Solved by verified expert:Research a public health concern in your jurisdiction, and highlight how your local public health agency is taking steps to reduce or eliminate risks. Include the following information:Define your jurisdiction (Introduction).Define the public health concern.Describe the steps that your Public Health Department has taken to reduce or eliminate risks.Conclusion400–600 words, APA Format, in text citationSee attachment for the jurisdiction focus (Fayetteville,NC), please use other references tooResources Helphttp://www.co.cumberland.nc.us/docs/default-source… (see attachment as well)
community_health_assessment_2016.pdf
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Cumberland County Community Health
Assessment-2016
Cumberland County Department of Public Health
1235 Ramsey Street
Fayetteville, NC 28301
(910) 433-3600
1
Table of Contents
TABLE OF CONTENTS…………………………………………………………………….2
ACKNOWLEDGEMENTS…………………………………………………………………..3
EXECUTIVE SUMMARY…………………………………………………………………..4
SECTION 1: BACKGROUND AND PROCESS……….………………..………………….8
SECTION 2: HISTORICAL AND GEOGRAPHIC OVERVIEW…………………………..10
SECTION 3: HEALTH DATA COLLECTION PROCESS..………………………………14
SECTION 4: HEALTH DATA RESULTS.…………………………………………………16
SECTION 5: PREVENTION AND HEALTH PROMOTION………………………………47
SECTION 6: HEALTH PRIORITIES…………………………………………………………52
APPENDIX…………………………………………………………………………………….54
2
Acknowledgements
The Cumberland County Department of Public Health would like to thank all of our community
partners and others for their contributions and support in conducting the 2016 Community Health
Assessment.
Community Health Assessment Team:
Name
Buck Wilson, Health Director
Sandy Godwin, Executive
Director for Corporate Planning
William Haithcock, Sr. Financial
Analyst
Barbara Carraway, Health
Education Supervisor
Sharon Gallagher, ProfessorNursing
Melvin Lindsay
Phyllis McLymore, Health
Educator II
Susan Dover, Health Educator I
Marisa Ramos-Mason, Health
Educator I
Antwi Innocent, Intern Student
Artimisha Campbell-Williams,
Student
Miranda Chang, Student
Agency
Cumberland County Department
of Public Health
Cape Fear Valley Health System
Role/Contribution
Advisory to CHA Team
Cape Fear Valley Health System
Coordinator/ CHA Work Group
Cumberland County Department
of Public Health
Fayetteville State University
Coordinator/ CHA Work Group
Cumberland-Fayetteville Park
and Recreation
Cumberland County Department
of Public Health
CHA Work Group
Cumberland County Department
of Public Health
Cumberland County Department
of Public Health
Liberty University
Methodist University
CHA Work Group
Advisory to CHA Team
CHA Work Group
CHA Work Group
CHA Work Group
CHA Work Group
Analyzed and wrote narrative for
primary data
Methodist University
Analyzed and wrote narrative for
primary data
Dr. Warren McDonald
Methodist University
Instructor /Adviser to Methodist
students.
Theresa Lofton
Cumberland County Department Review and Edit document.
of Public Health
Special thanks to senior groups that help to prioritize the health issues.
3
Executive Summary
The Cumberland County Department of Public Health and Cape Fear Valley Health Systems
launched a comprehensive community health assessment and planning process collaborating
with a wide range of community partners on January 28, 2016.
The Community Health Assessment (CHA) describes the health of the community by identifying
and presenting information on the community’s health status, needs, and resources. Its goal is to
describe the health needs of the community and to develop strategies to address those needs. The
CHA also identifies areas where better information is needed, especially information on health
disparities among various subpopulations, and the quality of health care.
The CHA is the basis for all local public health planning, giving the local health unit the
opportunity to identify and interact with key community leaders, organizations and concerned
residents about health priorities and needs. This information forms the basis of improving the
health status of the community through a strategic community action plan.
The CHA is conducted every three to four years to meet requirements for the Consolidated
Agreement between the NC Division of Public Health and State Accreditation of Local Health
Departments. As a part of the Affordable Care Act, Non-profit Hospitals are now required to
conduct a Community Health (Needs) Assessment at least every three years.
http://publichealth.nc.gov/lhd/cha/about.htm
The Department of Public Health and Cape Fear Valley Health Systems decided to collaborate
on the CHA since both agencies were required to conduct an assessment. This collaboration
created a broad-range of partners (Human Service Agencies, Institutions of Higher Learning, and
Non-Profits etc.) to complete a comprehensive overview of the county’s health.
