HNC 2030 Scorecard: Stanly County 2021-2023

Executive Summary

Vision Statement:   Striving to create a community where all achieve optimal health and well-being.

Key Findings:

Top 5 Causes of Death in Stanly County 2015-2019

1. Heart Disease

2. Cancer - all sites

3. Alzheimer's Disease

4. All Other Unintentional Injuries

5. Chronic Lower Respiratory Disease

Top 5 Health Issues in Stanly County (identified through Community Health Assessment responses)

1. Substance Use Disorder/Overdose

2. Obesity/Overweight

3. Tobacco Use

4. Mental Illness

5. Inactivity/Lack of Physical Activity

To see the full report, visit 2021 Stanly County Community Health Assessment

Priorities

2021 -2023 HEALTH PRIORITIES

❖ Substance Misuse/Overdose,

❖ Healthy Living (healthy weight, nutrition, & physical activity)

❖ Mental Health

Why Is This Important?

Suicide ranks at 13 in causes of mortality in Stanly County. Stanly County's suicide death rate is 15.6, over two points higher than North Carolina's suicide death rate (at 13.4). According to Stanly County's 2021 CHA, access to mental health services was ranked in fourth place by assessment survey participants as being major access to issues. The following community issues were also ranked in the top 10 according to assesment survey participants: unemployement/underemployment, poverty, Lack of/inadequate Health Insurance, Crime, Homelessness, Inadequate/unaffordable Housing, Racism, Child Abuse/Neglect, and Domestic Violence. All of these issues contribute to an indivduals overall mental well-being. The COVID-19 pandemic quickly pushed mental health concerns to the forefront due to various reasons and impacted people of all ages. From job losses or increased workload and stress for adults to the extended periods of time that the elderly were isolated/quaratined to the innumerable challenges that our school age children faced, the COVID-19 pandemic affected everyone's mental health.

What We Do

Stanly County Health Department has chosen suicide prevention as one of our NC Healthy Communities strategies.  The strategy aligns with our priority area of mental health.  Suicide gatekeeper training such as Applied Suicide Intervention Skills Training (ASIST), Question, Persuade, and Refer (QPR), Counseling on Access to Lethal Means (CALM) or Mental Health First Aid are offered to community members and organizations.  For more information visit NC Healthy Communities  

Who We Serve

Suicide prevention education programs are provided for the public by Partners Health Management and Atrium.  Stanly County Schools provides suicide education to teachers and school staff.  Stanly Community College provides suicide prevention education to staff and students. 

How We Impact

We will measure number of staff and community members reached, number of trainings held, and gained knowledge from program exit surveys.  More information coming soon!

What We Do

Stanly County Schools as well as Gray Stone Day School train faculty and staff in suicide gatekeeper education.  Programs such as Question, Persuade, Refer (QPR) and Mental Health First Aid (MHFA) are provided to teachers and staff who work directly with students.  Gray Stone students participate in "Say Something" education and Mission 34 mental health programming.  Stanly County Schools students participate in education such as Too Good for Drugs, Botvin LifeSkills, and Second Step curriculums that address mental wellness and drug use prevention.  Visit https://www.stanlycountyschools.org/apps/pages/index.jsp?uREC_ID=1227282&type=d&pREC_ID=2257483 for more information on Stanly County Schools mental health plan. 

Who We Serve

We strive to reach students and their families with mental health education and resources.  

How We Impact

We will measure number of students receiving education and evaluate gained knowledge of students who participate in each curriculum through exit surveys.  We will also measure outreach to families through participation in community events and school sponsored health fairs. 

Why Is This Important?

Deaths, hospitalizations, and emergency department (ED) visits due to medication or drug overdose, have become a growing public health concern nationally and in North Carolina.  In 2018, Stanly County had some of the highest rates for overdose and overdose death in the state.  

Historically, prescription opioids have been a major driver of this epidemic. However, illicit drugs are now contributing to this problem in increasing numbers. The majority of overdose deaths now involve illicit opioids like heroin or fentanyl, a synthetic narcotic. The number of overdose deaths involving stimulants is also on the rise.

Source: North Carolina Department of Health and Human Services - Division of Public Health. (2022). Injury and Violence Prevention Branch: Overdose data. Retrieved August 26, 2022 from https://injuryfreenc.dph.ncdhhs.gov/DataSurveillance/overdose.htm 

What We Do

Stanly County Project Lazarus partner agencies work together to host medication take back events and distribute medication lockboxes several times each year.  They also work to inform the public about permanent medication dropbox locations at Albemarle Police Department, Oakboro Police Department, and Norwood Police Department.  The purpose of this program is to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications. 

Who We Serve

All residents of Stanly County with special emphasis on prescription drug safety in homes where children reside.

How We Impact

Safe storage of prescription drugs and proper disposal of prescription medications reduces the amount of drugs available for illicit use and accidental poisoning. 

What We Do

Stanly County Schools and Center Prevention Services are partners in the SAMHSA (Substance Abuse and Mental Health Services Administration) Partnership for Success grant.  This grant provides funding for evidence-based youth prevention education curricula and training of teachers.  This funding also support the Youth Drug Survey which gives the county important information about student use and perceptions of tobacco, marijuana, and other drugs.  Prevention education programs for youth serving organizations are also available through Center for Prevention Services. 

