HNC 2030 Scorecard: Jackson County (2021-2023)

Executive Summary

The executive summary can be found on page 28 of the 2021 Jackson County Community Health Assessment Report. 

2021 Jackson County Community Health Assessment

CHA Priorities

The 2021 Jackson County Community Health Assessment priorities are: 

• Healthy Living - physical activity & nutrition (long-term priority)
• Substance Misuse (long-term priority)
• Mental Health (new priority)

Experience and Importance

How would we experience Jackson County residents having access to mental health care in our community?

• Decrease in law enforcement involvement

• Confidence in receiving help

• Less substance misuse

• Happier overall population

• More social workers employed within the county

• More access to treatment and services

• More vocal support

• More community events centered aroun mental health

• Less medical debt

What information led to the selection of this health issue and related result?

Regarding mental health, the Community Health Assessment workgroup in 2021 identified the percent of residents experiencing suicide ideation and poor mental health to be very alarming in Jackson County.

During our group process, the following criteria were applied to the issue listed above as well as others to select priority health issues of focus for our community over the next three years:

● Criteria 1 – Relevant – How important is this issue? (Size of the problem; Severity of problem; Focus on equity; Aligned with HNC 2030; Urgency to solve problem; Linked to other important issues)

● Criteria 2 – Impactful – What will we get out of addressing this issue? (Availability of solutions/proven strategies; Builds on or enhances current work; Significant consequences of not addressing issue now)

● Criteria 3 – Feasible – Can we adequately address this issue? (Availability of resources (staff, community partners, time, money, equipment) to address the issue; Political capacity/will; Community/social acceptability; Appropriate socio-culturally; Can identify easy, short-term wins)

Participants used an open discussion to rate the priorities using the criteria listed above.

For mental health, data cycles showed that resident’s mental health had been suffering, but the COVID-19 pandemic severely exacerbated the strain on our mental health and the limited systems to address it. Jackson County had the highest suicide ideation percentage in all Western North Carolina counties, and many report ongoing days of poor mental health, seeking treatment for mental health, and not being able to get the mental health care that they need. This was and is very concerning to all involved in the CHA process and it clearly needed to be selected a priority. 

What Is It?

Mental Health Prevention Education and Awareness was identified by Healthy Carolinians, community members and stakeholders as an action, that when combined with other actions in our community, has a reasonable chance of making a difference in poor mental health status in our community. This is a new program in our community.

Mental Health Prevention Education and Awareness is a new project for Healthy Carolinians of Jackson County. New interventions are needed and will be researched. The priority population/customers for this project are Jackson County residents of all ages and socioeconomic status, and the project aims to make a difference at the individual/interpersonal behavior and environmental change level. Implementation will take place in local social media, news, newsletter, radio, and word of mouth form. An example of one of the events that fits within this project is the Climb Out of the Darkness Postpartum Disorder Awareness Event. The event aims to raise awareness about postpartum mood disorders and encourage mothers and families to seek help. On the environmental change level, we seek to make a difference with employers about their employee's mental health needs. 

This project will address health disparities. As we are in a rural setting, it will impact rural residents who have low access to mental health care and treatment. We will also research and utilize specific awareness information and campaigns for racial and ethnic minorities, sexual identity and orientation, and disability status or health care needs. 

Partners

The partners for this project include:

Progress in 2023

The first ever Music for Mental Health Awareness and fundraising event was held in July 2023. This event was created and hosted by a family member of a relative who attempted sucide. They saw the importance of creating awareness and breaking the stigma around mental health. The event took place over 2 days at a local restaurant show casing local muscians and various mental health organizations and resources. There were over 100 people in attendance at the multi- day event recieving resources.

What Is It?

Partnering with organizations and agencies who are advocating at the federal, state, and local level for increased funding and resources for mental health treatment and services in Western North Carolina was identified by Healthy Carolinians of Jackson County, community members and stakeholders as an action, that when combined with other actions in our community, has a reasonable chance of making a difference in the mental health status in our community. This is a new focus for Healthy Carolinians of Jackson County. 

The priority population/customers for this project are North Carolina legislators and senators, North Carolina Department of Health and Human Services, Dogwood Trust and WNC Bridge Foundation, Community Foundation of WNC, local providers like Meridian, Appalachian, Youth Villages and VAYA Health. The advocacy efforts aim to make a difference at the organizational/policy and environmental change level. Implementation will take place in [describe setting for program type].

Health Disparities exacerbate poor mental health status. We live in  rural area where people have low access to mental health services due to geographic location and not many services being available. This project seeks to bring mental health services to our area to reduce the impact health disparities such as living in a rural area have on our mental health. Additionally, we seek services brought to our area for everyone regardless of socioeconomic status. 

