2008

State of the County Health Report

 

 

 

 

SC logo Redone

 

 

 

 

 

 

Overview

The 2008 Stanly County State of the County Health (SOTCH) report is a yearly review of the county’s health indicators and status.  The purpose of this report is to inform the community and stakeholders about the health status of our residents.  The Stanly County SOTCH Report complements and updates the information provided in the Stanly County 2007 Community Health Assessment. 

The State of North Carolina requires every county to write a SOTCH report every year, except the year the Community Health Assessment is prepared.   A Community Health Assessment Report is prepared every four years.  Stanly County’s most current Community Health Assessment was written in 2007 by the Stanly County Health Department.

The 2007 Community Health Assessment and 2008 SOTCH Report can be accessed at http://health.co.stanly.nc.us/.

 

Introduction

Stanly County is located in the south central portion of North Carolina, approximately 45 miles east of Charlotte.   There are 10 incorporated communities in the county: Albemarle, Badin, Locust, New London, Norwood, Oakboro, Richfield, Stanfield, Red Cross, and the Village of Misenheimer. There are also several unincorporated communities which include Aquadale, Frog Pond, Porter, Cottonville, and Millingport.  According to the 2000 North Carolina Department of Commerce, 32.3% live in urban areas and 66.1% of the population lives in a rural setting.  Of that rural setting total, 1.7% (962) live on farms. 

Stanly County has become increasingly influenced by the growth occurring in the Charlotte region.  Overall, the county has experienced slow, steady population growth but recent expansion of east/west highways is making Stanly County an attractive location for new economic and residential developments. Stimulating new economic development and increasing employment options have become focal points of the county but displaced workers and out-of-county commuting has presented challenges to the socio-economic fabric of the community.  According to the 2000 North Carolina Department of Commerce, 68.2% of the county residents work in Stanly County, 31.1% work outside Stanly County, and 0.8% work outside of North Carolina. 

 

Demographics

The U.S. Census Bureau estimated that the population of Stanly County was 59,195 in 2007.  The median age is estimated to be 39.1.  The demographics of Stanly County are as follows:

 

POPULATION DATA

Race/Ethnicity

Race

Number

Percentage (%)

Caucasian/White

50,570

85.4%

African-American/Black

6,974

11.8%

Asian

1,048

1.7%

American Indian/Alaskan Native

 

157

 

.2%

Native Hawaiian/Other Pacific Islander

 

19

 

.03%

Two or more races

427

.72%

Ethnicity

Number

Percentage (%)

Hispanic/Latino

1,951

3.3%

 

Sex and Age

Sex

Number

Percentage (%)

Male

29,243

49.4%

Female

29,952

50.6%

Age

Number

Percentage (%)

Under 5 years

3,655

6.2%

5 to 9 years

3,714

6.3%

10 to14 years

3,873

6.5%

15 to 19 years

4,162

7.0%

20 to 24 years

3,453

5.8%

25 to 34 years

7,345

12.4%

35 to 44 years

8,473

14.3%

45 to 54 years

8,537

14.4%

55 to 59 years

3,922

6.6%

60 to 64 years

3,255

5.5%

65 to 74 years

4,524

7.6%

75 to 84 years

3,078

5.2%

Over 85 years

1,204

2.0%

 

Priorities

The Stanly County Health Department in collaboration with Partners in Health, the Stanly County Healthy Carolinians task force, identified county health priorities after reviewing the results of the 2007 Community Health Assessment and additional secondary data from the North Carolina State Center for Health Statistics.  The community focused priorities for FY2008-2010 are: Health Promotion (Obesity, Substance Abuse, & Adolescent Pregnancy/STD Prevention), Injury Prevention, and Infant Mortality Reduction.  The following table highlights the results of the 2007 Community Health Assessment, secondary data, and identified risk facts.

 

                                                  Community Health Concern Matrix

Areas of Concern Identified through Primary Data Collection

 

Areas of Concern Identified through Secondary Data

 

Modifiable Risk Factors

Associated with Identified Concerns

2007 Community Survey

  • Drug Abuse
  • Access to Affordable Medical Care
  • Unemployment/Under-employment
  • Obesity
  • Child Abuse
  • Tobacco Use
  • Teen Pregnancy
  • Quality of Education (K-12)
  • Alcoholism
  • Affordable Childcare

 

2007 Leader Survey

  • Drug Abuse
  • Obesity (tie)
  • Unemployment/Underemployment(tie)
  • Tobacco Use
  • Access to Affordable Healthcare
  • Child Abuse
  • Domestic Violence
  • Quality of Education (K-12)
  • Teen Pregnancy
  • Illiteracy

