HNC 2030 Scorecard: Northampton County (2021-2023)

Executive Summary

The Northampton County Health Department and community partners are excited to present the 2021 Community Health Needs Assessment, which provides an overview of the significant community health needs identified in Northampton County, North Carolina.

A Community Health Assessment is a process by which community members and stakeholders gain an understanding of the health issues that affect their county by collecting, analyzing and sharing information about community assets and needs. The process results in the selection of community health priorities.

Findings from this report will be used to identify, develop and target initiatives to provide and connect community members with resources to improve the health challenges in their communities.

The 2021 Community Health Needs Assessment was developed through a collaboration with Health ENC.

Vision Statement

The vision for Northampton County Health Department and Northampton Healthy Carolinians Task Force is to improve the quality of life for its citizens by offering efficient, culturally sensitive and cost-effective health care services and programs that will enrich and improve the lives of its citizens. This in turn will promote a higher standard of life through prevention, education, and intervention.

Leadership

Partnerships/Collaborations

Northampton County Health Department partnered with The Northampton Healthy Carolinians Task Force for the Community Health Assessment.  The Task Force is dedicated to improving the life of Northampton’s citizens by addressing health and safety issues at the community level. Northampton County Health Department has a mission to promote, provide and protect the health and safety of the citizens of Northampton County. The Task Force is made up of local leaders from various healthcare and nonprofit groups serving Northampton County.  Under the cross-sectoral leadership of these entities, Northampton County conducted the 2021 Community Health Assessment.

Regional/Contracted Services

The Community Health Needs Assessment was developed through a collaboration with Health ENC.  Health ENC is a collaborative initiative of health departments and hospitals in eastern North Carolina. The collaborative serves 35 counties with 34 participating health departments and 31 participating hospitals. The collaborative uses a shared approach for primary and secondary data collection to produce a comprehensive Regional Community Health Needs Assessment every three years that can be used to partially satisfy requirements for North Carolina Local Health Department Accreditation and the Internal Revenue Service requirement under the Patient Protection and Affordable Care Act for charitable hospitals.

Theoretical framework/model

Contracted vendor used a modified population health framework for collecting the primary data and secondary data.

Collaborative Summary

Community Health Needs Assessments are completed every three years. These health assessments involve identifying and highlighting the health needs of the county and developing strategies to address those needs. This process is a collaboration and includes agencies and stakeholders from public health, local churches, local community groups and governmental agencies. This process included the direct involvement of the county’s residents through surveys and public engagement. Each of these partnerships allowed the department to identify those health priorities of greatest need and importance to the county. The CHA is an ongoing continuous improvement process that remains community centered and focused on improving the overall health and well-being of Northampton County.

Key Findings

The leading causes of death in Northampton County are Heart Disease, Cancer, Chronic Lower Respiratory Diseases, Diabetes Mellitus and Alzheimer’s Disease.

Community Survey Results: Northampton County

Top 3 Quality of Life Issues identified in community survey

• 25.94% responded Low income/Poverty
• 13.05% responded Lack of Community Resources and,
• 10.18% responded Drugs/alcohol (substance abuse)

Listed above are the top three community issues that were ranked by residents as most affecting the quality of life in Northampton County. Number one was low income/poverty, which was the most frequently selected issue and was ranked by 25.94% of survey respondents, followed by lack of community resources, which was ranked the second highest issue at 13.05%. Survey respondents ranked Drugs/alcohol (substance abuse) as the third issue most affecting quality of life in Northampton County at 10.18%. Less than 1% of survey respondents selected child abuse, lack of access to enough food & rape/sexual assault as issues most affecting the quality of life in Northampton County.

Health Priorities:

The task force met three times and reviewed the community health assessment data. The health priorities were selected after reviewing the PowerPoint presentation provided by Health ENC. The  priorities selected were:

• Substance Awareness 
• Chronic Disease Management 
• Access to Services
• Tobacco/Vaping 

Next Steps:

The Northampton County Health Department will provide resources to its citizens as well as quality programs that will address many, if not most, of the concerns expressed by our citizens. All materials will be free of charge and accessible to all citizens of Northampton County

Priorities

The priorities selected were:

• Chronic Disease 

• Drug/Alcohol and Substance Abuse

• Access to Services 

• Tobacco/Vaping 

Why Is This Important?

Well-being is a complex, multifaceted, and multilayered concept. There are many different approaches to defining and measuring well-being, and the focus and terminology used to describe these measures vary. Concepts that fall within the category of well-being include psychological well-being, emotional well-being, quality of life, health-related quality of life, psychosocial functioning, thriving, flourishing, happiness, satisfaction, and others.
 

What We Do

LIFT is an eight week educational program to promote balance, flexibility and strength training to improve functional fitness. The LIFT group meets for one hour sessions twice a week over the course of 8 weeks.

Who We Serve

Any adult citizen in Northampton County is eligible to register for this free program.

How We Impact

LIFT classes help participants to improve strength and mobility, learn healthy food options, create a habit of physical activity and help to form community.

