“there is no better way to build support for public health ... · 2 “there is no better way to...
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“There is no better way to build support for public
health interventions than to engage
community residents…”--State Center for Health Statistics
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Who are Healthy Carolinians?Who are Healthy Carolinians?Network of partnerships that address health and Network of partnerships that address health and safety issues at the community level.safety issues at the community level.Participants:Participants:
Key community representativesKey community representativesLeadersLeadersAgenciesAgenciesHealth care service providersHealth care service providers
Focus:Focus:Eliminate health disparitiesEliminate health disparitiesExpand access to health care servicesExpand access to health care servicesCollaborate to best utilize limited resourcesCollaborate to best utilize limited resources
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The The MissionMission ofofHealthy Carolinians of Healthy Carolinians of
Macon CountyMacon Countyis to assess and develop is to assess and develop
health resources for health resources for Macon County residents.Macon County residents.
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Benefits of Healthy CaroliniansBenefits of Healthy Carolinians
Collaborative LeadershipCollaborative LeadershipCoordinated Efforts and ServicesCoordinated Efforts and ServicesAvoidance of DuplicationAvoidance of DuplicationIncreased Access to Health CareIncreased Access to Health CareExpanded Health Promotion/Disease Expanded Health Promotion/Disease PreventionPreventionReduction of Health DisparitiesReduction of Health DisparitiesEfficient Use of ResourcesEfficient Use of Resources
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Healthy Carolinians of Macon County, Inc.Full Partnership
Approximately 100 members
Kenneth RingHealth Director
Permanent Board Member of HCMCMCPHC provides Adm. Staff under contract
Board of Directors9 – 15 members
Anne HyderAsst. Health Director
Kathy McGahaProgram Director
Rhonda BlantonOffice Assistant
Steering CommitteeIncludes BOD & Subcommittee Chairs
Child/Adolescent Health IssuesCombined with Health Ed. Committee to work
on Childhood Obesity
Chronic DiseaseTobacco
Asthma Coalition
Health EducationCombined with Child/Adol. Health Issues Committee to work on Childhood Obesity
Substance Abuse Task Force
Teenage Pregnancy PreventionTask Force
Community Needs Assessment
Health AssessmentYouth Risk Behavior Survey
Access to CareDental Care
Primary Care for Indigent Population
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Funding has come fromFunding has come froma variety of sourcesa variety of sources::
Private FoundationsPrivate FoundationsState and County AppropriationState and County AppropriationInIn--kind contributions from partnering kind contributions from partnering agenciesagenciesCommunity ContributionsCommunity Contributions
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How Has Healthy How Has Healthy Carolinians Worked for Carolinians Worked for
Macon County?Macon County?
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AccomplishmentsAccomplishmentsSchool Health ProgramSchool Health Program
School NursesSchool NursesHealth FairHealth FairSchool Health Advisory School Health Advisory CouncilCouncilYouth Risk Behavior Youth Risk Behavior SurveySurveyGroups involved:Groups involved:
MCPHCMCPHCMacon County SchoolsMacon County SchoolsLocal MDLocal MD’’ssHospitalsHospitalsDSSDSSMental HealthMental Health
Medication Assistance Medication Assistance ProgramProgram
First Baptist ChurchFirst Baptist ChurchAngel Medical CenterAngel Medical CenterMCPHCMCPHCDSSDSSCarenetCarenetLocal MDsLocal MDs
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Accomplishments, Cont.Accomplishments, Cont.Dental Care for Dental Care for Uninsured & UnderUninsured & Under--insuredinsured
MCPHCMCPHCLBJ Job CorpLBJ Job CorpMacon County Macon County SchoolsSchoolsHighlandsHighlands--Cashiers Cashiers HospitalHospital
Asthma CoalitionAsthma CoalitionAngel Medical CenterAngel Medical CenterMacon County Macon County SchoolsSchoolsLocal MDLocal MD’’ssMCPHCMCPHCParents of Asthmatic Parents of Asthmatic ChildrenChildrenAdults with AsthmaAdults with Asthma
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Accomplishments, Cont.Accomplishments, Cont.Tobacco EducationTobacco Education
MCPHCMCPHCMacon County Macon County SchoolsSchoolsAngel Medical CenterAngel Medical CenterLocal MDLocal MD’’ss
Substance Abuse Substance Abuse Task ForceTask Force
