HNC 2030 Scorecard: Forsyth County 2021-2024

Partners

Strategy

Public Health Framework

The Forsyth County Steering Committee utilized the socioecological model to analyze the population health of the county. The Socioecological model was selected as it is  one of the best approaches for identifying and examining the factors that influence  diverse populations’ health outcome. This model focuses on the interactions between individuals and the environment in which they live, work, and play. The socioecological model employed includes the following levels of analysis: individual, interpersonal, institutional, community and policy. 

Executive Summary

Forsyth County holds the 34th ranking, out of the 100 NC counties for how healthy its residents are and the impact it'll have on their future health status (County Health Rankings, 2023). 

On April 1, 2020, an estimated 382,590 persons lived in Forsyth County (Table 2). This estimated count represented an increase of about 9.0% in Forsyth County’s  population from the April 2010 census. Between 2010 and 2020, Forsyth County’s population became older and more diverse.

Priorities

The CHA Steering Committee will focus on the following health priorities with an emphasis on the social determinants that influence health outcomes.

• Infant Mortality/Infant Mortality Disparity Ratio- Significant disparities are present among the infant mortality rate for the Black, non-hispanic/latino populations and all other Forsyth County race/ethnicity populations. 
• Violence- The rate of violent crime in Forsyth County was almost double the state's annual rate in 2020. 
• Chronic Diseases- Over a five year period, 2015-2019, the average chronic disease death rate for Forsyth County has been greater than the state's rate. 
• Behavioral Health (Drug Overdose and Mental Health): Drug overdose deaths in Forsyth County accounts for 4.5% of NC's drug overdose death rates in 2020. Related to Mental Health, WS/FCS Youth Risk Behavior Survey show's alarming percentages of students who considered, planned and/or have attempted suicide at some point in their lives. 

Why Is This Important?

Infant mortality is considered a key indicator of the overall health of the population, and both infant and maternal mortality are multifaceted problems impacted by factors such as access to care, poverty, systemic racism, and housing. Forsyth County’s infant mortality rate exceeded the state’s infant 
mortality rate each year from 2016 to 2020 (Table 13). 

Our desired result is aligned with Healthy NC 2030 indicators to (1) "reduce the infant mortality racial disparity between African Americans and Whites" and (2) Increase access to prenatal care. 

It's important because babies are dying! 

• American babies still die from many problems that we CAN prevent, along with complications we have no idea how to stop. Many of our babies that die are born months too early (premature), with serious birth defects, or die due to complications the mother faces during her pregnancy. Some babies are born too small and sickly because the mother smoked while she was pregnant, or did not get enough nutritious food to eat and grow her baby. There are many steps we can all take to help each pregnancy end in a healthy baby. One of the most important steps to take is to help all women be healthy BEFORE they become pregnant.
• Causes of death:
  • Premature Births: Born too soon, and too small.
    • Caused by 
      • Having a previous preterm birth
      • Having a short cervix
      • Short time between pregnancies
      • History of certain types of surgery on the uterus or cervix
      • Certain pregnancy complications, such as multiple pregnancy and vaginal bleeding
      • Lifestyle factors such as low prepregnancy weight, smoking during pregnancy, and substance abuse during pregnancy
  • Birth Defects
    • ​​​​​​​Most common: problems with the heart. 

What We Do

The Forsyth County Infant Mortality Reduction Coalition (FCIMRC) is a community partnership housed within the Forsyth County Department of Public Health that began around 1996. Its vision is that all babies born in Forsyth County will be healthy and thrive (FCIMRC, 2022). Thus, its mission is to reduce infant mortality by educating the community about how to prevent  infant death and advocating for systems and policy changes that support healthy birth outcomes (FCIMRC, 2022).

Along with the various activities facilitated throughout the year, the coalition organized 1-mile walk in 2011 that has since been held every year. From the coalition's first community campaign, "smoking and babies just don't mix", the coalition has implemented several activites, fact sheets, conferences that focuses on issues related to infant mortality. 

FCIMRC members include AmeriHealth Caritas, Atrium Wake Forest Baptist Health, Forsyth County Department of Public Health, HealthCare Access, ImprintsCares, March of Dimes, Newborns in Need, Novant Health Forsyth Medical Center, Novant Health Today's Woman, Outreach Alliance, Parenting PATH, Piedmont Health Services & Sickle Cell Agency, PowerUp, Smart Start, and Wake Forest School of Medicine (FCIMRC, 2022).

