program as part of their Health and P.E. curriculum. The program is to increase their knowledge and awareness of how to be a safe pedestrian, as well as bicycle laws and proper hand signals. Each child was given the opportunity to test out their skills on a safety course that is set up at their school. Over 150 children completed the course and received a free bicycle helmet.
The health department was awarded a Healthy Futures Grant from the Health Foundation. The grant is for two years and the health department will receive $7,000 per year to help support the Market Bucks initiative. Market Bucks is currently on its eighth season of providing Market Bucks to families in need. This year saw the return of our traditional distribution of Market bucks. Our distribution sites are: Wilkes County Library, North Wilkesboro Housing Authority, Wilkesboro Elementary, Traphill Elementary, St. Paul’s Crisis Ministry, Mulberry Elementary, and we have added Wilkes Recovery this season. In 2022 Market bucks provided over $6,617.00 in fresh local fruit, vegetables, and meat to families in need.
Diabetes and Nutrition Center- Registered Dietitians offer individual and group classes for Diabetes education. Medical Nutrition Therapy assists patients with Weight Management, Eating Disorders, Hypertension, Hyperlipidemia, Renal Disease, Celiac Disease, Food Allergies, Sports Nutrition and Other Diagnoses. In FY 2021-2022 there were 54 Diabetes Education/Medical Nutrition Unique Patients with 31 Diabetes Education Visits/Medical Nutrition Visits. After three month follow-up 7.69% of our patients are checking their feet daily, 30.77% of our patients have a hemoglobin A1c of less than 7%, and on average, 23.08% of patients have decreased their Hemoglobin A1c.
Diabetes Prevention Program (DPP). Through a Healthy People Healthy Carolinians (HPHC) grant from the Duke Endowment, The Wilkes Diabetes and Nutrition Program began its first DPP cohort in June of 2019.
Each DPP program cohort meets for one year. In the first six months the group meets weekly, while in the second six months the group meets monthly. The program follows a CDC developed, evidence-based curriculum that includes topics such as eating well, stress management, coping with triggers, getting enough sleep, energy balance, heart health, enlisting support, and staying motivated, among others. The program is led by a trained lifestyle coach and registered dietitian and emphasizes adopting sustainable lifestyle changes that have been proven to prevent or delay the onset of type 2 diabetes among high risk individuals by 58%.
Currently, the program is held at the Wilkes County WIC offices on Tuesdays at 5:30 pm.
The most recent cohort participants have lost 33lbs and has a weekly exercise average of over 150 minutes with 83% of the participants achieving this goal. Over 5 participants in 2022 improved their BMI. To supplement the CDC-based curriculum, while maintaining fidelity to the program, the cohort is invited to participate in monthly exercise challenges and walks at the greenway.
Wilkes County Schools continues to offer free breakfast and lunch to all elementary and middle school students through the Community Eligibility Provision (CEP) program.
The Healthy Wilkes Action Team meets quarterly and guides the work of Healthy People, Healthy Carolinas, a program supported by The Duke Endowment.
Kids in Parks. By turning existing, outdoor trails into kid-friendly hiking trails, the Kids in Parks (KIP) program increases access to and the number of places for physical activity. KIP influences multiple levels of the socio-ecologic model by directly changing the community environment and by providing incentives and organizational supports to promote physical activity through hiking. Wilkes County has four trails located at Smoot Park, Cub Creek Park, Jefferson Turnpike, and Mulberry Fields at West Park. Two Wilkes County Schools piloted a Track Rx Program with Kids in Parks. Children for the program register on the Kids in Parks website and receive prizes and activities in the mail. Children grades 1-3 were prescribed activity at the Kids in Park locations in Wilkesboro and North Wilkesboro.
Wilkes Fresh. Wilkes Fresh is a mobile produce market increasing access to local fruits and vegetables. It traveled to 9 different sites weekly, adding 2 additional sites in 2022, and operated from May through September. In addition to accepting cash and cards, Wilkes Fresh accepts Market Bucks and EBT/SNAP. Market Bucks is a very successful local program that gives 'Bucks' to lower income households to use at Farmer's Markets. Wilkes Fresh had a successful year in 2022, with 1,640 total transactions equaling $15, 609.29 in sales.
