HNC 2030 Scorecard: Edgecombe County (2021-2023)
Executive Summary
Executive Summary
Edgecombe County is pleased to present its 2021 Community Health Needs Assessment. This report provides an overview of the methods and process used to identify and prioritize significant health needs in Edgecombe County.
Vision Statement
The Edgecombe County Community Health Needs Assessment Team is dedicated to improving the health and well-being of the residents of Edgecombe County.
Leadership
The 2021 Community Health Needs Assessment (CHNA) was conducted in a regional NC Community Health Needs Assessment process, spearheaded by Health ENC. The completion of the County assessment and priorities were compiled in partnership with the Edgecombe County Health Department, Vidant Edgecombe Hospital, Health ENC, and members of the Edgecombe County Rural Health Network. Several other local community partners were involved in the completion of the 2021 CHNA.
|
Organization |
Chair |
|
Edgecombe County Rural Health Network |
Meredith Capps, Chair |
|
Edgecombe County Health Department |
Michelle Etheridge, Health Director |
|
Vidant Edgecombe Hospital |
Patrick Heins, President |
|
Brody School of Medicine Department of Public Health at East Carolina University |
Dr. Ronny Bell, Department Chair |
Partnerships/Collaborations
|
Partnerships |
Number of Partners |
|
Hospital/Health Care System |
1 |
|
Healthcare Provider |
4 |
|
Behavioral Healthcare Providers |
3 |
|
Dental Health Providers |
1 |
|
Community Organization(s)—Advocacy, Charitable, NGO |
4 |
|
Government Agency |
4 |
|
Business(s)—Employers, not organizations |
0 |
|
Educational Institution(s)—Colleges, Universities |
1 |
|
Public School System |
1 |
|
Media/Communication Outlet(s) |
1 |
|
Public Member(s) |
0 |
Regional/Contracted Services
The 2021 Edgecombe County CHNA was developed in collaboration with the Edgecombe County Health Department, Vidant Edgecombe Hospital, Vidant Health System, and Health ENC.
Theoretical Framework/Model
The Social-Ecological Model was used to guide the development of the 2021 CHNA. The CHNA includes all levels of the model including: primary data through individual responses to the community survey, focus groups to promote relationship and community engagement and secondary data analyses to assess societal factors on health outcomes.
Collaborative Process Summary
Vidant Edgecombe Hospital and the Edgecombe County Health Department worked closely with Health ENC to provide the community with the needs assessment survey. The survey was distributed using several different methods from April, 2021 to June, 2021. The results from the completed surveys helped drive the CHNA team’s determination of priorities to address over the next three years.
Key Findings
Primary Data
The primary data used in this assessment consisted of (1) a community survey distributed through online and paper submissions. 385 Edgecombe County residents contributed their input on the community’s health and health-related needs, barriers, and opportunities, with special focus on the needs of vulnerable and underserved populations.
Secondary Data
Secondary data used for this assessment were collected and analyzed from Conduent HCI’s community indicator database. The database, maintained by researchers and analysts at Conduent HCI, includes over 100 community indicators from various state and national data sources such as the North Carolina Department of Health and Human Services, the Centers for Disease Control and Prevention and the American Community Survey. See Appendix B for a full list of data sources used.
Indicator values for Edgecombe County were compared to North Carolina counties and U.S. counties to identify relative need. Other considerations in weighing relative areas of need included comparisons to North Carolina state values, comparisons to national values, trends over time, Healthy People 2030 targets and Healthy North Carolina 2030 targets. Based on these seven different comparisons, indicators were systematically ranked from high to low need.
Summary of Findings
The CHNA findings are drawn from an analysis of an extensive set of secondary data (over 100 indicators from national and state data sources) and in-depth primary data from community leaders, health and non-health professionals who serve the community at large, vulnerable populations, and populations with unmet health needs. Through a synthesis of the primary and secondary data the significant health needs were determined for Edgecombe County and are displayed in Table 1.
