Wilson County

Photo credit: Brian Strickland

Wilson County

2019 Community Health Needs

Assessment

A collaboration of:

Healthcare Foundation of Wilson,

Wilson County Health Department, and

Wilson Medical Center

Table of Contents

Executive Summary ........................................................................................................................... 5

Service Area ...................................................................................................................................................... 5

Methods for Identifying Community Health Needs ............................................................................................ 5

Primary Data ...................................................................................................................................................................................... 5

Secondary Data .................................................................................................................................................................................. 5

Summary of Findings ........................................................................................................................................ 5

Selected Priority Areas – Top three significant health needs ............................................................................. 6

Conclusion ........................................................................................................................................................ 6

Introduction ...................................................................................................................................... 7

Regional Collaboration ...................................................................................................................................... 7

Member Organizations ....................................................................................................................................................................... 7

Steering Committee ........................................................................................................................................................................... 9

HealthENC.org ................................................................................................................................................ 10

Consultants ..................................................................................................................................................... 10

Healthcare Foundation of Wilson-Wilson County Health Department-Wilson Medical Center Collaborative ... 11

Community Health Team Structure ....................................................................................................................................................11

Distribution .....................................................................................................................................................12

Evaluation of Progress since Prior CHNA ........................................................................................ 13

Community Feedback on Prior CHNA ..............................................................................................................13

Methodology ................................................................................................................................... 13

Overview ..........................................................................................................................................................13

Primary Data Collection & Analysis ..................................................................................................................13

Community Survey ............................................................................................................................................................................14

Focus Group Discussions ...................................................................................................................................................................17

Community Health Summit ...............................................................................................................................................................18

Secondary Data Sources & Analysis ................................................................................................................. 19

Health and Quality of Life Topic Areas Table 4. ............................................................................................... 19

Health ENC Region Comparison ...................................................................................................................... 20

Data Considerations ........................................................................................................................................ 20

Prioritization ...................................................................................................................................................21

Overview of Wilson County .............................................................................................................. 23

About Wilson County ...................................................................................................................................... 23

Demographic Profile ....................................................................................................................................... 23

Population ........................................................................................................................................................................................23

Age and Gender ................................................................................................................................................................................24

Birth Rate ..........................................................................................................................................................................................27

Race/Ethnicity ...................................................................................................................................................................................28

Tribal Distribution of Population .......................................................................................................................................................29

Military Population ...........................................................................................................................................................................29

Veteran Population ...........................................................................................................................................................................30

Socioeconomic Profile ......................................................................................................................................31

NC Department of Commerce Tier Designation ..................................................................................................................................31

Income ..............................................................................................................................................................................................31

Poverty .............................................................................................................................................................................................34

Housing .............................................................................................................................................................................................36

Food Insecurity .................................................................................................................................................................................37

Employment .....................................................................................................................................................................................38

Major employers ...............................................................................................................................................................................38

SocioNeeds Index ..............................................................................................................................................................................38

Educational Profile ......................................................................................................................................... 40

Educational Attainment ....................................................................................................................................................................40

High School Dropouts ........................................................................................................................................................................42

High School Suspension Rate .............................................................................................................................................................42

Wilson County Public Schools ............................................................................................................................................................43

Environmental Profile ..................................................................................................................................... 43

Transportation Profile .................................................................................................................................... 44

Crime and Safety ............................................................................................................................................. 46

Violent Crime and Property Crime .....................................................................................................................................................46

Juvenile Crime ...................................................................................................................................................................................47

Child Abuse .......................................................................................................................................................................................48

Incarceration .....................................................................................................................................................................................48

Access to Healthcare, Insurance and Health Resources Information ............................................................... 49

Assessment and Analysis of Community Resources ......................................................................................... 50

Civic Activity ................................................................................................................................................... 50

Findings .......................................................................................................................................... 52

Secondary Data Scoring Results ...................................................................................................................... 52

Primary Data ................................................................................................................................................... 52

Community Survey ............................................................................................................................................................................52

Focus Group Discussions ...................................................................................................................................................................54

Data Synthesis ................................................................................................................................................. 55

Topic Areas Examined in This Report .................................................................................................................................................56

Navigation Within Each Topic ............................................................................................................................................................56

Maternal, Fetal & Infant Health ....................................................................................................................... 57

Key Issues .........................................................................................................................................................................................57

Secondary Data .................................................................................................................................................................................57

Primary Data .....................................................................................................................................................................................58

Education ........................................................................................................................................................ 58

Key Issues .........................................................................................................................................................................................58

Secondary Data .................................................................................................................................................................................59

Primary Data .....................................................................................................................................................................................60

Heart Disease & Stroke .................................................................................................................................... 60

Key Issues .........................................................................................................................................................................................60

Secondary Data .................................................................................................................................................................................60

Primary Data .....................................................................................................................................................................................61

Diabetes .......................................................................................................................................................... 61

Key Issues .........................................................................................................................................................................................61

Secondary Data .................................................................................................................................................................................61

Primary Data .....................................................................................................................................................................................62

Public Safety

........................................................................................................................................................................ 63

Key Issues .........................................................................................................................................................................................63

Secondary Data .................................................................................................................................................................................63

Primary Data .....................................................................................................................................................................................64

Mortality ......................................................................................................................................................... 65

Data Analysis on Significant Health Needs ...................................................................................... 66

Access to Health Services ................................................................................................................................ 66

Exercise, Nutrition, Weight & Obesity – Top health need identified ................................................................. 66

Economy ......................................................................................................................................................... 67

Substance Abuse ............................................................................................................................................. 68

Disparities by Age, Gender and Race/Ethnicity ............................................................................... 68

Geographic Disparities .................................................................................................................................... 69

Conclusion ...................................................................................................................................... 70

Appendix A. Impact since Prior CHNA ............................................................................................. 71

Appendix B. Secondary Data Scoring ............................................................................................... 74

Overview ......................................................................................................................................................... 74

Comparison Score .............................................................................................................................................................................74

Indicator Score ..................................................................................................................................................................................74

Topic Score........................................................................................................................................................................................74

Comparison Scores ......................................................................................................................................... 75

Comparison to a Distribution of North Carolina Counties and U.S. Counties .......................................................................................75

Comparison to North Carolina Value and U.S. Value ..........................................................................................................................75

Comparison to Healthy People 2020 and Healthy North Carolina 2020 Targets ..................................................................................75

Trend Over Time ...............................................................................................................................................................................76

Missing Values ..................................................................................................................................................................................76

Indicator Scoring ............................................................................................................................................ 76

Topic Scoring .................................................................................................................................................. 76

Age, Gender and Race/Ethnicity Disparities .....................................................................................................77

Topic Scoring Table ......................................................................................................................................... 78

Indicator Scoring Table ................................................................................................................................... 79

Sources ........................................................................................................................................................... 95

Appendix C. Primary Data .............................................................................................................. 96

Appendix D. Community Resources ................................................................................................. 97

Community Resource Guide Link: ................................................................................................................... 97

Crime Prevention/Law Enforcement/Victim Assistance .................................................................................. 97

List of Figures ................................................................................................................................ 98

List of Tables ................................................................................................................................. 100

Addendum to Appendix C - Surveys ................................................................................................................ 101

English Survey ............................................................................................................................................... 101

Spanish Survey ............................................................................................................................................... 123

Focus Group Questions ................................................................................................................................. 148

Photo credit: S. Larkin

Executive Summary

Wilson County is pleased to present its 2019 Community Health Needs Assessment. This report provides

an overview of the methods and process used to identify and prioritize significant health needs in

Wilson County. Healthcare Foundation of Wilson, Wilson County Health Department and Wilson

Medical Center collaborated together to complete one comprehensive assessment

Service Area

The service area for this report is defined as the geographical boundary of Wilson County, North

Carolina. Wilson County is located inland from the coastal area of the state and covers an area of 23.3

square miles, of which only a small portion is water.

Methods for Identifying Community Health Needs

Primary Data

The primary data used in this assessment consisted of (1) a community survey distributed through

online and paper submissions, three (3) focus group discussions, and a community health summit. Over

600 Wilson County residents contributed their input on the community’s health and health-related

needs, barriers, and opportunities, with special focus on the needs of vulnerable and underserved

populations.

See Appendix C for all primary data collection tools used in this assessment.

Secondary Data

Secondary data used for this assessment were collected and analyzed from Conduent HCI’s community

indicator database. The database, maintained by researchers and analysts at Conduent HCI, includes

over 100 community indicators from various state and national data sources such as the North Carolina

Department of Health and Human Services, the Centers for Disease Control and Prevention and the

American Community Survey. See Appendix B for a full list of data sources used.

Indicator values for Wilson County were compared to North Carolina counties and U.S. counties to

identify relative need. Other considerations in weighing relative areas of need included comparisons to

North Carolina state values, comparisons to national values, trends over time, Healthy People 2020

targets and Healthy North Carolina 2020 targets. Based on these seven different comparisons, indicators

were systematically ranked from high to low need. For a detailed methodology of the analytic methods

used to rank secondary data indicators see Appendix B.

Summary of Findings

The CHNA findings are drawn from an analysis of an extensive set of secondary data (over 100 indicators

from national and state data sources) and in-depth primary data from community leaders, health and

non-health professionals who serve the community at large, vulnerable populations, and populations

with unmet health needs. Through a synthesis of the primary and secondary data the significant health

needs were determined for Wilson County and are displayed in Table 1.

Table 1. Significant Health Needs

Access to Health Services

Adolescent Pregnancy & STD’s

Diabetes

Fitness & Nutrition

Heart Disease & Stroke

Maternal, Fetal & Infant Health

Mental Health/Alcohol & Substance Misuse

Obesity

Selected Priority Areas – Top three significant health needs

The top three selected health priority areas are:

 Obesity

 Fitness/Nutrition

 Mental Health—including Alcohol and Substance Misuse

These selected priority areas will be addressed over the next three years. Community-wide Action Plans

will be developed to address these health priorities and may also be found on the websites of

Healthcare Foundation of Wilson, Wilson County Health Department and/or Wilson Medical Center.

Conclusion

This report describes the process and findings of a comprehensive health needs assessment for the

residents of Wilson County, North Carolina. The prioritization of the identified significant health needs

will guide community health improvement efforts of Wilson County. Following this process, Healthcare

Foundation of Wilson, the Wilson County Health Department, and Wilson Medical Center will outline

how they plan to address the prioritized health needs in their implementation plan.

Photo compliments of Barton College

Introduction

Wilson County is pleased to present the 2019 Community Health Needs Assessment, which provides an

overview of the significant community health needs identified in Wilson County, North Carolina.

The goal of this report is to offer a meaningful understanding of the most pressing health needs across

Wilson County, as well as to guide planning efforts to address those needs. Special attention has been

given to the needs of vulnerable populations, unmet health needs or gaps in services, and input

gathered from the community.

Findings from this report will be used to identify, develop and target initiatives to provide and connect

community members with resources to improve the health challenges in their communities.

The 2019 Wilson County Community Health Needs Assessment was developed through a partnership

between the Healthcare Foundation of Wilson, the Wilson County Health Department, and Wilson

Medical Center. These organizational also participated in a regional eastern NC collaborative with

Health ENC, Conduent Healthy Communities Institute, and with The Duke Endowment serving as the

fiscal sponsor.

Regional Collaboration

Health ENC, now a program of the Foundation for Health Leadership and Innovation (FHLI), coordinates

a regional CHNA in 33 counties of eastern North Carolina. Initiated in 2015 by the Office of Health Access

at the Brody School of Medicine at East Carolina University, Health ENC grew out of conversations with

health care leaders about improving the community health needs assessment (CHNA) process in eastern

North Carolina.

As part of the Affordable Care Act, not for profit and government hospitals are required to conduct

CHNAs every three years. Similarly, local health departments in North Carolina are required by the

Division of Public Health (DPH) in the NC Department of Health and Human Services (DHHS) to conduct

periodic community health assessments as well. Local health departments have been required to submit

their community health needs assessments once every four years. The particular year CHNA submissions

are made by hospitals within a three-year cycle or by local health departments within a four-year cycle is

not uniform across the state or region.

Health care leaders across eastern North Carolina have partnered to standardize the CHNA process for

health departments and hospitals in the region. This effort will also sync all participant organizations on

to the same assessment cycle. Combining efforts of local health departments and hospitals in a regional

CHNA will ultimately lead to an improvement in the quality and utility of population health data, the

ability to compare and contrast information and interventions across geographic boundaries, and the

reduction of costs for everyone involved, while maintaining local control and decision-making with

regard to the selection of health priorities and interventions chosen to address those priorities.

Simultaneously, it will create opportunities for new and better ways to collaborate and partner with one

another.

Member Organizations

Health ENC is comprised of more than 40 organizations. Twenty-two hospitals, twenty-one health

departments, two health districts, and one health care foundation participated in the regional CHNA.

Partner Organizations

 Foundation for Health Leadership & Innovation

 ECU Brody School of Medicine

 The Duke Endowment

Hospitals and Health Systems

 Cape Fear Valley Health (Cape Fear Valley Medical Center, Hoke Hospital and Bladen County

Hospital)

 Carteret Health Care

 Halifax Regional Medical Center

 Healthcare Foundation of Wilson

 Johnston Health

 UNC Lenoir Health Care

 Nash Health Care System

 Onslow Memorial Hospital

 The Outer Banks Hospital

 Pender Memorial Hospital

 Sampson Regional Medical Center

 Sentara Albemarle Medical Center

 Vidant Beaufort Hospital

 Vidant Bertie Hospital

 Vidant Chowan Hospital

 Vidant Duplin Hospital

 Vidant Edgecombe Hospital

 Vidant Medical Center

 Vidant Roanoke-Chowan Hospital

 Wayne UNC Health Care

 Wilson Medical Center

Foundations

 Healthcare Foundation of Wilson

Health Departments and Health Districts

 Albemarle Regional Health Services

 Beaufort County Health Department

 Bladen County Health Department

 Carteret County Health Department

 Cumberland County Health Department

 Dare County Department of Health and Human Services

 Duplin County Health Department

 Edgecombe County Health Department

 Franklin County Health Department

 Greene County Department of Public Health

 Halifax County Public Health System

 Hoke County Health Department

 Hyde County Health Department

 Johnston County Public Health Department

 Lenoir County Health Department

 Martin-Tyrrell-Washington District Health Department

 Nash County Health Department

 Onslow County Health Department

 Pamlico County Health Department

 Pitt County Health Department

 Sampson County Health Department

 Wayne County Health Department

 Wilson County Health Department

Steering Committee

Health ENC is advised by a Steering Committee whose membership is comprised of health department

and hospital representatives participating in the regional CHNA, as well as other health care

stakeholders from eastern North Carolina. The program manager oversees daily operations of the

regional community health needs assessment and Health ENC.

Health ENC Program Manager

 Will Broughton, MA, MPH, CPH - Foundation for Health Leadership & Innovation

Health ENC Steering Committee Members

 Constance Hengel, RN, BSN, HNB-BC - Director, Community Programs and Development, UNC

Lenoir Health Care

 James Madson, RN, MPH - Steering Committee Chair, Health Director, Beaufort County Health

Department

 Battle Betts - Director, Albemarle Regional Health Services

 Caroline Doherty - Chief Development and Programs Officer, Roanoke Chowan Community

Health Center

 Melissa Roupe, RN, MSN - Sr Administrator, Community Health Improvement, Vidant Health

 Davin Madden – Heath Director, Wayne County Health Department

 Angela Livingood – Pharmacy Manager, Pender Memorial Hospital

 Lorrie Basnight, MD, FAAP - Executive Director, Eastern AHEC, Associate Dean of CME, Brody

School of Medicine

 Anne Thomas- President/CEO, Foundation for Health Leadership & Innovation

HealthENC.org

The Health ENC web platform, shown in Figure 1, is a resource for the community health needs

assessment process in eastern North Carolina. The website serves as a “living” data platform, providing

public access to indicator data that is continuously updated, easy to understand and includes

comparisons for context. Much of the data used in this assessment is available on HealthENC.org and

can be downloaded in multiple formats. Results of the 2018 Eastern North Carolina Community Health

Survey can be downloaded by county or the entire Health ENC Region.

In addition to indicator data, the website serves as a repository for local county reports, funding

opportunities, 2-1-1 resources and more. Health departments, hospital leaders and community health

stakeholders in the 33-county region are invited to use the website as a tool for community assessment,

strategic planning, identifying best practices for improvement, collaboration and advocacy.

You may access HealthENC.org.

Figure 1. Health ENC Online Data Platform

Consultants

Health ENC commissioned Conduent Healthy Communities Institute (HCI) to assist with its Community

Health Needs Assessment.

To learn more about Conduent HCI, please visit https://www.conduent.com/community-population-

health/.

Healthcare Foundation of Wilson-Wilson County Health Department-Wilson Medical Center

Collaborative

The 2019 Community Health Needs Assessment (CHNA) is a collaboration of Healthcare Foundation of

Wilson, Wilson County Health Department and Wilson Medical Center. Collaboratively these three

organizations engaged the community to define priorities for health improvement, created a

collaborative environment to engage stakeholders and provided an open and transparent process to

listen and truly understand the health needs of Wilson County, NC.

Community Health Team Structure

An advisory group was selected for the Wilson County CHNA process. The Health and Wellness

Committee of Wilson Forward had a broad spectrum of membership and agreed to serve as the advisory

group for the Wilson County CHNA process. This committee represents the combined efforts of city, and

county government, businesses and neighborhoods, schools and colleges, civic organizations and

churches and represents all sectors of the community coming together for the purpose of creating,

supporting and promoting positive developments that result in the greatest possible benefits for all

citizens of Wilson. The committee met monthly and contributed to the CHNA plan for survey

distribution, focus group selection, implementation, and the CHNA summit for priority determination.

The Committee consists of members from the following companies and organizations:

Area L AHEC

Barton College

Boy Scouts of America

Carolina Family Health Center

City of Wilson

Eastpointe

EMS

Healthcare Foundation of Wilson

Hope Station

Minister's Association

N.C. Cooperative Extension, Wilson County Center

NC Parent Resource Center

Options Industry Council (OIC)

Poe Health Center

Recovery Concepts Community Center (RC3)

Retired Community Members

Salvation Army Boys & Girls Club of Wilson

Save-A-Youth

Seeds of Hope

St. John CDC

The SPOT Wilson Youth United

The Urban Farmer

United Way of Wilson County, Inc.

Upper Coastal Plains

Veterans Residential Service of Wilson

Wesley Shelter

Wilson Co. 4H Youth Development

Wilson Community College

Wilson Community Health Center

Wilson County DSS

Wilson County Health Department

Wilson County Partnership for Children

Wilson County Schools

Wilson County Substance Prevention Coalition

Wilson Family YMCA

Wilson Medical Center

Wilson Police Department

Wilson Pregnancy Center

Wilson Value Drug

Distribution

An electronic copy of this report is available at the locations below. A hard copy of this document may

also be obtained at:

 Healthcare Foundation of Wilson - www.healthcarefoundationofwilson.org, 2505-A Nash Street

NW, Wilson, NC 27896, 252.281.2105

 Wilson County Health Department - www.wilson-co.com/85/Health-Department, 1801 Glendale

Drive, Wilson, NC 27893, Contact: Jessica Williams 252.237.3141 ext. 6657

 Wilson Medical Center- http://www.wilsonmedical.com/ or 1705 Tarboro St W, Wilson, NC

27893, 252.399.8040

Photo credit: A. Walker

Evaluation of Progress since Prior CHNA

The community health improvement process should be viewed as an iterative cycle. An important piece

of that cycle is revisiting the progress made on priority health topics set forth in the preceding

community health needs assessment. By reviewing the actions taken to address priority health issues

and evaluating the impact those actions have made in the community, it is possible to better target

resources and efforts during the next round of the CHNA cycle.

As part of the 2016 Community Health Needs Assessment Obesity, Mental Health, Substance Use,

Adolescent Pregnancy and Sexually Transmitted Diseases were selected as prioritized health needs. A

detailed table describing the strategies/action steps and indicators of improvement for each priority

area can be found in Appendix A.

Community Feedback on Prior CHNA

The 2016 Wilson County Community Health Needs Assessment was made available to the public via the

three following websites:

 https://www.wilsonmedical.com/community/community-health-needs-assessment

 http://www.wilson-co.com/Home/ShowDocument?id=4836

 https://healthcarefoundationofwilson.org/wp-content/uploads/2016/12/Wilson-County-

Community-Health-Needs-Assessment-Final.pdf

Community members were invited to submit feedback via the contact link on each of the websites

listed above. No comments had been received on the preceding CHNA at the time this report was

written. However, one community member requested and was invited to join the advisory group to

provide input.

Methodology

Overview

Two types of data are analyzed for this Community Health Needs Assessment: primary data and

secondary data. Primary data has been collected directly as a part of this report while secondary data is

data that has been collected from other sources. Each type of data is analyzed using a unique

methodology, and findings are organized by health topic areas. These findings are then synthesized for a

comprehensive overview of the health needs in Wilson County.

Primary Data Collection & Analysis

Primary data used in this assessment consists of focus groups, a community survey, both in English and

Spanish-languages, and a community Summit. All community input tools are available in Appendix C.

The top areas were identified and helped to prioritize the most significant health needs in the

community for the next three-year period. The top three selected health priority areas are:

 Obesity

 Fitness/Nutrition

 Mental Health – including Alcohol and Substance Misuse

Community Survey

Community input was collected via a 57-question online and paper survey available in both English and

Spanish. Survey Monkey was the tool used to distribute and collect responses for the community survey.

Completed paper surveys were entered into the Survey Monkey tool.

The community survey was distributed across Health ENC’s entire survey area from April 18, 2018 – June

30, 2018.

Survey Distribution

The survey was distributed in a variety of ways. Healthcare Foundation of Wilson, Wilson County Health

Department, and Wilson Medical Center as well as other partner organizations listed a link to complete

the survey on their respective websites. In addition to the website link, the partner organizations also

emailed the survey link to their listserv of staff members (Wilson County Residents) for completion. The

survey was also advertised through the local newspaper, Wilson Times and community members were

advised to call the Wilson County Health Department for information on completing the survey.

Minority populations were sought out for input during the survey distribution. Additional efforts

included health educator visiting barber shops, salons and popular businesses in minority communities

to distribute paper copies of the survey and links to the online survey. Some were completed during the

time the health educators were present, some were completed later and were picked up by the health

educators later in the week. The OIC of Wilson’s food distribution was also used to distribute surveys.

Incentives, including gift cards to local grocery stores, were provided to those who agreed to complete

the health services portion of the survey. Surveys were also distributed to local minority churches after

worship services. They could be returned to the church and picked up by educators at a later date.

Table 2 summarizes the number of survey respondents. A total of 18,917 responses were collected

across all 33 counties, with a survey completion rate of 86.5%, resulting in 16,358 complete responses

across the entire survey area. A total of 650 responses were collected from Wilson County residents,

with a survey completion rate of 89.2%, resulting in 580 complete responses from Wilson County. The

survey analysis included in this CHNA report is based on complete responses.

Table 2. Survey Respondents

Number of Respondents*

Service Area

English

Survey

Spanish

Survey

Total

All Health ENC Counties

15,917

441

16,358

Wilson County

570

580

*Based on complete responses

Survey participants were asked a range of questions related - but not limited – to poverty issues and the

personal health challenges which might thereby be impacted, and what the most critical health needs

are for Wilson County. The survey instrument is available in Appendix C.

Demographics of Survey Respondents

The following charts and graphs illustrate Wilson County demographics of the community survey

respondents.

Among Wilson County survey participants, 56% of respondents were between the ages of 45 and 69 and

there was a lower concentration of respondents (34%) between the ages of 15 and 44. Only 9.8% of

respondents were over age 70. The majority of respondents were female (74.3%) and spoke English at

home (97.2%). More than half of respondents (56.1%) identified as White, while less than half identified

as Black (38.4%). The vast majority of respondents identified as Non-Hispanic (90.8%).

Survey respondents had varying levels of education, with the highest share of respondents (22.3%)

having a bachelor’s degree and the next highest share of respondents (18.1%) having an associate or

vocational degree and a similar number having graduated from high school as their highest level of

education (17.6%) (Figure 2).

Figure 2. Education of Community Survey Respondents

22.3%

18.1%

17.6%

15.1%

14.9%

7.7%

3.5%

0.7%

10%

15%

20%

25%

As shown in Figure 3, over half of the respondents were employed full-time (54.5 %). The average

household size was 2.8 individuals.

Figure 3. Employment Status of Community Survey Respondents

Figure 4 shows the health insurance coverage of community survey respondents. More than half of

survey respondents have health insurance provided by their employer (53.8%), while 22% have

Medicare and 13.3% have Medicaid. 8.9% of respondents have no health insurance of any kind.

Figure 4. Health Care Coverage of Community Survey Respondents

54.5%

15.6%

11.6%

10.5%

3.5%

3.3%

2.5%

1.2%

1.1%

0.2%

10%

20%

30%

40%

50%

60%

53.8%

22.0%

13.8%

9.6%

8.9%

7.5%

2.4%

1.6%

1.4%

0.3%

10%

20%

30%

40%

50%

60%

Overall, the community survey participant population consisted of white or black women that are

employed or retired. The survey was a convenience sample survey, and thus the results may not be

representative of the community population as a whole.

Key findings from select questions on the community survey are integrated into this report by theme or

topic area, with an emphasis on the most significant needs as evidenced by both primary and secondary

data. This approach is intended to offer a meaningful understanding of health needs. A summary of full

survey results (all 57 questions) is available on HealthENC.org. Full results can be downloaded by county

or for the entire Health ENC Region.

Focus Group Discussions

Another form of community input was collected through three (3) focus groups. Focus groups were

given carefully constructed dialogues that invited diverse groups of people to discuss important and

pressing issues. Focus groups provided community members an opportunity to engage in productive

learning and sharing sessions. The Focus group discussions focused on community strengths,

opportunities for improvement, existing resources, health needs, and possible solutions for improving

the health of Wilson County. A list of questions asked at the focus groups is available in Appendix C.