Tobacco and Smoking Action Plan Progress:
Wilkes County Schools decided to sign up as a district for the CATCH My Breath curriculum. The CATCH My Breath Youth E-cigarette Prevention Program’s goal is to increase students’ knowledge of e-cigarettes, nicotine and addiction dangers while cutting their intended use of the product in the future. The aim is to inform and educate teachers, parents, and health professionals in the school/after-school setting to equip students with answers about E-cigarettes to make informed decisions.
Wilkes County Schools has installed vape detectors at all four middle schools. The detectors are installed in student bathrooms and look very similar to smoke detectors. Once vaping is detected, a message is sent to administration.
A grant from the Appalachian District Health Department, through their maternal child grant has allowed the collaboration with the local school system.
Atrium Health’s Wake Forest Baptist Health’s Comprehensive Cancer Center and Atrium Health Wake Forest Baptist Health - Wilkes Medical Center’s Care Connection Pharmacy continue to partner to provide tobacco cessation for Wilkes County residents. The cessation program is for 12 weeks and includes a combination of tobacco education with free nicotine replacement therapy (patches AND lozenges or gum). The Tobacco Cessation Group Program includes 6 weeks of themed sessions on subjects in relation to quitting. Following those initial 6 weeks, we have 4 brief bi-weekly check-in sessions as a group. Currently Care Connections Pharmacy offers cessation classes. Care Connection utilizes student interns to deliver cessation classes. The curriculum is provided by Atrium Health’s Wake Forest Baptist Health’s Comprehensive Cancer Center. Cessation classes are generally 1:1, and either delivered in-person and then by phone or in-person for the in-patient referrals from hospitalist. If referral comes from patients at the Heart Center, receiving cardio-pulmonary rehab, the students extra time and they may meet with them once a week for 15-20 minutes. As a participant of the cessation classes they receive 3 months of nicotine replacement therapy (NRT), requiring the participants to meet a provider at hospital or Care Connection Pharmacy once every two weeks to receive their NRT. In 2022, 18 patients completed the program. Referrals for cessation classes come from local physican offices, patients from hospital in-patient, Care Connection Pharmacy, cardiac rehab and word of mouth.
QuitNow NC is a resource that provides free counseling to individuals who want to quit using tobacco. It is promoted in various methods through partnerships with local healthcare providers who can refer patients who are interested that can receive a call from a trained quit-coach.
The Wilkes County Health Department supports tobacco prevention through promotion of Quitline NC (1.800.QUITNOW) while also providing community services in tobacco prevention and cessation. We also support workplaces, governments, realtors, and others in exploring the benefits of adopting practices that support others in quitting while protecting many from secondhand smoke.
Changes in Data: From January 2021-December 2021, 47 Wilkes County residents utilized NC Quitline. From January 2022-December 2022, 93 Wilkes County residents utilized NC Quitline. Calendar year 2022 saw a 99% increase from 2021. March 2022 had the heaviest call volume with 19 callers for that month, compared to March 2021 with only 5 callers.
Morbidity and Mortality Changes Since Last CHA
COVID-19 Efforts
In 2022, Wilkes Health has continued battle against COVID-19, advocate and be a reliable source of information for COVID-19. We planned vaccination clinics to reach our population in all areas of our community. We were present at MerleFest in September 2021 and in April 2022 to provide opportunities for residences and tourists to receive their booster or primary shots. We have transitioned our COVID vaccines into clinic, making them available to any community member who is eligible. With the June 2022 approval of vaccines for everyone 6 months and older this has given many parents, caregivers and clinicians’ protection they have been waiting on, and this will help protect those vulnerable populations.
With the emergence of Omicron, COVID moved at a rapid pace starting in November 2021 and spread like wildfire. Since then, multiple Omicron subvariants emerged with stains such as BA.4 and BA.5 were causing more than than 50% of cases during the first half of 2022.
Toward the end of the summer in 2022, approximately 50% of the population in Wilkes had at least one dose, approximately 23% had received a booster or additional dose, and approximately 47% of our residents are fully vaccinated against COVID.
With the approval of COVID vaccinations for children 6 months-17 years, during the summer of 2022, it gave many parents, caregivers and clinicians’ protection they have been waiting on, and this will help protect those vulnerable populations.
By the end of December 2022, Wilkes County’s vaccination rate was 47%, 1% for those 0-4 years old, 16% for those 5-17 years old, 56% for those 18-64 years old and 75% for those 65 years and older. Women, 49%, are more vaccination than men, 44%, at any age. Both White and African Americans are vaccinated at 45% each respectfully, with 10% of other races data hidden for privacy. 47% of residents who identify as Hispanic have completed their initial series.