Table 1. Significant Health Needs
- Substance Abuse
- Community Resources
- Health Insurance
- COVID-19 Pandemic
- Transportation
- Food Insecurity
Health Priorities
On December 6, 2021, community partners and members of the Edgecombe County Rural Health Network met to discuss the results from the 2021 Community Health Needs Assessment for Edgecombe County. After reviewing the data and discussing health issues highlighted in the report, the following priority areas were chosen to be addressed for the next three years:
- Substance use/mental health
- Social determinants of health
- Health disparities and health equity
Next Steps
This report describes the process and findings of a comprehensive health needs assessment for the residents of Edgecombe County, North Carolina. The prioritization of the identified significant health needs will guide community health improvement efforts of Edgecombe County. Following this process, Edgecombe County will outline how they plan to address the prioritized health needs in their implementation plan.
Priorities
1. Substance Abuse/ Mental Health
2. Social Determinants of Health
3. Health Disparities and Health Equity
Why Is This Important?
An average of nine North Carolinians died each day from a drug overdose in 2020, a 40% increase from the previous year. This stark increase during 2020 aligns with the increases experienced nationwide with the nation exceeding 100,000 deaths. In North Carolina, the number of drug overdose deaths — from illicit substances and/or medications — increased by nearly 1,000 deaths, from 2,352 in 2019 to 3,304 in 2020. There were also nearly 15,000 emergency department visits related to drug overdoses in 2020. Provisional surveillance data suggest these increases continued through 2021. Both overdose deaths and the increases disproportionally affect historically marginalized populations.
What We Do
The aim of the Healthy Communities Program is to reduce the burden of chronic disease and injury in Edgecombe County. This program enables the county health department to implement community-based interventions that address poor nutrition, physical inactivity, tobacco use, violence and unintentional injury. The programs interventions should strive to provide opportunities for everyone in Edgecombe County to achieve their optimal level of health, regardless of race, ethnicity, gender, socioeconomic status, geographic location, education status, disability status or sexual orientation.
Who We Serve
All Edgecombe County communities.
How We Impact
Health Communities impacts the community by implementing policy and system changes that can result in postive behavior changes that decrease chronic disease and injuries and improve health.
What We Do
The Rural Communities Opioid Response Program (RCORP) is a multi-year initiative that addresses barriers to treatment for substance use disorder (SUD), including opioid use disorder (OUD). It works toward the HHS goal of ending the opioid epidemic.
Who We Serve
Edgecombe County residence who are experiencing barriers or seeking treatment for substance use disorder, including opiate use disorder.
How We Impact
This program impacts the community by offering Medicated Assisted Treatment(MAT). MAT is a comprehensive approach to the treatment of substance use disorders through medication managment and behavioral therapy using the chronic disease model.
What We Do
Intergrated Targeted Testing Services (ITTS) project provides HIV counseling, testing and referral services to high-risk "hard to reach" key priority groups in targeted setting in Edgecombe County.
Who We Serve
Edgecombe County residents interested in HIV testing and education. Key priority groups are racial and ethnic minorities, men who have sex with men of all races and ethnicities, people who inject drugs, commercial sex workers, and transgendered persons.
How We Impact
HIV testing , counceling, and referral
HIV/STD prevention education
Safer syringe referral
What We Do
Edgecombe County C.O.R.E. works to address opioid misuse and abuse by preventing misuse, reducing harm, and integrating the efforts of Edgecombe County Organizations.
Who We Serve
Edgecombe County C.O.R.E. serves all citizens of Edgecombe County.
How We Impact
Edgecombe County C.O.R.E impacts the community by preventing misuse, reducing harm & integrating the efforts of Edgecombe County organizations.
Why Is This Important?
Suicide rates increased 30% between 2000-2018 and declined in 2019 and 2020. Suicide is a leading cause of death in the United States, with 45,979 deaths in 2020. This is about one death every 11 minutes. The number of people who think about or attempt suicide is even higher. In 2020, an estimated 12.2 million American adults seriously thought about suicide, 3.2 million planned a suicide attempt, and 1.2 million attempted suicide. In 2020, suicide was among the top 9 leading causes of death for people ages 10-64. Suicide was the second leading cause of death for people ages 10-14 and 25-34.1
What We Do
We ensure those seeking help are linked to treatment to meet their needs. Our goal is to show co-existing disorders and assess suicide risk by offering screenings. Screenings are tools used to identify areas of concern by asking questions. Co-existing means having a substance use and mental health disorder at the same time. Knowing the areas of concern early, helps to make sure correct treatment is given and screenings are usually brief. Evidence suggests identifying those at risk of suicide and continued treatment along with support, produce positive outcomes.
