Martin-Tyrrell-Washington
District Health Department
Washington County Community Health Assessment
2010
Washington County Health Department
198 N. C. Hwy 45 North
Plymouth, NC 27962
252.793.3023
www.mtwdistricthealth.org
Table of Contents
Purpose…………………………………………………………………………………………. / 4Team Composition…………………………………………………………………………… / 4
Process Overview………………………………………………………………………………. / 4
Outcomes……………………………………………………………………………………….. / 5
Community Health Assessment Acknowledgements………………………………………….. / 6
County Overview………………………………………………………………………………. / 8
Demographics
Population Estimates………………………………………………………………………... / 13
Age Distribution……………………………………………………………………………. / 15
Trends in Population Data…………………………………………………………………. / 16
Race and Ethnicity…………………………………………………………………………. / 18
Education………………………………………………………………………………………. / 19
Economic Characteristics
Poverty……………………………………………………………………………………… / 22
Employment………………………………………………………………………………… / 23
Agriculture………………………………………………………………………………….. / 24
Transportation………………………………………………………………………………. / 24
Community Health Status
Community Health Ranking MATCH………………………………………………………
Peer Counties……………………………………………………………………………….. / 26
26
Leading Causes of Death
Heart Disease……………………………………………………………………………….. / 28
Cancer………………………………………………………………………………………. / 29
Cerebrovascular Disease (Stroke)………………………………………………………….. / 30
Chronic Lower Respiratory Disease………………………………………………………... / 31
Diabetes…………………………………………………………………………………….. / 31
Pneumonia and Influenza…………………………………………………………………… / 32
Update on 2009 H1N1 and 2009-10 Seasonal Influenza Activity………………………….. / 33
Motor Vehicle Injuries……………………………………………………………………… / 34
Nephritis, Nephrotic Syndrome, Nephrosis (Kidney Disease)……………………………... / 36
Septicemia…………………………………………………………………………………...
Suicide……………………………………………………………………………………… / 37
37
Maternal and Child Health
Infant Mortality……………………………………………………………………………... / 38
Childhood Asthma………………………………………………………………………….. / 38
Childhood Obesity………………………………………………………………………….. / 39
Communicable Diseases
HIV………………………………………………………………………………………….. / 40
AIDS………………………………………………………………………………………... / 40
Chlamydia…………………………………………………………………………………... / 41
Gonorrhea…………………………………………………………………………………… / 42
Syphilis……………………………………………………………………………………… / 42
Tuberculosis (TB)…………………………………………………………………………... / 43
Environmental Health
Air Quality………………………………………………………………………………….. / 44
Water Quality……………………………………………………………………………….. / 44
Emerging Issues………………………………………………………………………………... / 47
Access to Care………………………………………………………………………………….. / 49
Health Care Resources…………………………………………………………………………. / 49
Mental Health…………………………………………………………………………………... / 53
Review of Primary Care………………………………………………………………………... / 54
Key Findings………………………………………………………………………………... / 54
Summary and Next Steps………………………………………………………………………. / 62
Acknowledgements…………………………………………………………………………….. / 63
Appendix………………………………………………………………………………………. / 65
2010 Washington County Community Health Assessment
Purpose
Every four years local health departments within North Carolina are required to conduct a community health assessment. The purpose of the assessment is to examine the health status of the community in order to determine the health priorities for the next four years. The community health assessment process and findings should represent the concerns of the public and be conducted in such as a way as to involve the various stakeholders including members of the community.
Team Composition
Martin-Tyrrell-Washington District Health Department (MTW) and the Healthy Carolinians Community Health Group (CHAG) have jointly conducted the community health assessment for the past several years. For this assessment, a committee was formed in early 2010 with representatives from MTW District Health Department, Washington County School System, Washington County Cooperative Extension, Washington County Faith Community, Washington County Commissioners, Plymouth Police Department, Washington County Emergency Management, Washington County Department of Health and Human Services, Washington County Senior Circle, Washington County Hospital and local business partners in Washington County, as well as members of the community. Leadership for the committee was provided by the MTW District Health Department. Members of the committee were recruited from MTW District Health Department. Several meetings were held for the primary purpose of determining how best to solicit input from the community regarding health concerns. The assessment team decided that this year surveys would be the best avenue for collecting health information for Washington County. Once questions were developed for collecting information, committee members met to develop a survey and determine areas within Washington County to distribute the surveys.
Process Overview
One requirement for the community health assessment process is the collection of primary data from members of the community. A community health survey was developed to ascertain community members’ perception of health concerns and suggestions for improving the health within the communities of Martin, Tyrrell, and Washington counties. The population of Washington County is large enough and that is why the health assessment team decided to take the best avenue of using health surveys in Washington County.
A review of secondary data was conducted by reviewing county level health data primarily compiled by the NC State Center for Health Statistics. Other resources were also utilized such as Cecil G. Sheps Center for Health Services Research at the University of North Carolina – Chapel Hill.