Lower vaccination rates among underserved populations may be due to a lack of transportation to vaccination sites, social media misinformation regarding vaccines, or a lack of trust in local and state governments. To overcome this, the Wilkes County Health Department did several vaccination sites, including, St John Baptist de LaSalle Catholic Church, Lincoln Heights Historic School, and all four middle schools to promote awareness and distribute vaccines to underserved populations.
Emerging Issues Since Last CHA
New/Paused/Discontinued Initiatives Since Last CHA
Outdoor Economy:
The Great State of Wilkes Outdoor Action Plan is being led by the Outdoor Economy Workgroup, which includes representatives from the Health Foundation, Towns of Wilkesboro and North Wilkesboro, Wilkes Economic Development Corporation, Wilkesboro Tourism Development Authority, Wilkes Health Department, Yadkin River Greenway Council and the County of Wilkes. The group is focusing on the planning and development of outdoor recreation infrastructure projects such as trails, greenways, destination-quality parks, attractive downtowns, and the creation of multi-use public spaces suitable for major events and festivals. These projects contribute significantly to the quality of life for local residents, help grow small businesses, and attract visitors. In April 2022 the Outdoor Economy Workgroup along with staff of Boone-based Destination by Design held a community meeting to gather feedback to use in preparing a final plan. If finalized the plan would call for the development of a “river district” with a beach area and specialized parks, establishing a “regional STEM center” and greatly improved signage for trails and other amenities are among recommendations in preliminary results of an outdoor economy effort.
The River District proposal calls for establishing a beach area on the Reddies River. The river district would include a viewing area with the beach; creation of not-too-challenging rapids with rocks placed in the river; an “urban soccer park;” outdoor boulder gym with man-made climbing structures; pump track for bikes (with a series of hills) skate park; “bike garden” for younger cyclists. A regional STEM center with science- and technology-related activities and multi-family and single-family housing is proposed nearby.
The plan focuses on wayfinding/signage, state- and nationally-designated trails, state and federal lands and the Wilkesboros. It calls for continuing with implementation of a unified wayfinding signage program initiated by the Yadkin Valley Heritage Corridor and using it for trails, recreation areas and more. The plan includes improving six existing Yadkin River access sites in Wilkes, including making four capable of accommodate commercial outfitters, and developing one new site, which includes a park at an access site off N.C. 268 in Roaring River.
The plan includes using the 300-acre Wilkesboro watershed property on the Brushy Mountains, owned by Wilkesboro, as a family-friendly wilderness experience area, including camping, zip line, mountain bike and hiking trails, summer camp, and retreats. Also portions of the Town of North Wilkesboro’s Industrial Park property would be converted for outdoor recreation.
Last steps are to develop strategies, determine who will do what and identify funding sources, including involvement of private investors.
The project was funded by from the Health Foundation, Wilkes Health Department, Wilkes Economic Development Corp., Wilkesboro Tourism Development Authority and the governments of Wilkes County, Wilkesboro and North Wilkesboro. These entities and the Yadkin River Greenway Council signed a memorandum of agreement for the initiative in 2020.
Growing Initiative: Reducing Infant Mortalities in Communities:
The North Carolina General Assembly budgeted funds for local health departments to carry out evidence-based strategies that are proven to lower infant mortality rates, improve birth outcomes, and improve the overall health status of children ages birth to five. Wilkes Counties will be applying for funding to continue to provide evidence-based strategies Infant Safe Sleep Services (ISSS). With addition of Preconception and Interconception Health Services (PIHS).
Opioid Settlement:
In July 2021, a historic $26 billion agreement was announced that will help bring desperately needed resources to communities harmed by the opioid epidemic. The agreement resolves litigation over the role of four companies in creating and fueling the opioid epidemic. The agreement also requires significant industry changes that will help prevent this type of crisis from ever happening again. Before spending settlement funds, every local county or municipality must first select which opioid mitigation strategies they would like to fund. Wilkes County choose Additional Opioid Remediation Activities (“OPTION B”). These remediation activities include treatment, prevention, and other activities such as training and research. Over the next eighteen years Wilkes County will receive over 12.8 million to fund activities to help reduce opioid use disorders.
Progress on CHIPs
Substance Abuse and Mental Health Progress:
A task force focused on mental health and substance abuse began meeting in early 2010, eventually pathing the way for Project Lazarus, Wilkes Recovery Revolution, Wilkes Youth Life Development (WYLD), and Community Opioid Prevention and Education Team (COPE).