·         Leading Causes of Mortality

o    Heart Disease

o    Cancer – all

o    Cancer – trachea, bronchus & lung

o    Chronic Lower Respiratory Disease

o    Pneumonia & Influenza

o    Diabetes

o    Cancer – Breast 

         (↓state average)

o    Motor Vehicle Injuries 

          (↓ state average)

o    Unintentional Injuries

          (↓ state average)

·         Maternal & Child Health Factors

o    Infant Mortality

o    Low Birth Weight Births

o    Teen Pregnancy

·         Communicable Disease

o    Pneumonia

o    Influenza

o    Chlamydia

o    Gonorrhea

 

·         Chronic Diseases

o  Obesity

o  Inactivity

o  Tobacco Use

o  Nutrition

o  Access to Affordable Healthcare

o  Access to Affordable Medication

·         Infectious/Communicable Diseases

o  Drug Abuse

o  Alcohol Abuse

o  Adolescent Sexual Activity

o  Immunizations

·         Injuries

o  Child Safety Seat/Seat Belt Usage

o  Lead Poisoning

o  Substance Abuse (Alcohol & Drugs)

o  Motor Vehicle Safety

·         Infants & Children

o  Teen Pregnancy

o  SIDS

o  Birth Defects (folic acid)

o  Access to Affordable Healthcare

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Addressing Priorities

The Stanly County Health Department plays an invaluable role in the protection and improvement of the public’s health in Stanly County.  The three core public health functions are assessment, policy development, and assurance.   These core functions are implemented through collaborative relationships with public and private entities, elected and non-elected officials, communities, and residents of Stanly County. 

The Stanly County Health Department cannot solely address all the public health concerns that need attention due to limited staff, resources, time, funding and in some cases, community influence. As a result, it is critical that the department focus its direct services on high quality, effective practices, pursue appropriate modifications in service delivery and expansion and perhaps most importantly, serve as a catalyst to stimulate collaborative interventions in the community among various partners.  Together, we have collective strength, wisdom, and resources. 

Community partners include (but are not limited to) the following groups/agencies:  Partners in Health, a Healthy Carolinians task force; Stanly County school system; Community Care Clinic; Stanly Regional Medical Center; Stanly Community Christian Ministries; churches; Homes of Hope; Pregnancy Resource Center; Partnership for Children; fire departments; United Way of Stanly County; law enforcement; Butterfly House; Department of Social Services; and mental health services.

One word of caution:  Like the State as a whole, Stanly County’s health data reveals various health disparities among minority populations.  These conditions are significantly influenced by economic and social inequalities of our society.  Efforts to address this concern must include increasing our understanding of racial and ethnic cultures and promoting economic development and educational opportunities in addition to assuring the availability and accessibility of health and medical services.

Note:  The source of all data is the North Carolina State Center for Health Statistics unless otherwise noted.

 

Community Focused Priorities

 

Health Promotion:  Obesity - Adults

Obesity is a health concern for adults and children in Stanly County.   According to the 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey, 63.7% adults residing in the Piedmont area had a body mass index (BMI) greater than 25.  This placed them in the overweight or obese category.  People are considered overweight if their BMI was 25.0 to 29.9 and obese for BMIs 30.0 or greater.  Not much changed from 2006 and 2005.  According to the 2006 and 2005 BRFSS survey results, 65%-69% of Piedmont area adults were overweight or obese. 

The 2007 BRFSS survey results regarding physical activity showed Piedmont residents who responded participated in physical activity as shown in the following table:

 

%Yes

%No

Exercise (overall)

76.5

23.5

      Male

81.1

18.9

      Female

72.2

27.8

      White

79.9

20.1

      African American

72.0

28.0

      Other Minorities

62.9

37.1

      Hispanic

58.9

41.1

 

%Yes

%No

Leisure Time Physical Activity (overall)

76.5

23.5

      Male

81.1

18.9

      Female

72.2

27.8

      White

79.9

20.1

      African American

72.0

28.0

      Other Minorities

62.9

37.1

      Hispanic

58.9

41.1

 

%Yes

%No

Moderate Physical Activity (overall)

44.6

55.4

      Male

46.5

53.5

      Female

42.7

57.3

      White

47.4

52.6

      African American

39.8

60.2

      Other Minorities

34.7

65.3

      Hispanic

29.2

70.8

 

%Yes

%No

Vigorous Physical Activity (overall)

23.9

76.1

      Male

27.8

72.2

      Female

20.3

79.7

      White

25.3

74.7

      African American

21.0

79.0

      Other Minorities

20.4

79.6

      Hispanic

17.1

82.9

Definitions:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       

Exercise – activities such as running, calisthenics, gardening, or walking for exercise outside one’s regular job

Leisure Time Activity – any level of physical activity or exercise reported

Moderate Physical Activity – reported moderate physical activity for 30 minutes of more per day, five or more days a week or respondents who reported doing vigorous physical activity 20 or more minutes a day three or more days a week.