The purpose of the focus groups for the 2019 CHNA was to engage with a broad cross-section of

individuals from our county, such as the Hispanic population, African American population, and

community service/health groups.

Facilitator Training was provided. Topics included facilitation techniques, moderator and note taker

roles, as well as tips and expectations for documenting focus group discussions. Focus group questions

were reviewed and a transcript was provided for documentation purposes.

To ensure adequate representation of the Wilson Community, two focus groups sought input from

minorities (African-American and Latino). A local African American church hosted one focus group. The

pastor selected members of the church as well as other people from the surrounding community and

other churches to participate.

Health educators sought input from Latino participants in a diabetes prevention class offered through

the Wilson County Health Department. The participants from this class invited other family members.

An interpreter from the Wilson County Health Department assisted during the discussion. Incentives

were provided to both minority focus groups to encourage participation.

The third focus group consisted of stakeholders of the community. All attendees were invited via email,

and no incentives were used for this group. This group consisted of individuals from many partner

organizations who are included below:

 Americorps Vista (Wilson representatives)

 Barton College

 City of Wilson (Fire/Rescue)

 Healthcare Foundation of Wilson

 Retired Wilson County Schools Teacher

 Retired WMC Board & HFW Board Chair

 United Way of Wilson

 Wilson Business Community (local business owners)

 Wilson Chamber of Commerce

 Wilson County Department of Social Services

 Wilson Community College

 Wilson County

 Wilson County Health Department

 Wilson County Schools

 Wilson Forward

 Wilson Medical Center

The community stakeholder group attending represented the following populations: children, low

income, minorities, those without access, retirees, business and local healthcare organizations.

The three focus group discussions which were completed within Wilson County between July 17, 2018

and August 29, 2018 included a total of 35 individuals. Table 3 shows the date, location, population type,

and number of participants for each focus group.

Table 3. List of Focus Group Discussions

Date Conducted

Focus Group Location

Population Type

Number of

Participants

7/17/2018

White Oak Church

African American

7/30/2018

Wilson County Health Department

Latino Community

8/29/2018

Wilson Medical Center Auditorium

Community Stakeholders

Focus group transcripts were coded and analyzed by common theme. The frequency with which a topic

area was discussed in the context of needs and concerns or barriers and challenges to achieving health

was used to assess the relative importance of the need in the community. Key themes that emerged

from the focus group discussions are integrated into this report by topic area, with an emphasis on the

most significant needs as evidenced by both primary and secondary data. Additional analysis of focus

group findings is available on HealthENC.org.

Results of the focus group dialogues complement the results from other forms of primary data collected

(the community survey and the Healthcare Summit) and supports the findings from the secondary data

scoring. By synthesizing the discussions that took place at the focus groups in tandem with the

responses from the community survey and the Healthcare Summit, the primary data collection process

for Wilson County is rich with involvement by a cross section of the community.

Community Health Summit

The healthcare needs of Wilson County were prioritized. Goals and actions were brainstormed by the

table groups at the Community Health Summit and this formed the foundation of Wilson County’s

health initiatives. Using a dotmocracy, a nominal group technique, each attendee received three sticky

notes and selected their top three health needs in priority of the topic. The attendees were asked to

use the table below to help guide their selection of health initiatives considering the magnitude,

seriousness and feasibility of the need.

Magnitude/scale of the

problem

How big is the problem? How many people does the problem affect,

either actually or potentially? In terms of human impact, how does it

compare to other health issues?

Seriousness of Consequences

What degree of disability or premature death occurs because of this

problem? What would happen if the issue were not made a priority?

What is the level of burden on the community (economic, social or

other)?

Feasibility

Is the problem preventable? How much change can be made? What is

the community’s capacity to address it? Are there available resources

to address it sustainably? What’s already being done, and is it

working? What are the community’s intrinsic barriers and how big are

they to overcome?

Secondary Data Sources & Analysis

The main source of the secondary data used for this assessment is HealthENC.org. The secondary data

analysis was conducted using Conduent HCI’s data scoring tool, and the results are based on the 151

health and quality of life indicators that were queried on the Health ENC dashboard on July 18, 2018.

The data are primarily derived from state and national public data sources. For each indicator on the

platform, there exist several comparisons to assess Wilson County's status, including how Wilson County

compares to other communities, whether health targets have been met, and the trend of the indicator

value over time.

The data scoring tool systematically summarizes

multiple comparisons to rank indicators based on highest

need (Figure 5). For each indicator, the Wilson County

value is compared to a distribution of North Carolina and

U.S. counties, state and national values, Healthy People

2020 targets, Healthy North Carolina 2020 targets, and

the trend over the four most recent time periods of

measure. Each indicator is then given a score based on

the available comparisons. The scores range from 0 to 3,

where 0 indicates the best outcome and 3 indicates the

worst outcome. Availability of each type of comparison

varies by indicator and is dependent upon the data

source, comparability with data collected from other

communities, and changes in methodology over time. The

indicators are grouped into topic areas for a higher-level ranking of community health needs.

Please see Appendix B for further details on the secondary data scoring methodology.

Health and Quality of Life Topic Areas Table 4.

Table 4 shows the health and quality of life topic areas into which indicators are categorized. These topic

areas are broadly based on the Healthy People 2020 framework, with each topic area containing

multiple indicators. The five topic areas exhibiting the most significant need as evidenced by the

Figure 5. Secondary Data Scoring

secondary data analysis are included for in-depth exploration in the data findings. Four topic areas

specific to population subgroups, including Children’s Health, Men’s Health, Women’s Health, and Older

Adults & Aging, include indicators spanning a variety of topics. If a particular subgroup receives a high

topic score, it is not highlighted independently as one of the top 5 findings, but is discussed within the

narrative as it relates to highly impacted populations. Three additional categories (County Health

Rankings, Mortality Data, and Wellness & Lifestyle) are not considered for in-depth exploration, since all

three are general categories that include indicators spanning a wide variety of topics. Topic areas with

fewer than three indicators are considered to have data gaps and do not receive topic scores. These

topics are indicated by an asterisk in Table 4.

Table 4. Health and Quality of Life Topic Areas

Access to Health Services

Family Planning*

Other Chronic Diseases

Alcohol & Substance Misuse

Fitness & Nutrition

Oral Health*

Cancer

Food Safety*

Prevention & Safety

Children's Health

Heart Disease & Stroke

Public Safety

County Health Rankings

Immunizations & Infectious Diseases

Respiratory Diseases

Diabetes

Maternal, Fetal & Infant Health

Social Environment

Disabilities*

Men's Health

Teen & Adolescent Health*

Economy

Mental Health & Mental Disorders

Transportation

Education

Mortality Data

Vision*

Environment

Obesity

Wellness & Lifestyle

Environmental & Occupational Health

Older Adults & Aging

Women's Health

*Topic area has fewer than 3 indicators and is considered a data gap. The topic areas of adolescent pregnancy and

STDs were mentioned frequently in the “Other” but not directly correlated to this topic title, therefore no topic

score is provided.

Health ENC Region Comparison

When available, county-level data are compared to the state of North Carolina, as well as Health ENC

Counties. The Health ENC region consists of 33 counties in eastern North Carolina participating in the

regional CHNA: Beaufort, Bertie, Bladen, Camden, Carteret, Chowan, Cumberland, Currituck, Dare,

Duplin, Edgecombe, Franklin, Gates, Greene, Halifax, Hertford, Hoke, Hyde, Johnston, Lenoir, Martin,

Nash, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Sampson, Tyrrell, Washington, Wayne

and Wilson. Values for the Health ENC region were calculated by aggregating data from these 33

counties.

Data Considerations

Several limitations of the data should be considered when reviewing the findings presented in this

report. Although the topics by which data are organized cover a wide range of health and health-related

areas, within each topic there is a varying scope and depth of data availability. In some topics there is a

robust set of secondary data indicators, but in others there may be a limited number of indicators for

which data is collected, or limited subpopulations covered by the indicators.

Data scores represent the relative community health need according to the secondary data that is

available for each topic and should not be considered to be a comprehensive result on their own. In

addition, these scores reflect what was found in the secondary data for the population as a whole, and

do not factor in the health or socioeconomic need that is much greater for some subpopulations. In

addition, many of the secondary data indicators included in the findings are collected by survey, and

though methods are used to best represent the population at large, these measures are subject to

instability—especially among smaller populations.

The disparities analysis, used to analyze the secondary data, is also limited by data availability. In some

instances, data sources do not provide subpopulation data for some indicators, and for other indicators,

values are only available for a select number of race/ethnic groups. Due to these limitations, it is not

possible to draw conclusions about subpopulation disparities for all indicators.

The breadth of primary data findings is dependent on several factors. Focus group discussion findings

were limited by which community members were able to attend focus group discussions. Because the

survey was a convenience sample survey, results are vulnerable to selection bias, making findings less

generalizable for the population as whole.

Prioritization

A Community Health Summit was held on September 24, 2018 at Barton College in the Hardy Alumni

Hall with 60 community stakeholders present. The Summit was utilized as the prioritization session for

Wilson County. The audience consisted of healthcare providers, the Wilson County Health Department,

Healthcare Foundation of Wilson, Wilson Medical Center, business leaders, law enforcement,

government representatives, colleges, not-for-profit organizations, and other community members.

Primary and Secondary data was presented by Teresa Ellen, Health Director and Denise O’Hara,

Executive Director of the Healthcare Foundation of Wilson. Following the presentation and comparison

of primary and secondary health data the audience was asked to choose the top three health issues

Wilson County should focus on for the next three years. The Dotmocracy method of selection was used

for the prioritization process. Below is a list of community organizations represented in attendance:

Organization

Population Represented(kids,

low income, minorities, those

w/o access

How Involved

Area L AHEC

All

Summit

Barton College

College students, youth, diversity

Summit

Children's Hunger Elimination of Wilson

Children

Summit

City of Wilson

All

Summit

City of Wilson (fire/rescue)

All

Summit

City of Wilson (Planner)

City wide

Summit

Eastpointe

Mental Health

Summit

ECU Medical & Health Sciences

Children/Adults

Summit

Greenfield School

Youth

Summit

Healthcare Foundation of Wilson

All

Summit

Healthcare Foundation of Wilson Board Chair

All

Summit

Hope Station

Low income, minorities and those

without access

Summit

Retired Physician

All

Summit

Retired Secretary of NC Cultural Resources

All

Summit

SPC Mechanical Corporation

All

Summit

The Chesson Agency

All

Summit

The Wesley Shelter

Women & Children, especially

minorities and low-income

Summit

Upper Coastal Plain Council on Governments

Senior Citizens

Summit

Wilson City Council

All

Summit

Wilson Co. Department of Social Services

All – especially low income and

minorities

Summit

Wilson Community College

College students, youth, diversity

Summit

Wilson County Board of Commissioners

All

Summit

Wilson County Health Department

All

Summit

Wilson County Schools

Children

Summit

Wilson Crisis Center

All

Summit

Wilson Economic Development Council

All

Summit

Wilson Forward

All

Summit

Wilson Medical Center

All

Summit

Wilson Public Library

All

Summit

Wilson Veterinary Hospital

All

Summit

Wilson YMCA

All

Summit

Overview of Wilson County

About Wilson County

Wilson County is located roughly on the fall line that separates the Piedmont and the Coastal Plain.

Though the majority of the county is level, there are rolling hills in the west which are characteristic of

the Piedmont. Traveling in an easterly direction within the county, the geography becomes flat as the

land quickly transitions into the Coastal Plain.

There are no major rivers that flow through Wilson County. This may have contributed to the county’s

slower development, as rivers were thoroughfares for transportation in the absence of good roads

during the early history of North Carolina. Contentnea Creek is a large creek that spans the county and

is a tributary to the Neuse River.

Wilson County is comprised of one city (county seat) and eight smaller towns within the county.

Wilson has unique advantages of proximity, located near one of the fastest-growing areas in the

country, with great access to major highways. Wilson has also had the foresight to make strategic

investments like Buckhorn Reservoir, the Wilson Corporate Park and Greenlight Community Broadband

to ensure current needs and future opportunities are available in Wilson. This encourages growth from

individuals and businesses. Additional demographics for Wilson County are listed below.

Demographic Profile

The demographics of a community significantly impact its health profile. Population growth has an

influence on the county’s current and future needs. Specific population subgroups, including veterans

and different age, gender, race and ethnic groups, may have unique needs and require varied

approaches to health improvement efforts. The following section explores the demographic profile of

Wilson County, North Carolina.

Population

According to the U.S. Census Bureau’s 2016 population estimates, Wilson County has a population of

81,661 (Figure 6). The population of Wilson County has increased from 2014 to 2016.

Figure 6. Total Population (U.S. Census Bureau)

81,603

81,379

81,686

81,661

81,200

81,300

81,400

81,500

81,600

81,700

81,800

2013 2014 2015 2016

Total Population Count

Year

Figure 7 shows the population density of Wilson County compared to other counties in the Health ENC

region. Wilson County has a population density of 220.6 persons per square mile, and is more densely

populated than most other counties in the region.

Figure 7. Population Density of Health ENC Counties (U.S. Census Bureau, 2010)

Age and Gender

Overall, Wilson County residents are slightly older than average residents of North Carolina and the

Health ENC region. Figure 8 shows the Wilson County population by age group. The 45-54 age group

contains the highest percent of the population at 13.4%, while the 25-34 age group contains the next

highest percent of the population at 11.8%.

Figure 8. Population by Age (U.S. Census Bureau, 2016)

5.8%

6.7%

6.8%

6.0%

11.8%

11.6%

13.4%

7.1%

6.8%

10.2%

5.0%

2.0%

10%

12%

14%

16%

<5 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-59 60-64 65-74 75-84 85+

Percent of Population

Age Group

Wilson County North Carolina Health ENC Counties

People 65 years and older comprise 17.3% of the Wilson County population, compared to 15.5% in

North Carolina and 15.2% in the Health ENC counties (Figure 9).

Figure 9. Population 18+ and 65+ (U.S. Census Bureau, 2016)

Males comprise 47.4% of the population, whereas females comprise 52.6% of the population (Table 5).

The median age for males is 38.2 years, whereas the median age for females is 42.2 years. Both are

higher than the North Carolina median age (37.2 years for males and 40.1 years for females).

Table 5. Population by Gender and Age (U.S. Census Bureau, 2016)

Percent of Total

Population

Percent of

Male Population

Percent of

Female Population

Median Age

(Years)

Male

Female

18+

65+

18+

65+

Male

Female

Wilson County

47.4%

52.6%

74.9%

15.4%

78.1%

19.0%

38.2

42.2

North Carolina

48.6%

51.4%

76.3%

13.9%

78.4%

17.0%

37.2

40.1

Health ENC Counties

49.2%

50.8%

75.8%

13.5%

77.5%

16.9%

N/A

76.6%

17.3%

77.3%

15.5%

76.7%

15.2%

10%

20%

30%

40%

50%

60%

70%

80%

90%

18+ 65+

Percent of Population

Age Group

Wilson County North Carolina Health ENC Counties

Birth Rate

Birth rates are important measures of population health. The birth rate is usually the dominant factor in

determining the rate of population growth; however, population growth is also driven by the age

structure of the population (e.g., deaths), immigration and emigration. Figure 10 illustrates that the

birth rate in Wilson County (11.8 live births per 1,000 population in 2016) is lower than the birth rate in

North Carolina (12.0) and Health ENC counties (13.1). While the state and regional birth rates have

decreased slightly since 2014, the Wilson County birth rate has increased slightly over the same

timeframe.

Figure 10. Birth Rate (North Carolina State Center for Health Statistics)

11.5

11.9

11.8

12.1

12.2

12.0

13.6

13.4

13.1

0.0

3.0

6.0

9.0

12.0

15.0

18.0

2013 2014 2015 2016

Live Birth Rate per 1,000 Population

Year

Wilson County North Carolina Health ENC Counties

Race/Ethnicity

The race and ethnicity composition of a population is important in planning for future community needs,

particularly for schools, businesses, community centers, health care and child care. Race and ethnicity

data are also useful for identifying and understanding disparities in housing, employment, income and

poverty.

Figure 11 shows the racial and ethnic distribution of Wilson County compared to North Carolina and

Health ENC counties. The first six categories (White, Black or African American, American Indian or

Alaska Native, Asian, Native Hawaiian & Other Pacific Islander and Multiracial) are racial groups and may

include persons that identify as Hispanic or Latino. The seventh category (Hispanic or Latino) is an ethnic

group and may include individuals that identify as any race.

The White population accounts for 56.0% of the total population in Wilson County, with the Black or

African American population accounting for 40.6% of the total population. The proportion of residents

that identify as White is smaller in Wilson County (56.0%) as compared to North Carolina (71.0%) and

Health ENC counties (63.8%). Wilson County has a larger share of residents that identify as Black or

African American (40.6%) when compared to North Carolina (22.2%) and Health ENC counties (30.7%).

The Hispanic or Latino population comprises 10.0% of Wilson County, which is a larger proportion than

the Hispanic or Latino population in North Carolina (9.2%) and Health ENC counties (9.6%).

Figure 11. Population by Race/Ethnicity (U.S. Census Bureau, 2016)

56.0%

40.6%

0.6%

1.1%

0.2%

1.5%

10.0%

10%

20%

30%

40%

50%

60%

70%

80%

White Black or

African

American

Indian or

Alaska Native

Asian Native

Hawaiian &

Other Pacific

Islander

Multiracial

(Two or More

Races)

Hispanic or

Latino

Percent of Population

Race/Ethnicity

Wilson County North Carolina Health ENC Counties

Tribal Distribution of Population

The U.S. Census Bureau collects population estimates for various American Indian and Alaska Native

(AIAN) tribes. While population estimates of tribal data are not available at the county level, Table 6

shows the population estimates of eight tribal areas throughout the state of North Carolina.

Table 6. Named Tribes in North Carolina (American Community Survey, 2012-2016)

State Designated Tribal Statistical Area

(SDTSA)

Total Population

Coharie SDTSA

62,160

Eastern Cherokee Reservation

9,613

Haliwa-Saponi SDTSA

8,700

Lumbee SDTSA

502,113

Meherrin SDTSA

7,782

Occaneechi-Saponi SDTSA

8,938

Sappony SDTSA

2,614

Waccamaw Siouan SDTSA

2,283

Military Population

Figure 12 shows the percent of the population 16 years of age and older in the military (armed forces).

In 2012-2016, Wilson County has a smaller share of residents in the military (0.2%) compared to North

Carolina (1.0%) and counties in the Health ENC region (4.0%). Figure 12 also shows the trend analysis of

the military population over the 4 most recent measurement periods. Across four time periods, the

percent of the population in the military for Wilson County is lower than in North Carolina and the

Health ENC region.

Figure 12. Population in Military / Armed Forces (American Community Survey)

0.1%

0.2%

1.2%

1.1%

1.0%

4.4%

4.2%

4.0%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

5.0%

2009-2013 2010-2014 2011-2015 2012-2016

Percent of Population 16+

Years

Wilson County North Carolina Health ENC Counties

Veteran Population

The veteran population is given as a percent of the civilian population aged 18 years and older and this

data is used for policy analyses, to develop programs, and to create budgets for veteran programs and

facilities. Wilson County has a veteran population of 9.3% in 2012-2016, compared to 9.0% for North

Carolina and 12.4% for Health ENC counties (Figure 13).

Figure 13. Veteran Population (American Community Survey, 2012-2016)

9.9%

9.1%

9.3%

9.9%

9.6%

9.3%

9.0%

12.6%

12.4%

12.3%

12.4%

10%

12%

14%

2009-2013 2010-2014 2011-2015 2012-2016

Percent of Civilian Population 18+

Years

Wilson County North Carolina Health ENC Counties

Socioeconomic Profile

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. Community health improvement efforts must determine which subpopulations are most in

need in order to effectively focus services and interventions.

NC Department of Commerce Tier Designation

The North Carolina Department of Commerce annually ranks the state’s 100 counties based on

economic well-being and assigns each a Tier designation. The 40 most distressed counties are

designated as Tier 1, the next 40 as Tier 2 and the 20 least distressed as Tier 3. Wilson County was

assigned a Tier 2 designation for 2018; however this changed to a Tier 1 designation in 2019.

Income

Median household income reflects the relative affluence and prosperity of an area. Areas with higher

median household incomes are likely to have a greater share of educated residents and lower

unemployment rates. Figure 14 shows the median household income in Wilson County ($40,260), which

is less than the median household income in North Carolina ($48,256).

Figure 14. Median Household Income (American Community Survey, 2012-2016)

$40,260

$48,256

$36,000

$38,000

$40,000

$42,000

$44,000

$46,000

$48,000

$50,000

Wilson County North Carolina

USD

Wilson County has a similar median household income compared to other counties in the Health ENC

region (Figure 15).

Figure 15. Median Household Income of Health ENC Counties

(American Community Survey, 2012-2016)

Countywide, the median household income varies. For example, zip code 27893 has a median household

income of $32,178, while zip code 27880 has a median household income of $62,339 (Figure 16).

Figure 16. Median Household Income by Zip Code (American Community Survey, 2012-2016)

Poverty

Federal poverty thresholds are set every year by the Census Bureau and vary by size of family and ages

of family members. 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. Seniors who live in poverty are an especially vulnerable group due to increased

physical limitations, medical needs, and social isolation. Persons with a disability are more likely to live

in poverty compared to the rest of the population. Without adequate income, individuals with

disabilities may not be able to afford necessary expenses, such as rent or mortgage, utility bills, medical

and dental care, and food.

As seen in Figure 17, 22.5% percent of the population in Wilson County lives below the poverty level,

which is higher than the rate in North Carolina (16.8% of the population) and the Health ENC region

(19.2%).

Figure 17. People Living Below Poverty Level (American Community Survey, 2012-2016)

22.5%

16.8%

19.2%

10%

15%

20%

25%

Wilson County North Carolina Health ENC Counties

Percent of Population

As shown in Figure 18, the rate of children living below the poverty level is also higher for Wilson County

(39.3%) when compared to North Carolina (23.9%) and Health ENC counties (27.6%).

Figure 18. Children Living Below Poverty Level (American Community Survey, 2012-2016)

Similarly, as shown in Figure 19 the rate of older adults living below the poverty level is also higher in

Wilson County (11.9%) than in North Carolina (9.7%) and Health ENC counties (11.5%).

Figure 19. People 65+ Living Below Poverty Level (American Community Survey, 2012-2016)

39.3%

23.9%

27.6%

10%

15%

20%

25%

30%

35%

40%

45%

Wilson County North Carolina Health ENC Counties

Percent of Population <18

11.9%

9.7%

11.5%

10%

12%

14%

Wilson County North Carolina Health ENC Counties

Percent of Population 65+

As shown in Figure 20, the percent of disabled people living in poverty in Wilson County (31.8%) is

higher than the rate in North Carolina (29.0%) and Health ENC counties (28.1%).

Figure 20. Persons with Disability Living in Poverty (American Community Survey, 2012-2016)

Housing

The average household size in Wilson County is 2.5 people per household, which is the same as the

North Carolina value of 2.5 people per household.

High costs of homeownership with a mortgage can strain both homeowners and the local housing

market. Figure 21 shows mortgaged owners median monthly household costs in the Health ENC region.

In Wilson County, the median housing costs for homeowners with a mortgage is $1,173. This is less than

the North Carolina value of $1,243.

Figure 21. Mortgaged Owners Median Monthly Household Costs, Health ENC Counties

(American Community Survey 2012-2016)

31.8%

29.0%

28.1%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

Wilson County North Carolina Health ENC Counties

Percent of Disabled Population

20-64

Safe and affordable housing is an essential component of healthy communities, and the effects of

housing problems are widespread. Figure 22 shows the percent of households with at least one of the

following problems: overcrowding, high housing costs, lack of kitchen, or lack of plumbing facilities.

Countywide, 19.3% of households have severe housing problems, compared to 16.6% in North Carolina

and 17.7% in Health ENC counties.

Figure 22. Severe Housing Problems (County Health Rankings, 2010-2014)

Food Insecurity

The Supplemental Nutrition Assistance Program (SNAP) is a federal assistance program that provides

low-income families with electronic benefit transfers (EBTs) that can be used to purchase food. The goal

of the program is to increase food security and reduce hunger by increasing access to nutritious food.

Figure 23 shows the percent of households with children that participate in SNAP. The rate for Wilson

County, 51.3%, is lower than the state value of 52.6% and the Health ENC region value of 51.5%.

Figure 23. Households with Children Receiving SNAP (American Community Survey, 2012-2016)

19.3%

16.6%

17.7%

10%

15%

20%

25%

Wilson County North Carolina Health ENC Counties

Percent of Households

51.3%

52.6%

51.5%

10%

20%

30%

40%

50%

60%

Wilson County North Carolina Health ENC Counties

Percent of Households

Employment

Major employers

 Branch Bank & Trust – Financial

 Wilson County Schools – Education

 Bridgestone Americas – Manufacturing

 Wilson Medical Center – Healthcare Services

 S.T. Wooten Construction Co, Inc – Construction

 City of Wilson – Public Administration

 County of Wilson – Public Administration

 Smithfield Foods, Inc - Manufacturing

 Kidde Aerospace/Fenway Safety Systems – Manufacturing

 Merck Manufacturing – Manufacturing

 Alliance One International – Manufacturing

 NC Department of Health & Human Services – Public Administration

 Wal-Mart Associates, Inc – Trade, Transportation & Utilities

 Wilson Community College – Education

 Barton College – Education

SocioNeeds Index

Multiple socioeconomic factors across geographies were compared through Conduent’s SocioNeeds

Index®. This index incorporates estimates for six different social and economic determinants of health –

income, poverty, unemployment, occupation, educational attainment, and linguistic barriers – that are

associated with poor health outcomes including preventable hospitalizations and premature death.