The focus is on prevention and access to services. Goals include: community education, integration of physical and mental health, training in preventive mental health interventions, access to care, and drug overdose prevention. With partnering with local agencies and non-profits, the collaborative works to identify gaps in service in mental health care in Wilkes County.
Youth Mentor/Youth Services Advocates- Project Lazarus employees Youth Mentor/Youth Services Advocates. Youth Mentor/Youth Service Advocates are teaching the Botvin Life Skills Curriculum for Youth Advocates and has prevention clubs in North Wilkes High, North Wilkes Middle, East Wilkes Middle, Wilkes Central High, and West Wilkes High Schools. The Botvin curriculum focuses on self-improvement, decision making, alcohol, marijuana, vaping, cigarette, media and advertising, violence, coping with anxiety, anger management, communication, social skills, and how to resolve conflict.
Staff in the Community Health/Health Education Department have completed the Celebrating Families! training through Celebrating Families!- The Celebrating Families! curriculum is an evidence based cognitive behavioral, support group model written for families in which one or both parents have a serious problem with alcohol or other drugs and in which there is a high risk for domestic violence, child abuse, or neglect. Celebrating Families! works with every member of the family, from ages 3 through adult, to strengthen recovery from alcohol and/or other drugs, break the cycle of addiction and increases successful family reunification. Celebrating Families! fosters the development of safe, healthy, fulfilled, and addiction-free individuals and families by increasing resiliency factors and decreasing risk factors while incorporating addiction recovery concepts with healthy family living skills. Health Education staff have been trained and will assist Wilkes Youth Life Development (WYLD) in implementing the program and teaching classes.
Harm Reduction Work Group- Wilkes Health working with the Harm Reductions work group of COPE, and other subgroups, has implemented a PORT (Post Overdose Response Team) and a community paramedicine team with peer support specialist within Wilkes County. PORT aims to reduce the number of people suffering from the effects of addiction and overdose. The process can look different depending on the circumstances, however a PORT peer support specialist housed by Wilkes Recovery Revolution, receives a referral on an individual who could benefit from PORT services. The peer support specialist works to provide support and education and then connects the individual to community resources. The goal is for PORT and a community paramedicine team is following an overdose, the peer support specialist and the community paramedicine team would then follow up with the client for the next three days offering support and resources.
Change in Data: According to NC Region 3 Behavioral Risk Factor Surveillance System, in 2021, 92.3% of the residents reported having good, very good, or excellent health compared to 93.6 in 2020. An increase was seen in unintentional overdoses from 2020 (102 cases), 2021 (152 cases), 2022 (159) and 192 cases reported in 2023
Obesity and Chronic Disease Action Plan Progress:
Wilkes County has worked on multiple initiatives in the past year to help reduce chronic disease and obesity in our community. In April 2023 Safe Kids Wilkes County partnered with the Health Foundation and other agencies to host Wilkes county’s first Cyclovia Wilkes in downtown North Wilkesboro. These event was held on Saturday April 1, 2023. The event closed the Main Street and some connecting streets in Downtown North Wilkesboro to provide families an opportunity to walk or, ride a human powered wheeled vehicles through the streets. The event was kicked off with a bicycle parade where participants were given supplies and allowed to decorate their modes of human powered transportation to showcase during the parade. Safe Kids Wilkes County provided a traffic garden where kids were helped through a road course by volunteers and taught hand signals for bicycles as well as fitted for bicycle helmets. The event also had Zumba classes, bicycle repairs free of charge provided by Cook’s, as well as informational booths for parents and caregivers on age appropriate resources for families in Wilkes. In total over 300 participants attended.
The health department is in the second year of the Healthy Futures Grant from the Health Foundation. The grant was for two years and help supports the Market Bucks initiative. Market Bucks is currently on its ninth season of providing Market Bucks to families in need. We continued with our traditional distribution of Market bucks. Our distribution sites are Wilkes Recovery, Mulberry Elementary School, St. Paul’s Crisis Ministry, Wilkesboro Elementary School, North Wilkesboro Housing Authority, Wilkes County Public Library, Traphill Elementary School, Mountain View Elementary, and Wilkes Family Y. In 2023 Market bucks provided over $4,585.00, or almost 30% of Wilkes Fresh sales, in fresh local fruit, vegetables, and meat to families in need.