What We Do

The Med Instead of Meds class series helps citizens to Go Med by exploring 7 simple steps to eating the Med Way. Participants learn Med tips, life hacks, and recipes that will help them eat the Med Way every day.  Cooperative Extension Nutrionist EB Odom, along with Health Educator Kysha Gary, meet with citizens once a week for six weeks during lunchtime.

 

Who We Serve

Free registration is available to any Northampton County citizen.  

How We Impact

The Mediterranean-style eating pattern has been shown to promote health and decrease risk of many chronic diseases.

 

What We Do

Northampton County Health Department partnered with Northampton County Cooperative Extension to bring the Take Control Program to citizens.  Take Control is an 8 session chronic disease prevention program that provides strategies to help adults manage their health. It informs, empowers, and motivates participants to change their eating and physical activity patterns. The program provides opportunities for participants to track their goals and progress toward healthy eating and physical activity behaviors. Each 1-hour session contains a basic cooking demonstration of a healthy recipe. The recipes and nutrition handouts are provided to program participants. Evaluation of the program is conducted via a pre- and post-behavior survey.

 

Who We Serve

A site is eligible for Steps to Health adult programming if the site is documented to serve generally low-income people, where at least 50% of people have gross incomes at or below 200% of the Federal Poverty Line.
 

How We Impact

The impact is made through one-on-one instruction and coaching of program participants.  

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

Teams are made up of experienced clinical staff well-trained in crisis prevention and stabilization techniques. When a person experiences a behavioral health crisis, a member of the Mobile Crisis Team will respond and meet the person wherever it may be--at home, at school, at work or in the community. If you or a loved one is experiencing a mental health or substance use crisis, please call the Mobile Crisis Team at 1-866-437-1821.

For more information regarding the Mobile Crisis Unit click here.
 

Who We Serve

All Northampton county communities and other contracted counties. 

How We Impact

Crisis intervention services are provided at any location in the community to reduce barriers to service delivery.  The Mobile Crisis Unit is a 24 hour/7 days a week operational unit that provides services for:

• Suicidal or depressed persons
• Persons with homicidal ideations
• Domestic violence
• Emergency petitions situations
• Family education
• Delusional and psychotic persons
• Death notification and support
• Links to Mental Health services
• Links to Detox
• Family and Marital conflicts

What We Do

 Deterra® Drug Deactivation and Disposal System is a safe medication disposal pouch or container that can be used at home or in a clinical setting.

Who We Serve

Northampton County Citizens

How We Impact

The Deterra® Drug Deactivation and Disposal System is a safe medication disposal pouch or container that can be used at home or in a clinical setting. It is a safe, easy choice used to destroy and properly dispose of unused, unwanted and expired medications with the simple addition of tap water.  Northampton County Health Department distributes these pouches to citizens in the office  and through community events. to make sure homes have easy, safe access to medication disposal.  

What We Do

Community Paramedics provide a variety of non-emergent care and cost-effective options by helping patients’ manage their substance use disorder, avoid emergency department (ED) visits and subsequent hospital admissions, adhere to medication plans, and access social services in Northampton County.

Who We Serve

All Northampton County communities are served by the community paramedicine program.

How We Impact

The goals of a community paramedicine program are to improve individual and community health, reduce unnecessary hospitalizations and ED visits, improve patient satisfaction, and reduce healthcare costs.

What We Do

Who We Serve

How We Impact

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

The Northampton County Child Health Clinic program provides well-child visits for children ages birth to 21 as well as provides diagnosis and treatment for children who are ill through sick visits by Public Health Nurses and two Family Nurse Practitioners.  Our clinic accepts referrals from the Case Management for At-Risk Children (CMARC) Program, private providers, public schools, and Social Services.
 

Who We Serve

Children ages birth to 21.

How We Impact

Ensuring well-child, diagnosis, and treatment services through our Child Health Clinic program helps maintain the health of the children in Northampton County leading to positive overall health outcomes, decreased school absenteeism, and child enrichment.

The following services are provided through our Child Health Clinic:

• Vision & Hearing tests
• Immunizations
• Physical exams including: Sports, Head Start, Kindergarten, and routine physicals
• Screening of physical & emotional development
• Doctor’s evaluation as needed
• Lead & Sickle Cell Screening as necessary

Why Is This Important?

Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined — and thousands more die from other tobacco-related causes such as involuntary exposure to secondhand smoke, fires caused by smoking (more than 1,000 deaths/year nationwide) and smokeless tobacco use.
 

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.
 

Who We Serve

North Carolina Residents 

How We Impact

Provide free cessation and quit coaching services to all residents who need 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. 

Progress on CHIPs

The Northampton County Scorecard outlines the efforts being made in Northampton County to address the four health priorities identified in the CHA: 

• Substance Awareness 

• Chronic Disease Management 

• Access to Services

• Tobacco/Vaping 

The global COVID-19 pandemic has continued to impact Northampton County's ability to address these priorities in the way originally envisioned. 