Help Our Babies

Who We Serve

The Forsyth County Infant Mortality Reduction Coalition is a community partnership housed within the Forsyth County Department of Public Health serving all of Forsyth County, specifically those who have experienced infant loss.

Help Our Babies

How We Impact

Some of FCIMRC’s current goals include:

• Implement safe sleep daily messaging through social media platforms
• Implement a social media campaign such as a 30 second video to be displayed in hospitals, pediatric and OB/GYN offices
• Raise public awareness through the annual Walk a Mile to Save our Babies Event for Infant Mortality Awareness month (September) and SIDS Awareness Month (October)

Core Values: 

• Prevention is key! 
• System and policy changes are needed. 
• No one group can solve the problem alone. 
• Racism is only one underlying factor. 

What We Do

The Parenting Education Program provides classes, workshops, and other resources for parents and other caregivers who are preparing to raise young children. Our services focus on the health and safety of infants and children, in addition to maternal health issues, so that the entire family can thrive.  Within this program, families are able to participate in the following classes: 

1. Childbirth Education Classes- These classes help participants prepare for the third trimester of pregnancy, labor and delivery of their baby, and postpartum life. 
2. Prenatal Parenting Classes - Designed especially for soon-to-be parents but are also relevant for any family with a baby under one year old. Participants learn skills to help them raise a healthy, thriving baby through topics such as basic infant care, breastfeeding, nutrition, immunizations, birth control after baby, and more.
3. Baby Safety Classes - Participants learn how to create a safe sleep environment and reduce their babies’ risk of SIDS, as well as how to select and install the correct car seats for their children. 

https://www.forsyth.cc/PublicHealth/parenting_education.aspx

Who We Serve

We serve all parents and caregivers who are preparing to raise young children, typically to the age of 5, who are referred from care management programs, hospitals and/or other health providers. 

How We Impact

The many components of our Parenting Education Program positively impact parents and caregivers being sure they are equipped to raise their children thus, reducing rates of health outcomes contributing to high infant mortality rates. Classes are taught via a combination of online and in-person courses by health educators, whom have completed the NCPA Lamaze Childbirth Educator Program and/or National Child Passenger Safety Certification. In addition to our classes, FCDPH provides workshops and demostrations to the community on topics related to the health and safety of mothers, their infants and children. 

What We Do

Healthy Beginnings is a free case management service that provides a support system for minority women in the community during their pregnancy and up to two years after delivery. Families will receive one-on-one care management through home visits and education on health topics through group educational sessions. Our main goal is to help make pregnancy, childbirth and the early toddlers years an enjoyable and healthy experience!

Parents are educated on health topics related to 

• Folic Acid consumption
• Reproductive Health 
• Breast Feeding 
• Nutrition and Exercise 
• Baby Safety and 
• Child Development. 

Healthy Beginnings (forsyth.nc.us)

Who We Serve

Healthy Beginnings serves miniorty women who are pregnant or less than 60 days postpartum and reside in Forsyth County. Participants are paired with a case manager and are supported during their pregnancy and up to two years after delivery. 

How We Impact

Our program and case managers serve as a suport system for these women relieving participants of any perceieved concerns/stressors. Benefits of participanting in Healthy Beginnings include: educational health sessions, home visits and/or transportation to/from medical appointments or meetups, meetups with other participants, supply of multi-vitamins, and referrals to other community agencies. 

What We Do

Care Management for High Risk Pregnancies (CMHRP) is a statewide Medicaid program in North Carolina promoting healthy mothers and healthy babies. This program provides care management services by a social worker or registered nurse for high risk women during pregnancy and for two months after delivery.

Services Offered

• Going over your prenatal care provider's plan for a health pregnancy

• Helping you manage any medicines that you may be taking

• Helping arrange transportation to medical appointments, if needed

• Referring you to other programs like childbirth or breastfeeding education classes, parenting and baby safety

• Answering your questions

Who We Serve

Eligibility

If you have certain conditions you may qualify for Pregnancy Care Management services. Some examples include:

• History of pre-term birth

• History of low birth weights

• Multiple gestations

• Fetal complications

• Chronic conditions that may complicate pregnancy

• Tobacco or substance abuse

• Physician request for care management assessment

How We Impact

Participants are paired with a case manager who will work closely with mom and the prenatal care provider during the pregnancy. This support system aids in a healthy pregnancy, birth outcome and postpartum experience. 

