Executive Summary

Purpose of the Community Health Assessment

A community health needs assessment (CHNA) is a systematic process for evaluating community health. Data is collected, analyzed, and used to illustrate the state of health and wellbeing within a community. During this process, community members and the assessment team work to identify community needs, areas for improvement, resources, and strengths. Using this information, priority areas are selected to be the focus of strategic planning, ensuring a data and community-informed approach to health improvement. The final report describes the process and contains the findings from the assessment. The community assessment process and the final report aim to promote collaboration, action planning and resource sharing between local leaders, community-serving organizations, and community members as they work to improve community health.

Participation and Community Engagement

NHC HHS and Novant Health consulted with NCIPH to facilitate the assessment process. In addition to the steering committee, a stakeholder group comprised of representatives from various health and human service organizations met regularly to plan, review, and analyze data, and discuss priorities. The CHNA team engaged community members throughout the assessment process. The Community Health Opinion Survey (CHOS) engaged 1,334 community members to learn more about their personal health status and concerns, as well as their concerns for the community overall. Additionally, community members were invited to participate in community conversations to share their experiences living in New Hanover County. The conversation populations were identified by the stakeholder group to ensure a diverse set of voices and experiences were represented; they included Latinx community members, Black and African American community members, individuals with disabilities, older adults, LGBTQIA+ community members, and individuals experiencing homelessness. Finally, community members were invited to vote on a set of priorities for the CHNA cycle based on the information gathered during the assessment.

Process

The CHNA Team worked from January to October 2022 to collect and analyze data, present it for discussion to the stakeholder group, and set priorities that represent the county’s needs and concerns. The data collection process included primary data – data collected directly from the community through the community health opinion survey and community conversations – as well as secondary, or existing, data. The secondary data sources included the North Carolina Center for Health Statistics, the United States Census Bureau, and local government, among others.

Comparisons and Findings

Throughout the data collection and analysis process, the CHNA team compared data from New Hanover County to three peer counties (Brunswick, Buncombe and Gaston), which were chosen for their similarity to New Hanover in demographic and community context (e.g., rural and urban populations, regional service hub, or proximity). Data was also compared to the state of North Carolina, as well as targets from the Healthy North Carolina 2030 objectives, which serve as a health improvement plan for the state.

In some areas, New Hanover County is performing well compared to peers. For example, New Hanover has the highest percentage of individuals with a Bachelor’s degree as their highest level of education as compared to peer counties (27.8%). The high school graduation rate has also been increasing since 2015. New Hanover County is also meeting the Healthy NC 2030 goal of having at least one primary care provider per 1,500 population. The county has 152.8 registered nurses per 10,000 population and 32.8 physicians per 10,000 population. It is important to note that even though New Hanover is meeting the goal for primary care providers, many community conversation participants were concerned about access to care. They cited long wait times to see providers and a lack of providers accepting Medicare and Medicaid. 

Mental health and substance use are important issues in New Hanover County. New Hanover has seen a sharp increase in drug overdose deaths, from 19.4 per 100,000 in 2014 to 39.7 per 100,000 in 2020 – the highest among peers. When the data is broken down by sex, the rate of total medication and drug poisoning deaths of all intents is 63.5 per 100,000 for males compared to females at 23.9 deaths per 100,000. The rate of deaths for white, non-Hispanic residents is 44.9 per 100,000 population compared to 66.7 per 100,000 population for Black residents.

Economic indicators can represent upstream factors that influence health. Unemployment in New Hanover County had been decreasing since 2011, but there was a sharp increase in 2020. This trend is similar to peer counties and the state. It is important to acknowledge that this increase in unemployment may be attributed to the COVID-19 pandemic. Income has been increasing in recent years. In New Hanover, median household income has risen from $50,088 in 2015 to $56,689 in 2020, and per capita income from $29, 880 in 2015 to $36, 324 in 2020. However, not all residents are experiencing this rise in income equally. Household income in the highest quintile (80^th percentile) is increasing more than incomes in the lowest quintile (20^th percentile).