Who We Serve

Youth, parents, and those who work with youth are supported through prevention education. 

How We Impact

In 2022, Center for Prevention Services collaborated with Stanly County Schools to provide two prevention education curricula for students. Too Good for Drugs was implemented for students in grades 3-5. This program is designed for reducing risk factors and enhancing protective factors related to substance misuse in youth. This includes developing skills for making healthy choices, increasing self-esteem, and reducing peer pressure. Botvin Life Skills Training was implemented for students in grades 6-9. This is a substance misuse prevention program that is designed to reduce the risks associated with misuse of alcohol, tobacco, and other drugs. This curriculum focuses on increasing self-esteem and self-confidence, as well as increasing students’ knowledge of the effects of misusing substances. For school year 2021-2022, we evaluated the effectiveness of the Botvin Lifeskills program. For both life skills and anti-drug knowledge, students’ level of knowledge increased (3.1%, 0.9%) after participating in the curriculum. School year 2022-2023 is the first year of the Too Good for Drugs curriculum, evaluation for this program is not yet available. 

What We Do

Stanly County EMS - Community Paramedics

A post-overdose response team (PORT) is a program that follows up with a person who has recently overdosed, typically (e.g. within 24-72 hours of the overdose) to provide support, education, and connections to needed resources (e.g. naloxone). PORT programs are a great opportunity to build relationships with people who use drugs in your community and create connections to offer a variety of wraparound health and social services, even if that connection occurs at a later time.  Stanly County PORT is even able to provide a suboxone bridge for patients to begin medication assisted treatment after an overdose.  

Who We Serve

Stanly County PORT serves individuals who have experienced overdose or who have been identified as needing connections to resources such as Medication Assisted Treatment, naloxone, or detox.  

How We Impact

Stanly County EMS overdose call data, referrals to treatment, and induction of medication assisted treatment will be used as measures of impact.  

What We Do

Uwharrie Harm Reduction Initiative

Harm reduction is an approach that emphasizes engaging directly with people who use drugs to prevent overdose and infectious disease transmission, improve the physical, mental, and social wellbeing of those served, and offer low-threshold options for accessing substance use disorder treatment and other health care services.  

• Connect individuals to overdose education, counseling, and referral to treatment for infectious diseases and substance use disorders.
• Distribute opioid overdose reversal medications (e.g., naloxone) to individuals at risk of overdose, or to those who might respond to an overdose.
• Lessen harms associated with drug use and related behaviors that increase the risk of infectious diseases, including HIV, viral hepatitis, and bacterial and fungal infections.
• Reduce infectious disease transmission among people who use drugs, including those who inject drugs by equipping them with accurate information and facilitating referral to resources.
• Reduce overdose deaths, promote linkages to care, facilitate co-location of services as part of a comprehensive, integrated approach.
• Reduce stigma associated with substance use and co-occurring disorders
• Promote a philosophy of hope and healing by utilizing those with lived experience of recovery in the management of harm reduction services, and connecting those who have expressed interest to treatment, peer support workers and other recovery support services.

Who We Serve

Uwharrie Harm Reduction Initiative serves people who use drugs and people experiencing homelessness in Stanly County. 

How We Impact

Uwharrie Harm Reduction interactions with people who use drugs, numbers of naloxone kits distributed, number of referrals to treatment and services, and reported overdose reversals will be used as measures of impact. 

Why Is This Important?

The leading causes of death of Stanly County residents are Heart Disease and Cancer (all sites). Although, according to the 2021 Stanly County Community Health Assessment (CHA), there is a disconnect between the causes of mortality and the CHA survey respondents' perceptions of major health problems in Stanly County. The survey respondents ranked Heart Disease at 7 and Cancer at 11 for major health problems. Respondents did, however, rank contributory health issues such as Obesity/Overweight (rank #2), Tobacco Use (rank #3), Inactivity/Lack of Physical Activity (rank #5), and Diabetes (rank #6) as major health problems (and higher than Heart Disease and Cancer). There is a direct link between the lack of physical activity and healthy eating and Tobacco Use with that of Heart Disease, Cancer, Chronic Lower Respiratory Disease, Cancer (of Trachea, Bronchus, Lung), Pneumonia, and Diabetes Mellitus, which are all in Stanly County's top 10 causes of mortality.

What We Do

Stanly County Health Department operates a weekly farmers market within the county government building (1000 N. First St. Albemarle).  This market features locally grown and produced fruits and vegetables, meat, and baked goods.  Stanly Commons Farmers Market is the only market in the county currently accepting EBT cards as payment.  They also participate in the NC WIC (Women, Infants, & Children) and Senior Farmers Market Nutrition voucher program.  Clients of the John P. Murray Community Care Clinic receive fruit, vegetable, and meat vouchers that may be used at the farmers market.  For more information visit Stanly Commons Farmers Market

Who We Serve

Stanly Commons Farmers market serves all Stanly County residents with a focus on providing access to fresh fruits and vegetables to underserved communities. 