Zip codes within Wilson County are assigned an index value from 0 (low need) to 100 (high need), based

on how those zip codes compare to others in the U.S. Within Wilson County, the zip codes are then

ranked from 1 (low need) to 5 (high need) to identify the relative level of need. Zip codes with

populations under 300 persons are excluded. Zip code 27893, with an index value of 91.4, has the

highest level of socioeconomic need within Wilson County. This is illustrated in Figure 24. Index values

and the relative ranking of each zip code within Wilson County are provided in Table 7.

Figure 24. SocioNeeds Index® (Conduent Healthy Communities Institute, 2018)

Table 7. SocioNeeds Index® (Conduent Healthy Communities Institute, 2018)

Zip Code

Index Value

Relative Rank

27893

91.4

27883

78.6

27851

71.1

27880

60.1

27822

57.8

27896

29.1

Source: http://www.healthenc.org/socioneeds

Understanding where there are communities with high socioeconomic need is critical to forming

prevention and outreach activities.

Educational Profile

Educational Attainment

Graduating from high school is an important personal achievement and is essential for an individual’s

social and economic advancement. Graduation rates can also be an important indicator of the

performance of an educational system. Having a bachelor’s degree is often a prerequisite for higher-

paying jobs.

Countywide, the percent of residents 25 or older with a high school degree or higher (80.2%) is less than

the state value (86.3%) and the Health ENC region (84.7%) (Figure 25). Higher educational attainment in

Wilson County is 18.6%, which is less than the state value and the Health ENC region. While 29.0% of

residents 25 and older have a bachelor’s degree or higher in North Carolina, only 19.9% of residents 25

and older have a bachelor’s degree or higher in the Health ENC counties (Figure 25).

Figure 25. People 25+ with a High School Degree or Higher and Bachelor’s Degree or Higher

(American Community Survey, 2012-2016)

80.2%

18.6%

86.3%

29.0%

84.7%

19.9%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

With a High School Degree or Higher With a Bachelor's Degree or Higher

Percent of Population 25+

Wilson County North Carolina Health ENC Counties

In some areas of the county, including zip code 27893, which has a high poverty rate and high

socioeconomic need the high school degree attainment rate is below 75% (Figure 26).

Figure 26. People 25+ with a High School Degree or Higher by Zip Code

(American Community Survey, 2012-2016)

High School Dropouts

High school dropouts earn less income than high school and college graduates, and are more likely to be

unemployed. High school dropouts are generally less healthy and require more medical care. Further,

high school dropout rates are linked with heightened criminal activity and incarceration rates,

influencing a community’s economic, social, and civic health.

Wilson County’s high school dropout rate, given as a percent of high school students in Figure 27, is

3.6% in 2016-2017, which is higher than the rate in North Carolina (2.3%) and the Health ENC region

(2.4%). Wilson County’s high school dropout rate has been higher than the state and regional rate, and

is a focus for the Wilson County Schools.

Figure 27. High School Dropout Rate (North Carolina Department of Public Instruction)

High School Suspension Rate

High school suspension is a form of discipline in which a student is temporarily removed from a

classroom and/or school due to a violation of school conduct or code. Higher rates of suspension can be

related to high rates of antisocial or delinquent behaviors, which may further contribute to potential

future involvement in the juvenile justice system. Additionally, schools with higher suspension rates

have higher rates of law or board of education violations and generally spend more money per student.

Wilson County’s rate of high school suspension (60.8 suspensions per 100 students) is higher than North

Carolina’s rate (18.2) and the rate of Health ENC counties (25.5) in 2016-2017. As shown in Figure 28,

North Carolina and the Health ENC region values are fairly consistent across four time periods, yet

Wilson County’s values have increased in recent time periods.

Figure 28. High School Suspension Rate (North Carolina Department of Public Instruction)

2.5%

3.1%

3.8%

3.6%

2.3%

2.4%

2.3%

2.6%

2.4%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

2013-2014 2014-2015 2015-2016 2016-2017

Percent of High School

Students

Years

Wilson County North Carolina Health ENC Counties

38.0

35.1

62.1

60.8

19.5 19.5

19.6

18.2

26.5

27.2

28.8

25.5

2013-2014 2014-2015 2015-2016 2016-2017

Rate per 100 Students

in Grades 9

-13

Years

Wilson County North Carolina Health ENC Counties

The Wilson County Educational System includes:

Wilson County Public Schools

B.O. Barnes Elementary School

Beddingfield High School

Charles H. Darden Middle School

Elm City Middle School

Fike High School

Forest Hills Middle School

Frederick Douglass Elementary School

Gardners Elementary School

James Hunt High School

John W. Jones Elementary School

Lee Woodard Elementary School

Lucama Elementary School

Margaret Hearne Elementary School

Milton Daniels Learning Center

New Hope Elementary School

Rock Ridge Elementary School

Speight Middle School

Springfield Middle School

Stantonsburg Elementary School

Toisnot Middle School

Vick Elementary School

Vinson-Bynum Elementary School

Wells Elementary School

Winstead Elementary School

Charter Schools/Specialty

Eastern NC School for the Deaf

Sallie B. Howard School

Wilson Preparatory Academy

Wilson Early College Academy

Private / Specialty Schools

Community Christian School

Greenfield School

Wilson Christian Academy

Colleges

Barton College

Wilson Community College

Environmental Profile

Water Quality

There are ten community water systems in Wilson County that serve people year-round. The majority

of Wilson County’s drinking water is obtained from Contentnea Creek and the Tar River. The Wilson

County Health Department’s Environmental Health Division maintains the quality and safety of water

and water systems through inspections and permits and the N.C. Department of Environmental Quality

Division of Water Resources oversees their process.

On September 28, 2018, the N.C. Department of Environmental Quality Division of Water Resources

issued a notice of deficiency to the town of Lucama citing high iron and manganese levels in the water

being sold to residents. Further research showed that the water treatment provided was not

adequately removing or controlling the concentration of iron and manganese and providing trouble-

free, satisfactorily water to customers. The town has received two grants from the state. The first grant

in the amount of $500,000 will fund the renovation of a well and replace a filter at the water treatment

plant and the second grant in the amount of $2.2 million will replace waterlines and make additional

improvements to the water treatment plant.

Air Quality

The North Carolina Department of Environment and Natural Resources’ (NCDENR) Division of Air Quality

monitors ambient (outdoor) air quality throughout the State to protect the public from harmful ozone

and fine particle pollutants. The Environmental Protection Agency’s (EPA) Air Quality Index Color Code

Guide is used to inform and alert the public of air quality issues related to these pollutants. Air pollution

levels in the green category are satisfactory and pose little or no health effects. Air pollution levels in the

yellow, orange, red, purple and maroon categories exceed the Environmental Protection Agency’s

standard and may pose health risks to some or all populations.

Transportation Profile

Public transportation offers mobility, particularly to people without cars. Transit can help bridge the

spatial divide between people and jobs, services, and training opportunities. Public transportation also

reduces fuel consumption, minimizes air pollution, and relieves traffic congestion. Walking to work helps

protect the environment, while also providing the benefit of daily exercise.

Countywide, 1.6% of residents walk to work, compared to the state value of 1.8% and the regional value

of 2.4%. Public transportation is rare in Wilson County, with an estimated 0.2% of residents commuting

by public transportation, compared to the state value of 1.1% and the regional value of 0.4% (Figure 29).

In Wilson County, 82.0% of workers 16 and older drive alone to work, compared to 81.1% in North

Carolina and 81.4% in the Health ENC region (Figure 30).

Figure 29. Mode of Commuting to Work (American Community Survey, 2012-2016)

Figure 30. Workers who Drive Alone to Work (American Community Survey, 2012-2016)

0.2%

1.6%

1.1%

1.8%

0.4%

2.4%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

Workers Commuting by Public Transportation Workers who Walk to Work

Percent of Working Population

16+

Wilson County North Carolina Health ENC Counties

82.0%

81.1%

81.4%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Wilson County North Carolina Health ENC Counties

Percent of Working Population

16+

Transportation System

Amtrak

Amtrak travels all the way to New York City. Both the Piedmont and the Carolinas will transport

passengers to and from the Queen City of Charlotte and the state capital of Raleigh.

Wilson Industrial Air Center

The Wilson Industrial Air Center is located five miles from I-95. Wilson Industrial Air Center offers onsite

industrial lots with taxi-way access available for immediate development. Zoned for light industrial,

flexible site plan has been developed for the Air Center. The runway has three 4,500 foot runways, one

which is lighted, the airport is used extensively by industrial, commercial, governmental, medical, law

enforcement, military, and recreation. Businesses in Wilson County like the idea of having the proximity

of the Wilson Industrial Air Center because of saving time and money.

Frequently the North Carolina Department of Commerce uses the facility to bring industrial prospects to

visit Wilson. Aerial tours of sites and buildings, as well as of the city itself, are taken from the Air Center.

“The Wilson Industrial Air Center”, according to former Governor Jim Hunt is a tremendous asset for this

community and benefit to any company that locates here.

Wilson Transit System

Wilson Transit System, or WTS, operates fixed- route buses and provides taxicab shuttle services within

the city of Wilson. Hours of operation are 6:30 am to 6:30 pm., Monday through Friday, with limited

service on Saturday. Wilson County Transportation Service has a fleet of fourteen vehicles, including

nine specially modified vans to accommodate the elderly and handicapped, four standard vans and one

mini-van. These services are currently available to citizens twenty-four hours per day, three-hundred

sixty-four days per year, closing only on Christmas Day.

Services include the following sites:

 Wilson County Department of Social Services

 Diversified Opportunities

 Wilson Transit System

 Wilson County Office of Senior Citizens Affairs

 Wilson County Services for the Blind

Highway Systems

There are major highways that intersect in Wilson.

 U.S. Highways include: US 117, US 264, US 264 Alt, US 301

 State Highways include: NC 42, NC 58, NC 111, NC 222, NC 581

 Interstates: I-95, I-795

Raleigh Durham International Airport

Raleigh Durham International Airport is conveniently located forty-five minutes west of Wilson, NC.

Crime and Safety

Violent Crime and Property Crime

Both violent crime and property crime are used as indicators of a community’s crime and safety.

Violence negatively impacts communities by reducing productivity, decreasing property values and

disrupting social services. Violent crime includes four offenses: murder and non-negligent manslaughter,

rape, robbery, and aggravated assault. Property crime includes the offenses of burglary, larceny-theft,

motor vehicle theft, and arson.

The violent crime rate in 2015 in Wilson County is 454.8 per 100,000 population, compared to 356.3 per

100,000 people in North Carolina (Figure 31). Data for violent crime rate is not available for 2016. The

property crime rate in Wilson County (3,252.9 per 100,000 people) is higher than the state value

(2,779.7 per 100,000 people) (Figure 32). As shown in Figure 31 and Figure 32, the violent crime rate in

Wilson County has increased, whereas the property crime rate appears to be stable or exhibiting a slight

decrease.

Figure 31. Violent Crime Rate (North Carolina Department of Justice)

Figure 32. Property Crime Rate (North Carolina Department of Justice)

361.7

404.1

454.8

340.4

333.0

356.3

374.9

0.0

100.0

200.0

300.0

400.0

500.0

2013 2014 2015 2016

Violent Crimes Per 100,000

Population

Year

Wilson County North Carolina

3569.8

3269.6

3355.9

3252.9

3166.6

2954.1

2817.2

2779.7

500

1000

1500

2000

2500

3000

3500

4000

2013 2014 2015 2016

Property Crimes Per 100,000

Population

Year

Wilson County North Carolina

Juvenile Crime

Youth who commit a crime may not gain the educational credentials necessary to secure employment

and succeed later in life. Negative peer influences, history of abuse/neglect, mental health issues, and

significant family problems increase the risk of juvenile arrest. The juvenile justice system aims to reduce

juvenile delinquency through prevention, intervention, and treatment services.

Figure 33 shows the juvenile undisciplined rate per 1,000 youth ages 6-17 years old. The undisciplined

rate describes juveniles who are unlawfully absent from school, regularly disobedient and beyond

disciplinary control of the parent/guardian, are regularly found where it is unlawful for juveniles to be,

or have run away from home for more than 24 hours. The 2017 juvenile undisciplined rate in Wilson

County (0.7) is lower than the rate in North Carolina (1.5) and the Health ENC region (1.1).

Figure 33. Juvenile Undisciplined Rate (North Carolina Department of Public Safety)

Figure 34 shows the juvenile delinquent rate, or juvenile crime rate, per 1,000 youth ages 6-15 years old.

The 2017 juvenile delinquent rate in Wilson County (24.8) is higher than the rate in North Carolina (19.6)

and the Health ENC region (22.8).

Figure 34. Juvenile Delinquent Rate (North Carolina Department of Public Safety)

1.1

0.3

0.6

0.7

1.5

1.2

1.3

1.2

1.1

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2014 2015 2016 2017

Undisciplined Rate per 1,000

Population for Youth Aged 6

-17

Year

Wilson County North Carolina Health ENC Counties

16.0

28.4

21.6

24.8

22.5

20.8

19.2

19.6

2…

21.7

21.9

22.8

0.0

5.0

10.0

15.0

20.0

25.0

30.0

2014 2015 2016 2017

Delinquent Rate per 1,000

Population for Youths

Aged 6

-15

Year

Wilson County North Carolina Health ENC Counties

Child Abuse

Child abuse includes physical, sexual and emotional abuse. All types of child abuse and neglect can have

long lasting effects throughout life, damaging a child’s sense of self, ability to have healthy relationships,

and ability to function at home, at work, and at school. Figure 35 shows the child abuse rate per 1,000

population aged 0-18. The child abuse rate in Wilson County increased from 0.00 per 1,000 population

in 2016 to 1.21 per 1,000 population in 2017 and is higher than the rate in North Carolina (0.22 in 2017)

and the Health ENC region (0.28 in 2017).

Figure 35. Child Abuse Rate

(Management Assistance for Child Welfare, Work First, and Food & Nutrition Services in North Carolina &

University of North Carolina at Chapel Hill Jordan Institute for Families)

Incarceration

According to the U.S. Bureau of Justice Statistics, approximately one out of 100 adults in the U.S. are in

jail or prison. Conditions in jails and prisons can lead to an increased risk of infectious diseases such as

tuberculosis and hepatitis C, as well as assault from other inmates. After incarceration, individuals are

likely to face a variety of social issues such as employment discrimination, disruption of family

relationships and recidivism.

Figure 36 shows the incarceration rate per 1,000 population. The 2017 incarceration rate in Wilson

County (321.7 per 1,000 population) is higher than the rate in North Carolina (276.7) and the Health ENC

region (232.6).

Figure 36. Incarceration Rate (North Carolina Department of Public Safety)

0.31

0.42

0.00

1.21

0.23

0.21

0.22

0.28

0.25

0.28

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

2014 2015 2016 2017

Child Abuse Rate per 1,000

Population Aged 0

-18

Year

Wilson County North Carolina Health ENC Counties

29…

27…

272.8

321.7

306.5

283.0

281.3

276.7

249.2

228.0

232.7

232.6

100

200

300

400

2014 2015 2016 2017

Incarceration Rate per

1,000 Population

Year

Wilson County North Carolina Health ENC Counties

Access to Healthcare, Insurance and Health Resources Information

Health Insurance

Medical costs in the United States are very high. People without health insurance may not be able to

afford medical treatment or prescription drugs. They are also less likely to get routine checkups and

screenings, so if they do become ill they may not seek treatment until the condition is more advanced,

and therefore more difficult and costly to treat.

Figure 37 shows the percent of people aged 0-64 years old that have any type of health insurance

coverage. The rate for Wilson County, 86.4%, is lower than the rate for North Carolina (87.8%) and the

Health ENC region (87.2%). Countywide 13.6% of residents are uninsured.

Figure 37. Persons with Health Insurance (Small Area Health Insurance Estimates, 2016)

Figure 38 shows the percent of the population only receiving health insurance through Medicaid,

Medicare, or military healthcare (TRICARE). Wilson County has a higher percent of people receiving

Medicaid (24.3%) than North Carolina (18.2%) and Health ENC counties (21.7%). The percent of people

receiving Medicare is also higher in Wilson County (5.3%) when compared to North Carolina (4.8%) and

Health ENC counties (4.5%). The percent of people receiving military health insurance is lower in Wilson

County (0.8%), as compared to North Carolina (2.1%) and Health ENC counties (6.6%).

Figure 38. Persons Only Receiving Health Insurance through Medicaid, Medicare or Military Healthcare

(American Community Survey, 2012-2016)

86.4%

87.8%

87.2%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Wilson County North Carolina Health ENC Counties

Percent of Population 0

-64

24.3%

5.3%

0.8%

18.2%

4.8%

2.1%

21.7%

4.5%

6.6%

10%

15%

20%

25%

30%

Receiving Medicaid Only Receiving Medicare Only Receiving TRICARE/Military

Health Insurance Only

Percent of

Noninstituationalized

Civilian Population

Wilson County North Carolina Health ENC Counties

Assessment and Analysis of Community Resources

Wilson County relies on a variety of resources to meet the needs of the community. These resources

include the Wilson Community Health Center (FQHC), Wilson County Health Department, and Wilson

Medical Center as well as private practice physicians and dentists. These organizations provide services

in a variety of ways, each one meeting a necessary need. Other available resources located in Wilson

County can be found in a community resource guide through a link in Appendix D of this document.

Wilson County is growing and continuing to meet the needs of the county as it develops. Upon analysis

of existing resources there is a need for detoxification and rehab services within the county. With the

growth of opioid misuse a recovery center has been established and a syringe exchange program

implemented, yet the availability of detoxification and rehab services is a concern. Wilson Professional

Services offers substance abuse counseling and treatment; however capacity is limited. The nearest

out-patient treatment center is approximately 20-30 minutes away and the closest in-patient treatment

center is approximately 40 minutes from Wilson.

Civic Activity

Exercising the right to vote allows a community to choose elected officials and hold them accountable.

Voting ensures that all citizens have the opportunity to voice their opinions on issues such as the use of

tax dollars, civil rights and foreign policy. By voting, individuals shape their communities and influence

the next generation of society. A high level of voter turnout indicates that citizens are involved and

interested in who represents them in the political system.

Figure 39 shows the voting age population, or percent of the population aged 18 years and older. Wilson

County has a lower percent of residents of voting age (76.6%) than North Carolina (77.3%) and Health

ENC counties (76.7%).

Figure 39. Voting Age Population (American Community Survey, 2012-2016)

Figure 40 shows the percent of registered voters who voted in the last presidential election. The rate in

Wilson County was 66.7%, which is slightly lower than the state value (67.7%) and slightly higher than

Health ENC counties (64.3%).

Figure 40. Voter Turnout in the Last Presidential Election

(North Carolina State Board of Elections, 2016)

76.6%

77.3%

76.7%

50%

100%

Wilson County North Carolina Health ENC Counties

Percent of

Population

66.7%

67.7%

64.3%

20%

40%

60%

80%

Wilson County North Carolina Health ENC Counties

Percent of

Registered

Voters

County of Wilson

Wilson County is considered a rural area in eastern North Carolina. Historically, a major factor affecting

the growth of Wilson County was organized mass agriculture. Subsistence farming was replaced with the

large production of cash crops. Due to the economics of the time, merchants, investors, and landlords

encouraged and sometimes even demanded that farmers plant such crops for increased profits.

Between the 1860’s and the 1880’s, cotton was the primary cash crop. However, because cotton

depleted the soil and required expensive fertilization, it became less profitable. By the 1880’s, however,

the face of Wilson County agriculture was forever changed with the demand for flue-cured tobacco.

Wilson County was ideally suited for growing tobacco because its climate and its sandy, loamy soil. By

the turn of the century, tobacco had largely replaced cotton as the county’s main cash crop. In 1920,

Wilson came to be known as the “World’s Greatest Tobacco Market”. Tobacco continued to be one of

the largest industries in the county well into the 20th century.

With the completion of the nationwide interstate highway system after World War II, Wilson was able to

diversify its economy even further. Interstate 95, a major north/south artery on the east coast of the

United States, was constructed straight through the heart of the county. Coupled with the interstate and

its intersection with US Highway 264, new industries were attracted to the county. Wilson County has

developed a diverse industrial base that includes pharmaceuticals, life sciences, automotive parts, and

building supplies. Moreover, agriculture still remains and important industry.

As we move into the 21st century, Wilson County has become a major center for commerce, education,

culture, and tourism in Eastern North Carolina. Wilson County is also thought of as the center for world-

famous Eastern Carolina-style pork barbecue. As new development and industry continue to grow

within its borders, Wilson County maintains a strong presence in the communities of eastern North

Carolina. With its colorful and fascinating history, Wilson County promises to continue as a vibrant

community for today and tomorrow.

According to the U.S, Census Bureau, the county has a total area of 374 square miles, of which, 371

square miles of it is land and 3 square miles of it is water.

The county is divided into ten townships: Black Creek, Cross Roads, Gardners, Old Fields, Saratoga,

Springhill, Stantonsburg, Taylors, Toisnot, and Wilson.

Wilson is located approximately 45 minutes east of Raleigh, the North Carolina state capital.

Photo credit: A.Walker

Findings

Secondary Data Scoring Results

Table 8 shows the data scoring results for Wilson County by topic area. Topics with higher scores

indicate greater need. Maternal, Fetal & Infant Health is the poorest performing health topic for Wilson

County, followed by Education, Heart Disease & Stroke, Public Safety and Diabetes.

Table 8. Secondary Data Scoring Results by Topic Area

Health Topic

Score

Maternal, Fetal & Infant Health

2.25

Education

1.95

Heart Disease & Stroke

1.94

Public Safety

1.93

Diabetes

1.92

*See Appendix B for additional details on the indicators within each topic area

Primary Data

Community Survey

Figure 41 shows the list of community issues that were ranked by residents as most affecting the quality

of life in Wilson County. Low-income/poverty was the most frequently selected issue and was ranked by

34.5% of survey respondents, followed drugs/substance abuse. Less than 1% of survey respondents

selected domestic violence, neglect and abuse, elder abuse, child abuse and rape/sexual assault as

issues most affecting the quality of life in Wilson County.

Figure 41. Top Quality of Life Issues, as Ranked by Survey Respondents

34.5%

28.2%

5.2%

4.8%

4.7%

4.1% 4.1%

3.5%

2.8%

1.7%

1.6%

1.4%

1.2%

0.9%

0.7%

0.3% 0.3%

10%

15%

20%

25%

30%

35%

40%

Figure 42 displays the level of agreement among Wilson County residents in response to nine

statements about their community. Half or more than half of survey respondents agreed or strongly

agreed that it is easy to buy healthy food in the county, there are good parks and recreation facilities,

there is affordable housing, there is good health care, the county is a safe place to live and raise

children, as well as a good place to grow old. Less than half of survey respondents disagreed (27%) or

strongly disagreed (11%) that the county has plenty of economic opportunity. Further, 27% of survey

respondents either disagreed or strongly disagreed that there is plenty of help during times of need.

Figure 42. Level of Agreement Among Wilson County Residents in Response to Nine Statements about their

Community

Figure 43 shows the list of services that were ranked by residents as needing the most improvement in

Wilson County. Higher paying employment was the most frequently selected issue, followed by positive

teen activities, counseling or mental health support and availability of employment.

Figure 43. Services Needing the Most Improvement, as Ranked by Survey Respondents

11%

10%

13%

10%

27%

14%

17%

14%

12%

16%

28%

24%

21%

31%

27%

22%

19%

43%

50%

51%

26%

42%

34%

40%

46%

13%

14%

10%

11%

12%

There is good healthcare in my County.

This County is a good place to raise children.

This County is a good place to grow old.

There is plenty of economic opportunity in this County.

This County is a safe place to live.

There is plenty of help for people during times of need in…

There is affordable housing that meets my needs in this…

There are good parks and recreation facilities in this County.

It is easy to buy healthy foods in this County.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Strongly Disagree Disagree Neutral Agree Strongly Agree

17.1%

11.1%

10.0%

9.2%

7.8%

6.4%

5.5%

4.0%

3.8%

3.6%

2.9%

2.4%

1.7%

1.4%

1.2%

1.0%

0.9%

10%

12%

14%

16%

18%

Figure 44 shows a list of health behaviors that were ranked by residents as topics that Wilson County

residents need more information about. Substance abuse prevention was the most frequently selected

issue, being ranked by 22.4% of survey respondents. This was followed by fitness/nutrition, going to the

doctor for yearly check-ups and screenings and managing weight.

Figure 44. Health Behaviors that Residents Need More Information About, As Ranked by Survey Respondents

Focus Group Discussions

Table 9 shows the focus group results for Wilson County by topic area or code. Focus Group transcript

text were analyzed by the Conduent HCI team using a list of codes that closely mirror the health and

quality of life topics used in the data scoring and community survey processes. Text was grouped by

coded excerpts, or quotes, and quantified to identify areas of the highest need per the focus group

participants. All excerpts/quotes were also categorized as a strength or a barrier/need based on the

context in which the participant mentioned the topic. Topics with higher frequency and mentioned in

the context of needs/concerns or barriers/challenges suggests greater need in the community. Access to

Health Services was the most frequently discussed need among focus group participants, followed by

Exercise, Nutrition, & Weight, Children’s Health, Mental Health & Mental Disorders and Health Care

Navigation. Topics with a frequency more than 20 are included in the overall list of significant health

needs.

Table 9. Focus Group Results by Topic Area

Topic Area (Code)

Frequency

Exercise, Nutrition, Weight, & Obesity

Access to Health Services

Children’s Health

Mental Health/Alcohol & Substance Misuse

Health Care Navigation/Literacy

22.4%

11.1%

9.9%

8.0%

5.6%

5.2%

4.0%

3.8%

3.3%

2.4%

2.1%

1.9%

1.6%

1.2%

0.9%

0.7%

0.2%

0.0%

10%

15%

20%

25%

Data Synthesis

All forms of data have strengths and limitations. In order to gain a comprehensive understanding of the

significant health needs for Wilson County, findings from the community survey, focus group

discussions, community health summit and secondary data were compared and analyzed for areas of

overlap, if any. The top needs from each data source were identified using the criteria displayed in Table

10.

