11

22

“There is no better way to build support for public

health interventions than to engage

community residents…”--State Center for Health Statistics

33

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

44

55

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.

66

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

77

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

88

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

99

How Has Healthy How Has Healthy Carolinians Worked for Carolinians Worked for

Macon County?Macon County?

1010

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

1111

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

1212

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

1313

Community Health Community Health AssessmentAssessmentMacon County, NCMacon County, NC

20032003

1414

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

1515

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

1616

Highlights fromHighlights fromHealth StatisticsHealth Statistics

1717

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

1818

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

1919

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

2121

Shortage of DentistsShortage of Dentists

2533

3122

2488

3285

2495

3458

2477

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.

2222

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

2323

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

2424

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%

2525

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

2626

Highlights fromHighlights fromCommunity OpinionsCommunity Opinions

2727

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

2828

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

2929

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

3030

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

3131

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

3232

Community Health Community Health Action PlanAction Plan

3333

Macon County Health Priorities, 2003Macon County Health Priorities, 2003

Access to Health CareAccess to Health CareChildhood ObesityChildhood ObesityTobacco UseTobacco UseSubstance AbuseSubstance AbuseCommunity HealthCommunity Health

3434

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.

3535

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

3636

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

3737

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.

3838

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

3939

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

4040

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

4141

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

4242

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

4343

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

kmcgaha@maconnc.orgkmcgaha@maconnc.org

4444

DiscussionDiscussion