It is well recognized that other factors within a community affect the health of a community. Demographic, educational, economic, and environmental data for the County were reviewed as well to determine the potential for impact on health status within the county.
Additionally, where possible, Martin-Tyrrell-Washington District Health Department data was compared to data from Eastern North Carolina, North Carolina, and the United States. A review of data across several years was also conducted to determine trends in health status for Martin, Tyrrell and Washington counties.
The data was then compiled and formal presentations were made to the CHAG at the November 2010 meeting. Each member was given the opportunity to vote for the ten (10) top health priorities. The health categories/priorities were based on the 2010 Health Objectives. This meeting was announced through e-mails and through the MTW call-down system.
Members of CHAG received the data by mail prior to the November 2010 meeting. A review of the data was conducted at the November MTW Board of Health meeting, as well as a review process undertaken to determine health priorities. The Board voted to endorse the priorities identified by the Martin-Tyrrell-Washington District Health Department and CHAG.
Outcomes
The priority health objectives for 2010 – 2014 are as follows:
· Diabetes
· Communicable Disease
· Heart Disease
· Substance Abuse
· Stroke
· Obesity
· Kidney Disease
· Cancer
· HIV
· Nutrition and Physical Activity
Community Health Assessment Acknowledgement
The Healthy Carolinians Community Health Access Group (CHAG) included representatives from all areas of Washington County. Members also included individuals that work to provide health, wellness, and support resources to citizens in the Martin-Tyrrell-Washington Health District. CHAG met on the third Monday of each month starting in March 2010 to create a plan for conducting the health assessment and solving any problems encountered. The following individuals have contributed to the preparation of this document.
Jean Alexander
Washington County Commissioner
Martin-Tyrrell-Washington Board of Health Member
Ann Keyes
Emergency Manager
Washington County Emergency Management
Steve O’Neil
Chief of Police
Plymouth Police Department
Diane Linton
Nurse
Washington County Hospital
Wendy Downing Jackson
Nurse
Washington County Hospital
Reverend General James
Minister
Long Ridge Missionary Baptist Church
Rebecca Liverman
Agriculture Extension Agent
Washington County Cooperative Extension
Gail Spiewak
Director of Senior Circle
Washington County Hospital Senior Circle
Reverend Jim Hagwood
Minister
First Baptist Church
Billie Patrick
Health Education Supervisor/Public Health Preparedness Coordinator
Martin-Tyrrell-Washington District Health Department
Erica Payton
Public Health Educator II
Martin-Tyrrell-Washington District Health Department
Lynette Romero
Public Health Educator I
Martin-Tyrrell-Washington District Health Department
Charlene Puckett
CHAG Secretary
Washington County Center for Health and Human Services
Francine Hines
CHAG Chair
Washington County Center for Health and Human Services
Reverend Tom Banks
Minister
Plymouth Christian Church
Richard Woolard
Director/Community Member
Washington County Substance Abuse Coalition
Larry Norman
Director/Community Member
A-Plus Results
Rosa C. Brown
Retired Nurse
Community Member
Charles Sharpe
Retired
Washington County Community Member
Vannessa Whitley
Public Health Education Specialist
Martin-Tyrrell-Washington District Health Department
County Overview
Washington County, the only North Carolina County named for President George Washington, was established in the heart of East Carolina along the Roanoke River Basin. It was formed in 1799 and is comprised of 424 square miles. Plymouth, the county seat, predated the formation of the County due to its historical and industrial beginnings of the maritime industry. [1]
In 1680 people began to settle in the area that is now Washington County. In 1702, a saw mill was built along Kendrick’s Creek in present day Roper. The Town of Plymouth, older than Washington County, was established in 1787 by Arthur Rhodes.[2] The Town was named Plymouth due to the early shipping industry along the Roanoke River. The ships that frequented the harbor were captained by men from Plymouth, Massachusetts. Washington County was originally the western third of Tyrrell County that separated in 1799, named to honor George Washington. Washington County lies in the eastern part of North Carolina and is bounded by Bertie, Beaufort, Hyde, Martin and Tyrrell counties, and the Albemarle Sound. The courts were ordered to be held at Lee’s Mill until a courthouse could be erected. The Town of Plymouth emerged similarly to today’s subdivisions having one hundred acres set aside and divided into street and lots.
Being on the Roanoke River and near the Albemarle Sound, Plymouth’s prime importance was being a port, which was one of only six main ports in North Carolina. The Town was incorporated in 1807 with the County Courthouse relocating there in 1823.
During the Civil War, Union forces occupied Plymouth and most of the Albemarle Sound. In 1864, the Confederate Army planned to recapture Plymouth using the Albemarle, an ironclad ship constructed in a cornfield on the Roanoke River. Powered by two 200-horsepower engines with stern propellers, the Albemarle’s deck and deck house was covered by thick layers of iron plates.