SheriffSheriff’’s Offices OfficeMacon County Macon County SchoolsSchoolsMental HealthMental HealthDSSDSSEmergency ServicesEmergency ServicesRecovering AddictsRecovering AddictsHispanic Outreach Hispanic Outreach GroupGroup
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Community Health Community Health AssessmentAssessmentMacon County, NCMacon County, NC
20032003
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Assessment ProcessAssessment ProcessAssemble TeamAssemble TeamStudy health statisticsStudy health statisticsGather opinions of community members Gather opinions of community members through listening sessions and questionnairesthrough listening sessions and questionnairesRecognize community assetsRecognize community assetsIdentify health prioritiesIdentify health prioritiesPlan steps of actionPlan steps of actionReport to the communityReport to the community
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The TeamThe TeamMacon County Public Health Macon County Public Health CenterCenter
Anne Hyder, Chair, Asst. Anne Hyder, Chair, Asst. Health DirectorHealth DirectorStan Polanski, PAStan Polanski, PAKay Key, RDKay Key, RDKenneth Ring, Health Kenneth Ring, Health DirectorDirector
Macon County PhysiciansMacon County PhysiciansCarlos Vargas, MDCarlos Vargas, MD
Macon County Dept. of Social Macon County Dept. of Social ServicesServices
Dianne HolbrookDianne HolbrookMental HealthMental Health
Donna McClureDonna McClure--AllenAllenDept. on AgingDept. on Aging
Sheila JenkinsSheila Jenkins
Hospital RepresentativesHospital RepresentativesMichael Zuliani, Adm., Michael Zuliani, Adm., AMCAMCMartin Wadewitz, Assoc. Martin Wadewitz, Assoc. Adm., AMCAdm., AMCJane Yates, RN, HCHJane Yates, RN, HCHJoan Cabe, RN, HCHJoan Cabe, RN, HCH
Community RepresentativesCommunity RepresentativesBuck Trott, Mayor, Buck Trott, Mayor, HighlandsHighlands
Educational InstitutionsEducational InstitutionsRita deMaintenon, Rita deMaintenon, Southwestern Community Southwestern Community CollegeCollege
Business RepresentativeBusiness RepresentativeBarbara McRae, Franklin Barbara McRae, Franklin PressPress
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Highlights fromHighlights fromHealth StatisticsHealth Statistics
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Statistical Subcommittee ReportStatistical Subcommittee ReportSources of Statistical DataSources of Statistical Data
County Health Data BookCounty Health Data BookState Center for Health Statistics, State Center for Health Statistics, www.schs.state.nc.us/SCHS/www.schs.state.nc.us/SCHS/Office of Healthy Carolinians/Health EducationOffice of Healthy Carolinians/Health Education
US CensusUS CensusCounty Development DataCounty Development Data
Economic Development University Center at WCUEconomic Development University Center at WCUEmergency Medical Service Trip StatsEmergency Medical Service Trip Stats
Macon County EMSMacon County EMSBody Mass Index DataBody Mass Index Data
Macon County School Health FairsMacon County School Health Fairs
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Statistical Subcommittee ReportStatistical Subcommittee ReportMacon CountyMacon County StrengthsStrengths
LOW ageLOW age--adjusted death rates for heart adjusted death rates for heart disease, cancer, and all causesdisease, cancer, and all causesLOW property and violent crime ratesLOW property and violent crime ratesLOW abortion ratesLOW abortion ratesLOW rate of hospitalization of children due LOW rate of hospitalization of children due to asthmato asthmaDECLINING Teen Pregnancy RateDECLINING Teen Pregnancy Rate
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75.6 73.9 72.4 68.6 65 64.155.6 52.4
44.3
28.539 42
72.3
87.9101.9
95.5
78.3
44.751.757.2 57.2
0
20
40
60
80
100
120
1992 1993 1995 1998 2000 2001 2002
NCJacksonMacon
White Female Pregnancy Rates White Female Pregnancy Rates ages 15ages 15--1919
Pregnancies per 1000 females
2020
Statistical Subcommittee ReportStatistical Subcommittee ReportMacon CountyMacon County ProblemsProblems
Strain on Health Care ResourcesStrain on Health Care ResourcesShortage of Primary Care PhysiciansShortage of Primary Care PhysiciansLarge Seasonal Influx of PartLarge Seasonal Influx of Part--time Residentstime ResidentsHigh Percentage of ElderlyHigh Percentage of ElderlyShortage of DentistsShortage of Dentists
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Shortage of DentistsShortage of Dentists
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3122
2488
3285
2495
3458
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4090 3867
0
500
1000
1500
2000
2500
3000
3500
4000
4500
1993 1995 1997 1999 2003
NCMacon Co.