Story Behind the Curve

Nurse Family Partnership (NFP) serves a high risk population. All programs participants are low income and have health and/or social determinants of health challenges. The program is 2.5 years in length and participation is voluntary. Attrition can occur for reasons of moving away, miscarriage, unable to locate or clients decide to leave the program.

What We Do

Nurse-Family Partnership is an evidenced-based nurse home visiting program for first time, low income pregnant women and their families starting early in pregnancy until the baby’s second birthdaY.

https://www.nursefamilypartnership.org/   |   https://forsyth.cc/publichealth/assets/documents/NFP.pdf

Who We Serve

You may qualify for Nurse-Family Partnership if you:
• Are pregnant with your first baby.
• Live in Forsyth County.
• Are early in your pregnancy.
• Have an income that qualifies you for Medicaid or WIC.

How We Impact

Through weekly or twice a month home visits starting early in pregnancy until the baby is two years old, nurses support firsttime moms toward three goals:
1. Improved pregnancy outcomes
2. Improved child health and development
3. Improved economic self-sufficiency of the family

What We Do

CMARC Early Childhood Care Management is an at-risk population management program that serves children from birth to 5 years of age who meet the program’s risk criteria.

The goals of the program are:

• To help ensure that children are raised in healthy, safe, and nurturing environments
• To improve the care of children by linking them to services that will meet the needs of the child and family
• To support children in reaching their developmental potential
• Services provided by CMARC care managers are tailored to patient needs and risk stratification guidelines. Care Managers work with families through home visits, virtual visits, phone calls, community and hospital visits, and can even attend doctor’s appointments with families!

https://www.co.forsyth.nc.us/publichealth/child_service_coordination.aspx

Who We Serve

Who is Eligible?

• Children with complex/chronic/long term medical conditions
• Families dealing with challenging situations/social concerns
• Recent hospital or NICU stay, or frequent ED usage due to chronic medical conditions
• Foster Care placements

How We Impact

CMARC Care Managers help families get needed answers involving their child, offer referrals to community resources, provide information and education on various topics, and work to help families build strong links with their child’s doctors.

What We Do

WIC is a federally-funded health and nutrition program for women, infants and children. WIC helps families by providing checks for buying healthy supplemental foods from WIC-authorized vendors, nutrition education, and help finding healthcare and other community services. Participants must meet income guidelines and be pregnant women, new mothers, infants or children under age five.

https://www.co.forsyth.nc.us/publichealth/WIC.aspx

Who We Serve

WIC is available to pregnant, breast feeding and postpartum women, infants and children up to age five. To participate, persons must:

• Be a resident of Forsyth County.
• Have a family income less than 185% of the U.S. Poverty Income Guidelines. A person receiving Medicaid, Work First Families Assistance , or Food Stamps automatically meets the income eligibility requirement.
• Be at nutritional risk. A nutritionist or other health professional makes the nutritional risk assessment at no cost to the participant, usually at the local WIC office.

How We Impact

In Forsyth county we provide WIC services to over 11,000 women, infants and children. WIC helps improve health and nutrition program for women, infants and children. 

Why Is This Important?

What We Do

The Minority Diabetes Prevention Program (MDPP) is a free, year-long diabetes prevention program, funded by the NC Office of Minority Health and Health Disparities. Participants are guided by a trained lifestyle coach and learn about healthy eating, meal planning, physical activity and overcoming barriers.  The program follows an evidence-based curriculum by the CDC, PreventT2, a lifestyle change curriculum proven to help participants make lifestyle changes and cut their risk of type 2 diabetes by more than half. 

https://forsythcountync.gov/HHS/diabetes_prevention.aspx

Who We Serve

MDPP serves adults who have prediabetes or who are at high risk for type 2 diabetes and are ready and committed to make modest lifestyle changes.  Eligilibity is determined by the following:

1. Participants must meet all of these requirements: 18 years or older, overweight, not dignosed with Type 1 or 2 Diabetes AND not currently pregnant.
2. In addition, he/she must meet one of the following: Have been diagnosed with prediabetes, previouslt diagnosed with gestational diabetes, received a "High Risk Result" on the CDC screening Tool/assessment. 