How We Impact

Stanly Commons Farmers Market is located next to Stanly County Health Department and Department of Social Services and is accessible by public tranportation.  EBT shoppers are able to use their funds to purchase locally grown produce, farm raised meats, and baked goods.  In turn, local farmers benefit by being able to access customers who may not otherwise be able to shop at a farmers market.  

Community Care Clinic vouchers redeemed 2022 = $1065          

(Stanly Commons Farmers Market, 2022 CCC market records

WIC vouchers redeemed 2022 = $1550 (23% redemption rate)

Senior Farmers Market Nutrition Program vouchers redeemed 2022 = $3990 (79.5% redemption rate) 

(Heather Todaro, MPA, vendor consultant, North Carolina Department of Health and Human Services, Division of Public Health, Nutrition Services Branch, December 13, 2022)

In the 2021 and 2022 market seasons, Stanly Commons Farmers Market received a RAFI (Rural Advancement Foundation International) grant that provided "double bucks"  that provided a dollar for dollar match in produce and meats for money spent by customers using EBT, WIC, or Senior vouchers for payment.  

2021 RAFI funds provided $7672.14 in locally grown meat and produce to participants

2022 RAFI funds provided $9546.02 in locally grown meat and produce to participants

(Stanly Commons Farmers Market, 2021/22 RAFI market records)

What We Do

Stanly Community Christian Ministry, Inc. is a partner agency of Second Harvest Food Bank of Metrolina. This agency focuses on ensuring individuals and families have access to food to live healthy and active lives.  Stanly Community Christian Ministry (SCCM) organizes monthly Mobile Food Pantries in various locations in Stanly County. SCCM also hosts Community Tables at two locations in Stanly County and serves one free hot meal per day to Stanly County residents. SCCM also provides two food pantry locations in Stanly County. Eligible residents can receive grocery support every 30 days. 

In Stanfield, West Stanly Christian Ministries provides a food pantry for those in need.  The pantry is stocked primarily through individual and group donations (churches, civic organizations, businesses, etc) and supplemented through Second Harvest Food Bank purchases made with donations provided to West Stanly Christian Ministries. Currently clients can receive food from West Stanly Christian Ministries every 60 days.

Who We Serve

Stanly County residents experiencing food insecurity.

How We Impact

Stanly Community Christian Ministry (SCCM) organizes monthly Mobile Food Pantries in various locations in Stanly County. SCCM also hosts Community Tables at two locations in Stanly County and serves one free hot meal per day to Stanly County residents. SCCM also provides two food pantry locations in Stanly County. Eligible residents can receive grocery support every 30 days.

What We Do

Since 2009, the Partners in Health coalition has staged the Golden Shoe event to encourage Stanly County residents to be physically active and to utilize the recreational parks in the county.  In this event, the committee repurposes old shoes by painting them gold.  Shoes are then tagged with a unique number and hidden in designated parks throughout Stanly County.  The tag attached to each shoe also gives the lucky winner the information needed to pick up their fun prize on the designated pick up day. 

Who We Serve

The Golden Shoe event is popular with people of all ages, from toddlers to seniors, and encourages families to get out and play. In 2019, 100% of participants who claimed prizes indicated that they are likely to continue visiting their local park. 

How We Impact

Stanly County Partners in Health collect data at each Golden Shoe event.  We have found that people who have gone to local parks to hunt for shoes also participate in other physical activity while at the park.  They report being likely to return to the park for physical activity.  

                 2023 Golden Shoe Data

Participated Before: Yes (40%) No (60%)      Visit Parks More: Yes (57%) No (43%)

Physical Activity other than Golden Shoe while at the park: Yes (96%) No (4%)

What We Do

Nutrition education programs available through NC Cooperative Extension - Stanly 

Med Instead of Meds for adults and seniors (57 seniors taught in 2023)- a six-session class series focused on eating a healthy Mediterranean-style eating pattern.  Sessions focus on the 7 Simple Steps to Eating the Med Way.  Each session explores 1-2 simple steps, a mindfulness skill, and features Med Way recipes from medinsteadofmeds.com.  Food demonstration and/or cooking instruction is included in each session.  

Who We Serve

NC Cooperative Extension- Stanly serves all members of the Stanly County community with programming for Pre-K students to senior adults. 

How We Impact

NC Cooperative Extension - Stanly helps people make healthier decisions, reduce their risk of chronic disease and live better lives through a wealth of programs from nutrition to local foods to food safety.

Progress on CHIPs

The 2021 Community Health Assessment identified 3 focus areas: Mental Health, Substance Use, and Healthy Living (nutrition, physical activity, and healthy weight).  

Mental Health

Suicide Prevention Education: Partners Health Management, Atrium Health, Stanly Community College, Stanly County Schools, and Graystone Day School have each provided suicide gatekeeper training.  Available programs include Mental Health First Aid (MHFA) and Question, Persuade, Refer (QPR). Partners Health Management and Atrium Health are able to provide suicide gatekeeper training to community members and groups through outreach and virtual events.  Stanly County Partners in Health works to promote this training to the community as one of their identified focus areas. 