Partners

The partners for this advoacy project include:

Progress in 2023

This strategy was placed on hold during 2023 due to tranistion in the Health Education Supervisor position.

Experience and Importance

How would we experience Jackson County Residents at a Healthy Weight?

According to professionals and community members during the CHIP process, if this were true then we would see families who are fed healthy, fresh foods regularly with better/more access to grocery stores. We would also see more family and community gardens, education for growing food and food choices. We would experience seeing produce stands at various locations and times, flexible availability, volunteers manning school gardens, using community buildings to can/preserve foods. We would hear community involvement, family communication about growing food. We would feel/hear/experience people being outdoors more and physically active. 

What information led to the selection of this health issue and related result?

Healthy eating and physical activity originally emerged as health priorities during the 2011 Community Health Assessment. While much community effort has occurred to combat these issues, there is still much to be done. Jackson County has continued to have high numbers of residents who are practicing unhealthy eating habits (very low fruit, vegetable and water consumption, etc) and living sedentary lifestyles. In addition, overweight/obesity rates are climbing. During the 2021 Community Health Assessment prioritization process, many community members voted for the following identified health issues:

• Obesity
• Physical activity
• Nutrition

Obesity prevention is important to our community because it greatly effects our community members lives by leading to chronic disease and the overall burden it places on your lifestyle.  We envision a Jackson County where community members are able to feel their very best. 

What Is It?

The Breastfeeding-Friendly Community Project was identified by professional and community members as a strategy during the CHIP process, that when combined with other actions in our community, has a reasonable chance of making a difference in Jackson County. This is an on-going program in our community.

• The audience for the Breastfeeding-Friendly Community Project are all workplaces, businesses, and licensed child care centers in Jackson County. The project aims to make a difference at the individual/interpersonal behavior and organizational/policy change level. Implementation will take place in workplaces, businesses, and licensed child care centers.
• The Project seeks to make workplaces and child care centers breastfeeding-friendly by providing adequate, private space for employees and visitors to express breastmilk or nurse, store breastmilk, and develop policies to ensure ongoing support of lactating employees
• The Project seeks to shift the culture of infant feeding in our rural Appalachian community by making breastfeeding in public a normal behavior.  The Action Team will support local businesses in developing procedures to openly support breastfeeding and pumping patrons. 
• Overall, the Action Team will provide technical assistance and support for workplaces, businesses, and child care centers to achieve the Breastfeeding-Friendly Designations available through the North Carolina Breastfeeding Coalition and the NC Division of Public Health. 

Partners

The partners for Breastfeeding-Friendly Community Project include:

Progress in 2023

This strategy was not worked on in 2023 due to tranistion in Health Education Supervisor postion. 

What Is It?

A community-wide wellness program was identified by the Healthy for Life Action Team as a program that, when combined with other actions in our community, has a reasonable chance of making a difference in physical activity levels as well as weight status in our community. 

Elevate 828 is a 6-month community-wide wellness program that had a
soft-launch in 2020 due to the COVID-19 pandemic, then fully kicked off in 2021. The program begins with a health screening that includes total cholesterol and glucose, blood pressure, height/weight and body composition, as well as a health risk survey with questions regarding nutrition, physical activity, and stress management. The same screening is conducted at the end of the 6 months for a pre-and-post comparison. During the 6 months, participants complete monthly nutrition and stress management challenges, as well as a 6-month long physical activity challenge. 

The audience for this strategy is the community at large. This strategy aims to make a different at the individual level-- increasing knowledge and influence on individual attitudes and beliefs towards health. Implementation will take place community-wide in Jackson County and will also have a special focus on the public school system as their wellness program.

Partners

The partners for this strategy include:

Progress in 2023

No data on health improvement scores or total pounds lost was collected in spring 2023 for the Elevate828 wellness program due to lack of participant interest. Elevate828 pre screenings were held in September 2023 with over 100 participants signing up for the program. Post screenings will take place in spring 2024, collecting health score information and total pounds lost for participants.

What Is It?

The Healthy Snack Master Competition was identified by professionals and community members as a program that, when combined with other actions in our community, has a reasonable chance of making a difference in healthy food consumption as well as weight status in our community.