Table 10. Criteria for Identifying the Top Needs from each Data Source

Data Source

Criteria for Top Need

Community Health Summit

Community issues ranked by community attendees as most

affecting the quality of life*

Community Survey

Community issues ranked by survey respondents as most

affecting the quality of life*

Focus Group Discussions

Topics discussed most frequently by participants in context of

needs/concerns or barriers/challenges to achieving health

Secondary Data

5 topics receiving highest data score

Figure 45 displays the top needs from each data source.

Community Survey

Secondary Data

Focus Groups

Community Health

Summit

Alcohol & Substance

Misuse

Diabetes

Exercise & Weight

Obesity

Economy

Education

Nutrition & Obesity

Fitness/Nutrition

Heart Disease & Stroke

Access to Health

Services

Mental Health—

including Alcohol &

Substance Misuse

Maternal, Fetal &

Infant Health

Public Safety

As seen in Figure 45, the survey results and focus group discussion analysis cultivated unique and

additional topics not ranked as top priorities in the secondary data findings. A mixed-methods approach

to community assessment is a strength when evaluating a community as a whole. This process ensures

robust findings through statistical analysis of health indicators in addition to an examination of

constituent’s perceptions of community health issues.

Figure 45. Data Synthesis Results

Topic Areas Examined in This Report

Nine topic areas were identified as high scoring across the three data sources. These topics are listed

below in Table 11.

Table 11. Topic Areas Examined in this Report

Access to Health Services

Adolescent Pregnancy & STD’s

Diabetes*

Economy

Education*

Fitness & Nutrition

Heart Disease & Stroke*

Maternal, Fetal & Infant Health*

Mental Health/Alcohol & Substance Misuse

Obesity

Public Safety*

The five topic areas with the highest secondary data scores (starred*) are explored in-depth in the next

section and include corresponding data from community participants when available. Following the five

topic areas is a section called ‘Other Significant Health Needs’ which includes discussion of the

additional topics that were identified specifically in the community survey and focus group discussions.

The additional topics in ‘Other Significant Health Needs’ includes Access to Health Services, Exercise,

Nutrition & Weight, Economy and Substance Abuse.

Navigation Within Each Topic

Findings are organized by topic area. Within each topic, key issues are summarized followed by a review

of secondary and primary data findings. Special emphasis is placed on populations that are highly

impacted, such as older adults, race/ethnic groups or low-income populations. Figures, tables and

extracts from quantitative and qualitative data substantiate findings. Each topic includes a table with

key indicators from the secondary data scoring results. The value for Wilson County is displayed

alongside relevant comparisons, gauges and icons which are color-coded with green indicating good, red

indicating bad and blue indicating neutral. Table 12 describes the gauges and icons used to evaluate the

secondary data.

Table 12. Description of Gauges and Icons used in Secondary Dara Scoring

Gauge or Icon

Description

Green represents the "best" 50th percentile.

Yellow represents the 50th to 25th quartile

Red represents the "worst" quartile.

There has been a non-significant increase/decrease over time.

There has been a significant increase/decrease over time.

There has been neither a statistically significant increase nor decrease

over time.

Maternal, Fetal & Infant Health

Key Issues

 Percent of babies born at very low and low birth weight are significant indicators that are

increasing over time

 Teen Pregnancy is higher in Wilson County than in North Carolina overall, however, the rate is

decreasing over time

 There may be a lack of awareness by community members of the issues related to this topic

area

Secondary Data

The secondary data scoring results reveal Maternal, Fetal & Infant Health as the top need in Wilson

County with a score of 2.25. Additional analysis is performed to find specific indicators that contribute to

this area of concern, and these indicators are identified with high indicator data scores, shown in Table

13.

Table 13. Data Scoring Results for Maternal, Fetal & Infant Health

Score

Indicator

(Year) (Units)

Wilson

County

North

Carolina

U.S.

North

Carolina

Counties

Trend

Healthy

NC 2020

2020

2.63

Babies with

Low Birth

Weight

(2012-2016)

(percent)

11.5

8.1

7.8

2.33

Preterm Births

(2016)

(percent)

12.8

10.4

9.8

9.4

2.43

Babies with

Very Low Birth

Weight

(2012-2016)

(percent)

2.6

1.7

1.4

1.5

Teen

Pregnancy

Rate

(2012-2016)

(pregnancies/

1,000 females

aged 15-17)

23.9

15.7

36.2

2.35

Infant

Mortality Rate

(2012-2016)

(deaths/ 1,000

live births)

7.2

6.3

*See Appendix B for full list of indicators included in each topic area

Maternal, Fetal & Infant Health is a clear area of concern for Wilson County based performance on all

indicators within this topic area. Wilson County falls in the poorest performing quartile in comparison to

all North Carolina counties across all indicators available within the Maternal, Fetal and Infant Health

topic area. The indicator score for babies with low birth rate for Wilson County is 2.63 with a value of

11.5% of babies born at a low birth weight in 2012-2016. This is higher than the rate in both North

Carolina (9%) and the United States (8.1%) and there is a significant trend upwards over time. Wilson

County does not meet the Healthy People 2020 target of 7.8% of babies born at low birth rate.

Additionally, babies born with a very low birth weight is 2.6% in Wilson County which is also higher than

the rate for North Carolina (1.7%) and the U.S. overall (1.4). Wilson does not meet the Healthy People

2020 target for babies born with a very low birth rate (1.4%). There is an increase observed over time for

the babies born with a very low birth weight indicator in Wilson County, however this trend is not

statistically significant at this point in time.

The infant mortality rate is 9 deaths per 1,000 live births in Wilson County which is higher than the

infant mortality rate in North Carolina (7.2 deaths/1,000 live births) and does not meet either Healthy

NC 2020 (6.3 deaths/1,000 live births) or Healthy People 2020 (6 deaths/1,000 live births) goals. There is

an increase observed in the infant mortality rate indicator in Wilson County, however this trend is not

statistically significant at this point in time.

Finally, the teen pregnancy rate in Wilson County is 23.9 pregnancies/1,000 females aged 15-17 which is

higher than the teen pregnancy rate in North Carolina overall (15.7 pregnancies/1,000 females aged 15-

17). The Wilson County teen pregnancy rate meets the Health People 2020 goal and there is evidence of

a significant decreasing trend over time.

Primary Data

In the community survey, participants were asked to identify health behaviors

people in the community need more information about and “getting prenatal

care during pregnancy” was not selected by any of the survey respondents.

This result may have been due to the demographics of survey respondents and

not necessarily reflect the ultimate need in the community. During the focus

group discussions, teen pregnancy was raised as an issue in the community as

well as post-partum care as a need in the community.

Related to teen health and pregnancy, “positive teen activities” was selected as the second highest

ranking service needing improvement in the community (11.1%) and preventing pregnancy/sexually

transmitted diseases was selected as the fifth highest ranking health behavior than people in the

community need more information about.

The Community Health Needs Assessment identified vulnerable populations with multiple risk factors

that create complex health challenges. Among these health risk factors are aging and minorities living

below the poverty level. Factors impacting these populations include low income, lack of affordable

health insurance/ coverage, social isolation, mental health problems, substance abuse problems, poor

nutrition, sedentary lifestyle, sexual risk behaviors (including adolescent pregnancy and STD’s), and

tobacco use.

Education

Key Issues

 The percentage of students graduating high school graduation is lower than in the state and

does not meet Healthy People 2020 or Health NC 2020 goals

 Proficiency in certain subject matter in 4

and 8

grade is lower in the county when compared

to other counties in the state

 Dropping out of school was mentioned as issue in the community

“Positive teen

activities are needed

in our community.”

-Focus Group Participant

Secondary Data

Education has the second highest data score of all topic areas, with a score of 1.95. Table 14 highlights

indicators of concern.

Table 14. Data Scoring Results for Education

Score

Indicator (Year)

(Units)

Wilson

County

North

Carolina

U.S.

North

Carolina

Counties

Trend

Healthy

NC 2020

HP 2020

2.05

4th Grade Students

Proficient in

Reading

(2016-2017)

(percent)

47.3

57.7

2.05

8th Grade Students

Proficient in Math

(2016-2017)

(percent)

27.8

45.8

2.35

High School

Graduation

(2016-2017)

(percent)

75.9

86.5

94.6

2.05

Student-to-

Teacher Ratio

(2015-2016)

(students/ teacher)

16.5

15.6

17.7

2.05

8th Grade Students

Proficient in

Reading

(2016-2017)

(percent)

38.2

53.7

*See Appendix B for full list of indicators included in each topic area

There has been a focus in the Wilson County Schools toward moving educational outcomes for our

students. In the 2017-2018 NC Public School data Wilson County NC Schools ranks 59

in the state for

overall proficiency out of 115 school districts. This is an improvement from a 2015-16 rank of 90

. The

positive ranking change was due to our district’s increase of 9.1 percentage points on state tests, which

was the second highest gain in the state.

The 2017-2018 results showed an overall increase of 9.1% in proficiency as a district (EOG and EOC),

reading scores increased 10.0% in proficiency, and overall reading results improved for grades 4-8.

Mathematics scoring increased 12.5% in proficiency and overall results improved for grades 3-8.

Science outcomes improved for grades 5 and 8. Eighteen out of twenty-five schools earned either an A,

B or a C letter grade. This represents 72 percent, which is an improvement from 56% in 2016-17 and

45% in 2015-16.

Overall, twenty-two of twenty-five schools saw a numerical increase in the score that corresponds to its

letter grade.

Primary Data

Community survey participants were asked to rank the most pressing health issue in

their community. According to the data, education, or specifically dropping out of

school, ranked as the third most pressing issue in Wilson County. However, education

only represented 5.2% of the total responses. One community survey free-response

questions noted education as major issue the community, specifically raising the issue of

discipline within the school system. Overall, 63% of community survey respondents

strongly agreed or agreed that Wilson County is a good place to raise children and focus

group discussion did not raise issues of the education system in the community. These

results suggest that participants in the focus groups and community survey participant

may perceive other topics as more pressing as related to health, even if they consider

education an issue in the community.

Heart Disease & Stroke

Key Issues

 The Medicare population in Wilson County is highly impacted by heart disease and stroke

 There is early evidence of a possible decrease in heart failure among the Medicare population

over time, though this trend not currently statistically significant

 Community outreach may be needed to educate the public about managing heart related

conditions

Secondary Data

Heart Disease & Stroke received a data score of 1.94. Poorly performing indicators related to Heart

Disease & Stroke is displayed in Table 15.

Table 15. Data Scoring Results for Heart Disease & Stroke

Score

Indicator (Year)

(Units)

Wilson

County

North

Carolin

U.S.

North

Carolina

Counties

U.S.

Counties

Trend

Healthy

2020

Heart Failure:

Medicare

Population

(2015)

(percent)

14.7

12.5

13.5

2.35

Stroke: Medicare

Population (2015)

(percent)

4.5

3.9

2.5

Hyperlipidemia:

Medicare

Population

(2015)

(percent)

52.6

46.3

44.6

2.5

Hypertension:

Medicare

Population

(2015)

(percent)

64.4

*See Appendix B for full list of indicators included in each topic area

“Our schools are

making progress by

supporting students

and staff. It takes all

of us to help our

children.”

- Summit Participant

The poorest performing indicators for Heart Disease & Stroke specifically impact the Medicare

population. From 2012 to 2016, 5.3% of the population in Wilson County received their health care

benefits through the Medicare program. The percentage of Hyperlipidemia (52.6%) and Hypertension

(64.4%) are particularly high amongst the Medicare population in 2015, when compared to state and

U.S. overall Medicare populations. For both the Hyperlipidemia and Hypertension indicators, Wilson

County is in the poorest performing quartile when compared against other North Carolina and U.S.

counties and there is an observed increasing trend, though this trend is not statistically significant at this

point in time. The percentage of stroke within the Wilson County Medicare population (4.5%) is higher

than in the state (3.9%) and U.S. (4%) overall. There is an observed increasing trend of stroke within the

Medicare population, though this trend is not statistically significant at this point in time. The

percentage of heart failure within the Wilson County Medicare population (14.7%) is higher than in the

state (12.5%) and U.S. (13.5%) overall. Of note, there is an observed decreasing trend of heart failure

within the Medicare population, though this trend is not statistically significant at this point in time.

Primary Data

Heart Disease and Stroke came up in all three focus groups and was mentioned

specifically by four participants as a primary concern in the community. One

participant discussed their own experience with a high prevalence of strokes in the

community as a medical provider. The importance of changing habits was

discussed instead of taking more medication.

Of the community survey respondents, 22% reported that they received their

health insurance coverage through the Medicare benefit which is a much higher

percentage than in the overall population of Wilson County. When asked about

challenges to accessing health services for themselves or a family member, 13.9%

community survey respondents indicated that they had an issue in the past 12 months

accessing health care services or provider. For those respondents who had experienced challenges

accessing health care services or providers in the past 12 months, 23.3% indicated that they had trouble

accessing a specialist. Indirectly related, community survey respondents rated eating well/nutrition,

going to the doctor for yearly checkups and screenings and managing weight as topics the community

needs more information about which may impact the Medicare population living with conditions related

to heart disease and stroke.

Diabetes

Key Issues

 Diabetes highly impacts adults over 20 and the Medicare population

 Age-adjusted death rate due to diabetes is higher in Wilson County than other areas of the

state, some indication that this may be decreasing over time

 Community members are benefitting from current programs, more education and outreach may

benefit the community overall

Secondary Data

Diabetes received an overall data score of 1.92. Indicators of concern are displayed in Table 16.

“Changing behavior and

lifestyle is hard but

necessary for long term

health.”

- Focus Group Participant

Table 16. Data Scoring Results for Diabetes

Score

Indicator (Year) (Units)

Wilson

County

North

Carolina

U.S.

North

Carolina

Counties

U.S.

Counties

Trend

2.7

Diabetes: Medicare Population

(2015)

(percent)

28.4

26.5

2.25

Adults 20+ with Diabetes

(2014)

(percent)

13.1

11.1

1.93

Age-Adjusted Death Rate due to

Diabetes

(2012-2016)

(deaths/ 100,000 population)

26.8

21.1

*See Appendix B for full list of indicators included in each topic area

Diabetes amongst adults and older adults is a clear area of concern for Wilson County based on the 2

highest scoring indicators within the Diabetes topic area. The indicator score for diabetes amongst the

Medicare population is 35% in Wilson County and is higher than both the North Carolina (28.4%) and the

U.S. overall (26.5%) values in 2015. Wilson County falls in the bottom quartile in comparison to all North

Carolina and U.S. counties for diabetes amongst the Medicare population and there has been a

significant increase over time. The indicator score for diabetes amongst adults over 2o years old is 13.1%

in Wilson County and is higher than both the North Carolina (11.1%) and the U.S. overall (10%) values in

2014. Wilson County falls in the second to the bottom quartile in comparison to all North Carolina

counties and in the bottom quartile in comparison to all U.S. counties for diabetes amongst adults over

20 years old. There is no indication of an increase or decrease in diabetes in this population over time.

The score for age-adjusted death rate due to diabetes for Wilson County is 1.93 with a value of 26.8

deaths per 100,000 occurring between 2012 and 2016. This is higher than the rate in both North

Carolina (23 deaths/100,000 population) and the United States (21.1 deaths/100,000). There is evidence

of a decrease age-adjusted death rate due to diabetes in Wilson County over time, though this is not a

statistically significant trend at this time.

Primary Data

As mentioned in the previous topic, community survey

respondents rated eating well/nutrition, going to the doctor for

yearly checkups and screenings and managing weight as topics

the community needs more information which may also impact

the adult population living with Diabetes.

Diabetes was discussed six times during the focus group

discussions. In particular, multiple participants shared that they

had or were currently participating in the local Type 2 Diabetes

Prevention Program. Participants shared personal stories about

benefitting greatly from learning about healthy eating habits

specific to diabetes and discussing challenges with managing

their condition with their physicians. The most common challenge

participants raised was not feeling supported by their community

when making lifestyle changes to manage their diabetes. Participants also discussed wanting to learn

more about resources in the community that would help them with living healthier lives and especially

for those community members who may not already be participating in diabetes prevention programs.

“I went through a minority diabetes

prevention program to prevent type 2

{diabetes} and had to change lifestyle.

Got a lot of resistance from those

around because nobody wants to see

someone change because they might

feel uncomfortable. In a close-knit

community, you have to have a strong

desire and commitment to change.”

-Focus Group Participant

Public Safety

Key Issues

 Age-adjusted death rate due to homicide is the top scoring Public Safety issue

 Age-adjusted motor vehicle related deaths rate indicators are higher in Wilson County than the

state overall

 Violent crime and property crime rank high in the data scoring though not raised by community

participants as top concerns

Secondary Data

From the secondary data scoring results, Public Safety was identified to be a top need in Wilson County

with a score of 1.93. Specific indicators of concern are highlighted in Table 17.

Table 17. Data Scoring Results for Public Safety

Score

Indicator (Year)

(Units)

Wilson

County

North

Carolina

U.S.

North

Carolina

Counties

U.S.

Counties

Trend

Healthy

2020

2.58

Age-Adjusted Death

Rate due to

Homicide

(2012-2016)

(deaths/ 100,000

population)

9.1

6.2

5.5

6.7

5.5

2.1

Age-Adjusted Death

Rate due to Motor

Vehicle Collisions

(2012-2016)

(deaths/ 100,000

population)

17.8

14.1

2.3

Alcohol-Impaired

Driving Deaths

(2012-2016)

(percent)

36.8

31.4

29.3

4.7

1.85

Property Crime Rate

(2016)

(crimes/ 100,000

population)

3252.9

2779.7

1.98

Violent Crime Rate

(2016)

(crimes/ 100,000

population)

398.9

374.9

386.3

*See Appendix B for full list of indicators included in each topic area

Death rates due to homicide and driving deaths are a clear area of concern for Wilson County based on

the 2 highest scoring indicators within the Public Safety topic area. The indicator score for age-adjusted

death rate due to homicide for Wilson County is 2.5 with a value of 9.1 deaths per 100,000 occurring in

2012-2016. This is higher than the rate in both North Carolina (6.2 deaths/100,000 population) and the

U.S. (5.5 deaths/100,000) and there is a trend upward, though this increase is not statistically significant

at this time. Wilson County does not meet the Healthy North Carolina 2020 target of 6.7 deaths per

100,000 population or the Healthy People 2020 target of 5.5.

The age-adjusted death rate due to motor vehicle collision for Wilson County in 2012-2016 is 17.8

deaths per 100,000 population, which is higher than the rate for North Carolina (14.1 deaths/100,000).

There is an increasing trend for this indicator that is statistically significant. Additionally, the percentage

of alcohol-impaired driving deaths from 2012-2016 in Wilson County is 36.8% which is higher than North

Carolina (31.4%) and the U.S. (29.3) though there is some evidence that this indicator is decreasing over

time, though this is not statistically significant at this time.

Property crime is also an area of concern for Wilson County with 3,252.9 crimes per 100,000 population

which is higher than in North Carolina (2,779.7/100,000 population). There is some evidence that this

indicator is decreasing over time, though this is not statistically significant. Although the violent crime

indicator ranked high in data scoring (1.98), the Wilson County rate (398.9 crimes/100,000 population) is

comparable to North Carolina and the U.S. overall.

Primary Data

According to survey results, Public Safety did not rank high as one of the quality of life topics individuals

in Wilson County felt effected their lives. Only 5% selected violent crime as a top issue and less than 2%

selected theft as a top issue. The demographics of survey participants was skewed towards those who

are employed with moderate to high household incomes. This may suggest that survey participants are

not adversely effected in the same way others in the community are by higher rates of crime. 50% of

participants shared that they strongly agreed or agreed that Wilson County is a safe place to live, while

only 19% strongly disagreed or disagreed. Similarly, focus group discussion did not reveal any needs or

concerns related to safety overall though this may have been related to the direction of the

conversations.

Mortality

Knowledge about the leading causes of death in a population is critical to understanding how to target

interventions to maximize population health. Table 18 shows the leading causes of mortality in Wilson

County, North Carolina, and Health ENC Counties in 2014-2016, where the rate is age-adjusted to the

2000 U.S. standard population and is given as an age-adjusted death rate per 100,000 population.

Table 18. Leading Causes of Mortality (2014-2016, CDC WONDER)

Wilson County

North Carolina

Health ENC Counties

Rank

Cause

Deaths

Rate*

Cause

Deaths

Rate*

Cause

Deaths

Rate*

Cancer

538

170.1

Cancer

58,187

165.1

Cancer

12,593

177.5

Heart Diseases

478

157

Heart Diseases

54,332

159

Heart Diseases

12,171

178.8

Cerebrovascular

Diseases

131

42.1

Chronic Lower

Respiratory

Diseases

15,555

45.1

Cerebrovascular

Diseases

3,247

48.5

Accidental

Injuries

124

49.7

Accidental

Injuries

15,024

48.2

Accidental

Injuries

3,136

50.1

Chronic Lower

Respiratory

Diseases

105

33.2

Cerebrovascular

Diseases

14,675

43.6

Chronic Lower

Respiratory

Diseases

3,098

44.9

Diabetes

29.4

Alzheimer’s

Disease

11,202

34.2

Diabetes

2,088

29.9

Alzheimer's

Disease

Diabetes

8,244

23.6

Alzheimer's

Disease

1,751

27.3

Influenza and

Pneumonia

16.9

Influenza and

Pneumonia

5,885

17.5

Influenza and

Pneumonia

1,148

17.2

Kidney Diseases

5,614

16.5

Kidney Diseases

1,140

16.8

Septicemia

4,500

13.1

Septicemia

1,033

15.1

*Age-adjusted death rate per 100,000 population

The leading cause of death in Wilson County is cancer, followed by heart disease as in the Health ENC

counties and North Carolina. Cerebrovascular diseases and chronic lower respiratory diseases ranks

amongst the top five causes of death for all three locales, which indicates chronic disease as an area of

concern for Wilson County and the state as a whole. Deaths due to accidental injuries ranks fourth in

Wilson County as it does in the Health ENC counties and North Carolina. Deaths due to diabetes and

cerebrovascular diseases ranks the same in Wilson county in other Health ENC counties but higher than

in the state. Overall Wilson County leading causes of mortality is the same as the Health ENC region and

similar to the state with some exceptions.

Data Analysis on Significant Health Needs

Access to Health Services

Secondary Data

From the secondary data scoring results, the Access to Health Services topic had a score of 1.75 and was

the 11

highest scoring health and quality of life topic. High scoring related indicators include:

Preventable Hospital Stays: Medicare Population (2.15) and Primary Care Provider Rate (2.00).

A list of all secondary indicators within this topic area is available in Appendix B.

Primary Data

As previously summarized, the majority of community survey respondents have

health insurance through an employer (54.6%) followed by Medicare (22.2%)

and Medicaid (14%) benefit programs. Participants were asked where they most

often go to seek medical treatment, the majority sought care at a doctor’s office

62.1% and 14.4% sought care at an urgent care center. The majority of

participants did not report any problems getting the health care they needed in

the past 12 months (83.6%). For those who reported have difficulties accessing

health care services, the most common reported providers that they had trouble

getting services from were a dentist (43.3%), specialist (23.3%),

pharmacy/prescriptions (22.2%), eye care/optometrist (20%) or a general

practitioner (17.8%). The top reasons participants reported not being able to get the necessary health

care they needed were not having health insurance (40.4%), insurance did not cover services (24.7%),

share of their costs were too high (24.7%), the wait was too long (19.1%) or they couldn’t get an

appointment (13.5%). 77.1% of participants reported being able to see the medical provider they

needed within Wilson County.

Focus Group participants frequently discussed difficulties scheduling appointments with primary care

providers and specialists due to transportation and language barriers.

Exercise, Nutrition, Weight & Obesity – Top health need identified

Secondary Data

From the secondary data scoring results, the Exercise, Nutrition, Weight & Obesity topic had a score of

1.54 and was the 21

highest scoring health and quality of life topic. High scoring related indicators

include: Food Insecurity Rate (2.30), Workers who Walk to Work (2.20), Child Food Insecurity Rate (2.10)

and Adults 20+ who are Obese (2.05).

Primary Data

Among community survey respondents, 43% rated their health is good and 28.2% rated their health as

very good. However, 46.7% of respondents reported being told by a health professional that they were

overweight and/or obese. This was closely followed by high reports of high blood pressure (43.3%), high

cholesterol (37.5%) and diabetes (19.5%). Moreover, reported physical activity is very low for Wilson

County. Additionally, data from the community survey participants show that 36.5% of community

members do not engage in any physical activity or exercise during the week that lasts at least 30

minutes. Among individuals that do not exercise, respondents reported not having enough time (31.4%),

being too tired to exercise (31.1%) and not liking exercise (19.9%). For those individuals that do exercise,

64.1% reported exercising or engaging in physical activity at home while 23.9% do so at the YMCA

followed by a public park (18.4%) or private gym (18.4%).

Exercise, Nutrition & Weight was discussed in all three focus groups. Participants shared their concerns

for obesity amongst both young people and adults in the community. One participant shared concerns

“Living in East

Wilson, I would like

to see more fitness

opportunities.”

-Focus Group Participant

with food served at schools for young children and described the need to intervene early with

influencing eating habits. Suggestions included providing more services or activities to help families stay

physically active in the community. They shared that they struggled with not knowing how to eat

healthy or what to select as healthy food choices when eating away from home. To emphasize this

point, when community members were asked about specific topic areas they were interested in learning

more about in the community survey, weight-loss, nutrition, and diabetes/diabetic food preparation

were high frequency responses.