School Mental Health: Stanly County Schools and Graystone Day School have focused on strategies to improve mental wellness among students.  Youth prevention education with curricula such as Too Good for Drugs and Botvin Life Skills develop skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure and influence.  These lessons are used for both improving mental health and preventing substance use by youth. 

Substance Use

Prescription Drug Safety:  Stanly County Health Department, Center for Prevention Services, Safe Kids, and local law enforcement have partnered to educate the community on the importance of safely storing and disposing of prescription medications.  There are 3 permanent medication dropboxes and medication take back events are held in many locations throughout the county, collected drugs are disposed of by Albemarle Police Department.  Medication lockboxes are distributed at community events and at the health department so that prescription drugs are more difficult to access by youth.  Lock Your Meds media campaigns through print, social media, and digital marketing were used to reach the community about the importance of keeping medications stored properly. 

Youth Prevention Education: Stanly County Schools, Center for Prevention Services, and Stanly County Health Department have partnered to provide drug use prevention education to students in grades 3-12.  This includes curriculums such as Avoid Vapes, Too Good for Drugs, Second Step, and Botvin Life Skills.  Each of these programs is designed to give students the social and emotional skills needed to make healthy decisions.  This education is available through a SAMHSA (Substance Abuse and Mental Health Services Administration) Partnership for Success grant. 

Stanly County Post Overdose Response Team:  Stanly County EMS has developed a community paramedicine program in which specially trained paramedics and a certified peer support specialist respond to emergency calls that indicate the possibility of overdose.  On the scene, they are able to assist the patient through the medical emergency as well as educate the patient on overdose prevention, use of naloxone, and treatment options.  Community paramedics are able to start the patient on MOUD (medication for opioid use disorder) at that time if it is wanted and deemed appropriate.  The certified peer support specialist is able to follow up with the patient to link them to local resources and provide counseling. 

Harm Reduction Services:  Uwharrie Harm Reduction Initiative, Stanly County Health Department, and Stanly County Project Lazarus partner to bring harm reduction resources to people who use drugs.  Participants are counseled by certified peer support specialists, linked to treatment, provided with recovery resources, educated on overdose and disease prevention, and receive prevention supplies.  Additionally, they provide services such as document restoration, supplies for people experiencing homelessness, on the job training with NC Works, advocacy with the court system, testing for communicable diseases, and more.  Services reach people where they are and are based on the harm reduction focus of promoting any positive change. 

Healthy Living

Stanly Commons Farmers Market:  This farmers market was established by Stanly County Health Department to ensure that residents have access to healthy, locally grown produce.  The market is open on Mondays and is located inside Stanly Commons near Stanly County Department of Social Services and Stanly County Health Department. Stanly Commons Farmers Market accepts EBT for payment and participates in a local food prescription program with the John P. Murray Community Care Clinic, as well as WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) voucher and Senior Farmers Market Nutrition voucher programs.  In 2021 and 2022, the market participated in the RAFI (Rural Advancement Foundation International) grant program which allowed low income shoppers to double their buying power at the market.  

Food Banks/Pantries, Community Tables, and Mobile Food Bank:  Stanly Community Christian Ministries continues to operate food pantries and community tables to support people experiencing food insecurity.  In 2022, they partnered with groups such as Stanly YMCA and Atrium to bring mobile food pantries to multiple sites throughout the county.  West Stanly Christian Ministries supports people experiencing food insecurity on the west side of the county through their food pantry in Stanfield.  

Golden Shoe:  Stanly County Partners in Health relaunched the Golden Shoe event in 2022 after a two year hiatus.  Two hundred old shoes are repurposed by painting them gold, tagging them with a unique number, and hiding them in local parks throughout the county.  From toddlers to seniors, residents get out and get moving while searching for golden shoes and each shoe is associated with a fun prize.  When surveyed, participants report that while they were searching for shoes they participated in other fitness activities at the park and that they were likely to return to the park beyond the Golden Shoe event. 

Nutrition and Physical Activity Education:  School aged children are reached by several programs through NC Cooperative Extension-Stanly and Atrium Health-Stanly, that come into the schools to teach the importance of nutrition and physical activity.  Atrium Health-Stanly's office of health promotion also offers education to adults on physical activity for all stages of life and nutrition education in support of chronic health conditions.  NC Cooperative Extension-Stanly offers educational programs on growing, cooking, and preserving healthy foods as well as physical activity for all ages.    

Morbidity and Mortality Changes Since Last CHA

Changes in Mortality

Since the 2021 Community Health Assessment, Stanly County has seen decreases in several of the rates of the Top 10 Causes of Mortality including: heart disease, cancer (all sites), Alzheimer's Disease, cancer (trachea, bronchus, lung), and pneumonia & influenza.  Each of these rates remain higher than North Carolina rates.  Stanly County mortality rates have increased in the following: all other unintentional injuries, chronic lower respiratory disease, cerebrovascular disease, diabetes mellitus, and motor vehicle injuries.  A new addition to Stanly County causes of mortality is COVID-19, coming in as the 12th leading cause of mortality even though only one year of data was included in the 2016-2020 data set.  