Housing is another concern in New Hanover County. Nearly 70% of survey respondents disagreed with the statement that they can find affordable housing. Community conversation participants across groups reported concerns about the lack of affordable housing in the county. Looking at the secondary data, housing costs in New Hanover County are higher than peer counties. As of 2020, 21.3% of homeowners and 44.3% of renters are spending more than 35% of their monthly income on housing. Additionally, 19.1% of New Hanover households have at least one of four severe housing problems (incomplete kitchen facilities, incomplete plumbing facilities, having more than 1.5 persons per room, and a cost burden greater than 50%).

Prioritization

The stakeholder group was invited to participate in two data walk presentations. During these data walks, data from primary and secondary sources were grouped thematically. NCIPH facilitated the data presentations and discussion, during which community members reacted to the data and provided insight into community context. After the data walks, an online prioritization survey was used to gather votes from New Hanover County residents. The stakeholder group convened again to review the results from community voting, and then vote for themselves on the top three health priorities. The steering committee reviewed these recommendations and selected the following three priority areas:

• Housing
• Mental Health and Substance Use
• Access to care

Next Steps

This assessment serves as a foundation for the health improvement process and the next step is to develop health improvement action plans for each of the three priorities. Working with community partners, New Hanover County will develop measurable objectives to address each priority, identify evidence-based strategies to achieve those objectives, and plan evaluation and accountability throughout the next three years.

Priorities

The priorities identified by the community are:

• Housing
• Mental Health and Substance Use
• Access to Care

Mental health and substance use were separate but was voted by the stakeholder group to be combined as the two have a big impact on one another.

Why Is This Important?

Many factors related to housing quality and affordability can negatively impact health outcomes to include limited space, environmental contaminant and repair issues, high costs, and homelessness. 1 in 6 households within North Carolina faces severe housing problems which means an issue with one of the following: overcrowding, high housing costs, or the lack of kitchen and/or plumbing facilities (NCDHHS, 2022). Housing was the number one priority identified through a survey completed by New Hanover County residents and stakeholders.

Secondary Data from the 2022 Community Health Needs Assessment

• 19.1% of households have at least one of four severe housing problems.

• 21% of homeowners and 44% of renters spend 35% or more of their income on housing costs.

Primary Data from the 2022 Community Health Needs Assessment & Community Conversations:

• Nearly 70% of respondents disagreed that they can find affordable housing.

• 76% of respondents are concerned about the lack of affordable and safe housing.

• Participants of community conversations reported unaffordable housing prices are pushing residents out of the county.

Environmental Health Data Snapshot

• In the past five years (2018-2022), there have been 72 lead investigations.

• In the past five years (2018-2022), there have been 208 mold complaints and investigations.

• Often, mold investigations can occur but homeowners have no recourse to fix the root of the problem.

North Carolina Department of Health and Human Services (2022) . North Carolina State Health Improvement Plan. NC State Center for Health Statistics. Retrieved from https://schs.dph.ncdhhs.gov/units/ldas/docs/NCSHIP-2022-Full.pdf.  

What We Do

The Healthy Homes Program is a grant awarded to the City of Wilmington by HUD. The primary objectives will be to inspect/assess eligible households for mold, perform Home Hazard Interventions, promote awareness of the importance of Healthy Homes, and provide potential economic opportunities to local small business contractors that will perform the Home Hazard intervention projects.

https://www.wilmingtonnc.gov/departments/community-services/community-development-housing/healthy-homes-programs

Who We Serve

Eligible households/housing units that are either privately owned or low-income rental and/or owner occupied housing where low-income individuals (below 80% AMI in Wilmington) reside within the city limits of Wilmington, NC.

How We Impact

Remediating housing-related health and safety hazards that pose the highest degree of likelihood of harm to the occupants if not addressed based on the findings of the inspections/assessments.