Plymouth was the site of the second largest Civil War battle in North Carolina.[3] The CSS Albemarle was built along the Roanoke River near Hamilton, NC. Commissioned in 1864, the Albemarle led the attack on Union forces at Plymouth, sinking the Southfield and forcing the Miami to withdraw. Union forces had to surrender Plymouth to the Confederate forces on April 20, 1864. The Albemarle was torpedoed and sunk; in 1867 she was raised and towed to Norfolk, VA, and was sold for junk. The Albemarle’s battered smokestack is on display in Raleigh at the North Carolina Museum of History.
During the 20th Century, Washington County was later modernized by the Norfolk Southern Railroad, which services were discontinued in 1948.[4] New schools, banks, and businesses came to Plymouth and the County. Currently, downtown Plymouth is a mecca for tourism stemming from water front revitalization which built boat ramps, slips, piers and a picturesque boardwalk. Several museums and eateries dot the bucolic downtown. With an increase in water sports, fishing, and tourist events, Washington County boasts a diverse business establishment with primary employment based in the agricultural, educational, governmental, and medical fields.
Geographic Information of Washington County
According to the State Library of North Carolina, Washington County is located in the northeastern part of the state in the Coastal Plain Region.[5] The northern portion of the county is completely surrounded by the Albemarle Sound. Washington County is bordered by Bertie and Martin Counties to the west, Beaufort and Hyde to the south, and Tyrrell and the Roanoke River to the east.[6] Washington County is considered a rural community with a population density of 39.4 persons per square mile and a total area of 348 square miles, with 278.1 square miles of land and 67.9 square miles of water area.[7]
Map 1-A. Displays Washington County’s exact location in Eastern North Carolina.[8]
Source: State Library of North Carolina
Washington County Community Health Assessment 2010 74
Map 1-B: This is a topographical map shows the towns and major highways and roads located in Washington County.[9]
Washington County Community Health Assessment 2010 74
Washington County Government
Washington County has an administrative form of government overseen by a five-person board of commissioners. Commissioners are elected at large and each serves a four-year term. These terms are staggered with two chosen in one election and three chosen in the next.
Washington County Commissioners are as follows:
· Tracey A. Johnson, Chairman
· Buster Manning, Vice Chair
· Jean Alexander
· Woodrow (Woody) Collins
· Raymond McCray
o Julie Bennett, Clerk to the Board of Commissioners
· David Peoples, County Manager
· Cheryl Young, County Attorney
County Fax: 252.793.1183
County Email Address:
The Commissioners meet the first Monday of every month at 6:00 p.m.
The Governing Board of MTW District Health Department
The Board of Health of Martin-Tyrrell-Washington District Health is established and maintained as the governing body in accordance with the laws of the State of North Carolina of General Statues 130A-34 through 130A-42.
The Board of Health serves as the global policy-making, rule-making, and adjudicatory body for the district health department.The Board of Health has 15 members. The commissioners of each county in the district appoint one of their members to the Board of Health.These appointed commissioner members then appoint the other members of the Board including at least one licensed physician licensed to practice in the State of North Carolina, one licensed dentist, one licensed optometrist, one licensed veterinarian, one registered nurse, one licensed pharmacist, and one professional engineer. If there is not a member of the district available for appointment as designated above, additional representatives of the general public shall be appointed.
When a member of the general public is appointed due to the unavailability of one of the licensed or professional level members shall, he/she serves only until a licensed or professional member can be appointed.
The composition of the Board of Health shall reasonably reflect the population makeup of the entire district and provide equitable district-wide representation. All members shall be residents of the district.
Board of Health Members
Chairman: Thomas Spruill, Tyrrell County Commissioner
Martin County
Derek Price, Commissioner
Denise Edmondson, Registered Nurse
Robert M. Stalls, Public Member
Dr. Ben Shelton, Veterinarian
Ben Jones, Public Member
Tyrrell County
Hannah Rogers, Public Member
Washington County
Jean Alexander, Commissioner
Dr. Carter Bennett, Dentist
Logan Womble, Pharmacist
Dr. Robert Venable, Physician
Judy Wright, Public Member, Vice Chairman
Eddie McNair, Public Member
Demographics
Population Estimates
According to 2009 population estimates from the U.S. Census Bureau, Washington County’s population is approximately 12,851.[10] This reflects a population decrease of 6.4%, which is based on population comparison from the 2000-2009 estimates. Based on the population trend data from the North Carolina Office of State Budget and Management, the State of North Carolina grew, gaining over 1.4 million people between 1990 and 2000; however, only three counties, Bertie, Edgecombe, and Washington, lost population. Washington peer counties, Anson, Bertie, Martin, and Northampton had net out-migration during this period, but had sufficient births to show small population growth. The trend is predicting the continued aging of the population due to the rising number of seniors as depicted in the chart below.[11]
2009 Population Estimates – Washington County and Peer Counties