2Macon County, NC 2013 State of the County Health Report
Review of Current Data Demographic Profile and Key Mortality and Morbidity Data
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 20-24 1,680 1,394 87 53 146 882 798 SEX OTHER NON- HISPANIC HISPANIC MALE FEMALE TOTAL TOTAL 33,869 30,665 581 388 2,235 16,422 17,447 0-4 1,654 1,237 43 34 340 839 815 5-9 1,779 1,423 38 26 292 894 885 10-14 1,917 1,639 36 25 217 1,002 915 15-19 1,852 1,560 115 28 149 982 870 25-29 1,651 1,394 22 24 211 846 805 30-34 1,651 1,380 25 9 237 800 851 35-39 1,515 1,287 22 26 180 785 730 40-44 1,837 1,626 41 27 143 931 906 45-49 2,027 1,894 22 28 83 958 1,069 50-54 2,441 2,319 30 15 77 1,183 1,258 55-59 2,503 2,424 23 21 35 1,156 1,347 60-64 2,835 2,768 22 20 25 1,337 1,498 65-69 2,698 2,608 22 22 46 1,258 1,440 70-74 2,124 2,081 12 18 13 979 1,145 75-79 1,603 1,566 11 8 18 757 846 80-84 1,131 1,116 6 1 8 504 627 85+ 971 949 4 3 15 329 642 Source: 2014 - County Health Data Book N.C. Department of Health and Human Services
2008-2012 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 2,051 755.0 394,087 800.6 Diseases of Heart 478 168.3 85,890 174.4 Acute Myocardial Infarction 66 23.1 18,189 36.7 Other Ischemic Heart Disease 1 231 79.6 35,189 71.1 Cerebrovascular Disease 4 114 39.7 21,821 45.1 Cancer 463 165.1 89,505 175.9 Colon, Rectum, and Anus 32 11.2 7,561 14.9 Pancreas 25 8.6 5,330 10.4 Trachea, Bronchus, and Lung 2 164 55.8 27,204 52.8 Breast 37 29.8 6,415 22.4 Prostate 27 21.2 4,356 23.4 Diabetes Mellitus 47 16.8 10,984 21.8 Pneumonia and Influenza 40 14.4 8,710 18.0 Chronic Lower Respiratory Diseases 3 141 46.8 22,884 46.6 Chronic Liver Disease and Cirrhosis 34 15.3 4,926 9.3 Septicemia 22 8.6 6,597 13.4 Nephritis, Nephrotic Syndrome, and Nephrosis 44 14.6 8,795 18.0 Unintentional Motor Vehicle Injuries 22 12.6 6,875 14.3 All Other Unintentional Injuries 88 43.0 14,168 29.4 Suicide 34 20.2 5,958 12.2 Homicide 6 N/A 2,846 6.0 Alzheimer's disease 5 94 31.4 13,746 29.3 Acquired Immune Deficiency Syndrome 2 N/A 1,560 3.1 Source: 2014 - County Health Data Book N.C. Department of Health and Human Services
Community Health Priorities & Improvement
Our Health Priorities Selected as a result of the 2011 and 2012 Macon County Community Health Needs Assessments www.maconnc.org/healthy-carolinians
Reduce the incidence of preventable chronic diseases related to obesity particularly diabetes and heart disease.
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 5-2-1-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.
Heart Disease Macon County vs. NC 250 200 Rate / 100,000 150 100 50 0 03-07 04-08 05-09 06-10 07-11 Macon Death Rate/ 100,000 195.4 190.5 191.2 181.7 174 NC Death Rate / 100,000 210.7 202.2 191.7 184.9 179.3 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
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 322.2-483.9 265.5-322.1 221.7-265.4 170.3-221.6 97.0-170.2 Robeson Bladen Columbus Brunswick Pender New Hanover North Carolina Resident Data 2007-2011 Figure 2.A Heart Disease Source: NC Vital Statistics Volume 2 Leading Causes of Death - 2011 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 240.8-341.6 209.4-240.7 187.1-209.3 164.2-187.0 136.2-164.1 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 2007-2011
Diabetes Macon County vs NC 30 25 Rate/100,000 20 15 10 5 0 03-07 04-08 05-09 06-10 07-11 Macon Death Rate/ 100,000 23 22.1 15.8 13 12.7 NC Death Rate / 100,000 26.4 25.2 23.6 22.5 22 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
Promote recruitment and retention of additional primary care physicians and dental practitioners serving Macon County residents.