Progress on CHIPs

2023 Progress

The Healthy Home Program (HHP) started on May 15, 2023 and has assessed eight households. Six of these homes are in the beginning phases of the intervention and three of the six homes have tested positive for lead-based paint hazards. Providing education is an integral part of this program. Community outreach events were attended, such as Smart Start Information Event and Cape Fear Community College business fair, in order to promote the program. HHP has conducted trainings for staff and partners to increase their knowledge and expectations of potential health hazards and pest control methods.

What We Do

New Hanover County Environmental Health has updated their policy to not require a child under the age of 18 years living in the home and a physicians note when indoor air quality issues, such as mold, arise in the home. All complaints will be investigated.

Who We Serve

This program is available to all New Hanover County Residents. Eligible individuals living within the City of Wilmington will be able to apply to the Healthy Homes Program mold grant.

How We Impact

Environmental Health will educate owners/renters within New Hanover County. The City of Wilmington will conduct Health Homes inspections and repair homes if the owner/renter qualifies. 

Progress on CHIPs

2023 Progress

Environmental Health received and responded to 101 mold complaints in 2023. Procedure changes led to complaints no longer requiring a doctor's note for a child under the age of 18 years old. Educational information on mold, moisture, and other indoor air quality issues are provided to complaints about suspected mold, and eligible individuals are referred to the City of Wilmington's Health Home Program.

What We Do

New Hanover County Environmental Health follows the state rules regarding lead investigations.

Who We Serve

Children under the age of 6 years with elevated blood lead levels.

How We Impact

Homes are investigated and the lead source abated.

Progress on CHIPs

2023 Progress

There were 11 new cases of lead investigations which includes homes, child care centers, and schools. Cases are initiated through blood lead level tests. If elevated levels are found, education is given to the parents and investigations are offered but not mandated. Environmental Health also has an annual monitoring count of 13. These are residences with identified lead hazards which require yearly checks unless the lead hazard has been abated.

North Carolina had a case of lead in a brand of applesauce. The Environmental Health team notified 62 childcare centers of this incident and will remain vigilant on the potential increase of blood lead level results.

What We Do

This is to capture the programs within NHC that support the transitions from homelessness to housing including the use of Rapid Rehousing funding, the connections made through street outreach efforts, and the volume of Permanent Supportive Housing units in the market.

Who We Serve

Individuals and families experiencing homelessness.

How We Impact

Supporting transitions out of homelessness and return households to stability. 

What We Do

The Homeownership Program, Get That Deed, works towards homeownership for families up to 120% AMI (Area Median Income). This program has a cost of $30 for participants.

Who We Serve

Individuals and families up to 120% AMI.

How We Impact

This program has allowed real estate agencies to become certified and help to educate and house individuals.

Progress on CHIPs

2023 Progress

The Get That Deed (GTD) Program had eleven people who completed the course and got preapproved by a lender to find a home. This led to the total of 164 individuals completing the program over the last ten years. Along with course completions, GTD had 123 new consultations assessments and 71 individuals committed to working on their course gameplan. Individuals and families were able to be assisted through the support of grant funding from the Endowment but the funding was not re-secured. A 501c3, Elevate Center, was formed to encompass this program and to continue to support homeownership and sustainability.

What We Do

New Hanover County Housing Division staff will advertise a request for proposals (RFP) to solicit project applications from qualified entities and organizations to administer and deliver Housing Supportive Programs (HSP) supporting affordable housing projects including Gap Financing Program; Infrastructure Financing Program; Emergency Repair Program; Owner-Occupied Rehabilitation Program; Downpayment Assistance Program; Tenant-Based Rental Assistance Program; Affordable Housing Development Program.

Who We Serve

New Hanover County residents (both homeowners and renters) who earn 120% Area Median Income (AMI) or less.

How We Impact

The programs intentions are to increase and improve the housing stock available in New Hanover County.

Progress on CHIPs

2023 Progress

In 2023, funding commitment was made for the Covenant Senior Housing and Estrella Landing Projects to provide 68 and 84 new rental units respectfully. These new units are estimated to be completed in 2024. Also, New Beginning Christian Church was allocated a funding of $500,000 by NHC Board of Commissioners to help residents with rental assistance.

