2Macon County, NC State of the County Health Report

Transcription

1 2Macon County, NC 2013 State of the County Health Report

2 Review of Current Data Demographic Profile and Key Mortality and Morbidity Data

3 Macon County Resident Population Estimates by Age, Race, and Gender as of July 1, 2012 (based on the 2010 census) AGE WHITE NON- HISPANIC RACE/ETHNICITY AFRICAN AMERICAN NON-HISPANIC Review of Current Data ,680 1, SEX OTHER NON- HISPANIC HISPANIC MALE FEMALE TOTAL TOTAL 33,869 30, ,235 16,422 17, ,654 1, ,779 1, ,917 1, , ,852 1, ,651 1, ,651 1, ,515 1, ,837 1, ,027 1, , ,441 2, ,183 1, ,503 2, ,156 1, ,835 2, ,337 1, ,698 2, ,258 1, ,124 2, , ,603 1, ,131 1, Source: County Health Data Book N.C. Department of Health and Human Services

4 Death Rates, Macon County vs. NC Macon County Resident - Race/Ethnicity/Sex/Age-Adjusted Death Rates Rates are per 100,000 population, based on the 2000 US Census population Cause of Death Top 5 Macon County Overall NC Overall Deaths Rate Deaths Rate All Causes 2, , Diseases of Heart , Acute Myocardial Infarction , Other Ischemic Heart Disease , Cerebrovascular Disease , Cancer , Colon, Rectum, and Anus , Pancreas , Trachea, Bronchus, and Lung , Breast , Prostate , Diabetes Mellitus , Pneumonia and Influenza , Chronic Lower Respiratory Diseases , Chronic Liver Disease and Cirrhosis , Septicemia , Nephritis, Nephrotic Syndrome, and Nephrosis , Unintentional Motor Vehicle Injuries , All Other Unintentional Injuries , Suicide , Homicide 6 N/A 2, Alzheimer's disease , Acquired Immune Deficiency Syndrome 2 N/A 1, Source: County Health Data Book N.C. Department of Health and Human Services

5 Community Health Priorities & Improvement

6 Our Health Priorities Selected as a result of the 2011 and 2012 Macon County Community Health Needs Assessments

7 Reduce the incidence of preventable chronic diseases related to obesity particularly diabetes and heart disease.

8 Macon COUNTY 2013 Priority 1 Community Transformation Project, MountianWise, increased access to healthy foods at farmer s markets and food stands. Fruit and Vegetable Outlet Inventory Rack cards Media promotion via MountainWise SNAP access added Distribution of equipment and promotional items to assist markets (tents, signs, tables, coolers, mobile kitchen, etc.) Promoted Almost None initiative Recent expansions of local worksite wellness programs (Angel Medical Center, Drake Enterprises, Macon County, Town of Franklin, etc.) New partnership created by Macon County Public Health to expand nutrition counseling and education services. Eat Smart, Move More, Faithful Families initiative launched by Macon County Public Health. Expansion of Breastfeeding Resources New Certified Lactation Educator at AMC and Breastfeeding Peer Counselor at MCPH.

9 Heart Disease Macon County vs. NC Rate / 100, Macon Death Rate/ 100, NC Death Rate / 100, NC State Center for Health Statistics: NC and Macon County Resident Race/Ethnicity-Specific and Sex-Specific Age-Adjusted Death Rates Standard = Year 2000 U.S. Population ; *Rates Per 100,000 Population

