HNC 2030 Scorecard: Montgomery County
The Montgomery County Department of Health is excited to share the Healthy NC 2030 Scorecard for Montgomery County. This Community Health Improvement Scorecard is an easy way to learn about some of the efforts currently underway in Montgomery County to address three healthy priorities identified in the 2020 Montgomery County Community Health Assessment (CHA) :
- Diseases of the Heart
- Substance Abuse and Mental Health
- Health Equity
While our community has been adversely affected by the COVID-19 pandemic since March 2020, Montgomery County and our community partners are united in our efforts to support community health improvements to address these priorities. This Scorecard also serves as Montgomery County’s Community Health Improvement Plan (CHIP), fulfilling the NC Local Health Department Accreditation requirements that the local health departments complete two CHIPs following the CHA submission.
For each priority, this Scorecard spotlights:
- A Result Statement, a picture of where we would like to be
- Important local indicators or measures of how we are doing linked to Healthy NC 2030 Indicators
- Select Programs or activities and
- Key Performance Measures that show how those programs are making an impact.
Instructions: Click anywhere on the scorecard to learn more about programs and partners that are working together to improve the health of Montgomery County. The letters below represent key components of the Scorecard.
Use the icons to expand items and the
icons to read more. This scorecard is not intended to be a complete list of all the programs and partners working on these issues in Montgomery County.
Progress on CHIPs
During 2021, the Montgomery County Department of Health faced many challenges related to the COVID-19 pandemic when implementing the Community Health Improvement Plan (CHIP). Despite the challenges we have faced, the department has been able to effectively:
- Adopt the Results-Based Accountability concept to develop our county level health reports
- Transfer our current programs, initiatives, and performance measures into the online Clear Impact Scorecard platform
- Shift to a web based system for our Community Health Assessment, CHIP, and State of the County Health Report
- Link to the HNC 2030 Scorecard to create greater awareness of population accountability
Morbidity and Mortality Changes Since Last CHA
Leading Cause of Death
In 2019, the three leading causes of death in Montgomery County were Heart Disease, Cancer, and Chronic Lower Respiratory Disease. This accounted for nearly 50% of all deaths in Montgomery County.
Source: North Carolina State Center for Health Statistics (2019 is the most recent published data)
COVID-19 Confirmed Cases and Deaths
The data presented by the North Carolina State Center for Health Statistics regarding the leading cause of death in 2019 does not depict the impact that Coronavirus (COVID-19) had on our community in 2020-2021. Since March 2020, Montgomery County has noted 5,020 total cases of COVID-19 (Figure 1) in our community. Montgomery County has recorded 111 total deaths (Figure 2) attributed to COVID -19 from March 14, 2020 to January 1, 2022. Each confirmed case of COVID-19 is reported with data on race, ethnicity, and age (Figure 3, 4, 5) identified. Testing efforts in Montgomery County are a continued effort through the Montgomery County Department of Health, third party testing locations, and our community partners. The most current data on COVID-19 in Montgomery County can be found online in the Montgomery County COVID Dashboard. Additional information can be located on the State COVID Dashboard at https://covid19.ncdhhs.gov.
Montgomery County COVID-19 Vaccinations
Montgomery County vaccination data can be found on the North Carolina Department of Health and Human Services Data Dashboard. As of January 4, 2022, 42% (n = 11,516) of Montgomery County’s population was fully vaccinated with 45% (n = 12,233) being partially vaccinated. Current vaccination efforts in the county continue to reach the target goal set forth by NCDHHS.
Emerging Issues Since Last CHA
COVID-19 Pandemic
COVID-19 has continued to be a concern in Montgomery County that has had a lasting impact on every person and their overall health during 2021. Since the beginning of the pandemic in March of 2020, Montgomery County has reported 5,020 cases (as of January 2022) of COVID-19 and over 100 deaths attributed to COVID-19. To diminish the impact of COVID-19 on our community, we focused on creating new partnerships and maintain current programs when feasible to support the community during such a difficult time. Throughout the pandemic, many of our community members suffered from food insecurity. This was partially impacted by the decrease in volunteers for many food pantries due to such a large portion of the volunteer base being a vulnerable population. Due to a lack of food delivery options in the area, many individuals relied on food pantries or family members to ensure their food needs were met.