How We Impact

Participants are paired with trained life coaches to complete the MDPP. Upon completion, participants are equipped with skills related to physical activty and healthy eating, and incentives to reinforce the newly acquired skills; thus, contributing to a healthier lifestyle and lowering chances of developing T2 diabetes.  

What We Do

The Men's Health Program is a male-based community outreach program that helps men become knowledgeable of chronic diseases and prevention as it relates to Forsyth County by educating and collaborating with other local community organizations. There is also a dad component to the program.

Men's Health (forsyth.nc.us)

Who We Serve

All Forsyth County men. 

How We Impact

Men attend 9-week educational sessions on health topics to reduce their risk of developing chronic diseases. Topics include: 

• Heart health 
• High Blood Pressure 
• A1C 
• Overweight/Obesity 
• Colorectal/Prostate Cance 
• Mental Health 
• Nutrition 
• Sexual Health 
• Physical Activity. 

Story Behind the Curve

Working with MapForsyth to develop a Story Map regarding substance use in our community.  The stakeholder group meets regularly to assess progress and to pivot as needed to assure we support strategies that are demonstrating positive impact; FROST meets every other month to share information and updates and to assure our community is positioned to implement best practices and to obtain community impact; the settlement committee is committed to addressing root causes; and finally, there is great synergy amongst the community with emerging collaborations. 

What Works

• Forsyth Regional Opioid and Substance Use Team (FROST)
• Forsyth County Community Opioid Settlement Stakeholder Committee
• Employee and Community Naloxone Training 
• No barrier access to naloxone (no cost: dispensing machines, access via pharmacy)
• Prevention media campaign
• Stigma reduction
• Lock Your Meds campaign/medication lockboxes
• Medication disposal kits
• Drug takeback programs
• Access to treatment/timely inductions

What We Do

1. We convene stakeholders to provide education on recognizing an overdose and using naloxone/narcan to reverse an Opioid overdose

2. We provide no-cost access to naloxone/narcan (remove barriers to access)

3. We educate the community about the availability of harm reduction and treatment resources

4. We educate regarding prevention, e.g., the importance of safe disposal of expired or no longer needed prescripton medications, locking medication

Who We Serve

All Forsyth County residents. 

How We Impact

1. ​​​​​Education prepares individuals to respond to drug poisonings/overdoses
2. Providing naloxone/Narcan reduces the number of deaths as a result of drug poisonings/overdoses
3. We normalize discussions therefore reducing stigma

Why Is This Important?

The number of drug poisonings/overdoses in Forsyth County, NC has continued to increase.  Tools and resources are available to reduce harm and to prevent opioid overdoses.

What Works

It works because each WINS team members has lived experience with gun violence and are residents of Winston-Salem, NC. Having real-life experience and living day to day in this neighborhoods and surrounding areas increase rapport between the team and persons who are most likely to commit crimes. 

What We Do

Forsyth WINS (Cure Violence) is a program that targets areas with high violent crime rates and deploys violence interrupters and caseworkers who know the area. The goal is to form connections with people who are most likely to commit the crimes and set them on a different path. The team hosts monthly gatherings as part of their efforts to bring awareness to their services.  

Why Is This Important?

Forsyth WINS (Cure Violence) is important to make meaningful connections that will ultimately lead to a decrease in violent acts/crimes in Forsyth County Neighborhoods. 

What We Do

• We convene stakeholders, 'Forsyth Focused', to identify and implement strategies to reduce the number of deaths by suicide. 
• We coordinate Community Conversations on Suicide in collaboration with WSFCS, Partners Health Management, and Mental Health Association in Forsyth County. 
• We provide funding for CIT training for First Responders and community Mental Health First Aid & Question, Persuade, Refer (QPR) trainings. 
• We educate the community about the availability of community resources including crisis services.
• We collaborate with crisis services providers to assure accessibility to a continuum of care. 

Who We Serve

All Forsyth County residents

How We Impact

• Education de-stigmatizes behavioral health and normalizes related conversations
• We ready individuals with providing naloxone/Narcan reduces the number of deaths as a result of drug poisonings/overdoses
• We normalize discussions therefore reducing stigma

Why Is This Important?

Mental Wellbeing is a critical component of overall health.  

Progress on Performance Measures

CHIP I: Reduce Infant Mortality

Aim: To improve overall preconception health in Forsyth County in the next 5 years.