Why Is This Important?

From 2019 to 2020, the number of drug overdose deaths from ilicit substances and medications increased by nearly 1,000 deaths across the state of North Carolina (NCDHHS, 2022). Behavioral health continues to be a top priority identified by the residents of New Hanover County. In the 2019 community health needs assessment, drug misuse was indentified as an urgent community health issue as New Hanover County was receiveing national attention as being a hub for the opioid crisis in the United Stated. Substance use was selected as a top community health priority again in 2022, this time in conjunction with mental health, as the two are often regarded as co-occurring. This result statement and subsequent community health improvement plan align with the greater Healthy North Carolina 2030 indicators and goals. 

Information that led to the selection of Substance Use & Mental Health:

From the 2022 Community Health Needs Assessment: Secondary Data

• Emergency department visits for medication poisoning or drug overdose increased to 289.3 per 100,000 in 2020.
• Drug overdose deaths increased to 39.7 per 100,000 in 2020.
• Emergency department visits for suicidal ideation reached a count of nearly 1,200 in 2021. 
  • Suicide is the 3rd leading cause of death for New Hanover County residents ages 20-39.

From the 2022 Community Health Needs Assessment: Primary Data

• 25% of respondents reported binge drinking behavior.
• 11.3% of respondents reported using tobacco products.
• 30% of respondents reported substance use among themselves or a friend/family member in the past 30 days.
  • 20.4% reported marijuana use.
  • 5.6% reported using medication not prescribed to them, including illicit drugs.
• 9.8% of of respondents who reported substance use sought treatment. Of those who did not seek treatment...
  • 72.9% said it was not needed.
  • 8.1% cost related.
  • 6.7% said they could not take the time off work.
  • 5.7% said fear of stigma.
     
• 1 in 4 respondents reported fair or poor mental health. 
  • 35% of respondents reported mental health symptoms that impacted their daily activities over the last 6 months.
  • 67% received treatment for symptoms.
    • 32% sought treatment from mental health counselors.
    • 40% sought treatment from a primary care provider.
  • 24% of respondents reported challenges finding mental health resources in NHC.

North Carolina Department of Health and Human Services (2022) . North Carolina State Health Improvement Plan. NC State Center for Health Statistics. Retrieved from https://schs.dph.ncdhhs.gov/units/ldas/docs/NCSHIP-2022-Full.pdf.  

Strategy

Due to the amount of resources already being put towards addressing this problem in New Hanover County, the stakeholder group felt it would be best to narrow down the scope of work to address a specific aspect of mental health. The group associated barriers to seeking mental health service with the stigma many experience when asking for help. In addition, barriers to accessing mental health care were frequently brough up throughout stakeholder meetings. After discussion, the group felt it would be most beneficial to work on reducing barriers to seeking and accessing mental health care by increasing education on protective factors and positive coping skills, as well as normalizing mental health and the provision of mental health support in the areas we already live, work, and play. 

What We Do

The CARE 911 Program acts as a 911 diversion program for callers experiencing trauma and/or behavioral health crisis, and a referral service for first responders to connect callers to needed resources and supports while working to de-escalate and stabilize when possible. Staff who respond to callers perform a needs assessment and assess for suicidality when needed. The program began in 2023 and is fully funded by New Hanover County government. 

Who We Serve

The program serves all New Hanover County residents who call 911 or who request CARE follow-up through their First Responder during a crisis. 

How We Impact

The program helps to provide an appropriate response to callera in real time, connect callers to resources, make caring connections, and provide additional support as applicable. Often, a caller just needs someone to listen and to care in the moment. Staff are also trained to provide crisis and trauma support. 

Examples of CARE calls include, but are not limited to:

• Anxeity, panic attacks, PTSD
• Suicidal
• Family disturbance
• Sexual assault
• Stress/trauma
• Homelessness
• Grief support

Progress on CHIPs

This is a new program added to the scorecard for 2023. 