Community Centered Health
Community Centered Health
Community centered health involves shifting the focus from individuals to the community and works to prevent health issues before they require treatment. Better Together Montgomery, which consists of representatives from local community organizations, is using grant funds from the Blue Cross Blue Shield Foundation of North Carolina to use community centered health to improve food access and economic stability to the Peabody and Brutonville communities of Montgomery County. CCH has three main areas of focus:
1. Community members as leaders and partners
2. Community level changes in policies, systems, and environments
3. Clinical shifts prioritize creating health
The group paused many current projects in 2020 due to the rapid rate of COVID transmission in the community and focused on supplying the current needs of community members through local organizations. New and current group initiatives can be found in the New Initiatives Since Last CHA portion of the document.
New/Paused/Discontinued Initiatives Since Last CHA
COVID-19 Pandemic Impacts
Due to the impacts COVID-19 had on our community, many staff within the work place devoted more time to COVID-19 related activities. These activities included, but are not limited to, COVID-19 testing and mass vaccination clinics. Though these initiatives had taken a forefront during the course of 2021, our clinic remained opened on a modified schedule to continue to provide services to those in Montgomery County.
Conquering Motherhood
Throughout 2021, our health education staff were able to resume select outreach initiatives regarding infant mortality and maternal health through an online platform (Zoom). With the use of technology, educators were able to provide information on safe sleep practices and postpartum depression to new or current parents. These online classes were a part of the current Conquering Motherhood outreach initiative hosted by the Department of Health in partnership with Improving Community Outcomes for Maternal and Child Health (ICO4MCH). The Conquering Motherhood program targeted new or current parents seeking valuable information on topics such as infant feeding, car seat safety, postpartum depression, and general infant care. Meetings for the ICO4MCH initiatives resumed utilizing an online meeting platform and advertisement was conducted through a variety of social media platforms.
Car Seat Safety
Car seat safety classes were paused briefly due to a rise in COVID-19 cases in Montgomery County. Once the COVID-19 rate returned to a low rating for our community, we were able to restart our car seat safety class for parents in our area. Through this program, we were able to continue our partnership with Safe Kids North Carolina and provide valuable information and resources to parents in our community regarding the safety of their child while in or around the vehicle.
Community Centered Health
Better Together Montgomery uses a community centered health approach to focus on the individuals in the Peabody and Brutonville communities. Due to the rapid rate of COVID transmission in our county, many predefined initiatives were placed on a hold until it was safe to conduct in-person outreach. During this time, core team meetings transitioned to an online meeting platform as the group reassessed the current needs of each community. Members from the core team were able to work together to implement a community garden in the Brutonville community to assist with the food needs of those in the surrounding area. This effort was a combination of community participation, core team assistance, and community partners. As this work continues throughout 2022, the group will continue to connect with the community to gain insight and feedback as they work towards improved food access and economic stability.
Progress on CHIPs
The State of the County Health Report 2022 provides community partners, stakeholders, and the general public with an update on the priority health issues identified in the 2020 Community Health Assessment and the strategies implemented to address these issues. The Montgomery County Department of Health, FirstHealth of the Carolinas, and members of the Montgomery County 2020 Task Force collaborated to complete the 2020 assessment. The top three community health priority issues identified were:
-
Diseases of the Heart
-
Substance Abuse and Mental Health
-
Health Equity
To view the 2020 Community Health Assessment, please visit the Montgomery County Department of Health’s website at www.montgomerycountync.com/departments/health-department.
The following report includes progress made on each of the three priority health issues as well as demographic, morbidity, and mortality data for Montgomery County and the state of North Carolina. The last section in the report discusses emerging issues in the field of public health that are being addressed in Montgomery County: Mpox and Food Insecurity.
