HNC 2030 Scorecard: Craven County 2022-2024

Executive Summary

Purpose and Vision

The purpose of a Community Health Needs Assessment (CHNA) is to examine the health issues of communities within the county and to identify health priorities that will be the focus for community health improvement for the next three years (2022-2024). Craven County Health Department, Jones County Health Department, Pamlico County Health Department, and CarolinaEast Health System partnered to identify health priorities. Each organization will write its own CHNA report, but it was important to work together in identifying health priorities since Craven County is the hub for health services and resources in the tri-county area. The competed CHNA will satisfy requirements from the North Carolina Department of Health and Human Services, local Health Department Accreditation, and Federal Internal Revenue Services. While the executive committee's mission includes collaboration of community partners, identifying health priorities, and developing community health improvement plans, the vision is to improve the health status and quality of life for all people in our region.

Leadership/Partnership/Collaborations

The Craven County Health Department, led by the Craven County Health Director, and CHNA Executive Committee oversees the CHNA process. The 2021 CHNA process began with the formation of the Executive Committee and identification of community stakeholders in the spring of 2021. Community stakeholders represent diverse, multi-sectoral and cross-sectoral groups. The primary role of stakeholders is to support primary and secondary data collection, assist with analyzing data and information collected, and interpret county data and community feedback to identify top health priorities in Craven County.

CHNA Executive Committee

Amber Tabarrini, Quality Assurance Specialist - Craven County Health Department

Janzen Jones, Public Health Educator - Craven County Health Department

Adrian Smith, Public Health Educator - Jones County Health Department

Stormy Meadows, Health Education and Promotion Coordinator - Pamlico County Health Department

Brandi Popp, Public Relations Director - CarolinaEast Health System

Community Stakeholders

Scott Harrelson, Health Director - Craven County Health Department

Geoff Marrett, Director - Craven County Department of Social Services

Jim Davis, Chief Nursing Officer - CarolinaEast Medical Center

Barb Krcmar, Executive Director - Merci Clinic

Billy Wilkes, Director - Craven County Recreation and Parks

Jeff Futrell, Director - Craven County Veteran Services

Mike Swain, Director of Student Services - Craven County Schools

Kelly Walker, Director - Craven Area Rural Transit System

Susan Hall, System of Care Coordinator - Trillium Health Resources

Stephanie Scott, Practice Director - Pamlico Child and Family Therapy

Tamra Church, Chairperson - Coastal Coalition for Substance Awareness and Prevention

Regional Services

Health ENC structured primary data collection for the CHNA process and acquired secondary data from data sources.

Theoretical Framework Model

Craven County uses the North Carolina Department of Health and Human Services, Division of Public Health eight-phase community health assessment process. This process uses a systematic approach through collection, assembly, analysis, and dissemination of information about the health of the county.

1. Establish a community health assessment team

2. Collect primary data

3. Collect secondary data

4. Analyze and interpret data

5. Determine health priorities

6. Create the CHNA document

7. Disseminate the CHNA document

8. Develop community health improvement plans

Key Findings

Through feedback from community surveys, Craven County residents report that Craven County is a good place to raise children, it's a safe place to live, and there are good parks and recreation facilities. Residents expressed concerns about substance abuse, poverty, and the lack of 9 affordable housing as they relate to quality of life. Additional information about key findings can be found throughout the report by specific topic area.

Priorities

Health Priorities Identified for 2022-2024

Behavioral Health

Community Wellness

Workforce Development

Why Is This Important?

Substance use was identified as the top quality of life issue by Craven County residents that completed the CHNA survey in the spring of 2021. Suspected drug overdoses and deaths have continued to rise in Craven County since 2018. The rate per 100,000 for Craven County emergency department (ED)overdose visits in 2021 was 183.1 compared to North Carolina at 149.9. For 2021, the rate for overdose deaths in Craven County was 56.8 while the state was 35.8. Craven County is currently ranked as one of the highest counties for overdose related ED visits and overdose deaths in North Carolina. Substance use disorders often occur simultaneously in individuals with mental illness, usually as a coping mechanism. The lack of treatment facilities, high cost for treatment, and extreme decrease in substance use disorder providers in Craven County all contribute to substance misuse and overdose deaths.