Population served by each dentist, NC vs. Macon County
Not
Avail.
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Statistical Subcommittee ReportStatistical Subcommittee ReportMacon CountyMacon County Problems, Cont.Problems, Cont.
Lack of Indigent CareLack of Indigent CareResidents without health insuranceResidents without health insurance
Macon County Macon County -- 19%19%NC NC –– 16.3%16.3%
No primary care clinic for the medically No primary care clinic for the medically indigentindigent
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Statistical Subcommittee ReportStatistical Subcommittee ReportMacon CountyMacon County Problems, Cont.Problems, Cont.
Medical Problems related to Substance Medical Problems related to Substance AbuseAbuse
Chronic Hepatitis C is a rapidly growing Chronic Hepatitis C is a rapidly growing problem problem Death rate for liver disease/cirrhosis is higher Death rate for liver disease/cirrhosis is higher than the statewide ratethan the statewide rate
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Statistical Subcommittee ReportStatistical Subcommittee ReportMacon CountyMacon County Problems, Cont.Problems, Cont.
Smoking During PregnancySmoking During PregnancyMacon County Macon County -- 26.2%26.2%NC NC –– 14.8%14.8%
Low Birth WeightLow Birth WeightMacon County Macon County –– 8.5%8.5%NC NC –– 7.1%7.1%
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Statistical Subcommittee ReportStatistical Subcommittee ReportMacon CountyMacon County Problems, Cont.Problems, Cont.
Childhood Obesity, Childhood Obesity, (Macon County School Health Fairs)(Macon County School Health Fairs)
2003 2003 -- 21.9% of elementary children overweight21.9% of elementary children overweight2002 2002 –– 17.4% of elementary children overweight17.4% of elementary children overweight
Child Abuse/Neglect/DependencyChild Abuse/Neglect/DependencySubstantiated reports of child abuse, neglect, and Substantiated reports of child abuse, neglect, and dependency dependency
Macon County Macon County -- 19 per 1000 children19 per 1000 childrenNC NC -- 16 per 1000 children16 per 1000 children
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Highlights fromHighlights fromCommunity OpinionsCommunity Opinions
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Sources of Community DataSources of Community DataListening SessionsListening Sessions
Franklin High School Franklin High School Students (Two Groups)Students (Two Groups)Nantahala High School Nantahala High School StudentsStudentsFranklin Fire Dept.Franklin Fire Dept.Macon County Transit Macon County Transit ClientsClientsKiwanis Club of FranklinKiwanis Club of FranklinOtto Single Seniors GroupOtto Single Seniors GroupRotary Club of HighlandsRotary Club of Highlands
Questionnaire (82 Questionnaire (82 returned)returned)
Listening Session GroupsListening Session GroupsGeneral PublicGeneral PublicMCPHC StaffMCPHC StaffDSS StaffDSS StaffHighlandsHighlands--Cashiers Cashiers Hospital StaffHospital StaffScaly Mountain Fire Dept.Scaly Mountain Fire Dept.Smoky Mountain Mental Smoky Mountain Mental Health Ctr. ClientsHealth Ctr. Clients
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Additional Sources ofAdditional Sources ofCommunity DataCommunity Data
2002 Macon County Youth Risk Behavior 2002 Macon County Youth Risk Behavior SurveySurvey2002 Hispanic Community Assessment2002 Hispanic Community Assessment
Conducted by Macon County Public LibraryConducted by Macon County Public Library
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What are the serious health problems What are the serious health problems in your community?in your community?