Long term Goal: In the next 5 years, Forsyth County aims to reduce its infant mortality rate to 6.0.

Objective: Pilot a preconception health workshop (with faith-based community groups) between September 1, 2022 and June 30, 2023.

Performance Measures:

• Number of staff members who will complete the NC Community Health Worker Initiative and Core Competency Training [Goal: 1 staff member by June 30, 2023]

2022/2023 Accomplishment: Zero staff trained as yet, but key staff vacancy was filled.

• Number of partner agencies who collaborate with and refer to the Preconception Health project [Goal: 5 agencies by June 30, 2023]

  2022/2023 Accomplishment: Zero agency at this time. However, several agencies have expressed an interest in a potential partnership.

• Number of workshop sessions on preconception health topics offered to the community [Goal: 10 sessions by June 30, 2023]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

• Number of individuals participating in one workshop session [Goal: 25 participants by June 30, 2023]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

• Percent of participants who attend all workshop sessions in a series [Goal: 52% of participants]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

• Percent of participants who receive multivitamins with folic acid [Goal: 100% of participants]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

CHIP II: Reduce Infant Mortality Disparity Ratio

Aim: To improve overall preconception health in Forsyth County Black, Non-Hispanic/Latino communities.

Long-term Goal (5 years): In the next 5 years, Forsyth County aims to reduce its infant mortality disparity ratio to 2.0.

Objective: Pilot a preconception workshop (with community influencers and mothers) during this fiscal year (2022/2023)

Performance Measures:

• Number of staff members who complete the NC Community Health Worker Initiative and Core Competency Training [Goal: 1 staff member by June 30, 2023]

2022/2023 Accomplishment: Zero staff trained as yet, but key staff vacancy was filled.

• Number of partner agencies who collaborate with and refer to the Preconception Health project [Goal: 5 agencies by June 30, 2023]

2022/2023 Accomplishment: Zero agency at this time. However, several agencies have expressed an interest in a potential partnership.

• Number of workshop sessions on preconception health topics offered to the community [Goal: 10 sessions by June 30, 2023]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

• Number of participants from zip codes 27101, 27103, 27105, 27106, 27107, and 27127 who attend at least one workshop session [Goal: 25 participants by June 30, 2023]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

• Percent of participants who attend all workshop sessions in a series [Goal: 52% of participants]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

• Percent of participants who receive multivitamins with folic acid [Goal: 100% of participants]

2022/2023 Accomplishment: Zero at this time. The first session has been scheduled for April 2023.

Changes in the Infant Mortality Rate and the Infant Mortality Disparity Ratio

Infant Mortality. Table 1 shows that Forsyth County’s infant mortality rate exceeded the state’s infant mortality rate each year from 2017 to 2021. From 2017 to 2021, Forsyth County’s infant mortality rate has ranged from a high of 9.8 (2017, 2019) to a low of 7.2 (2020) (Table 1). In 2021, Forsyth County’s infant mortality rate was 8.1 in comparison to the state’s which was 6.8 (Table 1). Forsyth County 5-year rolling average infant mortality rate based

on race/ethnicity was highest among Black, Non-Hispanic/Latino populations (Table 2).  Forsyth County’s 5-year rolling average infant mortality rate for Black, Non-Hispanic/Latino (15.8), Hispanic/Latino (5.9), and White, Non-Hispanic/Latino populations (5.4) were each higher than the state’s infant mortality rate for the corresponding population (Table 2).

Infant Mortality Disparity Ratio. Forsyth County’s 5-year rolling average infant mortality disparity ratio increased from 2.2 (2013-2017) to 2.9 (2017-2021) (Table 3). Table 3 shows that Forsyth County’s 5-year rolling average infant mortality disparity ratio during 2016-2020 and 2017-2021 was higher than the state’s in each period.

Morbidity and Mortality Changes

Trends in Other Major Mortality and Morbidity Factors

Mortality. Deaths due to cancers and heart diseases were the top two major causes of death in Forsyth County during the 5-year rolling average period, 2016-2020 (Table 4). Table 4 shows that Forsyth County’s overall death rate (801.6) was higher than the state’s (793.7). While Forsyth County’s 5-year rolling average death rate for heart diseases (147.2) was lower than the state’s (156.1), its 5-year rolling average death rate due to cancers (156.3), unintentional injuries (50.5), cerebrovascular diseases (43.6), and chronic lower respiratory diseases (42.6) exceeded the state’s for the same period (Table 4).