Diabetes and Nutrition Center- Registered Dietitians offer individual and group classes for Diabetes education. Medical Nutrition Therapy assists patients with Weight Management, Eating Disorders, Hypertension, Hyperlipidemia, Renal Disease, Celiac Disease, Food Allergies, Sports Nutrition and Other Diagnoses. In 2023 there were 89 Diabetes Education/Medical Nutrition Unique Patients with 101 Diabetes Education Visits/Medical Nutrition Visits. After three-month follow-up 50% of Diabetes Management patients have decreased their Hemoglobin A1c.
Diabetes Prevention Program (DPP). Through a Healthy People Healthy Carolinians (HPHC) grant from the Duke Endowment, The Wilkes Diabetes and Nutrition Program began its first DPP cohort in June of 2019. Each DPP program cohort meets for one year. In the first six months the group meets weekly, while in the second six months the group meets monthly. The program follows a CDC developed, evidence-based curriculum that includes topics such as eating well, stress management, coping with triggers, getting enough sleep, energy balance, heart health, enlisting support, and staying motivated, among others. The program is led by a trained lifestyle coach and registered dietitian and emphasizes adopting sustainable lifestyle changes that have been proven to prevent or delay the onset of type 2 diabetes among high risk individuals by 58%.
The program was held at the Wilkes County WIC offices. The most recent cohort participants lost over 80lbs. Throughout the cohort participants increased their weekly exercise average from 100 minutes per week to an average of 290 minutes a week. 100% of the participants met their exercise goal. All participants improved their BMI, and 50% reduced their Hemoglobin A1c and 33% maintained their A1c. Overall 83% of the participants completed the cohort. To supplement the CDC-based curriculum, while maintaining fidelity to the program, the cohort is invited to participate in monthly exercise challenges and walks at the greenway.
Weight Management Program- Many reasons contribute to infant mortality, such as obesity. In 2020, there were 22.2% of non-Hispanic White women who were documented as being overweight during the pre-pregnancy period according to body mass index (BMI). Likewise, 25% of non-Hispanic African Americans were documented as being overweight prepregnancy according to body mass index (BMI). The total number of adults in Wilkes County in 2020 that were diagnosed as having obesity was 43%1 compared to the state total in 2020 of 33.6%. Currently our weight management program has 19 patients who have lost an average of 15 pounds and reported an increase in their physical activity levels
Wilkes Fresh- Wilkes Fresh is a mobile produce market increasing access to local fruits and vegetables. It traveled to 12 different sites weekly, adding 2 additional sites and operated from May- December, an additional 3 months in 2023. In addition to accepting cash and cards, Wilkes Fresh accepts Market Bucks and EBT/SNAP. When SNAP recipients uses their SNAP/EBT card for every $1.00 they spend they get $1.00. Market Bucks is a very successful local program that gives 'Bucks' to lower income households to use at Farmer's Markets. Wilkes Fresh had a successful year in 2023, with over 2,080 total transactions equaling $15,651.18 in sales
Wilkes County Schools continues to offer free breakfast and lunch to all elementary and middle school students through the Community Eligibility Provision (CEP) program.
The Healthy Wilkes Action Team meets quarterly and guides the work of Healthy People, Healthy Carolinas, a program supported by The Duke Endowment.
Tobacco and Smoking Action Plan Progress
Tobacco-Free Ordinances- After working for several years the city councils of the Town of Wilkesboro and the Town of North Wilkesboro passed Tobacco Free Ordinances. On November 6, 2023 the Town of Wilkesboro adopted the ordinance prohibiting the use of tobacco products and e-cigarettes in the Wilkesboro Parks System. Wilkesboro defines their park system as any building, grounds, tract of land, or body of water comprising part of the City/Town/County’s parks, playgrounds, recreation areas, greenways, or trails. The ordinance also includes buildings located in Wilkesboro’s parks system. The ordinance also states that Wilkesboro shall remove all ashtrays and other smoking receptacles from the grounds of the park system. The penalty for violation can consist up to a $50.00 fine and a citation issued by law enforcement. On December 5, 2023 the Town of North Wilkesboro adopted a resolution to prohibit the use of tobacco products and e-cigarettes in town parks that went into effect on January 1, 2024. The resolution prohibits the use of tobacco products and e-cigarettes in the Town of North Wilkesboro Parks System. The Town of North Wilkesboro defines their park system as any building, grounds, tract of land, or body of water comprising part of the Town of North Wilkesboro parks, playgrounds, recreation areas, greenways, or trails. The resolution also includes buildings located in the Town of North Wilkesboro’s parks system. The ordinance also states that the Town of North Wilkesboro shall remove all ashtrays and other smoking receptacles from the grounds of the park system. The penalty for violation can consist up to a $50.00 fine and a citation issued by law enforcement.