The audience for this strategy is the community at large. This strategy aims to make a difference at the individual level-- increasing knowledge and influence on individual attitudes and beliefs towards health. Implementation will take place community-wide in Jackson County

The Healthy Snack Master Competition is sponsored by the School Health Advisory Council (SHAC) and is open to all individuals or groups (i.e. classes, afterschool programs, clubs, etc.) in K-12th grade in Jackson County Public Schools. Students are encouraged to create an original recipe and turn it in to their school's cafeteria manager. Submitted recipes are reviewed by members of SHAC. The top student and group entries go on to compete in the Healthy Snack Master Competition. A panel of judges determines the winning healthy snack based on taste, appearance, healthfulness, and creativity. Superlatives are also awarded for the Best Bite, People's Choice, and Most Creative Name.

Partners

The partners for the Healthy Snack Master Competition include:

Progress in 2023

The 2023 Snack Master Competition was held in March at Blue Ridge School. 47 students participated in the event creating and preparing a healthy snack.

What Is It?

Walking Trails for Physical & Mental Health Project was identified by the School Health Advisory Council, Healthy Carolinians of Jackson County, community members and stakeholders as an action, that when combined with other actions in our community, that has a reasonable chance of making a difference in healthy living in our community.

The priority population/customers for this are the community at-large, and the project aims to make a difference at the individual/interpersonal behavior, organizational/policy, and environmental change level. Implementation will take place on Jackson County Public School grounds in various communities throughout the entire county. 

This project addresses health disparities. Jackson County is rural area with few sidewalks outside of the main section of town, and private and public gym access restricted to only a few pockets of the county. It is difficult for rural residents to drive to a gym or rec center, and often times not safe to exercise on their curvy, steep mountain roads. By partnering with the public schools to make walking trails at each school, we will be hitting many pockets throughout the county that have close to no opportunities for safe walking. The school faculty and students will have access to the trails during the day, and the community will have access after school hours. This will provide safe walking opportunities to historically marginalized populations and addresses health disparities. 

Partners

The partners for this [insert program type] include:

Progress in 2023

Walking trails and outdoor areas were created and/or improved upon at Jackson County Public Schools thru a grant that was awarded to the School Health Advisory Committee (SHAC). The SHAC chair person has worked to cordinate the completion of these trails and outdoor areas for students and staff use during their day. At this time no data has been collected on how many students and/or staff have been using the trails and outdoor areas.

Experience and Importance

How would we experience Jackson County Residents are Drug Free in our community?

If Jackson County residents are drug free, we would experience a decrease in overdoses, youth marijuana & vaping, and smoking/smokeless tobacco use rates and a reduction in substance use-related crime. Further, we would experience a more vibrant workforce and an increase in substance use counselors within the area, fewer auto accidents, less need for social services, police, EMS, and ER medical services, less homelessness and more options for treatment and recovery for substance use disorder.

What information led to the selection of this health issue and related result?

Substance abuse originally emerged as a health priority during the 2011 CHA. Topics identified as particularly concerning during the 2021 CHA process were:

• Overdose rates
• Deaths with heroin/fentanyl
• Youth tobacco use (especially e-cigarettes)

In terms of feasibility, the increase of youth tobacco use with the popularity of e-cigarette products has become a main concern of public school officials and families in Jackson County. Jackson County has/is receiving funding through the Opioid Settlement and other forms of funding to combat substance use. The action team will focus on supporting these efforts. 

What Is It?

The Opioid Awareness Campaign was identified by Jackson County local government, Healthy Carolinians of Jackson County and the School Health Advisory Council as a program that, when combined with other actions in our community, has a reasonable chance of making a difference in opioid misuse and overdoses in Jackson County. The Opioid Awareness Campaign is a community effort raising awareness on this nationwide epidemic.  A large focus of the Campaign is making sure medications are disposed of properly to keep them out of hands of children and anyone who may misuse them, the availibility and importance of narcan, and the reduction of stigma.  Substance abuse prevention has been a focus in our community since 2011, however this specific September as Opioid Awareness Month in Jackson County began in 2019. 

The audience for this campaign is the community at large.  This strategy aims to make a difference at the individual level- increasing knowledge and influence on individual attitudes and beliefs towards health decisions and substance abuse disorder. Implementation will take place community-wide in Jackson County.  

Partners

The partners for this Opioid Awareness Campaign include:

Progress in 2023

In December of 2022, Jackson County Department of Public Health received the Prevent Drug Overdose grant thru Community Impact North Carolina. With this grant money Naloxone education and kits as well as medication lockboxes were made available thru out the county at no cost to participants and over 390 Naloxone kits provided in 2023. The Lock Your Meds NC campaign message was shared thru social media posts, billboards and news paper articles. Thru partnership with Safe Kids Jackson County and the Jackson County Department on Aging, 23 pounds of expired or unused medications were take back at 2 medication take back events.  

What Is It?