Priority 2 Grand opening of new Macon County Adult Dental Clinic, April, 2013. 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.
Reduce the incidence and mortality rates of breast, colon, and lung cancer through prevention and early intervention efforts.
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.
Cancer (colon, rectum, anus) Macon County vs NC 25 20 Rate / 100,000 15 10 5 0 03-07 04-08 05-09 06-10 07-11 Macon Death Rate/ 100,000 19.3 18.1 13.6 12.6 12.7 NC Death Rate / 100,000 17.8 17.3 16.5 16 15.5 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
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 28.3-41.2 22.9-28.2 18.7-22.8 14.7-18.6 8.9-14.6 Robeson Bladen Columbus Brunswick Pender New Hanover North Carolina Resident Data 2007-2011 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 21.4-33.0 17.6-21.3 15.3-17.5 13.1-15.2 9.8-13.0 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 2007-2011 Source: NC Vital Statistics Volume 2 Leading Causes of Death - 2011
Cancer (trachea, bronchus, lung) Macon County vs NC 70 60 50 Rate / 100,000 40 30 20 10 0 03-07 04-08 05-09 06-10 07-11 Macon Death Rate/ 100,000 48.4 49.9 49.7 52.7 57.6 NC Death Rate / 100,000 59.6 59.1 57 55.9 54.5 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
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 86.8-105.2 75.3-86.7 62.9-75.2 40.5-62.8 30.9-40.4 Robeson Bladen Columbus Brunswick Pender New Hanover North Carolina Resident Data 2007-2011 Figure 6.A Cancer - Trachea, Bronchus and Lung Source: NC Vital Statistics Volume 2 Leading Causes of Death - 2011 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 68.2-77.9 61.3-68.1 54.9-61.2 47.5-54.8 35.5-47.4 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 2007-2011
Cancer (breast) Macon County vs NC 35 30 25 Rate / 100,000 20 15 10 5 0 03-07 04-08 05-09 06-10 07-11 Macon Death Rate/ 100,000 22.5 23.2 13.6 28.9 29.2 NC Death Rate / 100,000 25.5 25 13.4 23.4 23 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
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 38.6-59.2 30.2-38.5 25.0-30.1 20.3-24.9 10.8-20.2 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 2007-2011 Figure 7.A Cancer - Breast Source: NC Vital Statistics Volume 2 Leading Causes of Death - 2011 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 30.3-36.9 24.6-30.2 19.8-24.5 14.0-19.7 5.8-13.9 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 2007-2011
Emerging Issues & Local Changes
New & Emerging Issues Suicide Rabies Lead Gonorrhea E-Cigarettes
Macon County Suicides 2007-2012 14 12 10 8 6 4 2 0 13 7 5 5 4 2008 2009 2010 2011 2012 Deaths Source NC Detailed Mortality Statistics 2007-2012
Rabies Progression in North Carolina Community Forum planned for January 2014. MCPH sponsored 2 vaccination clinics in 2013. Vaccinated 1,189 animals. Increase in private organizations and businesses offering vaccination clinics.
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.
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.
Gonorrhea MCPH disease surveillance processes have documented a recent trending of locally acquired gonorrhea. Historically, gonorrhea has not been endemic in Macon County.
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.
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, 2012. 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.
For More Information Contact Macon County Public Health 1830 Lakeside Drive Franklin, NC 28734 828 349 2081 www.maconnc.org or www.facebook.com /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) 349 2081.