Progress on CHIPs
Montgomery County Department of Health was able to expand their outreach and communications with community groups and partners during 2022. This was in part due to the relief of some COVID-19 restrictions within the community. During this time, staff worked to promote healthy choices related to the health priorities identified in the 2020 Community Health Assessment. This includes:
- Training educators in the CATCH my Breath and other tobacco cessation educational course to encourage students to stop the use of vaping and using tobacco products
- Partnering with the Better Together Montgomery group as well as FirstHealth of the Carolinas to increase community access to walking trails and safe areas for outdoor play to increase communities that support healthy lifestyles
- Partnering with the Sandhills Opioid Consortium to promote the Peer Support Specialist for her work in recovery and harm reduction education
- Continuing the work of the safe sleep program to provide safe sleep materials to community members to help support healthy, equitable communities that offer complete social, physical and mental well-being to all its residents at all stages of life
Morbidity and Mortality Changes Since Last CHA
Mortality
The leading causes of death for Montgomery County was collected from the State Center for Health Statistics, with the most recent data being from 2019. The data shows that the leading causes of death have had little change from that represented in our 2020 Community Health Assessment. Compared to the leading causes of death in North Carolina (Cancer, Diseases of the Heart, and Chronic lower respiratory diseases), Montgomery County ranks slightly lower for the top three causes of death than that state level.
Morbidity
COVID-19 cases have shown a significant decline since the beginning of 2022. With a total of 3,847 reported cases, Montgomery County ranks lower than the state average for cases per each reporting week. (Moving forward, COVID-19 case data will be reported in a different manner).
Emerging Issues Since Last CHA
MonkeyPox (Mpox)
MonkeyPox was first identified in Montgomery County in August 2022. With the prevalence of the infection, our staff were able to educate community members on the proper infection control techniques and isolation protocols.
Food Insecurity
Identified in a current food assessment as well as the FirstHealth of the Carolinas CHNA, food insecurity has become a topic of discussion in Montgomery County within the past year. During the beginning of COVID, we saw many changes in food distribution sites and the allotment of food for each family. We are working within our community groups to ensure that the food distribution is still meeting the needs of our community as well as assessing the healthiness of the food being distributed.
New/Paused/Discontinued Initiatives Since Last CHA
New
Utilization of Opioid Settlement Funds
Montgomery County was allotted funds to increase the support of substance abuse resources. The current Board of Commissioners is responsible for allocating funds throughout the community and ensuring the funded partners are assisting the community to the best of their ability. Our current partner, Sandhills Opioid Consortium, has been allotted funding from the board to support the efforts of a designated Peer Support Specialist. This peer support specialist is housed within the department of health building and provides community members increased access to care revolving around recovery and harm reduction.
T2 Diabetes Education
Our education staff partnered with FirstHealth of the Carolinas to train in the T2 Diabetes prevention program. This program will allow our staff to implement a yearlong class for community members to focus on the importance of a healthy lifestyle when presented with pre-diabetes markers.
Discontinued
COVID-19 Vaccination Clinics
During 2022, our clinic continued hosting vaccination days for community members to receive their most up to date vaccine or booster for COVID-19. Due to the expansion of the availability of the most current COVID-19 vaccine, we limited vaccinations to appointments only. Through the availability of self-administered COVID-19 test kits from state partners our clinic was also able to provide community members with free testing kits.
Advancing Equity
The state level funding for the advancing equity program ended during the current fiscal year. Although the funding has been removed, MCDH is dedicated to continuing the work of the program to help improve our services and the care the community receives. Our staff continue to partner with our external equity committee and work to improve our services through policy development and change.
Progress on CHIPs
All Montgomery County priorities are addressed in the Community Health Improvement Plan (CHIP). Click on the links below for Progress Made in 2022-2023.
For the priority area Diseases of the Heart see progress tabs for each program below.
New Community garden structures.
Community Health Screenings/Education
The State of the County Health Report 2023 provides community partners, stakeholders, and the general public with an update on the priority health issues identified in the 2020 Community Health Assessment and the strategies implemented to address these issues. The Montgomery County Department of Health and members of the Montgomery County 2020 Task Force collaborated to complete the 2020 assessment. The top three community health priority issues identified were:
- Diseases of the Heart
- Substance Abuse and Mental Health
- Health Equity
To view the 2020 Community Health Assessment, please visit the Montgomery County Department of Health’s website at www.montgomerycountync.com/departments/health-department.