Data Collection:
Primary data was collected through distribution of Community Health Assessment (CHA)
Opinion Surveys. The purpose of the survey was to gather information about the health and
quality of life of the community. The survey measured perceptions and attitudes of Cumberland
County residents toward a variety of health and allied health issues that impact their lives.
Survey results can be found in the appendix. Appendix C
Secondary Data was collected from a variety of sources, including the North Carolina State
Center for Health Statistics, U S Census Bureau, the Shep Center and other data sources for
comparison with State data. Once all of the data was collected and analyzed the CHA work
4
group, advisory group and community members selected the top four priority health
concerns/issues.
Health Priorities:
After the CHA team reviewed and discussed the data obtained from the surveys and local and
state agencies the following health problems were identified: Obesity, Heart Disease, Cancer,
Fitness and Nutrition, Diabetes, Chronic Lower Respiratory Diseases, Stroke, Substance Abuse,
Sexually Transmitted infections and AIDS, Teenage unwanted pregnancy. The CHA team and
community residents provided feedback on the data to help determine the major health issues.
Participants were given a list of the health concerns identified and asked to rank them as to what
problem they wanted to see changed first, second, etc. Participants were given a health problem
work sheet with a short summary of the data findings and the criteria for rating the health
problems: (1) Magnitude, (2) Seriousness of the Consequences, (3) Feasibility of Correcting, (4)
Community and Financial Resources and (5) Existing Partnerships. The participants were asked
to score each problem one to ten with ten being the highest. The scores were tallied and the
health problem with the highest number was selected by descending order. The following health
problems were selected:
Chronic diseases including: Heart Disease, Cancer, Diabetes/Obesity
Sexually Transmitted Infections (STIs), AIDS, and Adolescent unwanted pregnancy
Substance/Opioid Abuse
During the period, 2011-2015, heart disease was the leading cause of age-adjusted death and
cancer (all sites) was the second leading cause of age-adjusted death. Heart disease and cancer
were selected due to the number of people affected and the effectiveness and feasibility of
interventions to address them. Diabetes death rate moved from fifth to sixth leading cause of
death in Cumberland County, it appears that the efforts at prevention may be working. Diabetes
affects every part of the body and may cause many complications that have an impact on the
quality of life. Obesity goes hand in hand with preventing diabetes and promoting increased
physical activity and healthy eating.
During the period 2011-2015, Sexually Transmitted Infections and AIDS remain higher than
peer counties. Cumberland County’s Syphilis, Gonorrhea, Newly Diagnosed HIV infection and
AIDs rates remained higher than the state’s and peer counties’ rates. In 2015, Cumberland
County’s total teen pregnancy rate was higher than the state and peer counties rates. When an
adolescent faces an unwanted pregnancy, her life becomes disrupted as she might quit school and
expose herself and her unborn child to poverty and various other socio-economic and health
disparities.
5
Cumberland County
Demographics-2015
Population: 323,838
Race/Ethnicity:
Demographic and Population Characteristics:
White-Non-Hispanic 44.6 %
African American 37.9%
Hispanic 11.3%
Gender:
Male 48.9%
Female 51.1%
In 2015, there were 323,838 people living in
Cumberland County.
Cumberland County has a young population.
The median age is 31 years.
In 2015, Cumberland County is a diverse county:
White, non-Hispanic, 44.6%, African-American,
37.9% and Hispanic/Latino, 11.3%
Age:
5 years and below 8.2%
18 years and below 25.6%
65 years and above 11.3%
19-64 years 63.1%
Unemployment: 2016
Socio-Economic Characteristics:
In 2016, Cumberland County unemployment rate was
6.1%, higher than the State’s unemployment
rate of 4.9%.
During the period 2011-2015,the percentage of
Cumberland County families living in poverty was
slightly higher (18.8%) than the State (16.4%) and
the percentage of Cumberland County children living
in poverty (27.4%) was slightly higher than the State
(25.1%).
During the period 2011-2015, Cumberland County’s
median household income ($44,171) was lower than
the State’s median household income ($46,868).
When asked what issues most affect the quality of life
in Cumberland County, 40.9% stated low
income/poverty and 26.3% stated violent crime.
Cumberland County-6.1%
State- 4.9%
Residents living in poverty
(2011-2015)
Cumberland County-18.8%
State- 16.4%
Children living in poverty2011:
Cumberland County- 27.4%
State-25.1%
http://www.census.gov/quickfacts
-2015; 2011-2015
6
Chronic Diseases create a
heavy burden on health and
health care.