10 Heart Disease Cherokee Graham Clay Mitchell Avery Watauga Ashe Alleghany Wilkes Surry Yadkin Stokes Rockingham Caswell Person Forsyth Guilford Yancey Caldwell Alexander Davie Madison Iredell Davidson Burke Randolph McDowell Buncombe Catawba Rowan Haywood Swain Lincoln Rutherford Henderson Cabarrus Jackson Polk Cleveland Stanly Gaston Macon Transylvania Montgomery Mecklenburg Union Anson Orange Alamance Moore Chatham Lee Durham Harnett Granville Wake Vance Franklin Johnston Cumberland Richmond Hoke Sampson Warren Nash Wilson Wayne Duplin Halifax Northam pton Edgecombe Greene Lenoir Pitt Jones Martin Craven Hertford Bertie Beaufort Gates Washington Tyrrell Dare Pamlico Hyde Scotland Onslow Carteret Mortality Rates Per 100,000 Population Robeson Bladen Columbus Brunswick Pender New Hanover North Carolina Resident Data Figure 2.A Heart Disease Source: NC Vital Statistics Volume 2 Leading Causes of Death Cherokee Graham Clay Swai n Macon Jackson Haywood Madi son Transylvania Buncombe Henderson Yancey Mitchell McDowell Pol k Avery Rutherford Watauga Burke Ashe Caldwell Cleveland Alleghany W ilkes Alexander Catawba Lincoln Gaston Age Adjusted Mortality Rates Per 100,000 Population Iredell Surry Yadkin Mecklenburg Davie Rowan Cabarrus Union Stokes Rockingham Caswell Person Forsyth Davidson Stanly Anson Guilford Randolph Montgomery Alamance Moore Chatham Orange Lee Durham Harnett Granville Wake Vance Franklin Johnston Cum berland Richm ond Hoke Sam pson Scotland Robeson Bladen Colum bus Warren Brunswick Nash W ilson Wayne Duplin Pender New Hanover Halifax Northam pton Edgecom be Greene Lenoir Pitt Jones Onslow Martin Craven Hertford Bertie Beaufort Gates Washington Tyrrell Dare Pam lico Carteret Hyde North Carolina Resident Data

11 Diabetes Macon County vs NC Rate/100, Macon Death Rate/ 100, NC Death Rate / 100, NC State Center for Health Statistics: NC and Macon County Resident Race/Ethnicity-Specific and Sex-Specific Age-Adjusted Death Rates Standard = Year 2000 U.S. Population ; *Rates Per 100,000 Population

12 Promote recruitment and retention of additional primary care physicians and dental practitioners serving Macon County residents.

13 Priority 2 Grand opening of new Macon County Adult Dental Clinic, April, Increase in hospital-based physician employment. Highlands-Cashiers Hospital and Blue Ridge Dental Clinic receive dental expansion grant from the Duke Endowment. Mission affiliation has provided enhanced recruitment opportunities and increased local access to specialists. Contracts with new AMC hospital-based physicians and physician extenders provide volunteer support for the Franklin Community Care Clinic.

14 Reduce the incidence and mortality rates of breast, colon, and lung cancer through prevention and early intervention efforts.

15 Priority 3 Promoted participation in the American Cancer Society s CPS-3 study. Currently applying for grant funding for YES (Youth Empowered Solutions) training. YES trained youth will advocate for more tobacco-free public places. Ladies Night Out programs continue to focus on screening and early detection. Participation now averages 125 per month. Angel Medical Center has obtained new digital mammography equipment.

16 Cancer (colon, rectum, anus) Macon County vs NC Rate / 100, Macon Death Rate/ 100, NC Death Rate / 100, NC State Center for Health Statistics: NC and Macon County Resident Race/Ethnicity-Specific and Sex-Specific Age-Adjusted Death Rates Standard = Year 2000 U.S. Population ; *Rates Per 100,000 Population

17 Cancer - Colon, Rectum and Anus Cherokee Graham Clay Mitchell Avery Watauga Ashe Alleghany Wilkes Surry Yadkin Stokes Rockingham Caswell Person Forsyth Guilford Yancey Caldwell Alexander Davie Madison Iredell Davidson Burke Randolph McDowell Buncombe Catawba Rowan Haywood Swain Lincoln Rutherford Henderson Cabarrus Jackson Polk Cleveland Stanly Gaston Macon Transylvania Montgomery Mecklenburg Union Anson Orange Alamance Moore Chatham Lee Durham Harnett Granville Wake Vance Franklin Johnston Cumberland Richmond Hoke Sampson Warren Nash Wilson Wayne Duplin Halifax Northam pton Edgecombe Greene Lenoir Pitt Jones Hertford Bertie Gates Martin Washington Tyrrell Dare Craven Beaufort Pamlico Hyde Scotland Onslow Carteret Mortality Rates Per 100,000 Population Robeson Bladen Columbus Brunswick Pender New Hanover North Carolina Resident Data Figure 5.A Cancer - Colon, Rectum and Anus Cherokee Graham Clay Swai n Macon Jackson Haywood Madi son Transylvania Buncombe Henderson Yancey Mitchell McDowell Pol k Avery Rutherford Watauga Burke Ashe Caldwell Cleveland Alleghany W ilkes Alexander Catawba Lincoln Gaston Age Adjusted Mortality Rates Per 100,000 Population Iredell Surry Yadkin Mecklenburg Davie Rowan Cabarrus Union Stokes Rockingham Caswell Person Forsyth Davidson Stanly Anson Guilford Randolph Montgomery Alamance Moore Chatham Orange Lee Durham Harnett Granville Wake Vance Franklin Johnston Cum berland Richm ond Hoke Sam pson Scotland Robeson Bladen Colum bus Warren Brunswick Nash W ilson Wayne Duplin Pender New Hanover Halifax Northam pton Edgecom be Greene Lenoir Pitt Jones Onslow Martin Craven Hertford Bertie Beaufort Gates Washington Tyrrell Dare Pam lico Carteret Hyde North Carolina Resident Data Source: NC Vital Statistics Volume 2 Leading Causes of Death