The following report includes progress made on each of the three priority health issues as well as demographic, morbidity, and mortality data for Montgomery County and the state of North Carolina. The last section in the report discusses emerging issues for our community in the field of public health that are being addressed.
Montgomery County Department of Health and community partners has worked continuously throughout the calendar year of 2023 to address the health priorities listed in our most recent CHA. Chronic diseases of the heart is still a top health concern for people in Montgomery County, and through community partnerships several health improvement initiatives have been implemented to address them. Heart health has been at the forefront of these initiatives throughout 2023 with new programs being designed to address health risk screenings and blood pressure management.
Staff and community partners have also focused on health improvement initiatives to address the rising use of harmful substances among adults and youth aged individuals.
Community partners and local health department staff continue to address equitable access to care through collaborative group efforts. Health department staff have been able to grow their involvement with a local group operating on a community centered care approach to change. Through this group, initiatives have been put in place to address access to food, heart health, and more.
The clear impact scorecard (found above) outlines the efforts being made by the Montgomery County Department of Health and community partners to address the health priorities identified in the 2020 Community Health Assessment. Use the following links to see up to date information regarding each program and initiative taking place to improve the health outcomes in Montgomery County.
- All people in Montgomery County live in communities that support healthy lifestyles.
- SU All people in Montgomery County have equitable access to mental health and substance use disorder services.
- All people in Montgomery County live in healthy, equitable communities that offer complete social, physical and mental well-being to all its residents at all stages of life.
Morbidity and Mortality Changes Since Last CHA
Leading Cause of Death
In Montgomery County, heart disease ranks as the predominant cause of mortality. Its evasive nature, often missed in early stages and usually not presenting with immediate life-threatening symptoms, underscores its profound impact on the well-being of people living in Montgomery County. Heart disease exacts a notable toll on the quality of a person’s life, often with debilitating symptoms that impede daily life. The preventability of many heart conditions elevates the importance of addressing this serious health concern. Compounding the challenge, Montgomery County is a rural community, characterized by limited access to quality healthcare and screening services. This barrier exacerbates disparities in health outcomes and highlights the necessity for bolstered heart health initiatives. Prioritizing interventions at prevention, early detection, and comprehensive delivery of healthcare is paramount in mitigating the burden of heart disease within the community. By addressing these multifaceted challenges, a healthier, more resilient population is fostered to promote the collective well-being of Montgomery County.
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Leading Causes of Death in Montgomery County |
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|
|
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|
Rank |
Cause |
No. |
% |
|
1 |
Diseases of the heart |
71 |
20.4 |
|
2 |
Cancer |
69 |
19.8 |
|
3 |
Chronic lower respiratory diseases |
24 |
6.9 |
|
4 |
Alzheimer’s disease |
18 |
5.2 |
|
5 |
Cerebrovascular diseases |
18 |
5.2 |
|
6 |
All other unintentional injuries |
14 |
4 |
|
7 |
Motor vehicle injuries |
10 |
2.9 |
|
8 |
Diabetes mellitus |
8 |
2.3 |
|
9 |
Influenza and pneumonia |
7 |
2 |
|
10 |
Nephritis, nephrotic syndrome and nephrosis |
7 |
2 |
|
|
All other causes (residual) |
102 |
29.3 |
|
Total deaths – All causes |
348 |
100 |
|
|
|
|||
|
Source: State Center for Health Statistics, NC. 2019 |
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Health Ranking
Montgomery County occupies the 75th position among the 100 counties in North Carolina concerning health factors and outcomes. This inferior ranking correlates with elevated rates of premature mortality, diminished life expectancies, and substandard mental and physical well-being within the community. Contributing to these adverse outcomes are various health behaviors, to include smoking, obesity, sedentary lifestyles, teen pregnancy, and substance misuse. Furthermore, the scarcity of healthcare professionals, including primary care physicians and specialists, worsens these challenges, resulting in outcomes below those reflected at the state and national levels.