Who We Serve
Edgecombe County Residents
How We Impact
Screenings, assessments, and referral.
Why Is This Important?
Loss of income is linked to increased vulnerability to disease, unhealthy behaviors, and adverse health outcomes associated with poverty. Unemployment leads to disparities in health insurance coverage limiting access to medical attention and medication.
What We Do
NCCARE360 is the first statewide network that unites health care and human services organizations with a shared technology that enables a coordinated, community-oriented, person-centered approach for delivering care in North Carolina.
Who We Serve
NCCARE360 serves all 100 North Carolina Counties.
How We Impact
NCCARE360 helps providers electronically connect those with identified needs to community health and human service resources and allow for feedback and follow up. Whether it be connecting someone to a local food pantry, or assisting them with transportation to an employment agency, this solution ensures accountability for all services delivered, provides a “no wrong door” approach, closes the loop on every referral made, and reports outcomes of that connection.
Why Is This Important?
Having a primary care provider (PCP) is important for maintaining health and preventing and managing serious diseases. PCPs can develop long-term relationships with patients and coordinate care across health care providers. Strategies like team-based care and innovative payment methods are promising approaches for improving access to primary care.
What We Do
Edgecombe County Rural Health Network (ECHRN) is an effective multi-agency network that is collaborating in delivering care and reducing barriers based on exchanging and analyizing data, increasing efficicency, and sharing and generating resources. ECRHN members are : ECU Health Edgecombe Hospital, Edgecombe County Health Department, Edgecombe County Emergency Services, Carolina Family Health Centers, Rocky Mount OIC, Rural Health Group, Access East, Eastpointe and Area L AHEC. They operate and are guided by the network bylaws, a strategic plan, a multi agency MOA and multiple data sharing agreements.
Who We Serve
ECRHN serves all Edgecombe County residents.
How We Impact
access to care, education, collaboration, and funding.
Why Is This Important?
Access to foods that support healthy eating patterns contributes to an individual’s health throughout his or her life. Healthy eating habits include controlling calories; eating a variety of foods and beverages from all the food groups; and limiting intake of saturated and trans fats, added sugars, and sodium. Healthy eating can help lower the risk for chronic disease. Evidence also shows that poor nutrition and an unhealthy diet are risk factors for high blood pressure, diabetes, and cancer. According to the 2015—2020 Dietary Guidelines for Americans, healthy eating patterns include: a variety of vegetables; fruits, especially whole fruits; grains, at least half of which are whole grains; fat-free or low-fat dairy; protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), unsalted nuts and seeds, and soy products; and oils. Some research has shown that increased access to healthy foods corresponds with healthier dietary practices.
What We Do
This program address COVID-19 related health disparities and advances health equity by expanding Edgecombe County Health Department capacity and services to prevent and control COVID-19 Infections and transmisson.
Who We Serve
Edgecombe County residents with priority on historically marginalized populations.
How We Impact
Food security assessments, SNAP/EBT incentive programs, Healthy Food Retailer initiatives, policy change, and initiative support.
What We Do
The aim of the Healthy Communities Program is to reduce the burden of chronic disease and injury in Edgecombe County. This program enables the county health department to implement community-based interventions that address poor nutrition, physical inactivity, tobacco use, violence and unintentional injury. The programs interventions should strive to provide opportunities for everyone in Edgecombe County to achieve their optimal level of health, regardless of race, ethnicity, gender, socioeconomic status, geographic location, education status, disability status or sexual orientation.
Who We Serve
All residents of Edgecombe County.