Poverty and lack of resources continue to be a driving factor in the health of Northampton County citizens.  As noted in the chart below, the poverty rate in Northampton County was 45 out of 100 people in 2019.  Also related to poverty and access to healthcare is the rate of insured individuals in Northampton County.  Northampton County has one of the highest rates of uninsured citizens in the State of North Carolina with an uninsured rate of 14 out of 100 people.  These two factors alone make healthcare challenging in Northampton County.  

Morbidity and Mortality Changes Since Last CHA

Chronic Disease

Chronic disease continues to be the leading cause of death for citizens in Northampton County.  See charts below.  Since the last CHA, cancer has increased to the number one spot with an increased of 23%.

Heart disease was the leading cause of death during the last CHA, but has decreased to the second leading cause of death.   The rate of heart disease in Northampton County decreased by 5% since the last CHA.

The rate of diabetes in Northampton County decreased by 26% since the last CHA.  

Effect of the Global COVID-19 Pandemic

According to NCDHHS vital statistics, the total number of deaths in Northampton County was 266 in 2019, and increased to 355 in 2020.  This increase can be attributed to the global COVID-19 pandemic as evidenced by the charts below.  

Emerging Issues Since Last CHA

Mental Health Crisis

According to the 2022 NCDHHS Behavioral Health convening:

* Nearly 1 in 5 North Carolinians have a mental illness.

* During the pandemic, approximately 1 in 3 surveyed North Carolinians reported symptoms of depression and/or anxiety

* Alcohol-related ED visits increased 13% from 2019 to 2020.

* Opioid overdose visits to ED increased 40% from July 2019 to July 2020.

This trend is being seen in Northampton County as well.

Workforce Issues

According to the 2022 NCDHHS Behavioral Health convening:

* There are over 15,000 nurse vacancies in NC & nationally, nursing turnover rates were 15.8% between August 2020 and 2021 (McKinsey).

• In August 2020, 66.2% of public health workers nationwide reported feeling burnout (NIH)

This trend has been seen in Northampton County as well, and particularly at Northampton County Health Department as staff turnover has been an issue since the global COVID-19 pandemic.  NCHD is participating in the Careers in Public Health Joint Advisory Committee, a regional effort to address such issues.  

New/Paused/Discontinued Initiatives Since Last CHA

Substance Awareness

North Carolina is part of a historic $26 billion agreement that will help bring desperately needed relief to communities impacted by opioids. These funds will be used to support treatment, recovery, harm reduction, and other life-saving programs and services in communities throughout the state. Northampton County will receive a portion of these funds.  A County Task Force has been formed to discuss use of these funds and future substance awareness programs in Northampton County.  By creating a taskforce of individuals and county agencies, we will be able to strategically plan how to address the opioid misuse in Northampton County.

Recently approved initiatives include:

• Early Intervention - This strategy will be implemented by the Northampton County Health Department mostly through our Health Education program who will help implement different programs and trainings in the community and school settings.  Funds can help pay for required training for Health Department staff and to help fund the programs created within the community and schools.
• Post-overdose response team - This strategy will be implemented through the Northampton County Emergency Medical Services Community Paramedic Program.  Funds may be used to hire another Community Paramedic to concentrate on opioid misuse in Northampton County as well as supplies, vehicle, fuel, etc. needed to implement response.
• Syringe Service Program - This strategy will be implemented through the Northampton County Emergency Medical Services Community Paramedic Program.  
• Naloxone distribution - This strategy will be implemented by both the Northampton County Health Department (through clinic) and EMS (through the Community Paramedic program).  

Chronic Disease Management

NCHD continues to attend health fairs and other group gatherings in partnership with local nonprofit groups to provide education and awareness about chronic disease issues and provide resources to citizens. 

NCHD partners with NC Cooperative Extension monthly for a support group regarding strategies to prevent or manage chronic disease, such as, diabetes, heart disease, high blood pressure, high cholesterol, or overweight.  There is also a monthly Healthy Carolinians group meeting regarding tips and programs to build healthy lifestyle habits.  In addition, NCHD is participating in the Take Control program that helps teach lifelong habits that help citizens eat healthy and be physically active.
 

NCHD is co-leader for Faithful Families Thriving Communities (Faithful Families) which works directly in communities of faith across the country to promote health for individuals, families, and local communities. The practice-tested program is open to all faith and religious traditions and engages faith communities in health education, environmental changes to support health, and community-wide health initiatives. Faithful Families believes that communities of faith are important health advocates, particularly in communities affected by health disparities or lacking access to crucial resources. That’s why we are here to empower faith communities as they become change-makers in helping their communities thrive – physically, mentally, and spiritually.

Access to Services

NCHD will begin offering primary care to citizens in 2023.  NCHD will also update the County resource guide for citizens in 2023.

Tobacco/Vaping Cessation

Health Education has been in partnership with NC Cooperative Extension to bring the 4H ROCKS curriculum to students in the public school system.  This curriculum includes education about tobacco/vaping cessation.