What We Do

Craven County Health Department collaborates with the New Bern Police Department and Realo Discount Drugs to hold two drug take back events each year. This event allow the community to safely dispose of unused and/or expired medications. By collecting these medications we are helping to reduce the number of unintentional poisoning of Craven County residents.  Once the medication is collected it is weighed and then destroyed by law enforcement to ensure proper disposal. The total weight of medication collected is recorded and reported for each event. 

Who We Serve

While this program is available to all residents of Craven County,  there is a special focus on individuals that receive prescription medications.

How We Impact

When prescription drugs get into the wrong hands it can be dangerous and sometimes fatal. In Craven County, since 2020, over 1,000 pounds of unused and/or expired medications have been removed from the home and disposed of properly. This action is helpful in preventing medication misuse, potential opioid addiction, and reducing overdoses and overdose deaths. 

What We Do

The overall goal of CATCH My Breath is to prevent the initiation of e-cigarette use among preteen and teen adolescents. 

The program is designed to help students:

• Discover that non-use of e-cigarettes is the norm for adolescents
• Identify reasons why young people might start using e-cigarettes
• Recognize the subtle, and not so subtle, messages in e-cigarette advertising
• Practice skills for resisting peer pressure and advertising pressure to use e-cigarettes
• Decide on their personal reasons not to use e-cigarettes and set goals for future non-use

The intended outcomes are to ensure that students will:

• Resist their own curiosity, peer and advertising pressure to experiment with e-cigarettes
• Understand that e-cigarettes are addictive, unhealthy, and not as popular as they think
• Influence friends and peers not to use e-cigarettes

CATCH My Breath is taught by staff of the Craven County Opioid Task Force and Coastal Coalition for Substance Awareness & Prevention.

Who We Serve

This target population for this program is youth ages 10-18 years. CATCH My Breath was taught at the YMCA summer program in 2022. In the Spring of 2023, the program will be introduced to area middle school students. 

How We Impact

Nationally CATCH My Breath has reached 1,800,000 students and counting. After completing the CATCH My Breath program, 7 out of 8 students say they are less likely to use e-cigarettes. 

Why Is This Important?

Suicide is the second leading cause of death for individuals ages 20-39 in Craven County. According to the Substance Abuse and Mental Health Services Administration, people with mental illness are more likely to experience a substance use disorder than those not affected by a mental illness. The National Alliance on Mental Health also reports that 1 in 5 people report that the COVID-19 pandemic had a significant negative impact on their mental health. Mental illness individually or as a co-occurring disorder can make it difficult for individuals to work, go to school, keep a routine, socialize, or even have healthy relationships. It can also negatively impact the workforce in Craven County through lost productivity, workplace accidents and injuries, employee absenteeism, and increased illness.

What We Do

Mental Health First Aid (MHFA) is a public education program that helps participants identify, understand, and respond to signs of mental illnesses and substance use disorders. This is a 8-hour certification course that helps a layperson assist someone experiencing a mental health crisis.

Who We Serve

Professionals and community members in Craven County.

How We Impact

The individuals that complete MHFA training have the necessary tools and information regarding mental health and substance use and are more likely to intervene during a crisis. The confidence built from this training can start dialogues that lead people to get the help they need. Mental Health First Aide can even save lives. 

What We Do

Organize community trainings to reduce suicidal behaviors and save lives by providing sucide prevention training. 

Who We Serve

Professionals and the community. 

How We Impact

By giving people the tools to recoginize the warning signs of a suicide crisis and how to question, persuade, and refer someone to help will save lives. 

Why Is This Important?

Since the last CHNA the top two leading causes of death are still Cancer and Heart Disease. Cancer has been the leading cause of death in Craven County for over 10 years. Physical activity can help you maintain a healthy weight and lower your blood pressure, blood cholesterol, and blood sugar levels which can decrease the risk of heart disease. Obesity and diabetes may increase risk of certain cancers. Studies show that people who are physically active have a lower risk of certain cancers than those who are not. Self-care is an essential part of a healthy lifestyle. Good self-care not only improves physical health but mental health as well. The National Alliance on Mental Health reports that 1 in 5 people report that the COVID-19 pandemic had a significant negative impact on their mental health. Social support can have a positive impact on quality of life and encourage individuals to engage in healthy and active lifestyles.