Health Disparities

In Stanly County, mortality rates for all causes, diseases of the heart, cancer, and cerebrovascular disease (stroke) were higher for African American residents than White residents.  All causes rates for mortality for Other Races non-Hispanic are 510.4 per 100,000 population in Stanly County and 424.4 per 100,000 population in North Carolina.  All causes rates for mortality for Hispanic ethnicity is 304.2 per 100,000 population in Stanly County and 404.5 per 100,000 population in North Carolina.  All causes rate of mortality for American Indian in North Carolina is 889.6 per 100,000 population,  Stanly County rates were not available. Rates for American Indian, Other Race non-Hispanic, and Hispanic ethnicity are not calculated due to the low number of deaths in specific categories.

Stanly County infant mortality disparity has decreased. While African American infants in Stanly County are still 1.33 times more likely to die than White infants, this has decreased from 2.27 times more likely in the 2015-2019 report.  The North Carolina infant mortality disparity ratio has increased from 2.47 to 2.59 times more likely.  Infant mortality among White infants remains elevated.  

Changes in Morbidity Since the 2021 Community Health Assessment

Maternal, Child, and Infant Health 

Stanly County has seen decreases in rate of infant mortality, neonatal death, low birth weight, and teen pregnancy.  With the exception of neonatal death, these rates remain higher than North Carolina rates.  "Unmarried Mother" was removed from the summary report.

Communicable Diseases

Stanly County has seen increases in rates of newly diagnosed chlamydia, gonorrhea, and early syphilis.  Each of these rates remain lower than North Carolina rates.  Rates for newly diagnosed HIV, AIDS, acute hepatitis B, and hepatitis C have decreased and remain lower than North Carolina rates. 

Priority Areas

Mental Health - Mental wellness, especially for children, was identified as a priority due to social isolation that occurred during COVID-19.  Schools and other social outlets were closed or modified during the period of March 2020 through 2022.  Age specific rates for self-inflicted injury and suicide ideation in the NCDETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool) Mental Health Dashboard support the need for this priority. This dashboard provides an overview of emergency department visits for anxiety, depression, self-inflicted injury, suicide ideation, and trauma/stressors.

Stanly County rates for self-inflicted injury and suicide ideation increased for individuals ages 10-17 between 2019 and 2021. 

Source: https://ncdetect.org/mental-health-dashboard/  

Data from 2020 should be interpreted with caution as ED visits dropped significantly, especially at the beginning of the COVID-19 pandemic. 

Substance Use - Stanly County saw a 3.9% increase in overdose deaths in 2021, compared to a 22% increase in North Carolina.  Overdoses reported by the emergency department decreased by 16.3% in 2022 in Stanly County, and by 6.3% in North Carolina.  From 2018, Stanly County has seen a 42% decrease in overdoses, while North Carolina has seen a 30% increase.  This is attributed to broad naloxone distribution from community partners including Stanly County EMS and Uwharrie Harm Reduction Initiative. 

Source: https://www.ncdhhs.gov/opioid-and-substance-use-action-plan-data-dashboard

Healthy Living (nutrition, physical activity, healthy weight)

The 2021 Behavioral Risk Factor Surveillance System (BRFSS) % Body Mass Index Grouping is divided into regions, with Stanly County being represented by the Piedmont region.  Body mass index (BMI) screens for weight categories that may lead to health problems, but it does not diagnose the body fatness or health of an individual.  Only 30.7% of the Piedmont region is considered to be within the recommended range for body mass index.  68% of the Piedmont region falls within the overweight or obese categories.  

Source: 2021 Behavioral Risk Factor Surveillance System (BRFSS), North Carolina State Center for Health Statistics / Body mass index is computed as weight in kilograms divided by height in meters squared: (kg/m2) / Underweight=BMI <18.5, Recommended Range=BMI 18.5 to 24.9, Overweight=BMI 25 to 29.9, Obese=BMI >30

Emerging Issues Since Last CHA

Sexually Transmitted Infections

• Newly diagnosed chlamydia annual rates are up from 457.0 in 2019 to 498.2 in 2021 (9% increase)
• Newly diagnosed early syphilis average rate (Primary, secondary, early latent syphilis) up from 4.8 in 2019 to 6.4 in 2021 (33% increase)
• Newly diagnosed gonorrhea annual rates are up from 119.4 in 2019 to 198.7 in 2021 (66% increase)
• Though rates are increasing, Stanly County rates continue to be below state averages

COVID-19

• First COVID-19 death reported locally was in April 2020
• 2016-2020 mortality data include COVID-19 data for the first time
• 12th leading cause of death over the five year period (2016-2020) 

New/Paused/Discontinued Initiatives Since Last CHA

New Initiatives

Opioid Settlement Funds

• $4.66 million designated for Stanly County over 18 years in Wave 1, potential additional funds in Wave 2
• Strategies funded must follow state Memorandum of Agreement
• Stanly County Board of Commissioners is responsible for approving allocations
• Disbursements have been made in support of recovery housing, recovery resources, harm reduction, and post overdose response
• Funded organizations must submit impact reports and show that they are following guidelines
• For more information visit: North Carolina Opioid Settlement