Chronic Disease Health Disparity. In Forsyth County, Black, Non-Hispanic/Latino populations disproportionately experienced deaths due to cancers and heart diseases (Table 5). For example, for the 5-year rolling average periods 2012-2016 to 2016-2020, Black, Non-Hispanic populations experienced higher cancer and heart disease death rates than White, Non-Hispanic/Latino populations for all 5 periods (Table 5). The differences in their 5-year rolling average death rates ranged from a low of 28.2 (2013-2017, cancers) to a high of 53.5 (2012-2016, heart diseases) (Table 5).

Morbidity

            Cancer. Forsyth County’s number of new cancer cases is projected to increase from 2,295 in 2021 to 2,324 in 2022 (Table 6). Female breast cancer is projected to have the largest increase in cases from 419 in 2021 to 429 in 2022.  Forsyth County’s colon/rectum cancer cases is projected to decrease from 171 in 2021 to 169 in 2022 (Table 6).

Emerging Issues

Emergency department care of patient overdose of two or more drugs of interest continues to be an area of concern for the Forsyth Community. In 2022, 237 visits were made to the ED for polysubstance overdose. The majority of people who receive polysubstance overdose care were between ages 25 and 44 (Table 7).

New/Paused/Discontinued Initiatives Since the Last CHA

New Initiatives

Cobblestone Farmers Market.  Forsyth County’s Women, Infant and Children’s (WIC) Program has partnered with Cobblestone Farmers’ Market for it to have a fresh food market twice per month during Summer 2023 at the Department of Public Health. Having the farmers on site decreases some of the barriers that some WIC participants experience when seeking to access fresh fruits and vegetables. A significant number of WIC participants live in the zip code where the Health Department is located. Each eligible WIC participants receive a one-time amount of $30.00 to shop at a qualified Farmer’s Market in NC.  No extra funding is necessary and no additional staff is needed for this initiative.

Novant Health Forsyth Medical Center. Forsyth County WIC program is partnering with Novant Forsyth Medical Center maternal unit. A signed authorization allows a WIC Team (one nutritionist and one Dr.’s Office Assistant) to complete certifications for new babies and post-partum women while still at the hospital. In addition to the certifications, WIC will be able to provide electric breast pumps for moms who have premature babies that are ing in the NICU unit.

Objectives. Reduce stress among new mothers by eliminating the burden of them having to come into the WIC clinic for services when they have just delivered and by being able to provide electric breast pumps for High-Risk premature babies. WIC needs additional staff to staff in order to fulfill this initiative.

Novant Health Waughtown Pediatrics and OBGYN. Forsyth County WIC is collaborating with Novant Health Waughtown Pediatrics and OBGYN clinic to have WIC team on site by Fall 2023. This clinic is located in an area that would be very beneficial for current and future WIC recipients. Currently WIC staffing limitations, and accommodations on site have influenced the delay to September 2023.  

Head Start of Forsyth County. A Memorandum of Understanding (MOU) between Head Start of Forsyth County and WIC is forthcoming in the 2023/2024 fiscal year. The MOU will outline the collaboration of services/referrals between Head Start and WIC. Head Start provides comprehensive early childhood education, health, nutrition, and parent involvement services to low-income children and families in Forsyth County. All Head Start eligible participants are income eligible for WIC services.  Both programs offer nutrition education and perform weights, heights and hemoglobin testing.  With the two agencies working together the goal is to facilitate these services by sharing information and streamlining other requirements such as nutrition education. No additional funding is needed for this initiative, other than WIC funding for normal operations.

Expansion of the current Women, Infant and Children (WIC) Program at Atrium Health Wake Forest Baptist Medical Center. WIC staff are able to provide Post-partum certifications and add newborn babies at the hospital.  In addition, WIC is able to provide electric breast pump to moms whose babies are in the NICU unit. As of September 2022, WIC has certified more than 355 women and babies and have issued more than 25 electric breast pumps. This collaboration has helped to reduce stress among new mothers by eliminating the burden of their coming to the Department of Public Health.

Progress on Performance Measures

Morbidity and Mortality Changes

Emerging Issues

New/Paused/Discontinued Initiatives Since the Last CHA