My Catawba County

Building a Healthy Community

You may not have heard of the Community Health Assessment (CHA), but the CHA touches and impacts every resident’s life here in some way. To learn more about the CHA and what it means to our community, we reached out to Public Health Director Jennifer McCracken to explain.

What is the Community Health Assessment (CHA) and how often does it take place?
The Community Health Assessment is a yearlong process that consists of community conversations, community building, and listening to feedback from individuals from all walks of life. During the year of information gathering, Local Health Departments (LHDs) gather their own data and use data collected by the U.S. Centers for Disease Control and Prevention (CDC), North Carolina Department of Health and Human Services (NCDHHS), the U.S. Census Bureau and other national, state and local sources for analysis. Health priorities are determined based on input from the community as well as from the data gathered during the process. In North Carolina, LHDs must submit a CHA report every 4 years.

But work on the CHA doesn’t end with just a report. Information gathered informs priorities that will be addressed collectively in the community, making it a truly continuous, collaborative community process.

How does the CHA help Catawba County Public Health and our community?
Information gathered from the CHA assessment helps us hone in on priorities and where we can collectively make real change in our community.  We want to be able to understand from the community itself what is most important. This allows Public Health and other community partners to lead and implement strategies that will help promote change. Historically, data in the CHA has also been used by other organizations as they apply for grant funds to further promote health of the community and as they set strategic priorities of their own to align with CHA findings. Information within the CHA helps Public Health as we serve the community both in our clinics and beyond, as it helps inform our daily decisions and makes us better able to respond to the community’s identified needs.

What is the process for completing the CHA? Who is involved and how do they go about the work?
The Community Health Assessment (CHA) uses input from a broad base of community members and combines this with the most recent local data to understand the strengths and needs of our community to inform our county’s health priorities for the next four years. We begin by identifying existing county plans or assessments with relevant data that we may be able to use. We then collect additional data related to topic areas that arise and begin formatting information for review. We also conduct the Community Health Survey and community listening sessions to gain community input. As a part of the selection of health priorities, we gather additional input from community partners and individuals before finalizing the selected priorities.

Public Health’s Health Promotion and Strategy Team members are the primary contacts for the CHA work; however, we engage all of public health and the community in this process. For this year’s CHA, the team facilitated community conversations to gather input from community members, helped distribute surveys and met with individuals to seek input for the survey. We convened community partners for Data Walks, which revealed trends in data that was collected during the process. We also worked with a consultant to help analyze the data and to put the actual CHA document together, which will be released soon.

What was learned this year as the data was compiled? Did anything surprise you or stand out from previous CHAs?
The 2023 Health Priorities were determined to be: 

Brain Health:

• For the second Community Health Assessment in a row, brain health and substance use have been consistent areas of concern across Community Conversations, with participants often emphasizing the mental well-being of children and youth.
• One in four people who took our survey chose brain health supports and services as an area of focus to improve community health and well-being. More than 10% also selected substance use resources and support.
• In 2021, more than 16% of adults in Catawba County reported experiencing poor mental health for at least half the month on average.
• The death rate related to suicide has increased both statewide and within Catawba County and Emergency Department visits related to suicidal thoughts have increased among all age groups, with the biggest increases in youth and teens.
• Emergency Department visits and deaths related to drug overdose have increased significantly since 2015.
• About one in 10 people who took our survey were worried about accessing brain health services because of cost.
• In North Carolina, nearly one in five children have experienced at least two Adverse Childhood Experiences, which are tied to poor health as adults.

Access to Healthy Food:

• Food insecurity and food costs came up consistently in Community Conversations and about one in five survey respondents selected access to healthy, affordable food as an area of focus to improve community health and well-being. Both people who took the survey and people who attended the Community Food Gatherings said cost was the leading barrier to purchasing healthy food.
• Approximately 12% of all Catawba County residents and 13% of children are experiencing food insecurity, with the heaviest impact on Black and Latino residents. About half of our county’s children are federally classified as “economically disadvantaged” and are eligible for participation in the National School Lunch Program.
• About 10% of households have limited access to food based on where they live in the county.
• Less than 1 in 10 adults in our state health region eat five or more servings of fruits, vegetables, and beans daily.

Safe, Engaging, Active Spaces:

• Having safe, engaging and active spaces can help address cross-cutting issues like physical activity and chronic disease, social isolation and community connectedness, as well as community safety.
• When asked in our community survey what areas should be focused on to improve health and well-being in Catawba County,
  • 15.4% of respondents selected parks, recreation, and outdoor spaces,
  • 12.6% of respondents selected community safety,
  • 12.4% of respondents selected chronic disease prevention and management,
  • 8.5% of respondents selected social connection and community building, and
  • 6.5% of respondents selected art and cultural events.
• Cancer and heart disease are the leading causes of death in Catawba County, with the most severe impacts among our county’s Black residents. Diabetes and stroke are further down the list in overall county mortality, but also disproportionately affect members of our Black community.
• An estimated 22% of Catawba County adults are not physically active outside of their jobs, and 40% of residents don’t have adequate access to publicly accessible parks and recreation facilities based on where they live.

One thing that does stand out since the last CHA is social isolation and a lack of community connectivity. This was not a major concern in the 2019 assessment, but it came up in all of the Community Conversations we hosted in 2023. More than 10% of people who took the community health survey reported being lonely “often” or “always,” and almost half of survey respondents reported not feeling connected to the community or having a sense of belonging.

How will Public Health and community stakeholders work to address the findings of this year’s assessment?
Now that the CHA is nearing completion, we are moving into the next phase of this continuous process - developing our Community Health Improvement Plan (CHIP). In this plan, we look at ways Public Health and the community can take collective action that can be used to improve the quality of life in our community. To work on this plan, we convened workgroups of community partners who are already addressing some of the same issues in the community. Together, we looked at the data and determined what results could look like in our community, how will we measure these conditions, and what is the baseline data we need to measure success and decide where we are headed. We have also begun to look together at what strategies and programs might work to help improve these conditions. From these discussions, we are developing our community action plan with strategies and performance measures.

What’s next: In January, we will convene three work groups, one for each of the three health priority areas. These workgroups will include anyone in the community who would like to be a part of this process and will also encourage those who are already doing this work in our community to address these issues. Each workgroup will meet bi-monthly to refine action plans and implement identified improvement strategies while supporting efforts that are already underway.

Is there anything else you’d like to add about the Community Health Assessment?
There has been a lot of excitement around the CHA and many community partners have said they want to align their agencies’ priorities with the health priorities that have been identified during this process. This shows that our community has many organizations and leaders who want to work together toward a vision of a Catawba County that is a healthy place and it also shows just how important this collaborative work is to ensure a healthy community for everyone.