Economy

Secondary Data

From the secondary data scoring results, the Economy was the 9

ranked health and quality of life need

in Wilson County with a score of 1.84. Top related indicators include: Households with Supplemental

Security Income (2.70), Children Living Below Poverty Level (2.50), Students Eligible for the Free Lunch

Program (2.35), Families Living Below Poverty Level (2.30), Food Insecurity Rate (2.30), People Living

Below Poverty Level (2.30), People Living 200% Above Poverty Level (2.25), People 65+ Living Below

Poverty Level (2.20), Severe Housing Problems (2.15), Child Food Insecurity Rate (2.10), Total

Employment Change (2.10), Unemployed Workers in Civilian Labor Force (2.10) and Young Children

Living Below Poverty Level (2.10).

Primary Data

Community survey participants were asked to rank the issues most negatively affecting their

community’s quality of life. According to the data, both poverty and the economy were the top issues in

Wilson County that negatively impact quality of life. Community survey participants were also asked to

weigh-in on areas of community services that needed the most improvement. With the highest share of

responses, higher paying employment ranked first (17.1%), availability of employment ranked fourth

(9.2%) and more affordable/better housing ranked fifth (7.8%). When asked to expand on services that

could be improved, participants mentioned non-temporary employment, the need for more economic

activity in the community, higher salaries and more jobs for women.

Focus group participants also touched on key economic stressors: maintaining or achieving a work-life

balance, challenges with being able to afford healthy behaviors or activities, delays in seeking health

care due to costs and affordability of housing. One participant specifically identified the area of East

Wilson as needing economic support and investment.

“…early childhood intervention is important in order to

communicate the healthy (well)being and wellness of a child,

getting enough sleep, drinking water, playing outside for an

hour.”

-Focus Group Participant

Substance Abuse

Secondary Data

From the secondary data scoring results, the Substance Abuse topic was the 22

ranked health and

quality of life need in Wilson County with a score of 1.52. Top related indicators include: Adults who

Smoke (2.40) and Alcohol-Impaired Driving Deaths (2.30).

Primary Data

Community survey participants ranked substance abuse (28.2%) as a top issue

affecting quality of life in Wilson County. Additionally, 22.4% of community survey

respondents reported wanting to learn more about substance abuse prevention.

19.5% of survey participants reported currently use tobacco products. Of those who

reported tobacco product use, 33% reported that they don’t know where they would

go if they wanted to quit and 25.9% would go to a doctor. 44.7% of survey

participants reported having been exposed to secondhand smoke in the last year. Of

those who indicated that they had been exposed to secondhand smoke, 42.7% were

exposed in the home. Reported illicit drug use amongst survey participants in the past

30-days was low, 93.4% reported no illegal drug use and 96.8% reported no use of

prescription drugs they did not have a prescription for. Of those who reported any illegal drug use (<5%)

in the past 30 days, 83.9% reported marijuana use and 19.4% reported cocaine use.

Focus group discussion did not focus on substance abuse, however, one participant specifically raised

smoking and tobacco use as an issue in the community.

Disparities by Age, Gender and Race/Ethnicity

Secondary data are further assessed to determine health disparities for race/ethnic, age, or gender

groups. Table 19 identifies indicators in which a specific population subgroup differs significantly and

negatively from the overall population in Wilson County, with significance determined by non-

overlapping confidence intervals.

Table 19. Indicators with Significant Race/Ethnic, Age, or Gender Disparities

Health Indicator

Group(s) Disparately Affected*

Lung and Bronchus Cancer Incidence Rate

Male

All Cancer Incidence Rate

Male

Bladder Cancer Incidence Rate

Male

Children Living Below Poverty Level

Black or African American, Hispanic or Latino, Other,

Two or More Races

Families Living Below Poverty Level

Black or African American, Hispanic or Latino, Other,

Two or More Races

HIV, STD’s, and Hepatitis C

Persons with Substance Misuse Disorder

People Living Below Poverty Level

<6, 6-11, 12-17, Black or African American, Hispanic

or Latino, Other, Two or More Races

“Smoking and

tobacco use is still

an issue in

Eastern NC.”

-Focus Group Participant

People 65+ Living Below Poverty Level

Black or African American

Young Children Living Below Poverty Level

Black or African American, Hispanic or Latino, Other,

Two or More Races

Median Household Income

Black or African American, Hispanic or Latino, Two or

More Races

Per Capita Income

Black or African American, Hispanic or Latino, Other,

Two or More Races

People 25+ with a Bachelor's Degree or Higher

Black or African American, Hispanic or Latino, Other

People 25+ with a High School Degree or Higher

65+, Black or African American, Hispanic or Latino,

Other

Workers who Walk to Work

Ages 55-59

Workers who Drive Alone to Work

Native Hawaiian or Other Pacific Islander, White,

non-Hispanic

*See HealthENC.org for indicator values for population subgroups

From Table 19, race/ethnic population subgroups face the most disparity in economic related areas.

Hispanic or Latino, Black or African American, Other and Two or More Races groups appears as

disparately affected population in many of the indicators. Additionally, Cancer disparately impacts the

male population in Wilson County.

The list of indicators with significant disparities should be interpreted with caution. Indicators beyond

those displayed in Table 19 may also negatively impact a specific subgroup; however, not all data

sources provide subpopulation data, so it is not possible to draw conclusions about every indicator used

in the secondary data analysis.

Geographic Disparities

Geographic disparities are identified using the SocioNeeds Index®. Zip code 27893, with an index value

of 91.4, has the highest socioeconomic need within Wilson County, potentially indicating poorer health

outcomes for its residents. See the SocioNeeds Index® in the Demographics section for more details,

including a map of Wilson County zip codes and index values.

Conclusion

The Community Health Needs Assessment represents a great collaboration of work between Healthcare

Foundation of Wilson, Wilson County Health Department, Wilson Medical Center, along with Health

ENC, Conduent Healthy Communities Institute, and many of our Wilson County community partners.

Through a comprehensive process of gathering survey data from our county residents, three community

focus groups, a County Healthcare Summit and a comprehensive set of secondary data indicators

measuring the health and quality of life needs for Wilson County the following health priorities have

been selected as the focus for the next three years.

 Obesity

 Fitness/Nutrition

 Mental Health – including Alcohol and Substance Misuse

Each of the three primary organizations in Wilson County will outline how it plans to address these

health needs in its implementation plan.

We hope to incorporate any feedback on this report into the next CHNA process. Please send your

feedback and comments to:

 Healthcare Foundation of Wilson - info@healthcarefoundationofwilson.org

 Wilson County Health Department – jwilliams@wilson-co.com

 Wilson Medical Center - wilsonmedicalcenter@wilmed.org

We would like to express our thanks to all of the community partners and citizens whose efforts made

this document possible.

Appendix A. Impact since Prior CHNA

Significant Health

Need Identified in

Preceding CHNA

Planned Activities to

Address Health Needs

Identified in Preceding

Implementation Strategy

Was Activity

Implemented

(Yes/No)

Results, Impact & Data Sources

Obesity

Implement Eat Smart,

Move More Campaign

throughout Wilson

County. This was

implemented by Wilson

County DSS, with

assistance from Wilson

County Health

Department and funding

by Healthcare Foundation

of Wilson.

Yes

A three- year grant was provided to implement Eat

Smart Move More, an evidence-based program that

focuses on individual health behaviors to reduce

obesity. The initial focus was to work with

individuals, families, and the community at large to

reduce the consumption of sugar-sweetened

beverages. In 2017, 35 water bottle refilling stations

were installed in key locations, including schools,

businesses, local non-profits and faith-based

organizations. In addition to the water bottle

refilling stations, 2,242 Eat Smart Move More water

bottles were issued to promote drinking more water

instead of sugary sweetened beverages. The second

phase of the project focuses on physical activity by

providing health education, gym memberships and

in 2018 the focus of the program is on eating

healthier, and preparing healthier meals. 71% of

participants reported making healthier food choices

and 72% meeting walking challenges.

Healthy Food Choices for

Life – Implemented by

Wilson Hope Station and

funded by Healthcare

Foundation of Wilson.

Yes

The was a two-year program whereby

individuals/families who agreed to track their health

measures and attend sessions to learn how to eat

and cook healthier received additional and healthy

food. The clients were tracked showing weight loss

and a decrease in some medication needs

(increased blood pressures, improved blood sugars,

etc.) The Food Pantry also began a process of

recruiting healthier food to be available in the

pantry and designed food option selections based

on healthier options.

Diabetes Education

Programs - Wilson County

Health Department in

partnership with the

Wilson Family YMCA.

(Funding provided by

Healthcare Foundation of

Wilson.)

Yes

Wilson County Health Department and Wilson

Family YMCA implemented a minority diabetes

prevention program. Recently completing the third

class, participants lost 499.8 pounds and the

average A1c score change among the three classes

is -.5. A separate diabetes prevention class showed

weight loss of 93.5 pounds for the 16 participants

with an average A1c decrease of -.2.

Wilson County Schools

Obesity Education

Yes

Wilson Medical Center hosted numerous Lunch and

Learn events at Wilson County Schools with a focus

on Planning Your Wellness, Nutrition and Weight

Management/Healthy Eating on the Go, Diabetes

Education, and Heart Disease/Stroke/High Blood

Pressure. Additionally, Wilson Medical Center

participated in the 2017 WCS Opening Day Meeting

to provide education on healthy habits and

attended the 2018 Hunt High School Health Fair.

Wilson Medical Center –

Physician access for

obesity

Yes

Wilson Medical Center recruited 15 new physicians

to the community since 2016. Specialties included

Cardiology, Nephrology, Surgery, Pediatric

Dentistry, Orthopedics, Endocrinology, Radiology,

OB-GYN, Podiatry and Family Medicine

Mental Health

In-Patient Mental Health

Unit

Yes

Wilson Medical Center and Healthcare Foundation

of Wilson funded renovations in the hospital to

allow the opening on an in-patient mental health

unit. The unit was completed and opened in

February 2018.

Mental Health Screening -

Wilson County Health

Department

Yes

In partnership with Eastpoint, local mental health

management organization, a kiosk was placed in the

lobby of the Wilson County Health Department.

This provides a screening opportunity to identify

and refer patients confidentially for mental health

needs.

Wilson Medical Center –

Physician access for

mental health

Yes

Wilson Medical Center recruited 15 new physicians

to the community since 2016. Specialties included

Cardiology, Nephrology, Surgery, Pediatric

Dentistry, Orthopedics, Endocrinology, Radiology,

OB-GYN, Podiatry and Family Medicine

Substance Use

Wilson County Substance

Prevention RC3 Center

Yes

Healthcare Foundation of Wilson funded a grant to

Wilson County Substance Prevention to establish an

Alcohol and Substance Recovery Center whereby

individuals would have a place to reach out for

assistance when recovering from substance issues.

The center provides educational assistance, career

assistance, and referral options when needed.

NARCAN

Yes

The City of Wilson Police Department and the

Wilson County Sheriff’s Department maintain

Narcan in all vehicles in order to assist with any

overdose situation. The grant for the Narcan was

provided by Healthcare Foundation of Wilson.

Hope Alliance

Yes

Healthcare Foundation of Wilson funded a grant to

the Hope Alliance to connect opioid and heroin

addicts to vital resources. Funding specifically

supports the coordinated assistance of substance

users who seek help through the police department.

Wilson County Health

Department in

collaboration with the

Wilson County Police

Department and Wilson

County Sheriff’s

Department

Yes

Implemented a Syringe Services program and

partnered with OIC for a mobile exchange. Forty-

four participants and referred 20 individuals for

detox/rehabilitation services. The program began in

October 2017 and continues to be provided.

Wilson Medical Center –

Physician access for

mental health &

substance abuse

Yes

Wilson Medical Center recruited 15 new physicians

to the community since 2016. Specialties included

Cardiology, Nephrology, Surgery, Pediatric

Dentistry, Orthopedics, Endocrinology, Radiology,

OB-GYN, Podiatry and Family Medicine

Adolescent Pregnancy

and STDs

Long Acting Reversible

Contraceptives

Yes

Healthcare Foundation of Wilson funded a grant to

the Wilson County Health Department for Long

Acting Reversible Contraceptives. The Health

Department has provided 25 Nexplanons to

uninsured woman between the ages of 15 and 26

during the 2017-2018 fiscal year and we plan to

provide the same number this fiscal year and next

fiscal year.

Wilson Area School Health

Clinic

Yes

The Wilson County Health Department, along with

assistance from Wilson County Department of Social

Services, and funding from Healthcare Foundation

of Wilson, established a school health clinic in a

middle school, with plans to expand to a high

school. The clinic addresses all types of issues and

concerns, not limited to adolescent pregnancy and

STD. The clinic is staffed with a Nurse Practitioner.

Photo credit: A. Walker

Appendix B. Secondary Data Scoring

Overview

Data scoring consists of three stages, which are summarized in Figure 46:

Comparison Score

For each indicator, Wilson County is assigned up to 7 comparison scores based on its comparison to

other communities, whether health targets have been met, and the trend of the indicator value over

time. Comparison scores range from 0-3, where 0 indicates the best outcome and 3 indicates the worst

outcome (Figure 47).

Indicator Score

Indicator scores are calculated as a weighted average of comparison scores. Indicator scores range from

0-3, where 0 indicates the best outcome and 3 indicates the worst outcome (Figure 47).

Topic Score

Indicators are then categorized into topic areas. Topic scores are calculated by averaging all relevant

indicator scores, with indicators equally weighted. Topic scores range from 0-3, where 0 indicates the

best outcome and 3 indicates the worst outcome (Figure 47). Indicators may be categorized into more

than one topic area.

Compariso

n Score

•Quantitatively

score all

possible

comparisons

Indicator

Score

•Summarize

comparison

scores for

each indicator

Topic

Score

•Summarize

indicator

scores by topic

area

Figure 46. Secondary Data Scoring

Overview

Figure 47. Score Range

Comparison Scores

Up to 7 comparison scores were used to assess the status of

Wilson County. The possible comparisons are shown in Figure

and include a comparison of Wilson County to North Carolina

counties, all U.S. counties, the North Carolina state value, the

U.S. value, Healthy People 2020 targets, Healthy North Carolina

2020 targets, and the trend over time. Availability of each type

of comparison varies by indicator and is dependent upon the

data source, comparability with data collected for other

communities, and changes in methodology over time. The

determination of comparison scores for each type of

comparison is discussed in more detail below.

Comparison to a Distribution of North Carolina Counties and U.S. Counties

For ease of interpretation and analysis, indicator data on HealthENC.org is

visually represented as a green-yellow-red gauge showing how Wilson County is

faring against a distribution of counties in North Carolina or the U.S. (Figure 49).

A distribution is created by taking all county values within the state or nation,

ordering them from low to high, and dividing them into four equally sized groups

based on their order (Figure 50).The comparison score is determined by how Wilson County falls within

these four groups or quartiles.

Figure 50. Distribution of County Values

Comparison to North Carolina Value and U.S. Value

As shown in Figure 51, the diamond represents how Wilson County

compares to the North Carolina state value and the national value. When

comparing to a single value, the comparison score is determined by how

much better or worse the county value is relative to the comparison value.

Comparison to Healthy People 2020 and Healthy North Carolina 2020 Targets

As shown in Figure 52, the circle represents how Wilson County compares to a target value. Two target

values are taken into consideration for this analysis: Healthy People 2020 and Healthy North Carolina

Figure 49. Compare to

Distribution Indicator

Gauge

Figure 51. Comparison to

Single Value

Figure 48. Comparisons used in Secondary Data

Scoring

2020. Healthy People 2020

goals are national objectives for improving the

health of the nation set by the Department of Health and Human Services’

(DHHS) Healthy People Initiative. Healthy North Carolina 2020

objectives

provide a common set of health indicators that the state can work to improve.

The North Carolina Institute of Medicine, in collaboration with the Governor’s

Task Force for Healthy Carolinians; the Division of Public Health, North

Carolina Department of Health and Human Services (NC DHHS); the Office of

Healthy Carolinians and Health Education, NC DHHS; and the State Center for Health Statistics, NC DHHS,

helped lead the development of the Healthy NC 2020 objectives. When comparing to a target, the

comparison score is determined by whether the target is met or unmet, and the percent difference

between the indicator value and the target value.

Trend Over Time

As shown in Figure 53, the square represents the measured trend. The Mann-Kendall statistical test for

trend is used to assess whether the value for Wilson County is increasing or decreasing over time and

whether the trend is statistically significant. The trend comparison uses the four most recent

comparable values for the county, and statistical significance is determined at the 90% confidence level.

For each indicator with values available for four time periods, a comparison score is determined by the

trend’s direction and its statistical significance.

Figure 53. Trend Over Time

Missing Values

Indicator scores are calculated using the comparison scores, availability of which depends on the data

source. If an indicator does not have data for a specific comparison type that is included for indicator

score calculations, the missing comparison is substituted with a neutral score. When information is

unknown due to lack of comparable data, the neutral value assumes that the missing comparison score

is neither good nor bad and does not impact the indicator’s weighted average.

Indicator Scoring

Indicator scores are calculated as a weighted average of all included comparison scores. If none of the

included comparison types are possible for an indicator, no score is calculated, and the indicator is

excluded from the data scoring results.

Topic Scoring

Indicator scores are averaged by topic area to calculate topic scores. Each indicator may be included in

up to three topic areas if appropriate. Resulting scores range from 0-3, where a higher score indicates a

greater level of need as evidenced by the data. A topic score is only calculated if it includes at least three

indicators.

For more information on Healthy People 2020, see https://www.healthypeople.gov/

For more Information on Healthy North Carolina 2020, see: https://publichealth.nc.gov/hnc2020/

Figure 52. Comparison to

Target Value

Age, Gender and Race/Ethnicity Disparities

When a given indicator has data available for population subgroups – such as age, gender and

race/ethnicity – and values for these subgroups include confidence intervals, we are able to determine if

there is a significant difference between the subgroup’s value and the overall value. A significant

difference is defined as two values with non-overlapping confidence intervals. Confidence intervals are

not available for all indicators. In these cases, disparities cannot be determined because there is not

enough data to conclude whether two values are significantly different from each other.

Photo Credit: Brian Strickland

Topic Scoring Table

Table 20 shows the Topic Scores for Wilson County, with higher scores indicating a higher need.

Table 20. Topic Scores for Wilson County

Health and Quality of Life Topics

Score

Maternal, Fetal & Infant Health

2.25

Education

1.95

Wellness & Lifestyle

1.95

Heart Disease & Stroke

1.94

Public Safety

1.93

Diabetes

1.92

Men's Health

1.90

Immunizations & Infectious Diseases

1.84

Economy

1.84

Respiratory Diseases

1.77

Access to Health Services

1.75

Mortality Data

1.74

Other Chronic Diseases

1.73

Social Environment

1.71

Older Adults & Aging

1.68

Transportation

1.67

County Health Rankings

1.61

Women's Health

1.58

Environmental & Occupational Health

1.58

Mental Health & Mental Disorders

1.57

Exercise, Nutrition, Weight, & Obesity

1.54

Alcohol & Substance Misuse

1.52

Cancer

1.50

Environment

1.36

Children's Health

1.34

Prevention & Safety

1.22

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

Indicator Scoring Table

Table 21 (spanning multiple pages) presents the indicator data used in the quantitative data analysis. Indicators are grouped into topic areas and sorted by

indicator score, with higher scores indicating a higher need. Wilson County values are displayed alongside various comparison values and the period of

measurement. Additional data can be found on HealthENC.org.

Table 21. Indicator Scores by Topic Area

SCORE

ACCESS TO HEALTH SERVICES

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.15

Preventable Hospital Stays: Medicare

Population

2014

discharges/ 1,000 Medicare

enrollees

64.9

49.0

49.9

2.00

Primary Care Provider Rate

2015

providers/ 100,000

population

45.3

70.6

75.5

1.95

Mental Health Provider Rate

2017

providers/ 100,000

population

124.9

215.5

214.3

1.93

Adults with Health Insurance

2016

percent

83.8

84.9

88.0

100.0

1.85

Dentist Rate

2016

dentists/ 100,000

population

36.7

54.7

67.4

1.63

Persons with Health Insurance

2016

percent

86.4

87.8

100.0

92.0

1.58

Clinical Care Ranking

2018

ranking

1.40

Non-Physician Primary Care Provider

Rate

2017

providers/ 100,000

population

83.3

102.5

81.2

1.23

Children with Health Insurance

2016

percent

97.2

95.5

100.0

SCORE

CANCER

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.55

Age-Adjusted Death Rate due to

Prostate Cancer

2010-2014

deaths/ 100,000 males

27.6

21.6

20.1

21.8

2.40

Liver and Bile Duct Cancer Incidence

Rate

2010-2014

cases/ 100,000 population

9.1

7.7

7.8

2.30

Age-Adjusted Death Rate due to

Colorectal Cancer

2010-2014

deaths/ 100,000 population

17.5

14.1

14.8

14.5

10.1

2.28

Cervical Cancer Incidence Rate

2010-2014

cases/ 100,000 females

8.7

7.2

7.5

7.3

2.25

Age-Adjusted Death Rate due to Breast

Cancer

2010-2014

deaths/ 100,000 females

28.8

21.6

21.2

20.7

2.25

Age-Adjusted Death Rate due to Cancer

2010-2014

deaths/ 100,000 population

196.0

172.0

166.1

161.4

2.10

Oral Cavity and Pharynx Cancer

Incidence Rate

2010-2014

cases/ 100,000 population

13.6

12.2

11.5

2.00

Age-Adjusted Death Rate due to Lung

Cancer

2010-2014

deaths/ 100,000 population

54.6

50.7

44.7

45.5

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

CANCER

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.70

Lung and Bronchus Cancer Incidence

Rate

2010-2014

cases/ 100,000 population

71.7

70.0

61.2

Male

1.55

Breast Cancer Incidence Rate

2010-2014

cases/ 100,000 females

127.9

129.4

123.5

1.45

Pancreatic Cancer Incidence Rate

2010-2014

cases/ 100,000 population

12.3

12.0

12.5

1.25

All Cancer Incidence Rate

2010-2014

cases/ 100,000 population

443.8

457.0

443.6

Male

1.10

Prostate Cancer Incidence Rate

2010-2014

cases/ 100,000 males

109.3

125.0

114.8

0.98

Childhood Cancer Incidence Rate

2009-2013

cases/ 100,000 population

0-19

15.4

16.3

17.4

0.95

Mammography Screening: Medicare

Population

2014

percent

68.7

67.9

63.1

0.80

Age-Adjusted Death Rate due to

Pancreatic Cancer

2010-2014

deaths/ 100,000 population

9.9

10.8

10.9

0.70

Ovarian Cancer Incidence Rate

2010-2014

cases/ 100,000 females

8.5

10.9

11.4

0.65

Cancer: Medicare Population

2015

percent

6.9

7.7

7.8

0.50

Bladder Cancer Incidence Rate

2010-2014

cases/ 100,000 population

14.9

20.1

20.5

Male

0.15

Colorectal Cancer Incidence Rate

2010-2014

cases/ 100,000 population

33.2

37.7

39.8

39.9

SCORE

CHILDREN'S HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.10

Child Food Insecurity Rate

2016

percent

26.8

20.9

17.9

1.23

Children with Health Insurance

2016

percent

97.2

95.5

100.0

1.05

Children with Low Access to a Grocery

Store

2015

percent

1.0

0.98

Childhood Cancer Incidence Rate

2009-2013

cases/ 100,000 population

0-19

15.4

16.3

17.4

SCORE

COUNTY HEALTH RANKINGS

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.73

Morbidity Ranking

2018

ranking

1.73

Social and Economic Factors Ranking

2018

ranking

1.58

Clinical Care Ranking

2018

ranking

1.58

Health Behaviors Ranking

2018

ranking

1.58

Mortality Ranking

2018

ranking

1.43

Physical Environment Ranking

2018

ranking

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

DIABETES

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.70

Diabetes: Medicare Population

2015

percent

35.0

28.4

26.5

2.25

Adults 20+ with Diabetes

2014

percent

13.1

11.1

10.0

1.93

Age-Adjusted Death Rate due to

Diabetes

2012-2016

deaths/ 100,000 population

26.8

23.0

21.1

0.80

Diabetic Monitoring: Medicare

Population

2014

percent

90.5

88.8

85.2

SCORE

DISABILITIES

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.70

Households with Supplemental Security

Income

2012-2016

percent

10.1

5.0

5.4

1.88

Persons with Disability Living in Poverty

(5-year)

2012-2016

percent

31.8

29.0

27.6

SCORE

ECONOMY

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.70

Households with Supplemental Security

Income

2012-2016

percent

10.1

5.0

5.4

2.50

Children Living Below Poverty Level

2012-2016

percent

39.3

23.9

21.2

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

2.35

Students Eligible for the Free Lunch

Program

2015-2016

percent

74.1

52.6

42.6

2.30

Families Living Below Poverty Level

2012-2016

percent

16.8

12.4

11.0

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

2.30

Food Insecurity Rate

2016

percent

20.8

15.4

12.9

2.30

People Living Below Poverty Level

2012-2016

percent

22.5

16.8

15.1

12.5

<6, 6-11, 12-

17, Black or

African

American,

Hispanic or

Latino, Other,

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

Two or More

Races

2.25

People Living 200% Above Poverty Level

2012-2016

percent

55.3

62.3

66.4

2.20

People 65+ Living Below Poverty Level

2012-2016

percent

11.9

9.7

9.3

Black or

African

American

2.15

Severe Housing Problems

2010-2014

percent

19.3

16.6

18.8

2.10

Child Food Insecurity Rate

2016

percent

26.8

20.9

17.9

2.10

Total Employment Change

2014-2015

percent

1.2

3.1

2.5

2.10

Unemployed Workers in Civilian Labor

Force

April 2018

percent

6.2

3.7

2.10

Young Children Living Below Poverty

Level

2012-2016

percent

42.1

27.3

23.6

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

1.90

Homeownership

2012-2016

percent

53.6

55.5

55.9

1.88

Persons with Disability Living in Poverty

(5-year)