Heart Disease, Cancer (all
sites) and death rates exceeded
the State.
Health Priorities
Chronic Diseases: Chronic diseases, such as heart disease,
stroke, cancer and diabetes, are among the leading causes of
age-adjusted death and are among the most common, costly,
and preventable of all health problems in Cumberland
County. Chronic diseases create a heavy burden on health and
healthcare.
According to the 2016
community health assessment
(CHA) survey, when asked
what would you like to see
more of available in the
community, diabetes/obesity/
nutrition/fitness ranked first,
heart disease ranked second,
and cancer ranked third
Heart Disease: During the period 2011-2015, Cumberland
County’s total heart disease death rate of 193.5 was higher
than the State’s heart disease death rate of 163.7. Some of the
contributing factors for heart disease are:
High Blood Pressure
High blood cholesterol
Diabetes
Tobacco use
Physical inactivity
Poor nutrition
Obesity
According to the 2016 CHA
survey, when asked if they had
ever been told by a doctor or
health care professional if they
had any health condition, 422
reported discussing
overweight/obesity with their
doctor and 363 reported
discussing hypertension with
their doctor.
Cancer: During the period 2011-2015Cumberland County’s
Cancer (all sites) death rate of 181.3 was higher than the
State’s cancer (all sites) death rate of 169.1. Some of the
contributing factors for cancer are:
Environmental carcinogens
Tobacco
Diet
Obesity
Sedentary lifestyle
Family history
Sources:
2016 Community Health Assessment
Survey.
www.schs.state.nc.us/SCHS/data/databook,
2017
Diabetes/Obesity: The diabetes death rate of 29.2 moved
from fifth to sixth leading cause of age-adjusted death in
Cumberland County, and was higher than the state’s
diabetes age-adjusted death rate of 29.2. The community
residents who responded to the community health survey
ranked the need for “diabetes information” as number one.
Obesity goes hand-in-hand with preventing diabetes and
promoting increased physical activity and healthy eating.
7
Section 1: Background and Process
By providing the basis for discussion and action, the Community Health Assessment (CHA) is
the foundation for improving and promoting the health of community members. The role of
the community assessment is to identify factors that affect the health of a population and
determine the availability of resources within the community to adequately address these
factors.
Through collaborative efforts forged among community leaders, public health agencies,
businesses, hospitals, private practitioners, and academic centers, a community assessment
team works to identify, collect, analyze, and disseminate information on community assets,
strengths, resources, and needs. A CHA usually culminates in a report or a presentation that
includes information about the health of the community as it is today and about the
community’s capacity to improve the lives of residents.
Cumberland County initiated the CHA process on January 11, 2016 when invitation letters
signed by the Director of the Department of Public Health and the CEO of Cape Fear Valley
Health Systems (CFVHS) were mailed to approximately fifteen community agencies. The first
CHA meeting was held on January 28, 2016 with ten agency representatives present.
A review of the CHA process and requirements for Health Departments and Nonprofit Hospitals
was presented to the group. A CHA team was created to help guide the process. The CHA team
was composed of an advisory group and a work group.
The advisory group consisted of those in a leadership role; the work group was composed of
representatives from three community agencies and four staff members from the Department of
Public Health.
The work group had approximately five meetings and numerous email correspondences. The
work group was responsible for: developing and distributing the CHA survey tool, coordinating
survey analysis and interpretation with Methodist University and setting criteria for prioritizing
health problems. Also, members from the work group were assigned a section of the CHA to
complete i.e. Socio-economic, Education etc. The health education staff was responsible for
secondary data collection. After examining the results of the CHA survey (primary data) and
secondary health data the CHA team selected three health priorities for 2017: Heart Disease,
Cancer and Diabetes/Obesity.
The CHA team will continue to meet and prepare for development of the community action
plans to address the selected priority health problems.
8
The Community Health Assessment Team
Name
Buck Wilson, Health Director
Sandy Godwin, Executive
Director for Corporate Planning
William Haithcock, Sr. Financial
Analyst
Barbara Carraway, Health
Education Supervisor
Sharon Gallagher, ProfessorNursing
Melvin Lindsay
Phyllis McLymore, Health
Educator II
Susan Dover, Health Educator I
Marisa Ramos-Mason, Health
Educator I
Antwi Innocent, Intern Student
Artimisha Campbell-Williams,
Student
Miranda Chang, Student
Dr. McDonald
Agency
Cumberland County Department
of Public Health
Cape Fear Valley Health System
Role/Contribution
Advisory to CHA Team
Cape Fear Valley Health System
Coordinator/ CHA Work Group
Cumberland County Department
of Public Health
Fayetteville State University
Coordinator/ CHA Work Group
Cumberland-Fayetteville Park
and Recreation
Cumberland County Department
of Public Health
CHA Work Group
Cumberland County Department
of Public Health
Cumberland County Department
of Public Health
Liberty University
Methodist University
CHA Work Group
Methodist University
Methodist University
Advisory to CHA Team
CHA Work Group
CHA Work Group
CHA Work Group
CHA Work Group
Analyzed and wrote narrative for
primary data
Analyzed and wrote narrative for
primary data
Instructor /Adviser to Methodist
students.