Tobacco Cessation-Wilkes County Schools continues to utilize the CATCH My Breath curriculum. The CATCH My Breath Youth E-cigarette Prevention Program’s goal is to increase students’ knowledge of e-cigarettes, nicotine and addiction dangers while cutting their intended use of the product in the future. The aim is to inform and educate teachers, parents, and health professionals in the school/after-school setting to equip students with answers about E-cigarettes to make informed decisions.
Middle schools in Wilkes County Schools continue to utilize detectors. The detectors are installed in student bathrooms and look very similar to smoke detectors. Once vaping is detected, a message is sent to administration. A grant from the Appalachian District Health Department, through their maternal child grant has allowed the collaboration with the local school system.
Atrium Health’s Wake Forest Baptist Health’s Comprehensive Cancer Center and Atrium Health Wake Forest Baptist Health - Wilkes Medical Center’s Care Connection Pharmacy continue to partner to provide tobacco cessation for Wilkes County residents. The cessation program is for 12 weeks and includes a combination of tobacco education with free nicotine replacement therapy (patches AND lozenges or gum). The Tobacco Cessation Group Program includes 6 weeks of themed sessions on subjects in relation to quitting. Following those initial 6 weeks, we have 4 brief bi-weekly check-in sessions as a group. Currently Care Connections Pharmacy offers cessation classes. Care Connection utilizes student interns to deliver cessation classes. The curriculum is provided by Atrium Health’s Wake Forest Baptist Health’s Comprehensive Cancer Center. Cessation classes are generally 1:1, and either delivered in-person and then by phone or in-person for the in-patient referrals from hospitalist.
If referral comes from patients at the Heart Center, receiving cardio-pulmonary rehab, the students extra time and they may meet with them once a week for 15-20 minutes. As a participant of the cessation classes they receive 3 months of nicotine replacement therapy (NRT), requiring the participants to meet a provider at hospital or Care Connection Pharmacy once every two weeks to receive their NRT. In 2023, 25 patients completed the program. Referrals for cessation classes come from local physician offices, patients from hospital in-patient, Care Connection Pharmacy, cardiac rehab and word of mouth.
QuitNow NC is a resource that provides free counseling to individuals who want to quit using tobacco. It is promoted in various methods through partnerships with local healthcare providers who can refer patients who are interested that can receive a call from a trained quit-coach.
The Wilkes County Health Department supports tobacco prevention through promotion of Quitline NC (1.800.QUITNOW) while also providing community services in tobacco prevention and cessation. We also support workplaces, governments, realtors, and others in exploring the benefits of adopting practices that support others in quitting while protecting many from secondhand smoke.
Changes in Data: January 2021-December 2021, 47 Wilkes County residents utilized NC Quitline. January 2022-December 2022, 93 Wilkes County residents utilized NC Quitline. January 2023-December 2023, 105 Wilkes County Residents utilized NC Quitline. Calendar year 2023 saw a 12% increase from 2022. An average of almost 9 Wilkes County Residents were enrolled in NC Quitline cessation programs each month, with lowest call volume in November 2023 and highest call volume in May and August 2023.
Morbidity and Mortality Changes Since Last CHA
Wilkes County Demographics Snap Shot:
Total Population 65,784 (US Census, 7/1/22)
Emerging Issues Since Last CHA
New/Paused/Discontinued Initiatives Since Last CHA
Reducing Infant Mortality in Communities:
Reducing Infant Mortalities Grant /Safe Sleep Classes- Wilkes Health received $225,000 in grant funding for 3 years from the Women, Infant, and Community Wellness Section to reduce infant mortalities in our community. Wilkes health was one of six counties to receive funding. Funding will continue to provide infant safe sleep classes at the Wilkes County Library, North Wilkesboro Comprehensive Treatment Center, and new location at North Wilkesboro Housing Authority. The grant also focuses on Preconception and Interconception Health Services to anyone of reproductive age. Since January 2023 we have provided more than 150 participants with the NC Safe Sleep Class to help reduce the occurrence of sleep related injuries and deaths, as well as provided families with a pack-n-play or baby monitor to keep their infants safe.