What We Do

The New Hanover County Resiliency Task Force began in 2016 with a group of concerned child and education focused non-profit organizations who began meeting to collaborate on grant-writing efforts to address 3rd grade reading outcomes. After gaining some momentum in 2018, the group expanded to include additional New Hanover County entities and focus its efforts on addressing social determinants of health as it relates to Adverse Childhood Experiences (ACES's). The NHC Resiliency Task Force now works to reduce and prevent ACEs, respond to existing trauma in children, adults and providers with knowledge, empathy, and compassion, and create opportunities for our community to form meaningful connections with one another. The NHC Resiliency Task Force aims to create meaningful systems change by helping organizations approach their work through a trauma-informed lens. The task force is guided by a steering committee and operates through eight different subcommittees which all focus on a distinct area, including: birth to 8 years old; 4th grade to 12th grade; first responders and the justice system; healthcare; family, faith, and community initiatives; data; the arts; and equity and inclusion. 

https://www.nhcbouncesback.org/

Who We Serve

The New Hanover County Resiliency Task Force serves all people of New Hanover County, working primarily through an organizational approach. The task force partners with local agencies and community groups to provide trainings like Mental Health First Aid and the Community Resiliency Model. 

How We Impact

Trauma-informed organizations produce better outcomes for clients, patients, students and the “providers” themselves.

What We Do

Overall, the Life Enrichment Program (LEP) provides services in five focus areas, including (1) information, assistance, and options counseling services, (2) home-based services, (3) protection and advocacy, (4) family caregiver support, and (5) community enrichment. Specific to mental health, the LEP provides outpatient mental health and substance abuse services by a team of master's level Licesnced Clinical Therapists at no cost to members of the Senior Resource Center. Services are provided on campus, virtually, and in the residence as needed. 

The Mental Health Program at the Senior Resource Center (SRC) was initially funded through American Rescue Plan Funds. However, with the depletion of these grant funds, New Hanover County recognized the program's value and committed government dollars to sustain the program. To facilitate sustainable funding, SRC collaborated with New Hanover County Health and Human Services to establish National Provider Identifier (NPI) numbers, enabling the program to bill insurance for reimbursement. Notably, the program ensures accessibility by not charging copays for older adult clients. Beginning February 1, 2023, SRC will gradually transition to insurance reimbursement while continuing to provide services to individuals without insurance or those opting not to use it.

https://www.nhcgov.com/521/Information-and-Support---Life-Enrichmen

Who We Serve

Older adult residents of New Hanover County and their families.

How We Impact

It is the goal of this program to promote social, physical, economic, and emotional well-being while encouraging maximum independence and improving the quality of life for older adults and their caregivers. The team uses a collaborative approach to promote resilience and build on the strengths of the seniors they serve. The LEP strives to be a leader in providing high quality care to seniors grounded in evidence-based practice that supports them in achieving lasting sucess within the community. 

Progress on CHIPs

For the Life Enrichment Prorgam, we updated the performance measures to more accurately display the effectiveness of the prorgam through data that is currently being collected, including qualitative statements to support how the programming is bettering the lives of older adults in New Hanover County. We also added more information on how the program is funded and being sustained moving forward. 

What We Do

New Hanover County Health and Human Services has partnered with New Hanover County Schools (NHCS) to provide mental health services at no out of pocket cost. The county provides licensed clinical therapists at all NHCS elementary and middle schools by referral to treat behavioral and emotional concerns. The program began 20 years ago and was expanded in response to the COVID-19 pandemic with American Rescue Plan funding. The program currently employs 32 therapists serving 31 schools throughout the county. 

Who We Serve

New Hanover County students and their families.

How We Impact

Increasing access to affordable mental health services.

Progress on CHIPs

For the school-based mental health programs, we updated the performance measure to more accurately display the effectiveness of the program through data that is currently being collected and added a new performance measure to enhance the understanding of how well this program is impacting the elementary and middle school students it is serving. 

