Our nation faces a health crisis due to the increasing burden of chronic disease. In factor, 7 out of the 10 leading causes of death in the US are due to chronic disease while 50% of Americans live with a chronic disease. People suffering from these diseases like heart disease, stroke, diabetes, cancer, obesity, and arthritis experience limitations in function, health, activity, and work which effects this quality of life.

A number of risk factors are associated with chronic disease. They include:

• Tobacco use
• Tobacco exposure
• Physical inactivity
• Poor nutrition

Healthy NC 2020 lists Chronic Disease as a leading focus area for our state. Through evidence based strategies, our state hopes to achieve the following outcomes:

The 2011 Community Health Assessment identified healthy eating, physical activity, and substance abuse prevention as health priorities for Jackson County. Today, these priorities are still relevant. However, primary and secondary data collected during the 2015 CHA process indicated that Chronic Disease was emerging as an issue to note. During the prioritization process, community members used the following criteria to determine if chronic disease was a leading health priority:

• How important or relevant is this issue?
• What will we get out of addressing this issue or how impactful is it?
• Can we adequately address this issue or how feasible is it?

Ranking high on each criteria (diabetes ranked the highest of all health issues), community members determined that Chronic Disease is a health priority for Jackson County.

Community members participate in an annual Stroke Risk Screening, in partnership with Western Carolina University, Harris Regional Hospital, and the Department on Aging.

The following progress was made in 2016 on Chronic Disease in Jackson County.

• DPP Class: This year-long class ended in December 2016. Nine participants graduated. Each participant lost weight and lowered their HbA1c significantly. Data was submitted to the CDC with hopes of the Health Department receiving CDC recognition for this program.
• DSME Program: This program is offered at two locations-- the Health Department and Harris Regional Hospital. At the Health Department, DSME is offered at no cost. This year, 57 patients attended class with 83 total visits. Additionally, the program instructor received 45 referrals who did not show for their appointment. At the Hospital, DSME is billed to patients' insurance companies. This year, the program was offered through 7 classes, reaching 59 participants. The average HbA1c of patients decreased by 2.58 points and 88% of participants lost weight.

[Guidance: The report should identify the actual efforts made for priority areas, not data. The state is looking to see that the priority was addressed through some initiatives over the course of the year. Identify activities, outreach events, policies, screenings provided, number of classes conducted, program participation, or other evaluation measures from your action plans. Quantifiable measures are the easiest way to show progress, but you will not always have numbers to include in your SOTCH report.]

The following progress was made in 2017 on our action plan interventions for [insert health priority] in [insert county]. [Guidance: In order to make the SOTCH reports easier to review, the state reviewer has requested that the progress made on action plan interventions be separated from "other" progress made. Don't forget that even if you have not made any progress on an intervention mentioned in your action you still need to include "story" (e.g. program lost funding or not enough participants signed up.)]

• Action Plan Intervention 1
  • Example of Progress
• Action Plan Intervention 2
  • Example of Progress

Additionally, the following progress was made in 2017 on [insert health priority] in [insert county].

• Example 1
• Example 2
• Example 3