Suicide Prevention

• Suicide Gatekeeper training was chosen as a Healthy Communities strategy for 2022/23 because of community concerns over youth and adult mental health due to COVID-19 isolation
• Local organizations are encouraged to adopt new suicide prevention policies and/or programs and provide gatekeeper training sessions for suicide prevention using ASIST (Applied Suicide Intervention Skills Training), safeTALK, Faith and/or Start, QPR (Question, Persuade, Refer), CALM (Counseling on Access to Lethal Means), or Mental Health First Aid
• Health Department coalitions: Stanly County Partners in Health, Stanly County Minority Health Council, and Stanly County Project Lazarus work to inform the community about the availability of these no cost trainings from partner organizations
• Stanly County Schools, Stanly Community College, and Gray Stone Day School are also working on mental health initiatives for students and staff

Hands Only CPR

• Stanly County is an intervention county in the Duke University RACE-CARS (RAndomized Cluster Evaluation of Cardiac ARrest Systems) Trial. The primary goal of the trial is to improve survival with good neurological outcomes from Out of Hospital cardiac arrest by 33%
• Secondary outcomes are to improve bystander CPR rates by 33% and to improve AED defibrillation prior to EMS arrival by bystanders and first responders by 50%. 
• Partners such as Stanly County EMS, Atrium-Stanly, and Stanly County Health Department work to increase community knowledge of Hands Only CPR through outreach opportunities

Discontinued Initiatives

Healthy Beginnings 

• Program was focused on decreasing health disparities in minority infants
• Discontinued in 2022 due to end of grant period 
• Educational classes were held on subjects such as breastfeeding and safe sleep
• Over the course of the grant, there were 792 participant interactions

COVID-19 Mass testing and vaccination 

• In 2021 the health department was vaccinating several hundred individuals each day in drive through and indoor clinics
• Vaccination for COVID-19 is now widely available through physician offices and pharmacies and the role of the health department in vaccination is greatly reduced
• Self-administered COVID-19 tests have taken the place of laboratory tests conducted by the health department and contracted testing sites

Progress on CHIPs

The 2021 Community Health Assessment identified 3 focus areas: Mental Health, Substance Use, and Healthy Living (nutrition, physical activity, and healthy weight).

Mental Health

Suicide Prevention Education

Stanly County Partners in Health Coalition promotes suicide and mental wellness education to the community as one of the Healthy Communities initiatives. Partners Health Management, Atrium Health, Stanly Community College, Stanly County Schools, and Graystone Day School have each provided suicide gatekeeper training.  Available programs include Mental Health First Aid (MHFA), Question, Persuade, Refer (QPR), and Mental Health 101. Partners Health Management and Atrium Health are able to provide suicide gatekeeper training to community members and groups through outreach and virtual events.  Senior Citizen mental health is addressed by Partners Health Management Geriatric and Adult Specialty Team (GAST) through in-person training and webinars.  Centralina Area Agency on Aging also offers a webinar series that addresses the health of seniors including mental health.  Stanly Senior Center is often a collaborator with these organizations.

School Mental Health

Stanly County Schools and Graystone Day School have focused on strategies to improve mental wellness among students.  Youth prevention education with curricula such as Too Good for Drugs and Botvin Life Skills develop skills for making healthy choices, building positive friendships, developing self-efficacy, communicating effectively, and resisting peer pressure and influence.  These lessons are used for both improving mental health and preventing substance use by youth. Graystone Day School has adopted a partnership with For Students, which focuses on building student resilience and topics such as anxiety, personality, suicide prevention, and more.

Substance Use

Stanly County Project Lazarus Coalition (a subcommittee of Stanly County Partners in Health) is the lead coordinating organization for substance use prevention, harm reduction, treatment, and recovery strategies in Stanly County.  Stanly County Health Department works closely with other agencies and community based organizations to collaborate on initiatives to reduce overdose.

Prescription Drug Safety

Stanly County Health Department, Center for Prevention Services, Safe Kids, and local law enforcement have partnered to educate the community on the importance of safely storing and disposing of prescription medications.  There are 3 permanent medication drop boxes, and medication take back events are held in many locations throughout the county. Collected medications are properly disposed of by Albemarle Police Department.  Medication lock boxes are distributed at community events and at the health department so that prescription drugs are more difficult to access by youth.  Lock Your Meds media campaigns through print, social media, and digital marketing were used to reach the community about the importance of keeping medications stored properly. 

Youth Prevention Education

Stanly County Schools, Center for Prevention Services, and Stanly County Health Department have partnered to provide drug use prevention education to students in grades 3-12.  This includes curriculums such as Avoid Vapes, Too Good for Drugs, Second Step, and Botvin Life Skills.  Each of these programs is designed to give students the social and emotional skills needed to make healthy decisions.  This education is available through a SAMHSA (Substance Abuse and Mental Health Services Administration) Partnership for Success grant. 

Stanly County Post Overdose Response Team

Stanly County EMS continues their community paramedicine program in which specially trained paramedics and a certified peer support specialist respond to emergency calls that indicate the possibility of overdose.  On the scene, they are able to assist the patient through the medical emergency as well as educate the patient on overdose prevention, use of naloxone, and treatment options.  Community paramedics are able to start the patient on MOUD (medication for opioid use disorder) at that time if it is wanted and deemed appropriate.  The certified peer support specialist is able to follow up with the patient to link them to local resources and provide counseling. Eighty-four referrals were made in 2023.  Fifteen eligible patients began MOUD with 13 continuing treatment at the end of 2023.  Referrals are also made to outpatient treatment, facility-based crisis (detox), the recovery resource center, syringe service program, SUN Project (Substance Use Network for pregnant mothers using opioids), and other health and social services. 