What We Do

Wilmington Health Access for Teens offers comprehensive primary medical care, mental health and prevention services for children, adolescents and young adults ages 6-24. The WHAT Clinic has school wellness centers located in all four New Hanover County public high schools. 

https://www.whatwilmington.org/

Who We Serve

Children, adolescents, and young adults ages 6-24, including those enrolled in Medicaid or other public insurance plans.

How We Impact

The services provided by the WHAT Clinic are designed to meet the unique needs of the adolescent and young adult population through an accessible and comprehensive approach.

Strategy

Due to the amount of resources already being put towards addressing this problem in New Hanover County, the stakeholder group determined it would be best to narrow down the scope of work to address a specific aspect of substance use. The group felt there were still several barriers to adequately addressing this problem, including the inability to collect data from persons under 18 years of age and not being able to comprehensively implement harm reduction strategies. After discussion, the group determined it would be beneficial to have conversations with local leaders as well as community members to gain additional data and support for evidence-based solutions to various aspects of substance use issues. 

What We Do

Received by Coastal Horizons in May 2022 with the goal of learning what may prevent communities identified as high-risk or underserved from accessing mental health and substance use services, and other related concerns they see in their neighborhood. 

Who We Serve

The Northside and Westchester neighborhoods in Wilmington.

How We Impact

Why Is This Important?

Access to quality health care services is critical to achieve and maintain health, prevent and manage disease, and achieve health equity. Lack of health insurance can make health care inaccessible and unaffordable. 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. Access to care includes the availability of high-quality care and community members’ ability to take advantage of that care. In addition, having a strong focus on maternal health in our community is needed now more than ever. Prenatal through postpartum care is care given to pregnant women by an obstetrician or midwife and increases the likelihood of a safe and healthy delivery. By addressing chronic diseases such as diabetes and hypertension associated with preterm birth, prenatal care has been found to reduce adverse birth outcomes. Assessment of prenatal care utilization is considered a critical step in improving prenatal care access and birth outcomes.

As a result from our 2022 Community Health Needs Assessment, it was determined that 41% of respondents selected this area of priority. 2/3 of respondents reported a barrier to care in New Hanover within the last year, including: high costs, lack of appointments, and a coverage gap through their insurance provider.  

What We Do

The Cape Fear Mobile Wellness Collaborative is a new project being led by UNCW and Novant Health with the mission to promote and support mobile healthcare providers and wellness services to increase access to care and resources for all in Cape Fear region. With participation from partners ranging in work on homelessness, food insecurity, dentistry, and access to care, this collaborative will work to collectively bring together the mobile work to communities to meet them where they work, live, and play. Funding sources are being considered, such as the New Hanover Endowment Grant, and other local grants. As more information and formal decisions are established, they will be updated here.

Who We Serve

The vision for this program is for a community in which all people have equitable access to quality healthcare and health-related social support services. While this is still in the early stages of planning, as of September 2023, the group is working on reaching vulnerable communities and neighborhoods across Cape Fear. As more information and formal decisions are established, they will be updated here.

How We Impact

The program has 5 main goals of purpose, listed below. As more information and formal decisions are established, they will be updated here.

• Build capacity among partners.
• Support the establishment of trust with the community.
• Remove barriers to SDOH resources.
• Share knowledge on best practices and resources.
• Offer a venue for connection that meets the needs of most individuals.

Progress on CHIPs

While the CFMWC was getting off the ground in 2023 and did not have any formal events, there has been more collective efforts into the success of this initiative and events being planned for 2024. The CFMWC did apply for the New Hanover Community Endowment Grant and was not selected for funding, but organizers will contiune to seek out other funding sources as appropriate. 