9
Section 2: Historical and Geographic Overview
Cumberland County is located in the southeastern section of the State and is bounded by
Sampson, Bladen, Robeson, Hoke, Harnett and Moore counties. The present land area is 652.32
square miles. Cumberland County was named in honor of William Augustus, Duke of
Cumberland, and third son of King George II. Cumberland was the commander of the English
Army at the Battle of Culloden, in which the Scotch Highlanders were defeated in 1746. Many of
them came to America, and their principal settlement was in Cumberland County. Cumberland
was changed to Fayette County in early 1784, but the act was repealed at the next General
Assembly, which met in November 1784.
The county seat was first called Cumberland Court House. In 1762, Campbellton was established
at Cross Creek with provisions for the public buildings. In 1778, Cross Creek and Campbellton
were joined and the courthouse was ordered to be erected in that part of the town known as Cross
Creek. In 1783, Campbellton was changed to Fayetteville in honor of Lafayette. Currently,
Fayetteville is the County’s seat and its largest municipality. Other municipalities in Cumberland
County are Eastover, Falcon, Godwin, Hope Mills, Linden, Spring Lake, Stedman and Wade.
Cumberland County consists of 664 square miles located in the upper coastal plain section of the
State. The area is better known as the “Sandhills”. Elevations in Cumberland County range from
40 to 486 feet above sea level. Cumberland County has progressed from its beginnings as a river
front distribution center to a highly commercialized area offering a variety of services to its
citizens. Fayetteville is located in the Coastal Plain at the foot of North Carolina’s Piedmont
plateau. The city, located next to the Cape Fear River, is 107 feet above sea level.
Climate
The climate in Cumberland County is comparable to other communities in the Carolinas, with
pleasant spring and fall seasons, mild winters and hot summers. Snow and sleet are rare and even
freezing temperatures normally occur only during the months of December through February.
Although hurricanes do occur along the coast of North Carolina, and can wreak damage far
inland, only 8 hurricanes in the past 50 years have had a significant impact on Cumberland
County. Fayetteville is 90 miles from the closest point on the NC coast, and the effect of storms
is usually limited to water damage caused by heavy rains.
Cumberland County gets 47 inches of rain per year. Snowfall is 3 inches. The number of days
with any measurable precipitation is 106. On average, there are 217 sunny days per year in
Cumberland County. The July high is around 91 degrees. The January low is 31. Our comfort
index, which is based on humidity during the hot months, is a 32 out of 100, where higher is
more comfortable. www.bestplaces.net/climate/county/north_carolina/cumberland
10
Fort Bragg is one of the U.S. Army’s largest installations in the world. The installation covers
about 161,000 acres, or 251 square miles, stretching into six counties.
Fort Bragg underwent significant change in the 1990s. From the removal of wooden barracks to
building construction/renovation through expansion of training areas into the newly purchased
Overhills site, Fort Bragg greeted the new century with a fresh appearance.
Since 2000, Fort Bragg Soldiers have participated in combat and humanitarian operations in
countries around the world. Fort Bragg responded to provide support to those impacted by
Hurricane Katrina in 2005 and in Haiti after the 2010 earthquake. Fort Bragg serves a vital role
in the war on terror, deploying and supporting more troops than any other post, in support of
Operations Enduring Freedom, Iraqi Freedom and New Dawn.
Fort Bragg continues to invest to modernize and expand facilities. The 82nd Airborne Division’s
1955 barracks complex was replaced with modern buildings. Office buildings and barracks have
also been constructed for units recently added to the division. A new headquarters building was
constructed on Knox and Randolph Streets for the U.S. Army Forces Command (FORSCOM)
and the U.S. Army Reserve Command. These two major commands moved to Fort Bragg in
2011 when Fort Macpherson, Georgia, was closed under the Base Realignment and Closure
(BRAC) legislation. BRAC moves also resulted in the 7th Special Forces Group completing their
reloc …
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