2012-2016

percent

31.8

29.0

27.6

1.80

Median Household Income

2012-2016

dollars

40260

48256

55322

Black or

African

American,

Hispanic or

Latino, Two or

More Races

1.80

Population 16+ in Civilian Labor Force

2012-2016

percent

59.2

61.5

63.1

1.80

Renters Spending 30% or More of

Household Income on Rent

2012-2016

percent

49.3

49.4

47.3

36.1

1.78

Median Monthly Owner Costs for

Households without a Mortgage

2012-2016

dollars

431

376

462

1.73

Median Housing Unit Value

2012-2016

dollars

117100

157100

184700

1.73

Social and Economic Factors Ranking

2018

ranking

1.65

Per Capita Income

2012-2016

dollars

22519

26779

29829

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

1.60

Female Population 16+ in Civilian Labor

Force

2012-2016

percent

55.4

57.4

58.3

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

ECONOMY

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.05

Low-Income and Low Access to a

Grocery Store

2015

percent

1.1

0.98

Mortgaged Owners Median Monthly

Household Costs

2012-2016

dollars

1173

1243

1491

0.95

SNAP Certified Stores

2016

stores/ 1,000 population

1.3

0.83

Median Household Gross Rent

2012-2016

dollars

711

816

949

0.65

Households with Cash Public Assistance

Income

2012-2016

percent

1.6

1.9

2.7

SCORE

EDUCATION

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.35

High School Graduation

2016-2017

percent

75.9

86.5

87.0

94.6

2.05

4th Grade Students Proficient in Reading

2016-2017

percent

47.3

57.7

2.05

8th Grade Students Proficient in Math

2016-2017

percent

27.8

45.8

2.05

8th Grade Students Proficient in Reading

2016-2017

percent

38.2

53.7

2.05

Student-to-Teacher Ratio

2015-2016

students/ teacher

16.5

15.6

17.7

1.85

People 25+ with a Bachelor's Degree or

Higher

2012-2016

percent

18.6

29.0

30.3

Black or

African

American,

Hispanic or

Latino, Other

1.65

People 25+ with a High School Degree or

Higher

2012-2016

percent

80.2

86.3

87.0

65+, Black or

African

American,

Hispanic or

Latino, Other

1.55

4th Grade Students Proficient in Math

2016-2017

percent

54.1

58.6

SCORE

ENVIRONMENT

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.15

Severe Housing Problems

2010-2014

percent

19.3

16.6

18.8

1.85

Food Environment Index

2018

6.7

6.4

7.7

1.65

Access to Exercise Opportunities

2018

percent

71.1

76.1

83.1

1.55

Fast Food Restaurant Density

2014

restaurants/ 1,000

population

0.7

1.50

Liquor Store Density

2015

stores/ 100,000 population

8.6

5.8

10.5

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

ENVIRONMENT

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.43

Physical Environment Ranking

2018

ranking

1.40

Houses Built Prior to 1950

2012-2016

percent

12.2

9.1

18.2

1.40

Recognized Carcinogens Released into

Air

2016

pounds

489

1.35

Farmers Market Density

2016

markets/ 1,000 population

0.04

1.35

Recreation and Fitness Facilities

2014

facilities/ 1,000 population

0.06

1.30

Grocery Store Density

2014

stores/ 1,000 population

0.2

1.28

Drinking Water Violations

FY 2013-14

percent

1.9

4.0

5.0

1.20

PBT Released

2016

pounds

498

1.05

Children with Low Access to a Grocery

Store

2015

percent

1.0

1.05

Households with No Car and Low Access

to a Grocery Store

2015

percent

1.6

1.05

Low-Income and Low Access to a

Grocery Store

2015

percent

1.1

1.05

People 65+ with Low Access to a Grocery

Store

2015

percent

0.5

0.95

SNAP Certified Stores

2016

stores/ 1,000 population

1.3

SCORE

ENVIRONMENTAL & OCCUPATIONAL

HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.65

Age-Adjusted Hospitalization Rate due

to Asthma

2014

hospitalizations/ 10,000

population

113.0

90.9

1.65

Asthma: Medicare Population

2015

percent

8.0

8.4

8.2

1.43

Physical Environment Ranking

2018

ranking

SCORE

EXERCISE, NUTRITION, & WEIGHT

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.30

Food Insecurity Rate

2016

percent

20.8

15.4

12.9

2.20

Workers who Walk to Work

2012-2016

percent

1.6

1.8

2.8

3.1

55-59

2.10

Child Food Insecurity Rate

2016

percent

26.8

20.9

17.9

2.05

Adults 20+ who are Obese

2014

percent

33.0

29.6

28.0

30.5

1.85

Food Environment Index

2018

6.7

6.4

7.7

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

EXERCISE, NUTRITION, & WEIGHT

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.70

Adults 20+ who are Sedentary

2014

percent

27.1

24.3

23.0

32.6

1.65

Access to Exercise Opportunities

2018

percent

71.1

76.1

83.1

1.58

Health Behaviors Ranking

2018

ranking

1.55

Fast Food Restaurant Density

2014

restaurants/ 1,000

population

0.7

1.35

Farmers Market Density

2016

markets/ 1,000 population

0.04

1.35

Recreation and Fitness Facilities

2014

facilities/ 1,000 population

0.06

1.30

Grocery Store Density

2014

stores/ 1,000 population

0.2

1.05

Children with Low Access to a Grocery

Store

2015

percent

1.0

1.05

Households with No Car and Low Access

to a Grocery Store

2015

percent

1.6

1.05

Low-Income and Low Access to a

Grocery Store

2015

percent

1.1

1.05

People 65+ with Low Access to a Grocery

Store

2015

percent

0.5

0.95

SNAP Certified Stores

2016

stores/ 1,000 population

1.3

SCORE

FAMILY PLANNING

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.50

Teen Pregnancy Rate

2012-2016

pregnancies/ 1,000 females

aged 15-17

23.9

15.7

36.2

SCORE

GOVERNMENT & POLITICS

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.65

Voter Turnout: Presidential Election

2016

percent

66.7

67.7

SCORE

HEART DISEASE & STROKE

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.50

Hyperlipidemia: Medicare Population

2015

percent

52.6

46.3

44.6

2.50

Hypertension: Medicare Population

2015

percent

64.4

58.0

55.0

2.35

Stroke: Medicare Population

2015

percent

4.5

3.9

4.0

2.00

Heart Failure: Medicare Population

2015

percent

14.7

12.5

13.5

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

HEART DISEASE & STROKE

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.93

Age-Adjusted Death Rate due to

Cerebrovascular Disease (Stroke)

2012-2016

deaths/ 100,000 population

45.7

43.1

36.9

34.8

1.45

Age-Adjusted Death Rate due to Heart

Disease

2012-2016

deaths/ 100,000 population

171.0

161.3

161.5

1.40

Ischemic Heart Disease: Medicare

Population

2015

percent

26.0

24.0

26.5

1.35

Atrial Fibrillation: Medicare Population

2015

percent

7.3

7.7

8.1

SCORE

IMMUNIZATIONS & INFECTIOUS

DISEASES

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.28

Gonorrhea Incidence Rate

2016

cases/ 100,000 population

282.9

194.4

145.8

2.23

Tuberculosis Incidence Rate

2014

cases/ 100,000 population

4.9

2.0

3.0

1.0

2.03

Age-Adjusted Death Rate due to HIV

2012-2016

deaths/ 100,000 population

4.4

2.2

2.0

3.3

1.85

AIDS Diagnosis Rate

2016

cases/ 100,000 population

11.7

7.0

1.78

Chlamydia Incidence Rate

2016

cases/ 100,000 population

573.1

572.4

497.3

1.73

Age-Adjusted Death Rate due to

Influenza and Pneumonia

2012-2016

deaths/ 100,000 population

18.9

17.8

14.8

13.5

1.45

Syphilis Incidence Rate

2016

cases/ 100,000 population

6.1

10.8

8.7

1.40

HIV Diagnosis Rate

2014-2016

cases/ 100,000 population

14.7

16.1

22.2

SCORE

MATERNAL, FETAL & INFANT HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.63

Babies with Low Birth Weight

2012-2016

percent

11.5

9.0

8.1

7.8

2.43

Babies with Very Low Birth Weight

2012-2016

percent

2.6

1.7

1.4

2.35

Infant Mortality Rate

2012-2016

deaths/ 1,000 live births

9.0

7.2

6.0

6.3

2.33

Preterm Births

2016

percent

12.8

10.4

9.8

9.4

1.50

Teen Pregnancy Rate

2012-2016

pregnancies/ 1,000 females

aged 15-17

23.9

15.7

36.2

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

MEN'S HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.55

Age-Adjusted Death Rate due to

Prostate Cancer

2010-2014

deaths/ 100,000 males

27.6

21.6

20.1

21.8

2.05

Life Expectancy for Males

2014

years

73.3

75.4

76.7

79.5

1.10

Prostate Cancer Incidence Rate

2010-2014

cases/ 100,000 males

109.3

125.0

114.8

SCORE

MENTAL HEALTH & MENTAL

DISORDERS

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.95

Mental Health Provider Rate

2017

providers/ 100,000

population

124.9

215.5

214.3

1.90

Alzheimer's Disease or Dementia:

Medicare Population

2015

percent

10.3

9.8

9.9

1.80

Poor Mental Health: Average Number of

Days

2016

days

4.2

3.9

3.8

2.8

1.50

Frequent Mental Distress

2016

percent

13.3

12.3

15.0

1.35

Depression: Medicare Population

2015

percent

15.4

17.5

16.7

1.28

Age-Adjusted Death Rate due to Suicide

2012-2016

deaths/ 100,000 population

11.0

12.9

13.0

10.2

8.3

1.23

Age-Adjusted Death Rate due to

Alzheimer's Disease

2012-2016

deaths/ 100,000 population

24.4

31.9

26.6

SCORE

MORTALITY DATA

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.58

Age-Adjusted Death Rate due to

Homicide

2012-2016

deaths/ 100,000 population

9.1

6.2

5.5

6.7

2.55

Age-Adjusted Death Rate due to

Prostate Cancer

2010-2014

deaths/ 100,000 males

27.6

21.6

20.1

21.8

2.35

Infant Mortality Rate

2012-2016

deaths/ 1,000 live births

9.0

7.2

6.0

6.3

2.30

Age-Adjusted Death Rate due to

Colorectal Cancer

2010-2014

deaths/ 100,000 population

17.5

14.1

14.8

14.5

10.1

2.30

Alcohol-Impaired Driving Deaths

2012-2016

percent

36.8

31.4

29.3

4.7

2.25

Age-Adjusted Death Rate due to Breast

Cancer

2010-2014

deaths/ 100,000 females

28.8

21.6

21.2

20.7

2.25

Age-Adjusted Death Rate due to Cancer

2010-2014

deaths/ 100,000 population

196.0

172.0

166.1

161.4

2.20

Premature Death

2014-2016

years/ 100,000 population

8535.2

7281.1

6658.1

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

MORTALITY DATA

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.10

Age-Adjusted Death Rate due to Motor

Vehicle Collisions

2012-2016

deaths/ 100,000 population

17.8

14.1

2.03

Age-Adjusted Death Rate due to HIV

2012-2016

deaths/ 100,000 population

4.4

2.2

2.0

3.3

2.00

Age-Adjusted Death Rate due to Lung

Cancer

2010-2014

deaths/ 100,000 population

54.6

50.7

44.7

45.5

1.93

Age-Adjusted Death Rate due to

Cerebrovascular Disease (Stroke)

2012-2016

deaths/ 100,000 population

45.7

43.1

36.9

34.8

1.93

Age-Adjusted Death Rate due to

Diabetes

2012-2016

deaths/ 100,000 population

26.8

23.0

21.1

1.73

Age-Adjusted Death Rate due to

Influenza and Pneumonia

2012-2016

deaths/ 100,000 population

18.9

17.8

14.8

13.5

1.58

Mortality Ranking

2018

ranking

1.45

Age-Adjusted Death Rate due to Heart

Disease

2012-2016

deaths/ 100,000 population

171.0

161.3

161.5

1.28

Age-Adjusted Death Rate due to Suicide

2012-2016

deaths/ 100,000 population

11.0

12.9

13.0

10.2

8.3

1.23

Age-Adjusted Death Rate due to

Alzheimer's Disease

2012-2016

deaths/ 100,000 population

24.4

31.9

26.6

0.90

Death Rate due to Drug Poisoning

2014-2016

deaths/ 100,000 population

12.3

16.2

16.9

0.85

Age-Adjusted Death Rate due to

Unintentional Poisonings

2014-2016

deaths/ 100,000 population

12.6

15.1

15.4

9.9

0.80

Age-Adjusted Death Rate due to

Pancreatic Cancer

2010-2014

deaths/ 100,000 population

9.9

10.8

10.9

0.75

Age-Adjusted Death Rate due to

Firearms

2014-2016

deaths/ 100,000 population

11.0

12.7

11.0

9.3

0.58

Age-Adjusted Death Rate due to

Unintentional Injuries

2012-2016

deaths/ 100,000 population

28.3

31.9

41.4

36.4

SCORE

OLDER ADULTS & AGING

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.70

Chronic Kidney Disease: Medicare

Population

2015

percent

21.8

19.0

18.1

2.70

Diabetes: Medicare Population

2015

percent

35.0

28.4

26.5

2.50

Hyperlipidemia: Medicare Population

2015

percent

52.6

46.3

44.6

2.50

Hypertension: Medicare Population

2015

percent

64.4

58.0

55.0

2.35

Stroke: Medicare Population

2015

percent

4.5

3.9

4.0

2.20

People 65+ Living Below Poverty Level

2012-2016

percent

11.9

9.7

9.3

Black or

African

American

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

OLDER ADULTS & AGING

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.10

People 65+ Living Alone

2012-2016

percent

29.9

26.8

26.4

2.00

Heart Failure: Medicare Population

2015

percent

14.7

12.5

13.5

1.90

Alzheimer's Disease or Dementia:

Medicare Population

2015

percent

10.3

9.8

9.9

1.65

Asthma: Medicare Population

2015

percent

8.0

8.4

8.2

1.50

Rheumatoid Arthritis or Osteoarthritis:

Medicare Population

2015

percent

27.9

29.1

30.0

1.45

COPD: Medicare Population

2015

percent

11.9

11.2

1.40

Ischemic Heart Disease: Medicare

Population

2015

percent

26.0

24.0

26.5

1.35

Atrial Fibrillation: Medicare Population

2015

percent

7.3

7.7

8.1

1.35

Depression: Medicare Population

2015

percent

15.4

17.5

16.7

1.23

Age-Adjusted Death Rate due to

Alzheimer's Disease

2012-2016

deaths/ 100,000 population

24.4

31.9

26.6

1.05

People 65+ with Low Access to a Grocery

Store

2015

percent

0.5

1.00

Osteoporosis: Medicare Population

2015

percent

4.6

5.4

6.0

0.95

Mammography Screening: Medicare

Population

2014

percent

68.7

67.9

63.1

0.80

Diabetic Monitoring: Medicare

Population

2014

percent

90.5

88.8

85.2

0.65

Cancer: Medicare Population

2015

percent

6.9

7.7

7.8

SCORE

ORAL HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.10

Oral Cavity and Pharynx Cancer

Incidence Rate

2010-2014

cases/ 100,000 population

13.6

12.2

11.5

1.85

Dentist Rate

2016

dentists/ 100,000

population

36.7

54.7

67.4

SCORE

OTHER CHRONIC DISEASES

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.70

Chronic Kidney Disease: Medicare

Population

2015

percent

21.8

19.0

18.1

1.50

Rheumatoid Arthritis or Osteoarthritis:

Medicare Population

2015

percent

27.9

29.1

30.0

1.00

Osteoporosis: Medicare Population

2015

percent

4.6

5.4

6.0

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

PREVENTION & SAFETY

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.15

Severe Housing Problems

2010-2014

percent

19.3

16.6

18.8

2.10

Age-Adjusted Death Rate due to Motor

Vehicle Collisions

2012-2016

deaths/ 100,000 population

17.8

14.1

0.90

Death Rate due to Drug Poisoning

2014-2016

deaths/ 100,000 population

12.3

16.2

16.9

0.85

Age-Adjusted Death Rate due to

Unintentional Poisonings

2014-2016

deaths/ 100,000 population

12.6

15.1

15.4

9.9

0.75

Age-Adjusted Death Rate due to

Firearms

2014-2016

deaths/ 100,000 population

11.0

12.7

11.0

9.3

0.58

Age-Adjusted Death Rate due to

Unintentional Injuries

2012-2016

deaths/ 100,000 population

28.3

31.9

41.4

36.4

SCORE

PUBLIC SAFETY

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.58

Age-Adjusted Death Rate due to

Homicide

2012-2016

deaths/ 100,000 population

9.1

6.2

5.5

6.7

2.30

Alcohol-Impaired Driving Deaths

2012-2016

percent

36.8

31.4

29.3

4.7

2.10

Age-Adjusted Death Rate due to Motor

Vehicle Collisions

2012-2016

deaths/ 100,000 population

17.8

14.1

1.98

Violent Crime Rate

2016

crimes/ 100,000 population

398.9

374.9

386.3

1.85

Property Crime Rate

2016

crimes/ 100,000 population

3252.9

2779.7

0.75

Age-Adjusted Death Rate due to

Firearms

2014-2016

deaths/ 100,000 population

11.0

12.7

11.0

9.3

SCORE

RESPIRATORY DISEASES

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.23

Tuberculosis Incidence Rate

2014

cases/ 100,000 population

4.9

2.0

3.0

1.0

2.00

Age-Adjusted Death Rate due to Lung

Cancer

2010-2014

deaths/ 100,000 population

54.6

50.7

44.7

45.5

1.73

Age-Adjusted Death Rate due to

Influenza and Pneumonia

2012-2016

deaths/ 100,000 population

18.9

17.8

14.8

13.5

1.70

Lung and Bronchus Cancer Incidence

Rate

2010-2014

cases/ 100,000 population

71.7

70.0

61.2

Male

1.65

Age-Adjusted Hospitalization Rate due

to Asthma

2014

hospitalizations/ 10,000

population

113.0

90.9

1.65

Asthma: Medicare Population

2015

percent

8.0

8.4

8.2

1.45

COPD: Medicare Population

2015

percent

11.9

11.2

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

SOCIAL ENVIRONMENT

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.50

Children Living Below Poverty Level

2012-2016

percent

39.3

23.9

21.2

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

2.50

Single-Parent Households

2012-2016

percent

46.3

35.7

33.6

2.30

People Living Below Poverty Level

2012-2016

percent

22.5

16.8

15.1

12.5

<6, 6-11, 12-

17, Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

2.10

People 65+ Living Alone

2012-2016

percent

29.9

26.8

26.4

2.10

Total Employment Change

2014-2015

percent

1.2

3.1

2.5

2.10

Young Children Living Below Poverty

Level

2012-2016

percent

42.1

27.3

23.6

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

1.90

Homeownership

2012-2016

percent

53.6

55.5

55.9

1.85

People 25+ with a Bachelor's Degree or

Higher

2012-2016

percent

18.6

29.0

30.3

Black or

African

American,

Hispanic or

Latino, Other

1.80

Median Household Income

2012-2016

dollars

40260

48256

55322

Black or

African

American,

Hispanic or

Latino, Two or

More Races

1.80

Population 16+ in Civilian Labor Force

2012-2016

percent

59.2

61.5

63.1

1.78

Median Monthly Owner Costs for

Households without a Mortgage

2012-2016

dollars

431

376

462

1.73

Median Housing Unit Value

2012-2016

dollars

117100

157100

184700

1.73

Social and Economic Factors Ranking

2018

ranking

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

SOCIAL ENVIRONMENT

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.65

People 25+ with a High School Degree or

Higher

2012-2016

percent

80.2

86.3

87.0

65+, Black or

African

American,

Hispanic or

Latino, Other

1.65

Per Capita Income

2012-2016

dollars

22519

26779

29829

Black or

African

American,

Hispanic or

Latino, Other,

Two or More

Races

1.65

Voter Turnout: Presidential Election

2016

percent

66.7

67.7

1.63

Persons with Health Insurance

2016

percent

86.4

87.8

100.0

92.0

1.60

Female Population 16+ in Civilian Labor

Force

2012-2016

percent

55.4

57.4

58.3

1.10

Linguistic Isolation

2012-2016

percent

2.1

2.5

4.5

1.05

Mean Travel Time to Work

2012-2016

minutes

20.5

24.1

26.1

1.05

Social Associations

2015

membership associations/

10,000 population

11.8

11.5

9.3

0.98

Mortgaged Owners Median Monthly

Household Costs

2012-2016

dollars

1173

1243

1491

0.83

Median Household Gross Rent

2012-2016

dollars

711

816

949

SCORE

SUBSTANCE ABUSE

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.40

Adults who Smoke

2016

percent

19.8

17.9

17.0

12.0

13.0

2.30

Alcohol-Impaired Driving Deaths

2012-2016

percent

36.8

31.4

29.3

4.7

1.58

Health Behaviors Ranking

2018

ranking

1.50

Liquor Store Density

2015

stores/ 100,000 population

8.6

5.8

10.5

0.90

Death Rate due to Drug Poisoning

2014-2016

deaths/ 100,000 population

12.3

16.2

16.9

0.45

Adults who Drink Excessively

2016

percent

14.8

16.7

18.0

25.4

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

TEEN & ADOLESCENT HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

1.50

Teen Pregnancy Rate

2012-2016

pregnancies/ 1,000 females

aged 15-17

23.9

15.7

36.2

SCORE

TRANSPORTATION

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.70

Households without a Vehicle

2012-2016

percent

10.0

6.3

9.0

2.20

Workers who Walk to Work

2012-2016

percent

1.6

1.8

2.8

3.1

55-59

2.00

Workers Commuting by Public

Transportation

2012-2016

percent

0.2

1.1

5.1

5.5

1.65

Workers who Drive Alone to Work

2012-2016

percent

82.0

81.1

76.4

Native

Hawaiian or

Other Pacific

Islander,

White, non-

Hispanic

1.05

Households with No Car and Low Access

to a Grocery Store

2015

percent

1.6

1.05

Mean Travel Time to Work

2012-2016

minutes

20.5

24.1

26.1

1.05

Solo Drivers with a Long Commute

2012-2016

percent

21.3

31.3

34.7

SCORE

WELLNESS & LIFESTYLE

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.55

Self-Reported General Health

Assessment: Poor or Fair

2016

percent

20.9

17.6

16.0

9.9

2.25

Poor Physical Health: Average Number

of Days

2016

days

4.1

3.6

3.7

2.05

Life Expectancy for Males

2014

years

73.3

75.4

76.7

79.5

1.75

Life Expectancy for Females

2014

years

79.4

80.2

81.5

79.5

1.73

Morbidity Ranking

2018

ranking

1.65

Frequent Physical Distress

2016

percent

12.9

11.3

15.0

1.65

Insufficient Sleep

2016

percent

35.1

33.8

38.0

High Disparity includes differences in which subgroups do significantly better or significantly worse than the overall county value. Subgroup values are given in parentheses.

SCORE

WOMEN'S HEALTH

MEASUREMENT

PERIOD

UNITS

WILSON

COUNTY

NORTH

CAROLINA

U.S.

HP2020

HEALTHY NC 2020

HIGH

DISPARITY*

SOURCE

2.28

Cervical Cancer Incidence Rate

2010-2014

cases/ 100,000 females

8.7

7.2

7.5

7.3

2.25

Age-Adjusted Death Rate due to Breast

Cancer

2010-2014

deaths/ 100,000 females

28.8

21.6

21.2

20.7

1.75

Life Expectancy for Females

2014

years

79.4

80.2

81.5

79.5

1.55

Breast Cancer Incidence Rate

2010-2014

cases/ 100,000 females

127.9

129.4

123.5

0.95

Mammography Screening: Medicare

Population

2014

percent

68.7

67.9

63.1

0.70

Ovarian Cancer Incidence Rate

2010-2014

cases/ 100,000 females

8.5

10.9

11.4

Sources

Table 22 displays the list of sources used in secondary data scoring. Number keys are referenced alongside each indicator in the Indicator Scoring Table.

Table 22. Indicator Sources and Corresponding Number Keys

Number Key

Source

American Community Survey

Centers for Disease Control and Prevention

Centers for Medicare & Medicaid Services

County Health Rankings

Feeding America

Institute for Health Metrics and Evaluation

National Cancer Institute

National Center for Education Statistics

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

North Carolina Department of Health and Human Services

North Carolina Department of Health and Human Services, Communicable Disease Branch

North Carolina Department of Justice

North Carolina Department of Public Instruction

North Carolina State Board of Elections

North Carolina State Center for Health Statistics

North Carolina State Center for Health Statistics, Vital Statistics

Small Area Health Insurance Estimates

The Dartmouth Atlas of Health Care

U.S. Bureau of Labor Statistics

U.S. Census - County Business Patterns

U.S. Department of Agriculture - Food Environment Atlas

U.S. Environmental Protection Agency

Appendix C. Primary Data

Primary data used in this assessment was collected through a community survey, focus groups, and a community health

summit. The survey instruments and focus group questions are provided in this Appendix:

 English Survey

 Spanish Survey

 Focus Group Questions

 Community Health Summit

Link to the community survey:

http://www.healthenc.org/content/sites/fhli/2018_Community_Survey/Wilson_County_Data_All_180810.pdf

Appendix D. Community Resources

Community Resource Guide Link:

https://www.unitedwayofwilson.org/sites/unitedwayofwilson.org/files/United%20Way%20Community%20Reso

urce%20Guide_4.192017.pdf

Crime Prevention/Law Enforcement/Victim Assistance

City of Wilson Police Wilson County Sheriff’s Department

(Several Satellite offices throughout city) (Several satellite offices throughout county)

120 Goldsboro Street, N 100 Green Street, E

Wilson, NC 27893 Wilson, NC 27893

252.399.2323 252.237.2118

NC Highway Patrol Wilson Crisis Center

1822 Goldsboro Street, SW P.O. Box 8026

Wilson, NC 27893 Wilson, NC 27893

252.243.6439 252.237.5156

Black Creek Police Department Stantonsburg Police Department

112 W. Center Street 114 E Commercial Ave

Black Creek, NC 27813 Stantonsburg, North Carolina 27883

252.243.6439 252.238.3534

Fire Safety/Rescue Services:

City of Wilson Fire Departments/Rescue Services

Station 1: 307 Hines Street W Wilson, NC 27893 252.399.2890

Station 2: 1807 Forest Hills Rd, W Wilson, NC 27893 252.399.2895

Station 3: 6111 Ward Blvd Wilson, NC 27893 252.399.2891

Station 4: 109 Forest Hills Rd, NW Wilson, NC 27893 252.399.2897

Station 5: 3530 Airport Blvd Wilson, NC 27896

County of Wilson - Volunteer Fire Departments

Bakertown VFD 6505 Webb Lake Road Elm City, NC 27822 252.291.2535

Black Creek VFD Center Street Black Creek, NC 27813 252.291.8373

Contentnea VFD 4146 NC Hwy 42 W Wilson, NC 27893

Crossroads VFD 102 Grove St Lucama, NC 27851

East Nash VFD 4117 US Hwy 264 Alt E Wilson, NC 27893

Rock Ridge VFD 6501 Rock Ridge School Rd Wilson, NC 27893

Sanoca VFD Hwy 222 Saratoga, NC 27873 252.238.2392

Silver Lake VFD 5207 Hornes Church Rd Wilson, NC 27893 252.237.2780

Sims VFD 6217 US 264 Alt W Sims, NC 27880 252.243.0680

Stantonsburg-Moyton VFD 105 N. Saratoga St. Stantonsburg, NC 27883

Physician Directory:

https://www.wilsonmedical.com/need-a-doctor/find-a-doctor/?