What We Do

During the second week of each month, New Hanover County Health and Human Services Economic Services will be at three community locations from 10am to 1pm to accept applications for Medicaid or SNAP benefits. On Tuesday's they will be at the YWCA of Lower Cape Fear. On Wednesdays, the Nir Family YMCA. On Thursday's, Ephesus SDA Church. The goal of this outreach is to provide guidance and support for those who are looking to enroll in Medicaid and learn more about SNAP benefits. Click here to see the flyer for this program: EconSvcsFINALEngSpa.pdf. When clients come, they can receive education on the types of Medicaid plans, SNAP benefit eligibility, other New Hanover County resources, and more.

Who We Serve

This outreach is open to anyone in New Hanover County who is interested in learning more about Medicaid and/or SNAP benefits. The locations were selected based on community input and planning on reaching the highest number of individuals who would benefit from participating in the outreach.

How We Impact

Progress on CHIPs

The Econoic Services Outreach events have been very well recieved by the community, seeing nearly 150 clients in since the start of the 2023-2024 fiscal year. Events have also been well attended after the expansion of Mediciad in December 2023.

What We Do

New Hanover County Health and Human Services currently offers two different dental outreach programs throughout the County: The Mobile Dental Unit and the Older Adult Dental Program.

Our Mobile Dental Unit offers services in for children ages 3 to 18 years without accessible or established dental care or insurance. Typical services include comprehensive dental exams, cleanings, fluoride treatments, extractions, X-rays, sealants, and fillings.

Our Older Adult Dental Program provides comprehensive dental care for low-income older adults aged 55 and older. This service began in July 2022 and is provided through New Hanover County Health and Human Services and the Senior Resource Center, in partnership with Access Dental Care, Inc. Typical services include dental exams, X-rays, cleanings, fillings, extractions, select root canals, dentures, and partials. 

Who We Serve

Our Older Adult Dental Program is eligible for those who are: age 55 and older, a New Hanover County resident, whose income is below 200% the federal poverty level, and does not currently have dental insurance.

Our Mobile Dental Unit sees children 3 to 18 years of age, children with Medicaid, as well as children with no dental insurance (sliding fee scale, based on income). They are currently in the following schools between New Hanover and Brunswick counties:

New Hanover County:

• Rachel Freeman Elementary
• Sunset Park Elementary
• Gregory Elementary/Williston Middle
• Dorothy B Johnson Pre-K
• Wrightsboro Elementary
• Snipes Academy
• Mary C. Williams Elementary
• Castle Hayne Elementary/Holly Shelter Middle
• Alderman Elementary
• College Park Elementary
• Bradley Creek Elementary

Brunswick County:

• Belville Elementary
• Jessie Mae Monroe Elementary
• Lincoln Elementary
• Supply Elementary
• Union Elementary
• Town Creek Elementary
• Bolivia Elementary
• Waccamaw K-8
• Virginia Williamson Elementary

How We Impact

Progress on CHIPs

The New Hanover County Dental Outreach programs are doing well and had a successful year in 2023, seeing over 2,500 patients collectively.

Strategy

This workgroup was brought together after the 2023 YWCA Health Summit that addressed the national maternal health crisis, specifically minority populations. The idea of this workgroup is to come together to discuss the data on maternal health, identify strategies and programs to improve access to care and services, and focus more of our independent efforts into providing exceptional maternal health care. Additionally, New Hanover County leadership is working on different fronts, such as community listening sessions and working with various political leaders to address this issue.

Our goals as a group include: 

1. Bring back the program First Year Cape Fear.
2. Launch an educational campaign, including cultural awareness, for both the women and providers in the area. This campaign will be titled “See Me, Hear Me, Help Me”. This will reflect the “Hear Her” campaign with the CDC.
   1. For the women, the campaign will focus on advocacy.
   2. For the providers, the campaign will focus on how to better listen to BIPOC women when they explain signs and symptoms.
3. Target efforts into collecting more local data on maternal mortality and morbidity.

Partnerships

New Hanover County Health and Human Services

Novant Health New Hanover Regional Medical Center

YWCA of the Lower Cape Fear

University of North Carolina at Wilmington

MedNorth

Cape Fear Collective

SEAHEC

Community Members

Progress on CHIPs

Progress on First Year Cape Fear:

• Currently locating a "home" agency for the program with plans to establish a governing board with partners to share roles and responsibilities.
• All of the previous plans, lessons, and materials have been located and are ready for public use.