How We Impact
Healthy Communities impacts the community by implementing policy and system changes that can result in postive behavior changes that decrease chronic disease and injuries and improve health
Progress on CHIP
Substance Use/Mental Health
Substance use
- Edgecombe County Health Department is partnering with Edgecombe County rescue and Edgecombe County Coordinated Opiate Recovery Effort (CORE) to plan for a community paramedicine program that will provide community based health care approaches to the citizens of Edgecombe County with the program's main focus on opiod overdose.
Safer Syringe Initiative
- Edgecombe County Health Department is partnering with Carolina Family Health Centers' Freedom Hill Community Health Center to make them an extension site of the Edgecombe Safe Syringe Initiative.
MAT
- Carolina Family Health Centers started offering weekly recovery groups as of February 15, 2023. The FREEDOM RECOVERY GROUP is a support group of people working together on the four dimensions of recovery: health, home, purpose, and community. We are part of Medication-Assisted Recovery Anonymous (MARA), and support those who are prescribed medication as part of their recovery journey, though we welcome all individuals regardless of their recovery path.
Mental Health
- Edgecombe County Rural Health Network partnered with ECU Health and Eastpointe to conduct a provider education meeting around involuntary committment procedures and legal updates.
Health Disparities and Health Equity
Advancing Equity
- Edgecombe County Health Department increased the number of healthy food retail designations within the county from zero to one—getting rid of one food desert. The North Carolina Healthy Food Retail Collaborative awarded GNS Express Mart of Edgecombe County as a North Carolina Healthy Food Retail Designation on August 31, 2022. The store is now featured on the online statewide directory for small food stores with the NC Healthy Food Retail Designation to spread awareness of the store's healthier food options.
Edgecombe County Rural Health Network
- Edgecombe County Rural Health Network in partnership with Access To Care Network linked 2,551 uninsured Edgecombe County residents to care and other resources in 2022.
- Edgecombe County Rural Health Network in partnership with Access To Care Network held 5 open enrollment events in Edgecombe County during the ACA open enrollent period starting November 1, 2022 through January 15, 2023.
Healthy Communities
- Since September 7th, 2022, Edgecombe County Health Department (ECHD) has been partnering with the owner of McEachin Convenience Store for the store to meet the NC Healthy Food Retail Designation requirements. ECHD was able to obtain partners, such as Conetoe Family Life Center, for donations in order to increase the store’s healthier food options. As of January 2023, the store has met two new requirements towards the NC Healthy Food Retail Designation product criteria.
Social Determinants of Health
Healthy Opportunities Pilot/NCCARE360
- Edgecombe County is participating in the Healthy Opportunities Pilot. The Healthy Opportunities Pilots is a comprehensive program to test and evaluate the impact of providing select evidence-based, non-medical interventions related to housing, food, transportation and interpersonal safety and toxic stress to high-needs Medicaid enrollees. Importantly, the Pilots will allow for the establishment and evaluation of a systematic approach to integrating and financing evidence-based, non-medical services into the delivery of healthcare. If shown to be effective in improving health outcomes and reducing healthcare costs after rigorous evaluation, the NC Department of Health and Human Services will look to systematically integrate high-value Pilot services statewide through NC Medicaid Managed Care.
Morbidity and Mortality Changes Since Last CHA
The top three leading causes of death have remained the same since the last CHA. Data has shown some variation in number of deaths and rates. Heart Disease and Cancer have increased in the number of deaths and rates. Cerebrovascular Disease decreased in number of deaths while the rates increased, showing the trend of population decline in Edgecombe County.
Emerging Issues Since Last CHA
Since the last CHNA, syphilis has become an emerging issue in Edgecombe County as well as across the state. According to the North Carolina STD Surveillance Report, in 2020 Edgecombe County had 19 syphilis cases at a rate of 37.4. In 2021, Edgecombe County had an increase in syphilis cases from 19 to 35 at a rate of 72.4.
New/Paused/Discontinued Initiatives Since Last CHA
New Initiatives
- Edgecombe County Health Department's Child Health Program
- Edgecombe County Community Paramedicine Program
- Healthy Opportunities Pilot
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