18 Cancer (trachea, bronchus, lung) Macon County vs NC Rate / 100, Macon Death Rate/ 100, NC Death Rate / 100, NC State Center for Health Statistics: NC and Macon County Resident Race/Ethnicity-Specific and Sex-Specific Age-Adjusted Death Rates Standard = Year 2000 U.S. Population ; *Rates Per 100,000 Population

19 Cancer - Trachea, Bronchus and Lung Cherokee Graham Clay Mitchell Avery Watauga Ashe Alleghany Wilkes Surry Yadkin Stokes Rockingham Caswell Person Forsyth Guilford Yancey Caldwell Alexander Davie Madison Iredell Davidson Burke Randolph McDowell Buncombe Catawba Rowan Haywood Swain Lincoln Rutherford Henderson Cabarrus Jackson Polk Cleveland Stanly Gaston Macon Transylvania Montgomery Mecklenburg Union Anson Orange Alamance Moore Chatham Lee Durham Harnett Granville Wake Vance Franklin Johnston Cumberland Richmond Hoke Sampson Warren Nash Wilson Wayne Duplin Halifax Northam pton Edgecombe Greene Lenoir Pitt Jones Hertford Bertie Gates Martin Washington Tyrrell Dare Craven Beaufort Pamlico Hyde Scotland Onslow Carteret Mortality Rates Per 100,000 Population Robeson Bladen Columbus Brunswick Pender New Hanover North Carolina Resident Data Figure 6.A Cancer - Trachea, Bronchus and Lung Source: NC Vital Statistics Volume 2 Leading Causes of Death Cherokee Graham Clay Swai n Macon Jackson Haywood Madi son Transylvania Buncombe Henderson Yancey Mitchell McDowell Pol k Avery Rutherford Watauga Burke Ashe Caldwell Cleveland Alleghany W ilkes Alexander Catawba Lincoln Gaston Age Adjusted Mortality Rates Per 100,000 Population Iredell Surry Yadkin Mecklenburg Davie Rowan Cabarrus Union Stokes Rockingham Caswell Person Forsyth Davidson Stanly Anson Guilford Randolph Montgomery Alamance Moore Chatham Orange Lee Durham Harnett Granville Wake Vance Franklin Johnston Cum berland Richm ond Hoke Sam pson Scotland Robeson Bladen Colum bus Warren Brunswick Nash W ilson Wayne Duplin Pender New Hanover Halifax Northam pton Edgecom be Greene Lenoir Pitt Jones Onslow Martin Craven Hertford Bertie Beaufort Gates Washington Tyrrell Dare Pam lico Carteret Hyde North Carolina Resident Data

20 Cancer (breast) Macon County vs NC Rate / 100, Macon Death Rate/ 100, NC Death Rate / 100, NC State Center for Health Statistics: NC and Macon County Resident Race/Ethnicity-Specific and Sex-Specific Age-Adjusted Death Rates Standard = Year 2000 U.S. Population ; *Rates Per 100,000 Population