Increasing Access to Designated Public Breastfeeding Friendly Spaces:
Breast Feeding Grant- Wilkes Health received a grant from the Health Foundation to secure funding to provide a breastfeeding room at WIC’s new office. Funding will help provide comfortable, private are for nursing moms to breastfeed and/or pump as well as storage for their expressed milk while at their WIC appointments. Health Education staff are also working with Wilkes County Public Library on grants to establish a breastfeeding area in the library.
Talk. They Hear You:
Prevention subcommittee from COPE is working to implement an evidence based substance abuse prevention program within Wilkes. The Prevention team is looking at a program titled, “Talk. They Hear You.” This program developed by SAMHSA’s helps parents and caregivers, educators, and community members get informed, be prepared, and take action to prevent underage drinking and other substance use. “Talk. They Hear You.” aims to reduce underage drinking and other substance use among youths under the age of 21 by providing parents and caregivers with information and resources they need to address these issues with their children early and often.
Opioid Settlement:
In July 2021, a historic $26 billion agreement was announced that will help bring desperately needed resources to communities harmed by the opioid epidemic. Wilkes Health received $21,000 from the Opioid Settlement to provide a media campaign on safe storage and proper disposal of unused medications. The media campaign utilizes social media posts that are tracked for reactions, reposts and shares, as well as website advertisement and billboards. All media is focused on safe and proper storage and disposal of medication and unused or expired medication. Wilkes health is working with local medication drop box locations to track amount of medications disposed as well as working with Wilkes County Sheriff’s Office and Safe Kids Wilkes County to host more frequent medication takeback events.
Increasing Access to Long Acting Reversible Contraceptives (LARCs):
At the beginning of January 2024 Wilkes Health was awarded a $30,000 grant from the Wilkes Medical Center Foundation to expand and increase access to care, specifically for family planning and reproductive life services, and to reduce the number of unintended pregnancies in Wilkes County. Data from the 2019 Pregnancy Risk Assessment Monitoring System (PRAMS), based on a random sample of 866 women who had recently given birth, shows that 24.9% of North Carolina mothers responded that they wanted to be pregnant later or not at all, while another 19.2% were ambivalent about the pregnancy. Women who were young, black and/or of lower socioeconomic status were more likely to report an unintended pregnancy. Women who have unintended pregnancies are at a greater risk for poor birth outcomes (2019 North Carolina Pregnancy Risk Assessment Monitoring System Survey Results).
Wilkes County is in the top quartile for infant mortality disparity ratio. From 2016-2020, Wilkes County had a disparity ratio of 3.94. This rate includes non- Hispanic White and non-Hispanic African Americans. Many reasons contribute to infant mortality, such as obesity. In 2020, there were 22.2% of non-Hispanic White women who were documented as being overweight during the pre-pregnancy period according to body mass index (BMI). Likewise, 25% of non-Hispanic African Americans were documented as being overweight pre-pregnancy according to body mass index (BMI). The total number of adults in Wilkes County in 2020 that were diagnosed as having obesity was 43% compared to the state total in 2020 of 33.6%.
Grant funding could provide these services to women who are uninsured and underinsured, and approximately 64 women would benefit from these services. At Wilkes Health 38% of individuals are self-pay, meaning they are underinsured or uninsured.
LARC methods remain the most effective reversible contraception and have the highest continuation and satisfaction rates among all users.
Medicaid Expansion:
North Carolina started implementation of the ACA Medicaid expansion on December 1, 2023, after becoming the 41st state to adopt the Affordable Care Act (ACA) Medicaid expansion. An estimated 600,000 residents between ages 19-64 are newly eligible for full Medicaid coverage under the Medicaid expansion. Coverage expanded to nearly all nonelderly adults with incomes up to 138% of the Federal Poverty Level (FPL) ($34,307 for a family of three in 2023) on December 1 in North Carolina. Prior to expansion, North Carolina Medicaid income eligibility limits were 37% FPL for parents ($9,198 for a family of three in 2023) and 0% for other adults.
The state Department of Health and Human Services reported 278,000 North Carolinians were enrolled automatically on Dec. 1 through their participation in the state Medicaid’s limited Family Planning program.
Clear Impact Suite is an easy-to-use, web-based software platform that helps your staff collaborate with external stakeholders and community partners by utilizing the combination of data collection, performance reporting, and program planning.