View From Here WNC is the product of a 19 county collaboration spreading from Cherokee to McDowell, including the Eastern Band of Cherokee Indians and community based organization, UNETE. This umbrella social media campaign focuses on improving the lives of WNC residents by addressing the top three shared health priorities in our region, Substance Use, Mental Health, Healthy Eating/ Active Living as well as COVID/Flu Vaccinations.

What Is It?

Youth Tobacco Prevention was identified by the School Health Advisory Council as an action, that when combined with other actions in our community, has a reasonable chance of making a difference in substance abuse prevention in our community. This is a new program in our community.

The audience for this Youth Tobacco Prevention initiative is Jackson County Public School students and their families.  The program aims to make a difference at the individual/interpersonal behavior level as well as organizational/policy level. Implementation will take place in Jackson County Public Schools.

Partners

The partners for this Youth Tobacco Prevention initiative include:

Progress in 2023

In November 2023 Jackson County Public Schools and Project Aware hosted "Tall Cop Says Stop" event. At this awareness event Tall Cop, Jermaine Galloway, educated families and community members on substance use including vaping with youth.

Jackson County Public Schools School Health Advisory Council, SHAC, continued to gather vaping awareness resources that will be shared with students and families. These resources included ads for billboards to raise awareness of hazards caused by vaping as well as fliers and bathroom stall clings with information to encourage and help students quite vaping. SHAC plans to conitnue gathering and reviewing resources and tools to share in 2024.

AVOID Vaping classes were not implemented in 2023 due to the curriculum being under review by Jackson County Public Schools Curriculum Committee.

Notes

The following have been changes in 2022:

• National, state, and local election results from November 2022 could mean change in many areas. Jackson County has 4/5 new County Commissioners and a new Sheriff. 
• The opioid epidemic and overdose deaths have increased significantly since the pandemic. 
• County's in North Carolina began receiving their funding from the Opioid Settlement and will be working towards how to best spend those dollars over the next 18 years
• In December 2022, Jackson County received Prevent Overdose Deaths funding through 2024. This is a new initiative that seeks to focus on harm reduction and decreases in death
• For the first time, Environmental Health and Child Care Health Consultants partnered together to host the Early Care and Education Summit for all child care providers and workers in Haywood, Jackson, Swain, Macon, Clay, Cherokee, and Graham counties. It was a very successful event.
• Sylva Police now has a social work intern who follows up on mental health matters with clients

Notes

These issues listed below are not identified as priorities in the CHA, though they have been noticed, have increased in severity, or had a large impact on the community.

These are the new or emerging issues in our community that were not identified as priorities in our 2022 CHA.

• Long-COVID
• Changes to reproductive rights across the country
• Climate change, large-scale natural disasters
• Violence like school shootings, active shooter situations and intimate partner violence
• Gas prices
• Inflation
• Immigration
• Russia / Ukraine War
• Worker shortages
• Inadequate, affordable housing

Progress on Performance Measures

Click on each strategy to see updates in 2023 (under Progress in 2023 note tab). 

Mental Health:

•  Prevention Education
•  Advocate for Services and Resources

Healthy Living (Physical Activity & Nutrtion):

•  Breastfeeding-Friendly Community Project
•  Elevate 828
•  Healthy Snack Master Competition
•  Walking Trails for Physical & Mental Health

Substance Misuse Prevention

•  Opioid Awareness Campaign
•  View From Here - Jackson County
•  Youth Tobacco Prevention

Morbidity and Mortality Changes

COVID19 cases and deaths- 

Drug overdose death rate-

Emerging Issues

The following are new or emerging issues within our in 2023:

• Inadequate, affordable houseing
• Construction on HWY 107, closing several businesses
• Inflation 

New/Paused/Discontinued Initiatives and Community Changes Since the Last CHA

The following have been new/ paused/ discontinued intiatives and community changes in 2023:

• Employement changes in Health Education Supervisor, Health Director, County Manager, and Parks and Recreation Director.
• Southwestern Child Development Commission closed 4 child care facilities within the county.
• Lack of Foster Parents/ Families placing a strain on DSS staff.
• JCDPH received State Opioid Response funds from Community Impact NC to address proper medication storage safety.
• In partnership with MountainWise funds were awarded to JCDPH from a Duke Endowment grant to address healthy eating a physical activity initiatives.
• A new partnership between UNC Gillings School of Public Health and JCDPH has formed for Jackson County to become a new Hub location for UNC Gillings School of Public Health students.
• New facility in a new location opened for Jackson County Animal Shelter.
• Jackson County Parks and Recreation Department began construction on indoor pool facility.