Vigorous Physical Activity –respondents who reported doing vigorous physical activity 20 or more minutes a day, three or more days a week

When asked to respond to the following BRFSS survey question – “Do you believe you would increase your physical activity if your community had more accessible sidewalks or trails for walking or bicycling?” respondents answered 59.4% - yes and 40.6% - no.  Women were more inclined to respond to that question with yes than men – 62.6% versus 56.0%. 

Piedmont respondents to the 2007 BRFSS survey were questioned about their eating habits.  The questions and their responses were as follows:

1. How many days per week do you usually eat a main meal that is prepared at home?

 

1-3 Days/%

4-5 Days/%

7 Days/%

None

North Carolina

16.6

35.0

46.6

1.9

Piedmont (overall)

17.0

36.7

43.9

2.3

Male

19.0

36.6

41.7

2.7

Female

15.2

36.9

45.9

2.0

White

16.4

41.7

39.7

2.3

African American

26.8

29.3

42.0

1.9

Other Minorities

5.9

17.1

73.9

3.1

Hispanics

2.2

15.4

80.2

2.3

 

2.  Do you believe that you would eat healthy foods and beverages more often if they were more available in places you eat out?

 

Yes%

No%

North Carolina

71.8

28.2

Piedmont (overall)

72.3

27.7

Male

69.8

30.2

Female

74.6

25.4

White

70.3

29.7

African American

73.5

26.5

Other Minorities

83.5

16.5

Hispanics

85.3

14.7

 

3. Are you consuming smaller amounts of foods and beverages to reach or maintain a healthier weight?

 

Yes%

No%

North Carolina

60.8

39.2

Piedmont (overall)

60.9

39.1

Male

54.8

45.2

Female

66.5

33.5

White

61.9

38.1

African American

65.0

35.0

Other Minorities

47.3

52.7

Hispanics

43.8

56.2

 

Health Promotion:  Obesity – Children

NC-NPASS data provides a snapshot of the seriousness of obesity in children, ages 2-18.  NC-NPASS data is limited to children seen in North Carolina Public Health WIC and Child Health clinics and some School Health clinics.  The following tables highlight the extent of obesity in Stanly County children:

 

 

Under Weight

Normal

At-Risk

Over Weight

Total

 

 

<5th Percentile

 

>=5th to<85th Percentile

>=85th to <95th Percentile

 

>=95th Percentile

2007

 

 

 

 

 

2-4 Years Old

7.8%

69.9%

11.9%

10.4%

579

5-11 Years Old

7.9%

65.8%

5.3%

21.8%

38

12-18 Years Old

0.0%

33.3%

25.0%

41.7%

12

 

 

 

 

 

 

2006

 

 

 

 

 

2-4 Years Old

7.8%

73.0%

10.8%

8.3%

564

5-11 Years Old

8.3%

62.5%

12.5%

16.7%

24

12-18 Years Old

0.0%

27.3%

9.1%

63.6%

11

 

 

 

 

 

 

2005

 

 

 

 

 

2-4 Years Old

5.8%

68.6%

11.8%

13.8%

608

5-11 Years Old

5.0%

35.0%

25.0%

35.0%

20

12-18 Years Old

9.1%

54.5%

18.2%

18.2%

11

 

 

 

 

 

 

2004

 

 

 

 

 

2-4 Years Old

4.5%

70.9%

13.5%

11.1%

533

5-11 Years Old

8.3%

70.8%

4.2%

16.7%

24

12-18 Years Old

5.3%

15.8%

31.6%

47.4%

19

 

 

 

 

 

 

2003

 

 

 

 

 

2-4 Years Old

3.6%

69.8%

13.0%

13.6%

494

5-11 Years Old

0.0%

50.0%

6.3%

43.8%

32

12-18 Years Old

0.0%

23.1%

15.4%

61.5%

13

 

Conclusion: Obesity

Obesity was listed as fourth as a serious concern on the community respondents’ surveys and second on the leaders’ surveys.  It is clear from responses to the BRFSS survey & NC-NPASS data, that obesity is a serious health issue.  Causes of obesity include lack of exercise and unhealthy eating.  The BRFSS survey shows that almost 20% Piedmont area adult respondents eat meals prepared outside the home every week.  Less than 3% never eat meals prepared outside the home.  So, 97% of the respondents eat meals prepared outside the home.  What implication does this have?