Wilson County Elected Officials

Mayor: Bruce Rose

Chief of Police: Thomas P. Hopkins

Sheriff: Calvin Woodard, Jr.

Wilson City Council Wilson County Commissioners

District 1 – A.P. Coleman District 1 – Leslie Atkinson, Vice Chair

District 2 – Michael Bell District 2 – Sherry Lucas

District 3 – William “Tom” Fyle District 3 – JoAnne Daniels

District 4 – James M. Johnson District 4 – Roger Lucas

District 5 – Donald Evans District 5 – Rob Boyette, Chair

District 6 – Logan Liles District 6 – Chris Hill

District 7 – Derrick Creech District 7 – Bill Blackman

Wilson County Board of Education

District 1 – Debora Powell

District 2 – Velma Barnes

District 3 – Dr. Christine Fitch, Chair

District 4 – Henry Mercer, Vice Chair

District 5 – Beverly Boyette

District 6 – Gary Farmer

District 7 – Rhyan Breen

United Way of Wilson

509 Nash Street

Wilson, NC 27893

252.237.3194

North Carolina 2-1-1 (NC 2-1-1) is a United Way and local partner-based system with two call centers and a dedicated

team of database coordinators that partner to collaboratively maintain a robust database of health and human services

resources available by dialing 2-1-1 or through on-line search at nc211.org. No matter where you live in NC, you can call

2-1-1 and a trained 2-1-1 agent will help you to find available human services resources in your community. United Way

of Wilson County has updated the contact for Wilson County resources.

List of Figures

Figure 1. Health ENC Online Data Platform ................................................................................................ 10

Figure 2. Education of Community Survey Respondents ............................................................................ 19

Figure 3. Employment Status of Community Survey Respondents ............................................................ 15

Figure 4. Health Care Coverage of Community Survey Respondents ......................................................... 16

Figure 5. Secondary Data Scoring ............................................................................................................... 16

Figure 6. Total Population (U.S. Census Bureau) ........................................................................................ 23

Figure 7. Population Density of Health ENC Counties (U.S. Census Bureau, 2010) .................................... 24

Figure 8. Population by Age (U.S. Census Bureau, 2016)............................................................................ 25

Figure 9. Population 18+ and 65+ (U.S. Census Bureau, 2016) ................................................................... 26

Figure 10. Birth Rate (North Carolina State Center for Health Statistics) ................................................... 27

Figure 11. Population by Race/Ethnicity (U.S. Census Bureau, 2016) ........................................................ 28

Figure 12. Population in Military / Armed Forces (American Community Survey) .................................... 29

Figure 13. Veteran Population (American Community Survey, 2012-2016) .............................................. 30

Figure 14. Median Household Income (American Community Survey, 2012-2016) .................................. 31

Figure 15. Median Household Income of Health ENC Counties (American Community Survey, 2012-2016)32

Figure 16. Median Household Income by Zip Code (American Community Survey, 2012-2016) .............. 33

Figure 17. People Living Below Poverty Level (American Community Survey, 2012-2016) ....................... 34

Figure 18. Children Living Below Poverty Level (American Community Survey, 2012-2016) ..................... 35

Figure 19. People 65+ Living Below Poverty Level (American Community Survey, 2012-2016) ................ 35

Figure 20. Persons with Disability Living in Poverty (American Community Survey, 2012-2016) .............. 36

Figure 21. Mortgaged Owners Median Monthly Household Costs, Health ENC Counties (American Community Survey

2012-2016) .................................................................................................................................................. 36

Figure 22. Severe Housing Problems (County Health Rankings, 2010-2014) ............................................. 37

Figure 23. Households with Children Receiving SNAP (American Community Survey, 2012-2016) .......... 37

Figure 24. SocioNeeds Index® (Conduent Healthy Communities Institute, 2018) ..................................... 39

Figure 25. People 25+ with a High School Degree or Higher and Bachelor’s Degree or Higher (American Community

Survey, 2012-2016) ..................................................................................................................................... 40

Figure 26. People 25+ with a High School Degree or Higher by Zip Code (American Community Survey, 2012-2016)

.................................................................................................................................................................... 41

Figure 27. High School Dropout Rate (North Carolina Department of Public Instruction) ......................... 42

Figure 28. High School Suspension Rate (North Carolina Department of Public Instruction) .................... 42

Figure 29. Mode of Commuting to Work (American Community Survey, 2012-2016) .............................. 44

Figure 30. Workers who Drive Alone to Work (American Community Survey, 2012-2016) ...................... 44

Figure 31. Violent Crime Rate (North Carolina Department of Justice) ..................................................... 46

Figure 32. Property Crime Rate (North Carolina Department of Justice) ................................................... 46

Figure 33. Juvenile Undisciplined Rate (North Carolina Department of Public Safety) .............................. 47

Figure 34. Juvenile Delinquent Rate (North Carolina Department of Public Safety) .................................. 47

Figure 35. Child Abuse Rate (Management Assistance for Child Welfare, Work First, and Food & Nutrition Services in

North Carolina & University of North Carolina at Chapel Hill Jordan Institute for Families) ..................... 48

Figure 36. Incarceration Rate (North Carolina Department of Public Safety) ............................................ 48

Figure 37. Persons with Health Insurance (Small Area Health Insurance Estimates, 2016) ....................... 49

Figure 38. Persons Only Receiving Health Insurance through Medicaid, Medicare or Military Healthcare (American

Community Survey, 2012-2016) ................................................................................................................. 49

Figure 39. Voting Age Population (American Community Survey, 2012-2016) .......................................... 50

Figure 40. Voter Turnout in the Last Presidential Election (North Carolina State Board of Elections, 2016)50

Figure 41. Top Quality of Life Issues, as Ranked by Survey Respondents .................................................. 52

Figure 42. Level of Agreement Among Wilson County Residents in Response to Nine Statements about their Community

.................................................................................................................................................................... 53

Figure 43. Services Needing the Most Improvement, as Ranked by Survey Respondents ........................ 53

Figure 44. Health Behaviors that Residents Need More Information About, As Ranked by Survey Respondents 54

Figure 45. Data Synthesis Results ............................................................................................................... 55

Figure 46. Secondary Data Scoring ............................................................................................................ 74

Figure 47. Score Range ................................................................................................................................ 74

Figure 48. Comparisons used in Secondary Data Scoring ........................................................................... 75

Figure 49. Compare to Distribution Indicator Gauge .................................................................................. 75

Figure 50. Distribution of County Values .................................................................................................... 75

Figure 51. Comparison to Single Value ....................................................................................................... 75

Figure 52. Comparison to Target Value ...................................................................................................... 76

Figure 53. Trend Over Time ........................................................................................................................ 76

100

List of Tables

Table 1. Significant Health Needs ........................................................................................................................................... 6

Table 2. Survey Respondents ................................................................................................................................................ 14

Table 3. List of Focus Group Discussions .............................................................................................................................. 18

Table 4. Health and Quality of Life Topic Areas .................................................................................................................... 20

Table 5. Population by Gender and Age (U.S. Census Bureau, 2016) ................................................................................... 26

Table 6. Named Tribes in North Carolina (American Community Survey, 2012-2016) ........................................................ 29

Table 7. SocioNeeds Index® (Conduent Healthy Communities Institute, 2018) ................................................................... 39

Table 8. Secondary Data Scoring Results by Topic Area ....................................................................................................... 52

Table 9. Focus Group Results by Topic Area ......................................................................................................................... 54

Table 10. Criteria for Identifying the Top Needs from each Data Source ............................................................................. 55

Table 11. Topic Areas Examined in this Report ..................................................................................................................... 56

Table 12. Description of Gauges and Icons used in Secondary Dara Scoring ....................................................................... 56

Table 13. Data Scoring Results for Maternal, Fetal & Infant Health ..................................................................................... 57

Table 14. Data Scoring Results for Education ....................................................................................................................... 59

Table 15. Data Scoring Results for Heart Disease & Stroke .................................................................................................. 60

Table 16. Data Scoring Results for Diabetes ......................................................................................................................... 62

Table 17. Data Scoring Results for Public Safety ................................................................................................................... 63

Table 18. Leading Causes of Mortality (2014-2016, CDC WONDER) .................................................................................... 65

Table 19. Indicators with Significant Race/Ethnic, Age, or Gender Disparities .................................................................... 68

Table 20. Topic Scores for Wilson County............................................................................................................................. 78

Table 21. Indicator Scores by Topic Area .............................................................................................................................. 79

Table 22. Indicator Sources and Corresponding Number Keys ............................................................................................ 95

101

Addendum to Appendix C - Surveys

English Survey

Eastern North Carolina Community Health Survey 2018

Welcome to the Community Health Survey for Eastern North Carolina!

We are conducting a Community Health Assessment for your county. This assessment is being

undertaken by a partnership of 33 counties, hospitals, health systems, and health departments

in Eastern North Carolina. It allows these partners to better understand the health status and

needs of the community they serve and use the knowledge gained to implement programs that

will benefit the community.

We can better understand community needs by gathering voices from the community. This

survey allows community members like you to tell us about what you feel are important issues

for your community. We estimate that it will take about 20 minutes to complete this ~60 question

survey. Your answers to these questions will be kept confidential and anonymous.

Thank you very much for your input and your time! If you have questions about this survey,

please contact Will Broughton at [email protected].

Part 1: Quality of Life

First, tell us a little bit about yourself...

1. Where do you currently live?

ZIP/Postal Code

102

2. What county do you live in?

Beaufort

Bertie

Bladen

Camden

Carteret

Chowan

Cumberland

Currituck

Dare

Duplin

Edgecombe

Franklin

Gates

Greene

Halifax

Hertford

Hoke

Hyde

Johnston

Lenoir

Martin

Nash

Onslow

Pamlico

Pasquotank

Pender

Perquimans

Pitt

Sampson

Tyrrell

Washington

Wayne

Wilson

North Carolina County Map

103

3. Think about the county that you live in. Please tell us whether you “strongly disagree”, “disagree”,

“neutral”, “agree” or “strongly agree” with each of the next 9 statements.

Statements

Strongly Strongly

Disagree Disagree Neutral Agree Agree

There is good healthcare in my County.

This County is a good place to raise children.

This County is a good place to grow old.

There is plenty of economic opportunity in this County.

This County is a safe place to live.

There is plenty of help for people during times of need

in this County.

There is affordable housing that meets my needs in

this County.

There are good parks and recreation facilities in this

County.

It is easy to buy healthy foods in this County.

104

PART 2: Community Improvement

The next set of questions will ask about community problems, issues, and services that are important to

you. Remember your choices will not be linked to you in any way.

4. Please look at this list of community issues. In your opinion, which one issue most affects the

quality of life in this County? (Please choose only one.)

Pollution (air, water,

land)

Dropping out of

school

Low income/poverty

Homelessness

Lack of/inadequate

health insurance

Hopelessness

Discrimination/racism

Lack of community

support

Drugs (Substance

Abuse)

Neglect and abuse

Elder abuse

Child abuse

Domestic violence

Violent crime

(murder, assault)

Theft

Rape/sexual assault

Other (please specify)

105

5. In your opinion, which one of the following services needs the most improvement in your

neighborhood or community? (Please choose only one.)

Animal control

Child care options

Elder care options

Services for people

with disabilities

More affordable

health services

Better/more healthy

food choices

affordable/better

housing

Culturally appropriate

health services

Counseling/ mental

health/ support

groups

Better/ more

recreational facilities

(parks, trails,

community centers)

Healthy family

activities

Positive teen activities

Transportation

options

Availability of

employment

Higher paying

employment

Number of health

care providers

Road maintenance

Road safety

None

Other (please specify)

106

PART 3: Health Information

Now we'd like to hear more about where you get health information...

6. In your opinion, which one health behavior do people in your own community need more

information about? (Please suggest only one.)

Eating well/ nutrition

Exercising/ fitness

Managing weight

Going to a dentist for

check-ups/ preventive

care

Going to the doctor

for yearly check-ups

and screenings

Getting prenatal care

during pregnancy

Getting flu shots and

other vaccines

Preparing for an

emergency/disaster

Using child safety car

seats

Using seat belts

Driving safely

Quitting smoking/

tobacco use

prevention

Child care/ parenting

Elder care

Caring for family

members with special

needs/ disabilities

Domestic violence

prevention

Substance abuse

prevention (ex: drugs

and alcohol)

Suicide prevention

Stress management

Anger management

Preventing pregnancy

and sexually

transmitted disease

(safe sex)

Crime prevention

Rape/ sexual abuse

prevention

None

Other (please specify)

7. Where do you get most of your health-related information? (Please choose only one.)

Friends and family

Doctor/nurse

Pharmacist

Church

Internet

My child's school

Hospital

Health department

Employer

Help lines

Books/magazines

Other (please specify)

107

8. What health topic(s)/ disease(s) would you like to learn more about?

9. Do you provide care for an elderly relative at your residence or at another residence? (Choose only

one.)

Yes

10. Do you have children between the ages of 9 and 19 for whom you are the caretaker? (Includes

step-children, grandchildren, or other relatives.) (Choose only one.)

Yes

No (if No, skip to question #12)

11. Which of the following health topics do you think your child/children need(s) more information

about? (Check all that apply.)

Dental hygiene

Nutrition

Eating disorders

Fitness/Exercise

Asthma management

Mental health issues

Tobacco

STDs (Sexually

Transmitted Diseases)

Sexual intercourse

Alcohol

Drug abuse

Reckless

driving/speeding

Diabetes

management

Suicide prevention

Other (please specify)

108

PART 4: Personal Health

These next questions are about your own personal health. Remember, the answers you give for

this survey will not be linked to you in any way.

12. Would you say that, in general, your health is... (Choose only one.)

Excellent

Very Good

Good

Fair

Poor

Don't know/not sure

13. Have you ever been told by a doctor, nurse, or other health professional that you have any of the

following health conditions?

Yes

Don’t Know

Asthma

Depression or anxiety

High blood pressure

High cholesterol

Diabetes (not during pregnancy)

Osteoporosis

Overweight/obesity

Angina/heart disease

Cancer

109

14. Which of the following preventive services have you had in the past 12 months? (Check all that

apply.)

Mammogram

Prostate cancer

screening

Colon/rectal exam

Blood sugar check

Cholesterol

Hearing screening

Bone density test

Physical exam

Pap smear

Flu shot

Blood pressure check

Skin cancer screening

Vision screening

Cardiovascular

screening

Dental cleaning/X-

rays

None of the above

15. About how long has it been since you last visited a dentist or dental clinic for any reason? Include

visits to dental specialists, such as orthodontists. (Choose only one.)

Within the past year (anytime less than 12 months ago)

Within the past 2 years (more than 1 year but less than 2 years ago)

Within the past 5 years (more than 2 years but less than 5 years ago)

Don't know/not sure

Never

16. In the past 30 days, have there been any days when feeling sad or worried kept you from going

about your normal activities? (Choose only one.)

Yes

Don’t know/not sure

17. The next question is about alcohol. One drink is equivalent to a 12-ounce beer, a 5 ounce glass of

wine, or a drink with one shot of liquor.

Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5

or more drinks (if male) or 4 or more drinks (if female) on an occasion?

Don’t know / not sure

110

18. Now we will ask a question about drug use. The answers that people give us about their use of

drugs are important for understanding health issues in the county. We know that this information is

personal, but remember your answers will be kept confidential.

Have you used any illegal drugs within the past 30 days? When we say illegal drugs this includes

marijuana, cocaine, crack cocaine, heroin, or any other illegal drug substance. On about how many

days have you used one of these drugs? (Choose only one.)

Don’t know / not sure

(if you responded 0, skip to question #20)

19. During the past 30 days, which illegal drug did you use? (Check all that apply.)

Marijuana

Cocaine

Heroin

Other (please specify)

20. During the past 30 days, have you taken any prescription drugs that you did not have a

prescription for (such as Oxycontin, Percocet, Demerol, Adderall, Ritalin, or Xanax)? How many times

during the past 30 days did you use a prescription drug that you did not have a prescription for?

(Choose only one.)

Don’t know / not sure

111

21. The next question relates to veteran's health. Have you ever served on active duty in the US

Armed Forces (not including active duty only for training in the Reserves or National Guard)? (Choose

only one.)

Yes

No (if No, skip to question #23)

22. Has a doctor or other health professional ever told you that you have depression, anxiety, or post

traumatic stress disorder (PTSD)? (Choose only one.)

Yes

23. Now we'd like to know about your fitness. During a normal week, other than in your regular job,

do you engage in any physical activity or exercise that lasts at least a half an hour? (Choose only one.)

Yes

No (if No, skip to question #26)

Don’t know/not sure (if Don’t know/not sure, skip to question #26)

24. Since you said yes, how many times do you exercise or engage in physical activity during a normal

week?

112

25. Where do you go to exercise or engage in physical activity? (Check all that apply.)

YMCA

Park

Public Recreation Center

Private Gym

Worksite/Employer

School Facility/Grounds

Home

Place of Worship

Other (please specify)

Since you responded YES to #23 (physical activity/exercise), skip to question #27.

26. Since you said "no", what are the reasons you do not exercise for at least a half hour during a

normal week? You can give as many of these reasons as you need to.

My job is physical or hard labor

Exercise is not important to me.

I don't have access to a facility that has the

things I need, like a pool, golf course, or a

track.

I don't have enough time to exercise.

I would need child care and I don't have it.

I don't know how to find exercise partners.

I don't like to exercise.

It costs too much to exercise.

There is no safe place to exercise.

I would need transportation and I

don't have it.

I'm too tired to exercise.

I'm physically disabled.

I don't know

Other (please specify)

27. Not counting lettuce salad or potato products such as french fries, think about how often you eat

fruits and vegetables in an average week.

How many cups per week of fruits and vegetables would you say you eat? (One apple or 12 baby

carrots equal one cup.)

113

Number of Cups of Fruit

Number of Cups of Vegetables

Number of Cups of 100% Fruit Juice

28. Have you ever been exposed to secondhand smoke in the past year? (Choose only one.)

Yes

No (if No, skip to question #30)

Don’t know/not sure (if Don’t know/not sure, skip to question #30)

29. If yes, where do you think you are exposed to secondhand smoke most often? (Check only one.)

Home

Workplace

Hospitals

Restaurants

School

I am not exposed to secondhand smoke.

Other (please specify)

30. Do you currently use tobacco products? (This includes cigarettes, electronic cigarettes, chewing

tobacco and vaping.) (Choose only one.)

Yes

No (if No, skip to question #32)

31. If yes, where would you go for help if you wanted to quit? (Choose only one).

114

Quit Line NC

Doctor

Pharmacy

Private counselor/therapist

Health Department

I don't know

Not applicable; I don't want to quit Other (please specify)

32. Now we will ask you questions about your personal flu vaccines. An influenza/flu vaccine can be a

"flu shot" injected into your arm or spray like "FluMist" which is sprayed into your nose. During the

past 12 months, have you had a seasonal flu vaccine? (Choose only one.)

Yes, flu shot

Yes, flu spray

Yes, both

Don’t know/not sure

Part 5: Access to Care/Family Health

33. Where do you go most often when you are sick? (Choose only one.)

Doctor’s office

Health department

Hospital

Medical clinic

Urgent care center

Other (please specify)

34. Do you have any of the following types of health insurance or health care coverage? (Choose all

that apply.)

115

Health insurance my employer provides

Health insurance my spouse's employer provides

Health insurance my school provides

Health insurance my parent or my parent's employer provides

Health insurance I bought myself

Health insurance through Health Insurance Marketplace (Obamacare)

The military, Tricare, or the VA

Medicaid

Medicare

No health insurance of any kind

35. In the past 12 months, did you have a problem getting the health care you needed for you

personally or for a family member from any type of health care provider, dentist, pharmacy, or other

facility? (Choose only one.)

Yes

No (if No, skip to question #38)

Don’t know/not sure

36. Since you said "yes," what type of provider or facility did you or your family member have trouble

getting health care from? You can choose as many of these as you need to.

Dentist

General practitioner

Eye care/ optometrist/

ophthalmologist

Pharmacy/ prescriptions

Pediatrician

OB/GYN

Health

department

Hospital

Urgent Care Center

Medical Clinic

Specialist

Other (please specify)

37. Which of these problems prevented you or your family member from getting the necessary health

care? You can choose as many of these as you need to.

116

No health insurance.

Insurance didn't cover what I/we needed.

My/our share of the cost (deductible/co-pay) was too high.

Doctor would not take my/our insurance or Medicaid.

Hospital would not take my/our insurance.

Pharmacy would not take my/our insurance or Medicaid.

Dentist would not take my/our insurance or Medicaid.

No way to get there.

Didn't know where to go.

Couldn't get an appointment.

The wait was too long.

The provider denied me care or treated me in a discriminatory manner because of my HIV status, or

because I am an LGBT individual.

38. In what county are most of the medical providers you visit located? (Choose only one.)

Beaufort

Bertie

Bladen

Brunswick

Camden

Carteret

Chowan

Columbus

Craven

Cumberland

Currituck

Dare

Duplin

Edgecombe

Franklin

Gates

Granville

Greene

Halifax

Harnett

Hertford

Hoke

Hyde

Johnston

Jones

Lenoir

Martin

Moore

Nash

New Hanover

Northampton

Onslow

Pamlico

Pasquotank

Pender

Perquimans

Pitt

Richmond

Robeson

Sampson

Scotland

Tyrrell

Vance

Wake

Warren

Washington

Wayne

Wilson

The State of Virginia

Other (please specify)

117

North Carolina County Map

39. In the previous 12 months, were you ever worried about whether your family's food would run

out before you got money to buy more? (Choose only one.)

Yes

Don’t know/not sure

40. If a friend or family member needed counseling for a mental health or a drug/alcohol abuse

problem, who is the first person you would tell them to talk to? (Choose only one.)

Private counselor or therapist

Support group (e.g., AA. Al-Anon)

School counselor

Don't know

Doctor

Pastor/Minister/Clergy

Other (please specify)

Part 6: Emergency Preparedness

41. Does your household have working smoke and carbon monoxide detectors? (Choose only one.)

Yes, smoke detectors only

Yes, both

Don't know/not sure

Yes, carbon monoxide detectors only

118

42. Does your family have a basic emergency supply kit? (These kits include water, non-perishable

food, any necessary prescriptions, first aid supplies, flashlight and batteries, non-electric can opener,

blanket, etc.)

Yes

Don't know/not sure

If yes, how many days do you have supplies for? (Write number of days)

43. What would be your main way of getting information from authorities in a large-scale disaster or

emergency? (Check only one.)

Television

Radio

Internet

Telephone (landline)

Cell Phone

Print media (ex: newspaper)

Social networking site

Neighbors

Family

Text message (emergency alert system)

Don't know/not sure

Other (please specify)

44. If public authorities announced a mandatory evacuation from your neighborhood or community

due to a large-scale disaster or emergency, would you evacuate?

(Check only one.)

Yes (if Yes, skip to question #46)

Don’t know/not sure

45. What would be the main reason you might not evacuate if asked to do so? (Check only one.)

Lack of transportation

Lack of trust in public officials

Concern about leaving property behind

Concern about personal safety

119

Concern about family safety

Concern about leaving pets

Concern about traffic jams and inability to

get out

Health problems (could not be moved)

Don't know/not sure

Other (please specify)

Part 7: Demographic Questions

The next set of questions are general questions about you, which will only be reported as a summary of

all answers given by survey participants. Your answers will remain anonymous.

46. How old are you? (Choose only one.)

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85 or older

47. What is your gender? (Choose only one.)

Male

Female

Transgender

Gender non-conforming

Other

48. Are you of Hispanic, Latino, or Spanish origin? (Choose only one).

I am not of Hispanic, Latino or Spanish origin

Mexican, Mexican American, or Chicano

Puerto Rican

Cuban or Cuban American

120

Other Hispanic or Latino (please specify)

49. What is your race? (Choose only one).

White or Caucasian

Black or African American

American Indian or Alaska Native

Asian Indian

Other Asian including Japanese, Chinese, Korean, Vietnamese, and Filipino/a

Other Pacific Islander including Native Hawaiian, Samoan, Guamanian/Chamorro

Other race not listed here (please specify)

50. Is English the primary language spoken in your home? (Choose only one.)

Yes

No. If no, please specify the primary language spoken in your home.

