Community Health Assessment Takes Jackson’s Pulse | Best Stories
The Jackson County Public Health Department worked with local community agencies and members to complete the 2021 Community Health Assessment.
GBA is the foundation for improving and promoting the health of community members, and its role is to identify the factors that affect the health of a population and determine the availability of resources within community to respond appropriately to these factors. The CHA is a year-long process that leads to a comprehensive community health report.
The CHA compares Jackson County’s most recent health trends to the region and state. Jackson County’s three leading causes of death (cancer, heart disease, and chronic lower respiratory disease) align well with our region and state.
There are key data points that lead to the selection of three health priorities, which are healthy eating/physical activity, substance use prevention, and mental health.
In Jackson County, 28% of adults are of a healthy weight, with 23% meeting physical activity recommendations of 150 minutes or more per week. Less than 6% of residents meet the nutrition standard of five or more servings of fruits/vegetables per day.
According to the Centers for Disease Control and Prevention, unintentional injuries are the leading cause of death among Americans aged 1 to 44. This includes opioid overdoses and unintentional poisonings, as well as unintentional drownings, traffic accidents and falls. Suicide is now the second leading cause of death for the same age group and the numbers continue to rise. In Jackson County, the western North Carolina region, and the state, unintentional injury death rates have increased dramatically since the early 2000s.
Jackson County’s current rate (54.8) is now higher than the WNC region (50.7) and state (39.3). Additionally, men continue to die from unintentional injuries more often than women, although the large gap between the two has begun to close.
Unintentional poisoning mortality continues to be higher in Jackson County at a rate of 24 per 100,000 people, compared to the WNC region (23) and the state (19). According to the North Carolina Department of Health and Human Services, prescriptions for commonly prescribed opioids (oxycodone, hydrocodone, codeine) were historically the leading causes of opioid overdoses. However, heroin, fentanyl and fentanyl analogues are now implicated in the majority of these deaths.
A wide variety of demographics and urban and rural communities are experiencing an increase in overdose deaths, although those most commonly affected are white or Native American, male, and 25-48 year olds. A compelling data point regarding the increase in opioid overdoses is the number of naloxone reversals in the community. In Jackson County, in 2018 there were eight reversals, while in 2020 there were 65. That’s a rate of 148 per 100,000. For perspective, the WNC region has a rate of 71 and the state has a rate of 31 per 100,000.
Residents of Jackson County and the WNC area continue to report a drop in social/emotional support when needed. In 2012, 82% of Jackson County residents and 81% of WNC residents said they always/usually receive needed social/emotional support. Those numbers have increased to 66% in Jackson County and 70% in the WNC in 2021.
Additionally, the percentage of people reporting seven or more days of poor mental health in the past month increased significantly in Jackson County (20%) and the WNC (22%). Both percentages were below 15% in 2012. In Jackson County, 12% of the typical day for the population is extremely or very stressful. This rate is lower than the WNC rate (13%) and the US rate (16%).
Despite these rates, 84% of Jackson County residents and 87% of WNC residents are confident in their ability to handle stress.
Additionally, 74% of Jackson County residents are able to maintain hope in difficult times. Jackson County has the highest percentage of residents (12%) in WNC who have considered suicide in the past year. The average WNC is 8%.
Life dissatisfaction has doubled in Jackson County and the WNC since 2012, with rates of 5% for both in 2012 and rates of 10% in 2021.
The COVID-19 pandemic has negatively impacted mental health and strained the region’s limited resources.
On a positive note, the heart disease death rate in Jackson County has declined significantly since the early 2000s, dropping from 200 to 149 per 100,000 people during the 2015-19 period.
Additionally, motor vehicle accidental death rates have improved in Jackson County, the WNC region and the state. During the 2002-06 period, Jackson had a rate of 19%, then during the 2015-19 period, Jackson had an improved rate of 14%. In comparison, during the most recent period analyzed, the WNC region average was 13% and the state average was 15%.
Other issues to watch include the COVID-19 pandemic, health equity, poverty and chronic disease rates.
The next step is to develop community health improvement plans to address the three priorities, and the ACS Facilitator is looking for passionate and dedicated individuals to serve on Community Action Teams.