Harm Reduction Services

Uwharrie Harm Reduction Initiative, Stanly County Health Department, and Stanly County Project Lazarus partner to bring harm reduction resources to people who use drugs.  Participants are counseled by certified peer support specialists, linked to treatment, provided with recovery resources, educated on overdose and disease prevention, and receive prevention supplies.  Additionally, they provide services such as document restoration, supplies for people experiencing homelessness, on the job training with NC Works, advocacy with the court system, testing for communicable diseases, and more.  Services reach people where they are and are based on the harm reduction principle of promoting any positive change.

Healthy Living

Stanly Commons Farmers Market

This farmers market was established by Stanly County Health Department to ensure that residents have access to healthy, locally grown produce.  The market is open on Mondays from April through December and is located inside Stanly Commons near Stanly County Department of Social Services and Stanly County Health Department. Stanly Commons Farmers Market accepts EBT for payment and participates in a local food prescription program with the John P. Murray Community Care Clinic, as well as the Senior Farmers Market Nutrition voucher program.  In 2023, the WIC farmers market voucher program was not implemented due to the change from paper vouchers to a mobile phone app which was not embraced by farmers. The farmers market also hosts community outreach partners such as NC Medicaid Enrollment Broker, Guardian ad Litem, Stanly County Schools, and NC Cooperative Extension. 

Food Banks/Pantries, Community Tables, and Mobile Food Bank

Stanly Community Christian Ministries continues to operate food pantries and community tables in Albemarle, East Albemarle, and Norwood to support people experiencing food insecurity.  In 2023, they partnered with Atrium to bring mobile food pantries to additional sites throughout the county. Stanly Family YMCA has held twice monthly mobile food pantries at Stanly County Commons in Albemarle and Stanly Community College Crutchfield Campus in Locust.  West Stanly Christian Ministries supports people experiencing food insecurity on the west side of the county through their food pantry in Stanfield.  

Golden Shoe

Stanly County Partners in Health hold the Golden Shoe event every March. Two hundred old shoes are repurposed by painting them gold, tagging them with a unique number, and hiding them in local parks throughout the county.  From toddlers to seniors, residents get out and get moving while searching for golden shoes and each shoe is associated with a fun prize.  When surveyed, participants report that while they were searching for shoes they participated in other fitness activities at the park and that they were likely to return to the park beyond the Golden Shoe event. The prize claim is held at City Lake Park and community organizations are invited to distribute information about their services.  This has proven to be an effective way to engage with families. 

Nutrition and Physical Activity Education

School aged children are reached by several programs through NC Cooperative Extension-Stanly and Atrium Health-Stanly, that come into the schools to teach the importance of nutrition and physical activity.  Atrium Health-Stanly's Office of Health Promotion also offers education to adults on physical activity for all stages of life and nutrition education in support of chronic health conditions.  NC Cooperative Extension-Stanly offers educational programs on growing, cooking, and preserving healthy foods as well as physical activity for all ages.

Morbidity and Mortality Changes Since Last CHA

Changes in Mortality

Since the 2022 State of the County Health Report, Stanly County has seen increases in several of the rates of the Top 10 Causes of Mortality including: heart disease, cancer (all sites), cancer (trachea, bronchus, lung), all other unintentional injuries, chronic lower respiratory disease, cerebrovascular disease, and diabetes.  Each of these rates remain higher than North Carolina rates.  COVID-19 mortality increased by 190.3% to become the fifth leading cause of death even though data for it is only included for 2 years of the 2017-2021 data set. Stanly County mortality rates have decreased in the following: motor vehicle injuries, Alzheimer’s Disease, pneumonia and influenza, nephritis, nephrotic syndrome & nephrosis, and prostate cancer.  

Health Disparities

The 2023 State of the County Health Report has expanded reporting of mortality by race and ethnicity.  In cases where county specific race/ethnicity cases are too low to report, state data is included.  In Stanly County, mortality rates for all causes, diseases of the heart, other ischemic heart disease (coronary artery disease), cancer, nephritis, nephrotic syndrome, and nephrosis (kidney disease), and cerebrovascular disease (stroke) were higher for African American residents than White residents.  Rates for COVID-19 and all other unintentional injuries were higher in the American Indian/Pacific Islander population when comparing state data. All-causes rates for mortality for Hispanic ethnicity is 377.6 per 100,000 population in Stanly County and 444.5 per 100,000 population in North Carolina.

Stanly County infant mortality disparity has continued to decrease. While African American infants in Stanly County are still 1.15 times more likely to die than White infants, this has decreased from 2.27 times more likely in the 2015-2019 report.  The North Carolina infant mortality disparity ratio has increased from 2.59 to 2.63 times more likely.  Infant mortality among White infants in Stanly County remains elevated at 8.5 per 1,000 live births compared to the state rate of 4.8.

