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Health Care

Health Report: A Checkup For Counties

By Jenny Callison, posted Apr 5, 2019
Since the publication of the annual County Health Rankings & Roadmaps report in late March, area public health officials have studied the new data for what it can tell them.
 
“We compare the data, whether it’s trending up or down, to other sources of data,” said Phillip Tarte, director of the New Hanover County Health Department. “We try to pair it with what we have currently, with the Community Health Assessment. It’s up to us to determine if it’s accurate.”
 
The department relies more heavily on its own Community Health Assessment, but the Rankings & Roadmaps can help flag other trends and issues or confirm what public health officials believed.
 
This year’s report, which consists of data from 2018, contains a few new measures: increasing the age to 74 for women who receive annual mammograms and reflecting the number of Medicare beneficiaries who get a flu shot each year, for examples. Another addition was a measure of how many county residents died before age 75 – the researchers’ belief that this information is a good gauge of how healthy a community is.
 
The County Health Rankings & Roadmaps program is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The report ranks counties on both health outcomes and health factors.
 
New Hanover County was 19th for health outcomes and 13th for health factors, among North Carolina’s 100 counties. Average life expectancy for residents is 78.9 years, according to the report.
 
Brunswick ranked 34th in the state for health outcomes and 25th for health factors. Average life expectancy for Brunswick County residents is 78.4 years.
 
Pender County ranked 57th for health outcomes – a drop of 30 spots from its 2018 ranking of 27 – and 34th for health factors. Pender County residents’ average life expectancy is 76.8 years.
 
Pender County Health and Human Services Director Carolyn Moser is studying the report’s findings to try and understand her county’s significant drop in health outcomes ranking. She said her county is working to address major factors that contribute to early death and poor health among its residents. Premature births, accidents and suicide are the three leading causes, she said.
 
As to premature births, Moser said, “causes can be congenital, birth defects, mother smoking or vaping while pregnant, mother using drugs and alcohol during pregnancy, and thus having babies born with addiction. We provide prenatal care as well as health education and nutrition education through the WIC Program to ensure a healthy pregnancy and a healthy outcome. There are nurse visits postpartum for the mom and baby.”
 
As for suicide, a growing national problem, Moser says her county’s data helps identify those at greatest risk.
 
 “The main suicide problems are among our white men, aged 45-64, generally divorced and self-employed,” she said. “While we have had few teen suicides, the impact is felt regardless. Coastal Horizons has counselors in all the schools and works out of the school-based health centers. [The county] provides medical management for two school-based health centers with a focus on adolescent physical and mental health care. The health department offers acute and preventive care to those of all ages, where a variety of age-specific health education is provided.”
 
Like the region as a whole, Pender County has worked to address substance abuse problems.
 
“Our county commissioners allowed the health department to hire an extra health educator to address community education and outreach efforts help reduce the number of lives lost,” Moser said.
 
“Unfortunately, Pender County lacks primary care providers and is a health provider shortage area,” she added. “This is another reason the health department entered the primary care arena in order to assure access to our residents. Early detection and health promotions through regular appointments with a primary care provider are extremely important.”
 
County health departments work with an extensive network of health care providers and nonprofits to provide education, prevention and treatment for residents.
 
Threats to good health, Tarte said, are “not only public health’s issue to tackle, [they are] a community issue. We have surveillance with our medical practices, school systems, FQHCs [Federally Qualified Health Centers], governmental and nongovernment agencies who help us surveil and move policies forward.”
 
Many underlying factors, such as education and employment, influence a person’s health status, he added.
 
Despite a lack of medical resources in her county, Moser said Pender County is making progress.
 
“We are fortunate to have health education staff when other counties do not. But the health department is only one part of the health care delivery system. We partner with the hospital, the schools and other county and community organizations, along with our faith-based communities,” she said. “We all know these problems are not solved overnight; it takes generations.”
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