Listening SessionsListening SessionsElder Health Problems Elder Health Problems (Breathing, Diabetes, (Breathing, Diabetes, Heart Conditions)Heart Conditions)Cost of Health CareCost of Health CareSubstance AbuseSubstance AbuseAccess to Quality Access to Quality Health CareHealth CareObesityObesity
QuestionnairesQuestionnairesCancerCancerHeart DiseaseHeart DiseaseObesityObesitySubstance Abuse, Substance Abuse, including Tobaccoincluding TobaccoAsthma/Breathing Asthma/Breathing ProblemsProblems
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Community AssetsCommunity AssetsTwo Hospital Settings in Two Hospital Settings in Macon County (Angel Macon County (Angel Medical Center and Medical Center and HighlandsHighlands--Cashiers Cashiers Hospital) Hospital) -- the level of the level of technology including the technology including the equipment, facilities and equipment, facilities and staffstaffSchool SystemSchool SystemRecreational ActivitiesRecreational ActivitiesVolunteer SpiritVolunteer SpiritOpenOpen--mindedness and mindedness and tolerance of the tolerance of the communitycommunityHealth Services for the Health Services for the ElderlyElderlyHome Delivered MealsHome Delivered Meals
Specialized Adult Specialized Adult DaycareDaycareMedication AssistanceMedication AssistanceWellWell--trained EMS and trained EMS and First RespondersFirst RespondersSome MD's still do house Some MD's still do house callscallsTransportation programsTransportation programsActive and dynamic Active and dynamic Healthy Carolinians Healthy Carolinians groupgroupEffective Head Start Effective Head Start ProgramProgramHealth DepartmentHealth DepartmentDepartment of Social Department of Social ServicesServices
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Community Assets, Cont.Community Assets, Cont.Monitoring of Air/Water Monitoring of Air/Water QualityQualitySpecialists in the Specialists in the medical fieldmedical fieldAdequate Number of Adequate Number of PharmaciesPharmaciesFamily Restoration Family Restoration ServicesServicesLaw EnforcementLaw EnforcementREACH Support Group REACH Support Group --(Resources, Education, (Resources, Education, Assistance, Counseling, Assistance, Counseling, and Housing for and Housing for Domestic Violence Domestic Violence Victims)Victims)
Good infrastructure for Good infrastructure for healthy community (High healthy community (High Social Capital)Social Capital)Skilled Nursing FacilitiesSkilled Nursing FacilitiesStrong sense of Strong sense of history/culturehistory/cultureLow Unemployment RateLow Unemployment RateAestheticsAestheticsStrong Capital SourceStrong Capital Source
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Community Health Community Health Action PlanAction Plan
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Macon County Health Priorities, 2003Macon County Health Priorities, 2003
Access to Health CareAccess to Health CareChildhood ObesityChildhood ObesityTobacco UseTobacco UseSubstance AbuseSubstance AbuseCommunity HealthCommunity Health
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Access to Health CareAccess to Health Care
Continue to document the shortage of Continue to document the shortage of health professionals, including physicians, health professionals, including physicians, nurses, dentists, and mental health nurses, dentists, and mental health professionals, and the impact on permanent professionals, and the impact on permanent and seasonal populations.and seasonal populations.
Recruit when necessary.Recruit when necessary.
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Access to Health Care, Cont.Access to Health Care, Cont.