What We Do

Year-long CDC evidence based lifestyle change program offered to Craven County residents that are prediaetic, have a family history of diabetes, or gestational diabetes. The program is intended to give participants the knowledge and skills to prevent or delay Type-2 Diabetes. 

Who We Serve

Individuals at risk for developing Type-2 Diabetes specifically the minority population in Craven County. 

How We Impact

Thorughout this year-long program participants often lower their A1c, loose weight, and increase physical activity; thus decreasing their risk for the development of Type-2 Diabetes. 

What We Do

Creating safe, comprehensive, and affordable recreation oppourtunities for residents of Craven County.

Who We Serve

All Craven County residents, specifically those individuals looking to increase their physcial activity and engament in recreation. 

How We Impact

By providing afforable physical activity and recreation programming to citizens of all ages. Physical activity can help maintain a healthy weight, lower blood sugar, lower blood pressure,  lower blood cholesterol and decrease risk of heart disease. Engaging in physical activity not only can improve physical wellbeing but also mental health. 

Why Is This Important?

Social and economic factors are well known to be strong determinants of health outcomes – those with a low socioeconomic status are more likely to suffer from chronic conditions such as diabetes, obesity, and cancer. A high poverty rate is both a cause and a consequence of poor economic conditions. Children in poverty are more likely to have physical health problems, behavioral problems, and emotional problems. Without adequate income, individuals may not be able to afford necessary expenses, such as rent or mortgage, utility bills, medical and dental care, and food. Being employed not only provides financial benefits but intrinsic rewards such as feeling accomplished, pride, sense of competence, importance, and responsibility.

What We Do

The Volt Center provides workforce development training and offers hands-on learning in various trades. The programs offered are constantly evolving to meet the needs of the community in Craven and surrounding counties.

Who We Serve

Individuals intrested in gaining trade skills to ehance employment oppourtunities from Craven and surrounding counties. 

How We Impact

Upon completion of trade programs individuals are more likely to secure employment. Being employed makes it more likely for individuals to afford neccessary expenses such as rent/mortage, utility bills, medical and dental, and food- all of which can lead to overall better health outcomes.

Progress on CHIP

Community Wellness

Mass community education campaigns to prevent COVID-19. Over 5,000 N95 mask kits and over 3,500 at-home test kits were distributed to the public. 

Retained full recognition from the CDC for using the evidence-based Prevent T2 curriculum to promote healthy eating and physical activity. The cohort ending in November 2022 saw 57% of participants lose at least 3% of their total body weight. 

Through 35 community events over 2,200 community members were reached. Event topics included: heart health, physical activity, healthy eating, diabetes prevention, COVID-19, stress management, and smoking cessation. 

Behavioral Health 

Community partners came together to form the Recovery Alliance Initiative to address substance misuse. This initiative not only addresses the prevention of overdoses and deaths but also the needs related to a post overdose.

The annual Embrace Recovery Rally was held in September of 2022. The event had 41 vendors and an estimated attendance of 300 people. 

Through a partnership with the North Carolina Department of Health and Human Services, over 150 naloxone kits were distributed to community agencies. 

During two Drug Take Back events, over 600 pounds of medication was safely disposed of in 2022.

Workforce Development

In June of 2022, the health department partnered with Craven Community College to have a Career Coach available on-site at the health department every other week.

Morbidity and Mortality Changes Since Last CHA

After publication of the 2022 CHNA, the NCDHHS Opioid Dashboard was updated with 2021 data. Overdose deaths in Craven County increased from 49.0 per 100,000 in 2020 to 62.7 per 100,000 in 2021. Other Unintentional Injuries is the third leading cause of death in Craven County. Drug overdose deaths are included in deaths related to Other Unintentional Injuries.