21 Cancer - Breast Cherokee Graham Clay Mitchell Avery Watauga Ashe Alleghany Wilkes Surry Yadkin Stokes Rockingham Caswell Person Forsyth Guilford Yancey Caldwell Alexander Davie Madison Iredell Davidson Burke Randolph McDowell Buncombe Catawba Rowan Haywood Swain Lincoln Rutherford Henderson Cabarrus Jackson Polk Cleveland Stanly Gaston Macon Transylvania Montgomery Mecklenburg Mortality Rates Per 100,000 Female Population Union Anson Richmond Orange Alamance Moore Scotland Chatham Hoke Lee Robeson Durham Harnett Cumberland Granville Wake Bladen Columbus Vance Franklin Johnston Sampson Warren Brunswick Nash Wilson Wayne Duplin Pender New Hanover Halifax Northam pton Edgecombe Greene Lenoir Pitt Jones Onslow Hertford Bertie Gates Martin Washington Tyrrell Dare Craven Beaufort Pamlico Carteret Hyde North Carolina Resident Data Figure 7.A Cancer - Breast Source: NC Vital Statistics Volume 2 Leading Causes of Death Cherokee Graham Clay Swai n Macon Jackson Haywood Madi son Transylvania Buncombe Henderson Yancey Mitchell McDowell Pol k Avery Rutherford Watauga Burke Ashe Caldwell Cleveland Alleghany W ilkes Alexander Catawba Lincoln Gaston Iredell Surry Yadkin Mecklenburg Age Adjusted Mortality Rates Per 100,000 Female Population Davie Rowan Cabarrus Union Stokes Rockingham Caswell Person Forsyth Davidson Stanly Anson Guilford Randolph Montgomery Alamance Moore Chatham Orange Lee Durham Harnett Granville Wake Vance Franklin Johnston Cum berland Richm ond Hoke Sam pson Scotland Robeson Bladen Colum bus Warren Brunswick Nash W ilson Wayne Duplin Pender New Hanover Halifax Northam pton Edgecom be Greene Lenoir Pitt Jones Onslow Martin Craven Hertford Bertie Beaufort Gates Washington Tyrrell Dare Pam lico Carteret Hyde North Carolina Resident Data

22 Emerging Issues & Local Changes

23 New & Emerging Issues Suicide Rabies Lead Gonorrhea E-Cigarettes

24 Macon County Suicides Deaths Source NC Detailed Mortality Statistics

25 Rabies Progression in North Carolina Community Forum planned for January MCPH sponsored 2 vaccination clinics in Vaccinated 1,189 animals. Increase in private organizations and businesses offering vaccination clinics.

26 Lead Macon County Environmental Health staff discovered that approximately 10-12% of recently installed wells had lead levels exceeding maximum allowable levels. The lead levels have been associated with the use of galvanized system components.

27 Lead What s Next? Draft a joint communication release with the NC Division of Health and Human Services (DHHS) and Division of Environment and Natural Resources (DENR). Conduct meetings with the Heads of the Division of Public Health, the Division of Water Quality, and the Aquifer Protection Section. Also involve the Secretaries of DHHS and DENR. Advise all local Health Directors Work with Division of Public Health EPI Section staff on a sampling protocol.

28 Gonorrhea MCPH disease surveillance processes have documented a recent trending of locally acquired gonorrhea. Historically, gonorrhea has not been endemic in Macon County.

29 E-Cigarettes Current smoking and tobacco policies may not cover e-cigarettes. Nicotine Addiction viewed as a safe alternative by many, but may continue to be a gateway drug for youth. Health risks not established for the smoker or bystanders. Illicit drug delivery device reported use of liquid and wax based cannabis.

30 Changes That May Affect Health Long-term funding for the Community Care Clinic of Franklin remains unsecured. Angel Medical Center and Highlands-Cashiers Hospital have recently affiliated with the Mission Health System. This affiliation may provide opportunities for expanded operations, service capacity, and access to specialist care. Due to community demand, a new dialysis center opened in Macon County. This center provides access to care without long-distance travel. NC Tracs. Currently, many health care providers, are not getting paid for services. Some have elected to stop seeing Medicaid patients. ACA Impacts o Improved transition of care planning at hospital discharge. AMC implemented the Illuminate patient call back system in September, o WNC Healthy Impact coordinated region-wide collaborative community needs assessment and planning. o Community benefit planning by hospitals tied to demonstrated need CTP / MountainWise launched a new region-wide Health Impact Assessment (HIA). The HIA is called Mountain Elements. AMC adds a state-of-the-art Computed Tomography Scanner.

31 For More Information Contact Macon County Public Health 1830 Lakeside Drive Franklin, NC or /MaconPublicHealth What Next? This document will be disseminated to libraries, the Board of Health, municipality leaders, schools, the Macon County website and other community venues. To find out how you may become involved in the issues you have learned about here, please contact Becky Barr or Dawn Wilde at (828)