Establish a Primary Care Clinic for Establish a Primary Care Clinic for indigent residents, including OB/GYN indigent residents, including OB/GYN servicesservicesContinue to Advocate for the Continue to Advocate for the establishment of a Satellite Veterans establishment of a Satellite Veterans Affairs ClinicAffairs Clinic
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Childhood ObesityChildhood ObesityPromote the establishment and use of Promote the establishment and use of additional Physical Education and additional Physical Education and Physical Activity facilities, focusing on Physical Activity facilities, focusing on public accessible facilitiespublic accessible facilitiesAdvocate for addition Physical Advocate for addition Physical Education electives at the High School Education electives at the High School Level Level Advocate for the administration of the Advocate for the administration of the 2005 county2005 county--specific Youth Risk specific Youth Risk Behavior SurveyBehavior Survey
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Childhood Obesity, Cont.Childhood Obesity, Cont.Continue Annual School Health Screening Continue Annual School Health Screening Fairs and expand them to the High School Fairs and expand them to the High School Level, including Body Mass Index Level, including Body Mass Index screeningscreeningIncrease the nutritional value of child care Increase the nutritional value of child care and public school menusand public school menusEducate parents/caregivers regarding Educate parents/caregivers regarding nutrition and physical activity nutrition and physical activity recommendations, including risks of being recommendations, including risks of being overweight or obese, appropriate nutrition overweight or obese, appropriate nutrition and physical activity behaviors, etc.and physical activity behaviors, etc.
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Tobacco UseTobacco Use
Continue Tobacco Education effortsContinue Tobacco Education effortsAdvocate for additional Tobacco Advocate for additional Tobacco Cessation resourcesCessation resourcesAdvocate for Tobacco Free Campuses, Advocate for Tobacco Free Campuses, including educational, institutions, including educational, institutions, hospitals, businesses, etc.hospitals, businesses, etc.Advocate for the Administration of the Advocate for the Administration of the 2005 county2005 county--specific Youth Risk Behavior specific Youth Risk Behavior SurveySurvey
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Substance AbuseSubstance Abuse
Continue the Substance Abuse Task Continue the Substance Abuse Task Force ActivitiesForce ActivitiesProvide community members Provide community members Substance Abuse education, including Substance Abuse education, including prevention skills, coping skills, and prevention skills, coping skills, and availability of resources, etc.availability of resources, etc.Advocate for the administration of the Advocate for the administration of the 2005 county2005 county--specific Youth Risk specific Youth Risk Behavior SurveyBehavior Survey
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Substance Abuse, Cont.Substance Abuse, Cont.
Advocate for additional Substance Abuse Advocate for additional Substance Abuse Detoxification ServicesDetoxification ServicesMonitor the impact of the State Mental Monitor the impact of the State Mental Health Reform on the local substance Health Reform on the local substance abuse populationabuse populationResearch the feasibility of providing Research the feasibility of providing substance abuse counseling by laypeoplesubstance abuse counseling by laypeople
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Community HealthCommunity Health
Develop new media avenues for distributing Develop new media avenues for distributing health informationhealth information
Dispatch Service NoticesDispatch Service NoticesLocal Church Internet NetworkLocal Church Internet Network
Develop and Maintain a countyDevelop and Maintain a county--wide wide Healthcare Resources WebsiteHealthcare Resources Website
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Community Health, Cont.Community Health, Cont.
Research the feasibility of an Elder Care Research the feasibility of an Elder Care System that would promote the System that would promote the coordination of health services for elder coordination of health services for elder residentsresidentsDevelop opportunities for learning Spanish Develop opportunities for learning Spanish as a second languageas a second language
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For More Information about theFor More Information about the2003 Macon County Community Health Assessment, Contact:2003 Macon County Community Health Assessment, Contact:
Kathy McGaha, Program DirectorKathy McGaha, Program DirectorHealthy Carolinians of Macon CountyHealthy Carolinians of Macon County
1830 Lakeside Drive1830 Lakeside DriveFranklin, NC 28734Franklin, NC 28734
Phone (828) 349Phone (828) 349--24262426Fax (828) 349Fax (828) 349--91319131
[email protected]@maconnc.org
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DiscussionDiscussion