Progress on the “See Me, Hear Me, Help Me” Campaign:

• Subcommittee has been formed to begin working on the campaign.

Progress on Local Data Collection:

• NHC Health Staff have been working with NCDHHS on obtaining more recent data on maternal morbidity and mortality. The most recent data obtained is from 2014-2016.

What We Do

First Year Cape Fear is a task force comprised of local health advocates within New Hanover, Brunswick, and Columbus Counties that have come together to address concerning racial gaps in the Cape Fear’s infant mortality rates.

Who We Serve

Mothers and infants within New Hanover, Brunswick, and Columbus Counties - specifically those who are Black/African-American.

How We Impact

Progress on CHIPs

Click on Links belows for 2023 CHIP Program Updates:

Housing

•   Healthy Home Program
•   Indoor Air Quality Education
•   Lead Investigations
•   Homeownership Program
•   Workforce Housing Services Program

Substance Use and Mental Health

•   911 Community Assistance Response Engagement 
•   New Hanover County Resiliency Task Force
•   New Hanover County Senior Resource Center: Life Enrichment Program
•   School-Based Mental Health

Access to Care

•   Cape Fear Mobile Wellness Collaborative
•   New Hanover County Economic Services Outreach
•   New Hanover County Dental Outreach Programs

Morbidity and Mortality Changes Since Last CHA

Increase in HIV/STI Cases

• New Hanover County Health Department reported 17 new cases of HIV in 2023

Seasonal Illnesses (Flu, COVID-19, RSV)

Data Source: NC Detect

Emerging Issues Since Last CHA

Housing Crisis

• Individuals experiencing homelessness after relocating to New Hanover County via Transitional Programs
• Closure of different homeless shelters, such as Salvation Army

Increase in depression and anxiety in New Hanover County

• Older Adults - Social isolation
• Youth - Lack of social skill development and saturation of technology

New/Paused/Discontinued Initiatives Since Last CHA

New Initiatives

• 911 Community Assistance Response Engagement (CARE)
  • The CARE 911 Program began in 2023 and acts as a 911 diversion program for callers experiencing trauma and/or behavioral health crisis, and a referral service for first responders to connect callers to needed resources and supports while working to de-escalate and stabilize when possible.
• Medicaid Expansion
  • Medicaid Expansion came into effect December 1, 2023, and allows for mre adults to access health care coverage. The eligibility age range for adults increased to ages 19-64 and up to 138% of the Federal Poverty Level. 
• Clean Classrooms for Carolina Kids
  • The goal of this program is to 'address lead and asbestos hazards in NC public schools, licensed child care centers, and licensed family child care homes.' NHC Environmental Health will be overseeing lead water testing and hazards will be mitigated through grant funding. For more information about this program, visit: https://www.cleanwaterforuskids.org/en/carolina/.
• New Hanover Community Endowment Grant Recipients
  • The Community Endowment Grant was established through the 2020 sale of New Hanover Regional Medical Center to Novant Health. In 2023, multi-year grants were given to support 19 organization's initiatives along with 14 organizations receiving one-year nonrenewable grants. Click here to learn more about the recipients.
• Mental Health and Substance Abuse Strategy
  • New Hanover County provided funding to organizations- LINC, New Beginnings, Coastal Horizons, and TIDES- to support their programs and assist in building more capacity to serve more clients.
• Increase in Federal Poverty Level Requirements in New Hanover County

Discontinued Initiatives

• School-Based Mental Health Program losing Pre-K Therapists and Early Childhood Mental Health Program

  • Due to their current status as being grant funded, the pre-k therapist position and the early childhood mental health program will not continue into the next fiscal year. 

Progress on CHIPs

Morbidity and Mortality Changes Since Last CHA

Emerging Issues Since Last CHA

New/Paused/Discontinued Initiatives Since Last CHA