BY DEBBIE PAGE
debbiepage.iredellfreenews@gmail.com
Healthy Iredell, a coalition of Iredell County citizens and agency and organization representatives, met recently to continue its work to improve the quality of life and health status of all community members.
The coalition monitors the health status of the community through surveys and data collection, conducts the Community Health Assessment (CHA) every four years, develops the yearly State of the County Health Report, gathers data for the Iredell County Health Department, and coordinates subcommittees that work to improve specific health issues indicated by the CHA.
Current subcommittees focus on cancer, fitness and diet, mental health, and youth wellness.
The last CHA was conducted in 2019 so the Healthy Iredell group is in the process of gathering input to tweak and add to the 2023 assessment questions to help identify key health needs and issues based on thorough data collection, research, and analysis.
After the CHA is complete, Healthy Iredell will develop strategies to address any health inequities and identify the resources to address the identified gaps. This continual data collection helps increase knowledge about community members health needs and seeks to connect them to activities, education, and community resources to improve their health outcomes.
The data helps Healthy Iredell develop health focus areas and to create a Community Health Action Plan to mitigate prevalent community health concerns over the next four-year cycle.
Group members also decided that the Healthy Iredell website needs expansion and improvement to spread the word about its work, community data, and available community resources to help county residents improve their health and fitness levels.
NEW TOBACCO-FREE REQUIREMENTS COMING
Carleen Crawford, Regional Tobacco Control Manager of NC Health Region 4, discussed the new “tobacco free culture of care” that all behavioral health facilities in North Carolina must integrate into their facilities and treatment starting December 1.
The N.C. Standard and Tailored Prepaid Health Plans that serve Medicaid and uninsured patients requires that all contracted medical, behavioral health, and some intellectual/developmental disabilities and traumatic brain injury organizations provide a 100 percent tobacco-free facility for both staff and patients.
“There will be no more ‘let them keep their cigarettes,’ ” said Crawford, adding there will be a steep learning curve for staff to include the Change for Life: Tobacco Free Recovery program standards alongside their current treatment programs.
Facilities must adopt and implement tobacco-free campus policies, integrate best practice tobacco treatment into ongoing services, and employ shared messaging that supports a positive tobacco-free culture of care for clients and staff.
Crawford said research indicates that helping patients quit smoking can result in a 25 percent increased likelihood of sustained recovery from alcohol and other drug use.
She also noted that the tobacco industry targeted those with mental health disorders for years. Medicaid could realize huge cost savings if just 1 percent quit tobacco use, with an estimated $58 million in savings the year after the tobacco free standards are implemented, according to Crawford.
Resources to assist facilities in this transition are available at https://www.mecknc.gov/HealthDepartment/CommunityHealthServices/TobaccoFreeMecklenburg/Pages/Best-Practice-Resources.aspx.
2019 COMMUNITY HEALTH ASSESSMENT FINDINGS
The 2019 CHA surveyed 1,321 residents over three months, including residents of Statesville (49%), Mooresville (35%), Troutman (8%), Harmony (6%), Olin (1%), Stony Point (1%), and other (>1%).
The racial and gender breakdown of community respondents reflected the overall demographic data of the county. African-American and Hispanic are the two most prominent minority groups, followed by multi-racial individuals.
Fifty-five percent of those responding were female and 46 percent male, with age groups and income levels again reflecting Iredell County’s make-up.
Cancer and weight were among the top three selected health priorities by respondents in 2015, but residents’ mental health concerns increased in 2019. In 2015, only 19 percent selected mental health as a top health priority, compared to 34 percent in 2019.
Five of the top six selected health priorities related to chronic disease prevention. The leading causes of death in Iredell County remained constant from 2009-2019, including cancer (19.4%), heart disease (18.1%), and cerebrovascular disease (stroke, aneurysms, and vein malformations that interrupt blood flow) (5.6%).
Five of the top ten leading causes of death are chronic conditions that improved diet, exercise, and ceasing tobacco use can prevent.
The good news is that improvement to many health indicators related to chronic diseases, including stroke, heart disease, and diabetes, steadily decreased from 2009-19.
After 2019 data examination, the committee chose to prioritize mental health, chronic disease, and infant mortality in the Community Health Action Plan through 2022, the end of this CHA cycle.
Because of the pandemic, some of the planned work to address these issues was affected because committees could not meet and the community health focus shifted to COVID-19.
The committee members want to see the current four committee reports before reviewing the 2023 CHA questions to help inform their work and readdress any areas still lingering from the 2019 assessment.
MENTAL HEALTH
Sixty-five percent of residents expressed a need for improved mental health resources and awareness on the 2019 CHA. Mental health problems can be treated and managed with early detection, treatment, and support.
Many low-income individuals do not have access to mental health support services. Suicide is the third leading cause of death among individuals under age 17 in Iredell County. The committee sought to add social supports, such as community-based self-harm and suicide prevention education, over the past three years.
CHRONIC DISEASE
Most chronic conditions are preventable or treatable with early detection screenings, a healthy diet, physical activity, and quitting tobacco and other unhealthy substance use. Chronic diseases also cause financial hardship and serious health consequences.
The most common chronic diseases in Iredell County, according to the 2019 CHA, are cancer (19.4%), heart disease (18.1%), and cerebrovascular disease (5.6%).
The 2019 CHA found that one-third of Iredell County children ages 2 to 4 are overweight or obese, with 68 percent of Iredell County residents overall considered overweight or obese. Seventy percent of community respondents do not get the recommended amount of physical activity
Ninety-one percent of respondents did not consume the recommended amount of fruits and vegetables.
The committee sought to increase the community’s healthy eating and active living strategies, which are evidence-based and successful in reducing the risk of developing a chronic condition.
INFANT MORTALITY
Iredell County’s infant mortality rate has exceeded the state’s rate for the last decade. The county also has one of the most serious infant mortality disparity rates in North Carolina. In 2019, African-American infants were more than three times likely to die prior to their first birthday than their Caucasian peers.
The African-American Infant mortality rate was 22.4 compared to the Caucasian rate of 7.4. Some risk factors that impacted the infants’ health included the educational attainment of mothers, smoking during pregnancy, insufficient prenatal care, and the overall health status of the mother.
More than 7 percent of Iredell County mothers are receiving late or no prenatal care. Fifty-five percent are either overweight or obese. The African-American teen pregnancy rate is double the Caucasian rate.
NEXT STEPS
Healthy Iredell will next meet on Tuesday, October 25, at 3 p.m. to review committee reports, review the basic assessment, and to brainstorm a list agencies to ask for feedback on assessment questions and additional data points to include on the Iredell 2023 CHA.
Contact Dinikia Savage at dinikia.savage@co.iredell.nc.us for more information or to get involved.