Changes in Morbidity Since the 2021 Community Health Assessment

Maternal, Child, and Infant Health 

In Stanly County, overall infant mortality has decreased. The county has seen increases in the rate of fetal deaths and decreases in post-neonatal deaths.  Low birth weight remains unchanged since last reported. Rates of neonatal deaths and post-neonatal deaths remain lower than state rates.  The live births rate per 1,000 births has decreased slightly from the 2022 SOTCH report. Teen pregnancy rates also continue to decline. 

Communicable Diseases

Stanly County has seen decreases in rates of newly diagnosed chlamydia and gonorrhea.  Newly diagnosed early syphilis continues to increase.  Each of these rates remain lower than North Carolina rates.  Rates for newly diagnosed HIV have increased but numbers remain less than five and are difficult to interpret. Acute hepatitis B has seen a small increase in rates and acute hepatitis C has remained at zero.  Data for chronic hepatitis C has been added to the summary report this year as it is more prevalent in Stanly County than acute hepatitis C.

Priority Areas

Mental Health - Mental wellness, especially for children, was identified as a priority due to social isolation that occurred during COVID-19.  Schools and other social outlets were closed or modified during the period of March 2020 through 2022.  Age specific rates for self-inflicted injury and suicide ideation in the NCDETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool) Mental Health Dashboard support the need for this priority. This dashboard provides an overview of emergency department visits for anxiety, depression, self-inflicted injury, suicide ideation, and trauma/stressors.

In ages 10-14, 18-24, 45-64, and 65 and older experienced increases in suicidal ideation.  Age groups reporting the highest rates of suicidal ideation in 2021, 15-17 and 25-44, saw decreases in 2022.  

With the exception of ages 45-64, rates of self-inflicted injury decreased from 2021 to 2022.

Substance Use - Stanly County saw a 18.6% decrease in overdose deaths in 2022, falling below the state rate for the first time since 2016.  Overdoses reported by the emergency department increased by 11.9% in 2023 in Stanly County.  Opioid related overdoses continue to decrease with an estimated 45.5% of overdoses being attributed to opioids, which is down from 79.6% in 2018. From 2018, Stanly County has seen a 27.8% decrease in overdoses.  This is attributed to broad naloxone distribution from community partners including Stanly County EMS and Uwharrie Harm Reduction Initiative.

Healthy Living (nutrition, physical activity, healthy weight)

Stanly County is found to have 38% of adults who report a BMI (Body Mass Index) of greater than 30 kg/m sq. This percentage is highest when compared to our peer counties and higher than North Carolina by four percentage points. 

Thirteen percent of Stanly County adults are estimated to be food insecure.  This is slightly higher than the state at 12% but lower than the highest peer county percentage at 15%.

Emerging Issues Since Last CHA

Emerging Issues

While rates for sexually transmitted infections chlamydia and gonorrhea declined from the previous State of the County Health Report, there are continuing increases in early syphilis.  The rate of newly diagnosed early syphilis is up from 6.4 per 100,000 population in 2021 to 8.5 in 2022, this is still below the state rate of 30.5 per 100,000.  The rates for newly diagnosed HIV have also increased from 3.1 to 4.3 per 100,000, the low number of cases makes this increase difficult to interpret.  

Rates for newly diagnosed chronic hepatitis C were added to this year’s State of the County Health Report.  Since 2020, rates have increased 14% from 60.8 to 69.4 per 100,000 in 2022.  

New/Paused/Discontinued Initiatives Since Last CHA

New Initiatives

Opioid Settlement Funds

• $8.47 million designated for Stanly County 

  • Distributed in unequal annual installments through 2039

• Stanly County Opioid Settlement Funds Task Force was assembled in November 2023 for strategic planning 

  • Developed grant application

  • Will make recommendations for funding to the Board of County Commissioners

• Disbursements have been made in support of recovery housing, recovery resources, harm reduction, medication assisted treatment, and post overdose response

SUN (Substance Use Network) Project

• Program specifically for pregnant mothers who use substances

• Includes monthly care management and cooperation between agencies integrated with maternal healthcare

Stanly County Reentry Roundtable

• Convened local agencies and organizations to build a local reentry council

• Received training from state reentry council experts

Discontinued Initiatives

Stanly County Youth Drug Survey 

• Discontinued by Stanly County Board of Education in 2023 due to NC Senate Bill 49

• Without the data collected there are no sources for local data concerning youth concerning attitudes about and use of substances including tobacco/vaping 

HRSA RCORP (Health Resource Services Administration - Rural Communities Opioid Response Program) grant

• This grant concluded in May 2023 after three years and a nine month extension

• Work plan projects have transitioned in part to funding through opioid settlement funds

• Projects

  • Establishment of harm reduction services and certified peer support services

  • Support of post overdose response through community paramedic and certified peer support specialist positions

  • Increased access to medication assisted treatment for those with opioid use disorder and uninsured

  • Support of recovery housing

  • Anti-stigma media campaigns

• Outcomes

  • 18.6% decrease in overdose deaths in Stanly County from 2018-2022

  • 27.8% decrease in overdose cases that present to the emergency department in Stanly County from 2018-2023