Food portions served at eating establishments are usually now larger than they have been in the past.   In fact, portion sizes have doubled in many eating establishments.  Also, contributing to high caloric food content are special sauces, ingredients, and cooking styles. Couple this with lack of meaningful physical activity and the result is increases in body weights.

According to information posted on the Department of Health & Human Services National Institutes of Health the National Heart, Lung, and Blood Institute website, “Obesity and overweight substantially increase the risk of morbidity from hypertension; dyslipidemia; type 2 diabetes; coronary heart disease; stroke; gallbladder disease; osteoarthritis; sleep apnea and respiratory problems; and endometrial, breast, prostate, and colon cancers. Higher body weights are also associated with increases in all-cause mortality.”

According to information posted on the United States Department of Agriculture website, “being physically active is one of the best ways to keep you healthy. It helps you to

*       -feel great

*       -improve your fitness level and become more flexible, have stronger bones

*        and muscles,  and increased endurance

*       -burn more calories to aid with weight loss or maintenance.

It can, also, reduce your risk for many chronic diseases including: heart disease, high blood pressure, diabetes, osteoporosis, arthritis, depression, overweight and obesity.”

What is Stanly County doing to address the issue of obesity? 

The seriousness of obesity as a health issue has motivated several community groups and agencies to work together to begin addressing this health concern.  The Stanly County Health Department, Cooperative Extension and Stanly County YMCA are collaborating to offer the community an opportunity to participate in the program, Eat Smart, Move More, & Weigh Less.  The plan is to offer this program twice a year in 2009.  Schools are stressing healthier eating practices, including limiting snack selections to healthy choices.  All fourth graders in the Stanly County School system participate in Passport to Fitness, a health promotion program offered by Stanly Regional Medical Center.  Its goal is to increase children’s physical activity levels and their nutrition knowledge.  Healthy FUNdamentals, a healthy lifestyle promotion program for preschoolers and their families, is funded by Stanly County Partnership for Children and operated by Stanly Regional Medical Center.  County municipalities are constructing safe walking areas.  Two billboards sponsored by Partners in Health will advocate “Be Active” message.  They will be placed in Albemarle and Badin.  A nutrition table top trivia game developed by Karen Brown, former member of Partners in Health, is in the process of being printed.  This game will be placed on food establishment tables in Stanly County, so families can learn more about healthy eating choices. 

Health Promotion:  Adolescent Pregnancy/Sexually Transmitted Diseases (STDs)

The number of adolescents becoming pregnant has been trending downward with some exceptions.  However, there are still far too many unintended adolescent pregnancies. Research shows that abstinence only programs are not as effective as programs that incorporate contraceptive education with abstinence message.  Stanly County Schools have adopted an abstinence only policy regarding sex education.   Stanly County School policy No. 3196 states, “…..this program (Framework for Healthful Living) will include instruction on the benefits of sexual abstinence until marriage and the prevention of sexually transmitted diseases. 

An unintended consequence of sexual activity is the incidence of sexually transmitted diseases (STDs).  The incidence of STDs being reported in adolescents had been increasing until 2007.  In 2007, there was a decrease of reported STDs in adolescents.

The following charts (pregnancy & sexually transmitted diseases) visually illustrate the results of adolescent sexual activity.  The adolescent pregnancy charts show total numbers as well as rates. The adolescent STD chart shows total numbers collected by the Stanly County Health Department.

 

 

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

White 10--14

 

6

 

1

 

0

 

1

 

1

 

1

 

0

 

1

 

4

 

1

Minority 10-14

 

1

 

1

 

1

 

0

 

0

 

2

 

2

 

1

 

1

 

1

White 15-19

 

104

 

92

 

101

 

97

 

96

 

84

 

84

 

97

 

92

 

94

Minority 15-19

 

43

 

36

 

49

 

28

 

34

 

31

 

28

 

34

 

35

 

35

 

                                                Note:  SC - Stanly County     NC - North Carolina    

                                                                                                                                 

 

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

SC White 15-17

 

43.0

 

35.2

 

27.3

 

38.7

 

36.0

 

32.4

 

31.5

 

25.4

 

21.5

 

32.9

NC White 15-17

 

41.8

 

38.2

 

35.5

 

32.0

 

30.8

 

28.2

 

28.0

 

27.5

 

28.1

 

27.7

SC Minority 15-17

 

119.8