Executive Summary - Community Health Assessment

Executive Summary

Anson County Community Health Assessment

According to a Public Survey conducted as part of the Community Health Assessment (CHA) 56% of those surveyed disagree with the statement “People in Anson County can get good health care.”  In the same survey 38.3% said that people can get good health care and 5.7% said they “Don’t Know.”

The Public Survey and other research and data collection instruments were used to discover the things – lack of resources, lack of knowledge, lack of insurance/money, etc. – that are keeping people in Anson County from getting good health care.  The following instruments were used to collect the information:
·         671 Public Surveys were collected to gather specific information from citizens on health concerns and issues
·         115 Key Informant interviews were conducted to determine concerns and issues about health and the environment
·         120 interviews with health and wellness resources were conducted in order to develop a comprehensive Health Resource Directory
·         Secondary Data (statistics, summaries, etc.) that expanded and completed the findings from the surveys and interviews was gathered from local sources and from State and national sources (County Health Data Book, Census, NC Department of Health and Human Services, etc.)

This report includes details on the results from all of this research including:
·         Resource Directory
·         Resource Operation Directory
·         Detailed Summaries of Public Survey responses on all questions for the entire County and for each Town
·         Narratives of various health concerns, who is involved and the statistical data that support and explain them 

The CHA Guide from the NC Department of Health and Human Services was used to develop the data collection plan and instruments and to compile the information into this useable report.  The information collected enabled the Healthy Ansonians (serving as the Advisory Group of the CHA process) to determine the foremost Priorities that should be addressed through Action Plans in order to address the most serious and far reaching health concerns/issues.  The two Priorities chosen are Obesity and Diabetes.   

Addressing Obesity and Diabetes will have a positive impact on many health issues that have chronically been a problem in Anson County including Cardio/Heart Disease, Hypertension, Stroke and Kidney Disease.  If these two areas are addressed and improved they will have a larger impact on the overall health of Anson County citizens because they will lead to a healthier life-style for individuals and in turn will minimize other unhealthy choices and activities. 

The Public Survey and Key Informant interviews provided great insight into the concerns and attitudes of the people of Anson County.   Following are some of those results. 

The top five health concerns of those participating in the Public Survey are:
1.       Illegal Drug Use
2.       Tobacco Use/Smoking
3.       Teenage Pregnancy
4.       Obesity/Overweight
5.       Alcoholism/Alcohol Abuse

The top five health concerns of Key Informants interviewed are:
1.       Adult Diabetes
2.       Lack of knowledge/education/understanding of healthy life style and care of self or children
3.       Obesity
4.       Poor diet/Nutrition
5.       Cardio Problems/Diseases

According to the NC Department of Health and Human Services 2012 County Health Data Book the top 5 causes of death in Anson County are:
1.       Diseases of the Heart
2.       Cancer (primarily trachea, bronchus and lung)
3.       Cerebrovascular Disease (brain blood clot or hemorrhage)
4.       Chronic Lower Respiratory Disease
5.       Diabetes 

According to the County Health Rankings & Roadmaps 36% of the adults in Anson County are obese (have a Body Mass Index [BMI] of 30 or more).  In the Public Survey participants were asked if they had been diagnosed with several diseases related to the two Priorities – Obesity and Diabetes.  Here are those results:

·         17% have Heart Disease
·         27% have Hypertension (High Blood Pressure)
·         21% have High Cholesterol
·         5% have had a Stroke
·         12% have Diabetes 

The research revealed that there are non-health issues and behaviors that either impact the health and wellness of people in the County or are indicators that there are problems, some of which affect health and wellness.  Following are the top 5 Community Issues as shared by the Public Survey participants:

1.       Unemployment/Underemployment
2.       Crime (theft, robbery, etc.)
3.       Lack of Recreational Facilities
4.       Domestic Violence
5.       Lack of/Inadequate Health Insurance

The Key Informants said the following are the top 5 non-health issues:

1.       Lack of jobs, Unemployment
2.       Poverty
3.       Lack of Education
4.       Hopeless Society
5.       Economic Condition of County 

Unemployment and poverty have direct impacts on health and wellness because they make it difficult, sometimes impossible, to obtain proper health care and medication.  People who are unemployed usually do not have insurance; they may qualify for Medicaid or Medicare, but are still often hampered in getting the level of care they need because of finances.  

Other factors contributing to the health issues of County citizens and often directly related to Obesity and Diabetes are the things besides lack of insurance that keep people from getting the health care they need.  Here are those major factors.

Key Informants provided the following responses about barriers to health care:

·         14% -- Lack of Specialists
·         18% -- Must leave County for many types of care
·         15% -- People do not get care because it is not in the County and they cannot get it out-of-county because they:

o   Cannot afford to travel

o   Do not have transportation

o   Cannot take time off from work

o   Do not have someone to care for children

·         14% -- People do not have transportation to Health Care
·         12% -- Lack of Doctors and other Health Care Professionals

 Responses in the Public Surveys provided insight into the barriers to health care.  Following are two charts that show the responses when participants were asked which are barriers to their getting health care:

Many participants, Public Survey and Key Informants, in the CHA research said that a major contributor to the Obesity and Diabetes problems is the lack of affordable, accessible recreational and fitness facilities/programs and to healthy food.  Some also said that people often do not know/ understand the importance and/or components of a healthy life-style.  Key Informants gave the following responses:

1.       15% said people do not take advantage of what is available
2.       19% said it is too costly for many people to eat healthy
3.       23% said that using fitness facilities is too costly for many people
4.       14% said that affordable, accessible healthy life-style components are not available

Public Survey participants gave these responses:

·         Participants ranked “Inactivity/Lack of Physical Activity” as the 7th highest Health Concern – 83.2% of respondents have said it is a problem (Major or Somewhat)

·         51% of Survey respondents said that “Access to Healthy Food” is a problem (Major or Somewhat)
·         71% of Survey respondents said the “Lack of Recreational Programming” is a problem (Major or Somewhat)

 Information on the Environment of the County was also gathered during the CHA process.

Key Informants said the top two Environmental Concerns are:

1.       Poor water quality, antiquated water pipes
2.       Unsanitary living conditions, substandard housing 

Of the participants in the Public Survey 57.1% of survey participants said that water pollution is a problem (26% said Major, 31.1% said Somewhat).   76.6% of participants said that Litter is a problem (36.1% Major, 50.5% Somewhat).  48% of participants said that Land & Soil Pollution are a problem (19.5% Major, 28.5% Somewhat).


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