Source: Montgomery, North Carolina | County Health Rankings & Roadmaps
Emerging Issues Since Last CHA
Emerging issues identified in Montgomery County include the end of the COVID-19 pandemic health emergency by state officials. As the community continues navigating this new post-pandemic era, attention remains fixed on combatting food insecurity. These emerging & evolving issues, representative of the county’s resilience in the face of adversity, draw due attention to the need for action and innovative solutions.
COVID State of Emergency
The effects of the COVID-19 emergency, despite its ending, will have lasting effects due to reshaping various aspects of social, economic, and healthcare avenues. With the easing of restrictions and the restoration of normalcy, there remains a shortage of healthcare providers in Montgomery County to be addressed. While the reduced strain on resources and healthcare staff is promising, improving access to healthcare for people living in Montgomery County is paramount. The need for preventative care is once again able to be highlighted through the promotion of vaccination campaigns, heart health screenings, and community outreach and education.
Food Insecurity
Amidst the ongoing challenges posed by food insecurity in Montgomery County, light has been shed on the urgency of addressing the issue. Over the past year, our community experienced shifts in food distribution needs and resource allocation to meet the evolving needs of families in our communities. While the work remains unfinished, community partner collaboration has kept the issue as a top priority, with the hopes of ensuring food security for all people living in Montgomery County. Partners remain committed to distributing quality essential foods that are high in nutritional value, keeping the health of our community at the forefront of their mission.
New/Paused/Discontinued Initiatives Since Last CHA
Montgomery County Department of Health and its community partners made great strides in the calendar year 2023 to start new initiatives related to priority health issues identified in the 2020 Community Health Assessment. Through the partnership with Montgomery County Board of Commissioners and Sandhills Opioid Response Consortium, opioid settlement funds were leveraged to assist with the distribution of Naloxone in the form of harm reduction kits. The designated peer support specialist through the consortium has worked to develop lasting relationships with community leaders, first responders, and people in Montgomery County to ensure that harm reduction kits are widely available throughout the county. Through the scorecard, we are able to showcase how many kits are given out to community members through her work. In addition to providing life-saving doses of naloxone and opioid overdose reversal medication to individuals seeking access to care, the harm reduction kits contain information on recovery resources available as well as necessary test strips for individuals in search of them.
Staff at Montgomery County Department of Health have been able to address key concerns with parents and guardians through the implementation of the Positive Parenting Program (Triple P). Clinical and non-clinical staff have been trained at MCDH to administer the program to parents and guardians that bring up specific concerns related to their child’s behavior. MCDH staff can assist parents with any child under the age of twelve, but have developed relationships with community organizations that can administer assistance for children outside of the age range.
In addition to providing the triple p program, health education and maternal health staff have worked diligently with the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) collaborative to educate maternal health patients on post-partum depression. Through the use of the mothers and babies curriculum, educators can address common mental health related outcomes for mothers prior to delivery. This program addresses the signs and symptoms of post-partum depression to educate the mother prenatally on what she may experience. Due to the lack of maternal mental health services within the county, any program addressing mental health for our patients has been a priority.
Diseases of the Heart can have many root causes, but one key factor our local Better Together group addressed was the need for physical activity to help boost heart health of the community. After analyzing the need for outdoor physical activity spaces, group members along with community leaders developed a plan to increase the walkability of the community center by developing a walking trail. In early spring of 2023, Better Together was able to build a walking trail in the Brutonville Community for anyone in the county to utilize. This trial has helped with the facilitation of exercise groups and walking sessions with the community center.
Vaping cessation has been a topic of concern for many in the community, especially among the youth in our school system. Montgomery County Department of Health staff along with FirstHealth of the Carolinas educators were able to train in the CATCH My Breath program to help facilitate youth vaping cessation utilizing a nationwide evidence-based program. Facilitation and further training within the school system is a project that is ongoing to bring this information into our local schools.
Throughout this past year the T2 Diabetes program has been paused for Montgomery County. This program addresses healthy lifestyle choices for those that present with pre-diabetes markers. With continued efforts by Montgomery County Department of Health and FirstHealth of the Carolinas, it is our hope to facilitate the year-long class with community members in the future.
Clear Impact Suite is an easy-to-use, web-based software platform that helps your staff collaborate with external stakeholders and community partners by utilizing the combination of data collection, performance reporting, and program planning.