51. What is your marital status? (Choose only one.)

Never married/single

Married

Unmarried partner

Divorced

Widowed

121

Separated

Other (please specify)

52. Select the highest level of education you have achieved. (Choose only one.)

Less than 9th grade

9-12th grade, no diploma

High School graduate (or GED/equivalent)

Associate's Degree or Vocational Training

Some college (no degree)

Bachelor's degree

Graduate or professional degree

Other (please specify)

53. What was your total household income last year, before taxes? (Choose only one.)

Less than $10,000

$10,000 to $14,999

$15,000 to $24,999

$25,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 or more

54. Enter the number of individuals in your household (including yourself).

55. What is your employment status? (Check all that apply.)

122

Employed full-time

Employed part-time

Retired

Armed forces

Disabled

Student

Homemaker

Self-employed

Unemployed for 1 year or less

Unemployed for more than 1 year56. Do you have access to the Internet at home (including broadband, wifi,

dial-up or cellular data)? (Choose only one.)

Yes

Don't know/not sure

57. (Optional) Is there anything else you would like us to know about your community? Please feel free to tell us

below.

Thank you for your time and participation!

If you have questions about this survey, please contact us at will.broughton@foundationhli.org.

123

Spanish Survey

Encuesta de salud de la comunidad del Este de Carolina del Norte 2018

¡Bienvenido a la encuesta de salud comunitaria para el Este de Carolina del Norte!

Estamos llevando a cabo una evaluación de salud comunitaria para su condado. Esta evaluación

está siendo realizada por una asociación de 33 condados, hospitales, sistemas de salud y

departamentos de salud en el Este de Carolina del Norte. Esta evaluación les permite a estos

socios comprender mejor el estado de salud y las necesidades de la comunidad a la que sirven y

utilizar el conocimiento adquirido para implementar programas que beneficiarán a esta

comunidad.

Podemos entender mejor las necesidades de la comunidad reuniendo las voces de los miembros

de su comunidad. Esta evaluación permite que los miembros de la comunidad como usted, nos

cuente sobre lo que considera son asuntos importantes para su comunidad. De ante mano le

agradecemos por los 20 minutos que tomará completar esta encuesta de 57 preguntas. Sus

respuestas a estas preguntas se mantendrán confidenciales y anónimas.

¡Muchas gracias por su aporte y su tiempo! Si tiene preguntas sobre esta encuesta, puede enviar

un correo electrónico a Will Broughton en [email protected].

PARTE 1: Calidad de vida

Primero, cuéntanos un poco sobre usted:

3. ¿Dónde vive actualmente?

Código postal

124

4. ¿En qué condado vive?

Beaufort

Bertie

Bladen

Camden

Carteret

Chowan

Cumberland

Currituck

Dare

Duplin

Edgecombe

Franklin

Gates

Greene

Halifax

Hertford

Hoke

Hyde

Johnston

Lenoir

Martin

Nash

Onslow

Pamlico

Pasquotank

Pender

Perquimans

Pitt

Sampson

Tyrrell

Washington

Wayne

Wilson

Mapa del condado de Carolina del Norte

125

3. Piense en el condado en el que vive. Por favor díganos si está "totalmente en desacuerdo", "en

desacuerdo", "neutral", "de acuerdo" o "muy de acuerdo" con cada una de las siguientes 9

declaraciones.

Declaración

Muy en En De Muy de

desacuerdo desacuerdo Neutral acuerdo acuerdo

Hay una buena atención médica en mi condado.

Este condado es un buen lugar para criar niños.

Este condado es un buen lugar para envejecer.

Hay buenas oportunidades económicas en este

condado.

Este condado es un lugar seguro para vivir.

Hay mucha ayuda para las personas durante los

momentos de necesidad en este condado.

Hay viviendas accesibles que satisfacen mis

necesidades en este condado.

Hay buenos parques e instalaciones de recreación en

este condado.

Es fácil adquirir comidas saludables en este condado.

126

PARTE 2: Mejora de la comunidad

La siguiente serie de preguntas le preguntará sobre problemas y servicios de la comunidad que

son importantes para usted. Recuerde que sus respuestas son privadas y no serán relacionadas

con usted en ninguna manera.

4. Mire esta lista de problemas de la comunidad. En su opinión, ¿qué problema afecta más la calidad

de vida en este condado? (Elija solo una respuesta)

Contaminación (aire,

agua, tierra)

Abandono de la

escuela

Bajos ingresos /

pobreza

Falta de hogar

Falta de un seguro de

salud adecuado

Desesperación

Robo

Falta de apoyo de la

comunidad

Drogas (Abuso de

sustancias)

Descuido y abuso

Maltrato a personas

mayores

Abuso infantil

Violencia doméstica

Delito violento

(asesinato, asalto)

Discriminación /

racismo

Violación / agresión

sexual

Otros (especificar)

127

5. En su opinión, ¿cuál de los siguientes servicios necesita la mayor mejoría en su vecindario o

comunidad? (Por favor elija solo uno)

Control Animal

Opciones de cuidado

infantil

Opciones de cuidado

para ancianos

Servicios para

personas con

discapacidad

Servicios de salud más

accesibles

Mejores y más

opciones de alimentos

saludables

Más accesibilidad /

mejores vivienda

Servicios de salud

apropiados de

acuerdo a su cultura

Consejería / salud

mental / grupos de

apoyo

Mejores y más

instalaciones

recreativas (parques,

senderos, centros

comunitarios)

Número de

proveedores de

atención médica

Actividades familiares

saludables

Actividades positivas

para adolescentes

Opciones de

transporte

Disponibilidad de

empleo

Empleos mejor

pagados

Mantenimiento de

carreteras

Carreteras seguras

Ninguna

Otros (especificar)

128

PARTE 3: Información de salud

Ahora nos gustaría saber un poco más sobre dónde usted obtiene información de salud.

6. En su opinión, ¿sobre qué área de salud necesitan más información las personas de su comunidad?

(Por favor sugiera solo uno)

Comer bien /

nutrición

Ejercicio

Manejo del peso

Ir a un dentista para

chequeos / cuidado

preventivo

Ir al médico para

chequeos y exámenes

anuales

Obtener cuidado

prenatal durante el

embarazo

Recibir vacunas

contra la gripe y otras

vacunas

Prepararse para una

emergencia / desastre

Prevención del

suicidio

Usar asientos de

seguridad para niños

Usar cinturones de

seguridad

Conducir

cuidadosamente

Dejar de fumar /

prevención del uso de

tabaco

Cuidado de niños /

crianza

Cuidado de ancianos

Cuidado de miembros

de familia con

necesidades

especiales o

discapacidades

Manejo del estrés

Prevención del

embarazo y

enfermedades de

transmisión sexual

(sexo seguro)

Prevención del abuso

de sustancias (por

ejemplo, drogas y

alcohol)

Control de la

ira/enojo

Prevención de

violencia doméstica

Prevención del crimen

Violación / prevención

de abuso sexual

Ninguna

Otros (especificar)

129

7. De dónde saca la mayor parte de su información relacionada con la salud? (Por favor elija solo una

respuesta)

Amigos y familia

Doctor / enfermera

Farmacéutico

Iglesia

Internet

La escuela de mi hijo

Hospital

Departamento de

salud

Empleador

Líneas telefónicas de

ayuda

Libros / revistas

Otros (especificar)

8. ¿De qué temas o enfermedades de salud le gustaría aprender más?

9. ¿Cuida de un pariente anciano en su casa o en otra casa? (Elija solo una).

Sí

10. ¿Tiene hijos entre las edades de 9 y 19 de los cuales usted es el guardián? (Incluye hijastros, nietos

u otros parientes). (Elija solo una).

Sí

No (Si su respuesta es No, salte a la pregunta numero 12)

130

11. ¿Cuáles de los siguientes temas de salud cree que sus hijos necesitan más información? (Seleccione

todas las opciones que corresponden).

Higiene dental

Nutrición

Trastornos de la

alimentación

Ejercicios

Manejo del asma

Manejo de la diabetes

Tabaco

ETS (enfermedades de

transmisión sexual)

Relación sexual

Alcohol

Abuso de drogas

Manejo imprudente /

exceso de velocidad

Problemas de salud

mental

Prevención del

suicidio

Otros (especificar)

131

PARTE 4: Salud personal

Las siguientes preguntas son sobre su salud personal. Recuerde, las respuestas que brinde para

esta encuesta no serán ligadas con usted de ninguna manera.

12. En general, diría que su salud es... (Elija solo una).

Excelente

Muy buena

Buena

Justa

Pobre

No sé / no estoy seguro

13. ¿Alguna vez un médico, enfermera u otro profesional de la salud le dijo que tiene alguna de las

siguientes condiciones de salud?

Sí

No lo sé

Asma

Depresión o ansiedad

Alta presión sanguínea

Colesterol alto

Diabetes (no durante el

embarazo)

Osteoporosis

Sobrepeso / obesidad

Angina / enfermedad cardíaca

Cáncer

132

14. ¿Cuál de los siguientes servicios preventivos ha tenido usted en los últimos 12 meses? (Seleccione

todas las opciones que corresponden).

Mamografía

Examen de cáncer de

próstata

Examen de colon /

recto

Control de azúcar en

la sangre

Examen de Colesterol

Examen de

audición (escucha)

Examen físico

Prueba de densidad

de los huesos

Prueba de

Papanicolaou

Vacuna contra la gripe

Control de la presión

arterial

Pruebas de cáncer

de piel

Examen de la vista

Evaluación

cardiovascular (el

corazón)

Limpieza dental/

radiografías

Ninguna de las

15. ¿Cuánto tiempo hace desde la última vez que visitó a un dentista o clínica dental por algún

motivo? Incluya visitas a especialistas dentales, como ortodoncista. (Elija solo una).

En el último año (en los últimos 12 meses)

Hace 2 (más de un año pero menos de dos años)

Hace más de 5 años (más de 2 años pero menos de 5 años)

No sé / no estoy seguro

Nunca

16. En los últimos 30 días, ¿ha habido algún día que se ha sentido triste o preocupado y le haya

impedido realizar sus actividades normales? (Elija solo una).

Sí

No sé / no estoy seguro

133

17. La siguiente pregunta es sobre el alcohol. Un trago es equivalente a una cerveza de 12 onzas, una

copa de vino de 5 onzas o una bebida con un trago de licor.

Considerando todos los tipos de bebidas alcohólicas, ¿cuántas veces durante los últimos 30 días tomó

5 o más bebidas (si es hombre) o 4 o más bebidas (si es mujer) en una ocasión?

No sé / no estoy seguro

18. Ahora le vamos a hacer una pregunta sobre el uso de drogas. Las respuestas que nos dan las

personas sobre su uso de drogas son importantes para comprender los problemas de salud en el

condado. Sabemos que esta información es personal, pero recuerde que sus respuestas se

mantendrán confidenciales.

¿Has usado alguna droga ilegal en los últimos 30 días? Cuando decimos drogas, incluimos marihuana,

cocaína, crack, heroína o cualquier otra sustancia ilegal. ¿Aproximadamente cuántos días has usado

una de estas drogas ilegales? (Elija solo una).

No sé / no estoy seguro

(Si su respuesta es 0, salte a la pregunta numero 20)

19. Durante los últimos 30 días, ¿qué droga ilegal ha usado? (Marque todas las que corresponden).

Mariguana

Cocaína

Heroína

Otros (especificar)

134

20. Durante los últimos 30 días, ¿ha tomado algún medicamento recetado para el que no tenía una

receta (por ejemplo, Oxycontin, Percocet, Demerol, Adderall, Ritalin o Xanax)? ¿Cuántas veces

durante los últimos 30 días usó un medicamento recetado para el cual no tenía una receta? (Elija solo

una).

No sé / no estoy seguro

21. La siguiente pregunta se relaciona con la salud de una persona que ha servido en las fuerzas

Armadas. ¿Alguna vez ha estado en servicio activo en las Fuerzas Armadas de los Estados Unidos (Sin

incluir el servicio activo de solo entrenamientos en las Reservas o la Guardia Nacional)? (Elija solo

una).

Sí

No (Si su respuesta es No, salte a la pregunta numero 23)

22. ¿Alguna vez un médico u otro profesional de la salud le ha dicho que tiene depresión, ansiedad o

trastorno por estrés postraumático (TEPT)? (Elija solo una).

Sí

23. Ahora nos gustaría saber sobre su estado físico. Durante una semana normal, aparte de su trabajo

habitual, ¿realiza alguna actividad física o ejercicio que dure al menos media hora? (Elija solo una).

Sí

No (Si su respuesta es No, salte a la pregunta numero 26)

No sé / no estoy seguro

(Si su respuesta es No se / no estoy seguro, salte a la pregunta numero 26)

24. Como dijo que sí, ¿cuántas veces hace ejercicio o se involucra en alguna actividad física durante

una semana normal?

135

25. ¿A dónde va a hacer ejercicio o participa en actividad físicas? (Marque todas las que

corresponden).

YMCA

Parque

Centro de Recreación Pública

Gimnasio privado

Sitio de trabajo / Empleador

Terrenos escolares / instalaciones

Casa

Iglesia

Otros (especificar)

Como su respuesta fue Si a la pregunta 23 (actividad física / ejercicio), salte a la pregunta numero 27

26. Ya que dijo "no", ¿cuáles son las razones por las que no hace ejercicio por media hora durante una

semana normal? Puedes dar tantos de estos motivos como necesite.

Mi trabajo es trabajo físico o trabajo duro

El ejercicio no es importante para mí.

No tengo acceso a una instalación que tenga

las cosas que necesito, como una piscina, un

campo de golf o una pista.

No tengo suficiente tiempo para hacer

ejercicio.

Necesitaría cuidado de niños y no lo tengo.

No sé cómo encontrar compañeros de

ejercicio.

No me gusta hacer ejercicio

Me cuesta mucho hacer ejercicio.

No hay un lugar seguro para hacer

ejercicio.

Necesito transporte y no lo tengo.

Estoy demasiado cansado para hacer

ejercicio.

Estoy físicamente deshabilitado.

No lo sé.

Otros (especificar)

136

27. Sin contar ensalada de lechuga o productos de papa como papas fritas, piense en la frecuencia con

la que come frutas y verduras en una semana normal.

¿Cuántas tazas por semana de frutas y vegetales dirías que comes? (Una manzana o 12 zanahorias

pequeñas equivalen a una taza).

Cantidad de tazas de fruta

Número de tazas de verduras

Cantidad de tazas de jugo de fruta 100%

28. ¿Alguna vez estuvo expuesto al humo del cigarro de alguien que fumó cerca de usted durante el

último año? (Elija solo una).

Sí

No (Si su respuesta es No, salte a la pregunta numero 30)

No sé / no estoy seguro

(Si su respuesta es No se / no estoy seguro, salte a la pregunta numero 30)

29. En caso afirmativo, ¿dónde cree que está expuesto al humo de segunda mano con mayor

frecuencia? (Marque solo uno)

Casa

Lugar de trabajo

Hospitales

Restaurantes

Colegio

No estoy expuesto al humo de segunda mano.

Otros (especificar)

137

30. ¿Actualmente usa algún producto que contiene tabaco? (Esto incluye cigarros, cigarros

electrónicos, masticar tabaco o cigarro de vapor.) (Elija solo una).

Sí

No (Si su respuesta es No, salte a la pregunta numero 32)

31. En caso afirmativo, ¿a dónde iría en busca de ayuda si quisiera dejar de fumar? (Elija solo una).

QUITLINE NC (ayuda por teléfono)

Doctor

Farmacia

Consejero / terapeuta privado

Departamento de salud

No lo sé

No aplica; No quiero renunciar

Otros (especificar)

32. Ahora le haremos preguntas sobre sus vacunas personales contra la gripe. Una vacuna contra la

influenza / gripe puede ser una "inyección contra la gripe" inyectada en su brazo o también el espray

"FluMist" que se rocía en su nariz. Durante los últimos 12 meses, ¿se vacunó contra la gripe o se puso

el espray “FluMist? (Elija solo una).

Sí, vacuna contra la gripe

Sí, FluMist

Si ambos

No sé / no estoy seguro

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PARTE 5: Acceso a la atención / Salud familiar

33. ¿A dónde va más a menudo cuando está enfermo? (Elija solo uno)

Oficina del doctor

Departamento de salud

Hospital

Clínica Médica

Centro de cuidado urgente

Otros (especificar)

34. ¿Tiene alguno de los siguientes tipos de seguro de salud o cobertura de atención médica? (Elija

todos los que aplique)

Seguro de salud que mi empleador proporciona

Seguro de salud que proporciona el empleador de mi cónyuge

Seguro de salud que mi escuela proporciona

Seguro de salud que proporciona mi padre o el empleador de mis padres

Seguro de salud que compré

Seguro de salud a través del Mercado de Seguros Médicos (Obamacare)

Seguro Militar, Tricare o él VA

Seguro de enfermedad

Seguro médico del estado

Sin plan de salud de ningún tipo

35. En los últimos 12 meses, ¿tuvo problemas para obtener la atención médica que necesitaba para

usted o para un familiar de cualquier tipo de proveedor de atención médica, dentista, farmacia u otro

centro? (Elija solo uno)

Sí

No (Si su respuesta es No, salte a la pregunta numero 38)

No sé / no estoy seguro

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36. Dado que usted dijo "sí", ¿Con cual tipo de proveedor o institución tuvo problemas para obtener

atención médica? Puede elegir tantos de estos como necesite.

Dentista

Médico general

Cuidado de los ojos/

optometrista/

oftalmólogo

Farmacia / recetas

médicas

Pediatra

Ginecologo

Departamento de

salud

Hospital

Centro de atención

urgente

Clínica Médica

Especialista

Otros (especificar)

37. ¿Cuáles de estos problemas le impidieron a usted o a su familiar obtener la atención médica

necesaria? Puede elegir tantos de estos como necesite.

No tiene seguro medico

El seguro no cubría lo que necesitaba

El costo del deducible del seguro era demasiado alto

El doctor no aceptaba el seguro ni el Medicaid.

El hospital no aceptaba el seguro.

La farmacia no aceptaba el seguro ni el Medicaid.

El dentista no aceptaba el seguro ni el Medicaid.

No tengo ninguna manera de llegar allí.

No sabía a dónde ir.

No pude conseguir una cita.

La espera fue demasiado larga.

El proveedor me negó atención o me trató de manera discriminatoria debido a mi estado de VIH, o

porque soy lesbiana, gay, bisexual o trangenero.

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38. ¿En qué condado se encuentra la mayoría de los proveedores médicos que visita? (Elija solo uno)

Beaufort

Bertie

Bladen

Brunswick

Camden

Carteret

Chowan

Columbus

Craven

Cumberland

Currituck

Dare

Duplin

Edgecombe

Franklin

Gates

Granville

Greene

Halifax

Harnett

Hertford

Hoke

Hyde

Johnston

Jones

Lenoir

Martin

Moore

Nash

New Hanover

Northampton

Onslow

Pamlico

Pasquotank

Pender

Perquimans

Pitt

Richmond

Robeson

Sampson

Scotland

Tyrrell

Vance

Wake

Warren

Washington

Wayne

Wilson

El Estado de Virginia

Otros (especificar)

Mapa del condado de Carolina del Norte

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39. En los últimos 12 meses, ¿alguna vez le preocupó saber si la comida de su familia se agotaría antes

de obtener dinero para comprar más? (Elija solo uno)

Sí

No sé / no estoy seguro

40. Si un amigo o miembro de la familia necesita asesoría para un problema de salud mental o de

abuso de drogas o alcohol, ¿quién es la primera persona con la que les diría que hablen? (Elija solo

uno)

Consejero o terapeuta privado

Grupo de apoyo

Consejero de la escuela

No sé

Doctor

Pastor o funcionario religioso

Otros (especificar)

PARTE 6: Preparación para emergencias

41. ¿Tiene en su hogar detectores de humo y monóxido de carbono en funcionamiento? (Elija solo

uno)

Sí, solo detectores de humo

Si ambos

No sé / no estoy seguro

Sí, sólo detectores de monóxido de carbono

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42. ¿Su familia tiene un kit básico de suministros de emergencia? (Estos kits incluyen agua, alimentos

no perecederos, cualquier receta necesaria, suministros de primeros auxilios, linterna y baterías,

abrelatas no eléctrico, cobijas, etc.)

Sí

No sé / no estoy seguro

En caso que sí, ¿cuántos días tiene suministros? (Escriba el número de días)

43. ¿Cuál sería su forma principal de obtener información de las autoridades en un desastre o

emergencia a gran escala? (Marque solo uno)

Televisión

Radio

Internet

Línea de teléfono en casa

Teléfono celular

Medios impresos (periódico)

Sitio de red social

Vecinos

Familia

Mensaje de texto (sistema de alerta de

emergencia)

No sé / no estoy seguro

Otros (especificar)

44. Si las autoridades públicas anunciaran una evacuación obligatoria de su vecindario o comunidad

debido a un desastre a gran escala o una emergencia, ¿Ustedes evacuarían? (Elija solo uno)

Sí (Si su respuesta es Sí, salte a la pregunta numero 46)

No sé / no estoy seguro

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45. ¿Cuál sería la razón principal por la que no evacuaría si le pidieran que lo hiciera? (Marque solo

uno)

Falta de transporte

La falta de confianza en los funcionarios

públicos

Preocupación por dejar atrás la propiedad

Preocupación por la seguridad personal

Preocupación por la seguridad familiar

Preocupación por dejar mascotas

Preocupación por los atascos de tráfico y

la imposibilidad de salir

Problemas de salud (no se pudieron

mover)

No sé / no estoy seguro

Otros (especificar)

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PARTE 7: Preguntas demográficas

La siguiente serie de preguntas son preguntas generales sobre usted, que solo se informarán

como un resumen de todas las respuestas dadas por los participantes de la encuesta. Tus

respuestas permanecerán en el anonimato.

46. ¿Qué edad tiene? (Elija solo uno)

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85 o más

47. ¿Cuál es tu género? (Elija solo uno)

Masculino

Femenino

Transgénero

Género no conforme

Otro

48. ¿Eres de origen hispano, latino o español? (Elija solo uno)

No soy de origen hispano, latino o español

Mexicano, mexicoamericano o chicano

Puertorriqueño

Cubano o cubano americano

Otro - hispano o latino (por favor especifique)

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49. ¿Cuál es su raza? (Elija solo uno)

Blanco

Negro o Afroamericano

Indio Americano o nativo de Alaska

Indio Asiático

Otros- Asiáticos, incluidos Japonés, Chino, Coreano, Vietnamita y Filipino

Otros isleños del Pacífico, incluidos los nativos de Hawaii, Samoa, Guamanian / Chamorro

Otra raza no incluida aquí (especifique)

50. ¿El inglés es el idioma principal que se habla en su hogar? (Elija solo uno)

Sí

No. En caso negativo, especifique el idioma principal que se habla en su hogar.

51. ¿Cuál es tu estado civil? (Elija solo uno)

Nunca casado / soltero

Casado

Pareja- soltera

Divorciado

Viudo

Separado

Otros (especificar)

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52. Seleccione el nivel más alto de educación que ha alcanzado. (Elija solo uno)

Menos de 9no grado

9-12 grado, sin diploma

Graduado de secundaria (o GED / equivalente)

Grado Asociado o Formación Profesional

Un poco de universidad (sin título)

Licenciatura

Licenciado o título profesional

Otros (especificar)

53. ¿Cuál fue el ingreso total de su hogar el año pasado, antes de impuestos? (Elija solo uno)

Menos de $10,000

$10,000 a $14,999

$15,000 a $24,999

$25,000 a $34,999

$35,000 a $49,999

$50,000 a $74,999

$75,000 a $99,999

$100,000 o más

54. Ingrese el número de personas en su hogar (incluyéndose a usted)

55. ¿Cuál es su estado laboral? (Seleccione todas las opciones que corresponden).

Empleado de tiempo

completo

Empleado a tiempo

parcial

Retirado

Fuerzas Armadas

Discapacitado

Estudiante

Ama de casa

Trabajadores por cuenta propia

Desempleado 1 año o menos

Desempleado por más de 1 año

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56. ¿Tiene acceso al internet es su casa (Esto incluye alta velocidad, wifi, acceso telefónico o datos móviles)? (Elija

solo uno)

Sí

No sé / no estoy seguro

57. (Opcional) ¿Hay algo más que le gustaría que sepamos sobre su comunidad? Por favor, siéntase libre de decirnos a

continuación.

¡Gracias por su tiempo y participación!

Si tiene preguntas sobre esta encuesta, envíenos un correo electrónico a will.broughton@foundationhli.org.

148

Focus Group Questions

Participants’ Resident County(ies):

Focus Group Name / Number:

Date Conducted:

Location:

Start Time:

End Time:

Number of Participants:

Population Type (if applicable):

Moderator Name:

Moderator Email:

Note Taker Name:

Note Taker Email:

Core Questions

1. Introduce yourself and tell us what you think is the best thing about living in this community.

2. What do people in this community do to stay healthy?

Prompt: What do you do to stay healthy?

3. In your opinion, what are the serious health related problems in your community? What are some of the causes of these

problems?

4. What keeps people in your community from being healthy?

Prompt: What challenges do you face that keep you from being healthy? What barriers exist to being healthy?

5. What could be done to solve these problems?

Prompt: What could be done to make your community healthier? Additional services or changes to existing services?

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6. Is there any group not receiving enough health care? If so, what group? And why?

7. Is there anything else you would like us to know?

Additional Questions

1. How do people in this community get information about health? How do you get information about health?

2. Have you or someone close to you ever experienced any challenges in trying to get healthcare services? If so, what

happened?

3. What is the major environmental issue in the county?

4. Describe collaborative efforts in the community. How can we improve our level of collaboration?

5. What are the strengths related to health in your community?

Prompt: Specific strengths related to healthcare?

Prompt: Specific strengths to a healthy lifestyle?

6. If you had $100,000 to spend on a healthcare project in the county, how would you spend it?

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Key Themes

Summarize the top 2-3 themes from this focus group discussion.