Emerging Issues Since Last CHA

According to the CDC, an estimated 3.08 million U.S. middle and high school students reported current use of any tobacco product in 2022, representing approximately one in six high school students and one in 22 middle school students.

Craven County is now seeing vape products used by elementary aged children. 

New/Paused/Discontinued Initiatives Since Last CHA

Mental Health First Aid (MHFA) is a public education program that helps participants identify ,understand, and respond to signs of mental illnesses and substance use disorders. This is a 8- hour certification course that helps a layperson assist someone experiencing a mental health crisis. Trillium Health Resources offers this class to professionals and the public at no cost. In 2019, eleven training sessions were held in Craven County. Due to COVID-19, these trainings were put on pause in 2020 and no classes were held until 2022. The Craven County Health Department has been able to renew this effort and 10 individuals were recently trained.

Progress on CHIP

Community Wellness

The Craven County Health Department participated in 56 partner-sponsored community events in 2023. When participating in events the booth display covers topics such as heart health, physical activity, healthy eating, diabetes prevention, COVID-19, mental health, and smoking cessation. 

Over 1,000 at-home COVID-19 test kits were provided to the community at no cost. 

Mulitple mass media and messaging campgains were promoted. 

Craven County Recreation and Parks saw an increase in program participation with youth and adults. 

Behavioral Health, Substance Use

Craven County Health Department partnered with the Opioid Epidemic Response office to bring community Narcan and Hands-Only CPR to the community. 

The Health Department provided over 250 Narcan kits to the community. 

New Bern Police Department collected over 700 pounds of medication and safely disposed of it during the spring and fall Drug Take Back events.

Behavioral Health, Mental Health

Craven, Jones, and Pamlico counties worked together and brought a Mental Health Town Hall to New Bern in February of 2023. Over 150 individuals attended. .

A Walk for Recovery event was held in downtown New Bern, with over 50 people in attendance. This event brought awareness about recovery from substance use and mental health disorders. 

Craven County promoted the new 988 Lifeline number for suicide prevention. Craven County residents utilized the line 723 times in 2023.

Workforce Development

Craven Community College Career Coaches continue to be on-site at different locations with the county throughout the year. Coaches are dedicated to helping individuals expore a career path that matches their interests. 

In the fall of 2023, Craven Community College entered into a partnership with the North Carolina Division of Juvenile Justice and Delinquency Prevention to develop a pilot program for juctice-involved individuals. The program will offer training and employment opportunities. 

*More details can be found in the full SOTCH report at the bottom of this page. 

Morbidity and Mortality Changes Since Last CHA

Cancer and Heart Disease are still the top two leading causes of death among Craven County residents. The third leading cause of death is Other Unintentional Injuries, which includes drug overdose deaths. The drug overdose death rate for Craven County is 84.2, which ranks as one of the highest counties in North Carolina for overdose deaths. Fentanyl-positive deaths are on the rise and Craven County is ranked fifth for fentanyl-positive deaths in the state.

*More details can be found in the full SOTCH report at the bottom of this page. 

Emerging Issues Since Last CHA

Fentanyl-positive deaths in Craven County have increased over 100% in the past 5 years. Craven County is currently ranked 5th in the state for fentanyl-positive deaths.

Craven County parents are reporting high school students are now trying nicotine pouches. Nicotine pouches are microfiber pouches with flavored nicotine powder that users dissolve in the mouth without spitting. The CDC reports that in 2023 about 1 of every 100 high school students (1.7%) reported using nicotine pouches in the past 30 days. Any form of nicotine during adolescence can impact learning, attention span, proneness to addiction, and be harmful to adolescent brain development.

*More details can be found in the full SOTCH report at the bottom of this page. 

New/Paused/Discontinued Initiatives Since Last CHA

Craven County Government established the Craven County Opioid Epidemic Response department. The Opioid Epidemic Response was established to reduce opioid-related overdoses and deaths in Craven County through prevention, collaboration, harm reduction, treatment, short-term and long-term recovery, and recovery support services. 

*Full SOTCH Report: 2023SOTCH_1708961699.pdf