Transylvania Public Health is committed to protecting and improving the health of all people in Transylvania County. One way we do this is through identifying and working to address important health needs in the community.
Every three years, we conduct a Community Health Assessment to investigate and describe current health conditions in the county. We work with community members from health care, government, social service organizations, and the general public to identify the top three priority health issues in Transylvania County. (View or download the 2015 Transylvania County Community Health Assessment here.) We receive support and assistance in data collection, analysis, and followup from WNC Healthy Impact, which is a partnership between hospitals and health departments in western North Carolina to improve community health. We also collaborate with Transylvania Regional Hospital.
We then work to bring community members together to develop action plans that will address these top health priorities. Together, these action plans form a Community Health Improvement Plan (or CHIP), which is a strategic plan for the entire community designed to encourage cross-sector collaboration.
This "e-CHIP" scorecard is a low-cost, easy-to-use tool that helps us track and display data related to these health priorities and organize community improvement efforts to improve health in Transylvania County.
Substance use and abuse are major contributors to death and disability in North Carolina. Addiction to drugs or alcohol is a chronic health problem, and people who suffer from abuse or dependence are at risk for premature death, comorbid health conditions, injuries, and disability. Therefore, prevention of misuse and abuse of substances is critical. Furthermore, substance abuse has adverse consequences for families, communities, and society, contributing to family upheaval, crime rates, and motor vehicle fatalities. (Healthy NC 2020)
Substance abuse is linked to a number of poor health outcomes in Transylvania County. Key informants reported that the most problematic substances for the county were prescription drugs and alcohol.
WNC region sees high mortality rates due to unintentional poisoning related to
medication and drug overdose. However, the most recent rates of unintentional
poisoning related to drug overdose in Transylvania County were approximately
35% higher than the regional rates and 1.8 times the state rates.
A second cause of higher-than-expected mortality is liver disease: although the percentage of “excessive drinkers” in Transylvania County falls below the state average and the Healthy People 2020 Target, there is a strong association between alcohol abuse and chronic liver disease and cirrhosis.
In addition, substance abuse is associated with suicide, which is the third cause of death in which Transylvania County rates are higher than the state rates.
Develop and disseminate messages about safe storage and disposal of prescription medications
The following progress was made in 2016 on Substance Use in Transylvania County.
C.A.R.E. works toward creating a healthy, vibrant Transylvania County, free of underage drinking and substance abuse. Members include representatives from schools, law enforcement, health care, media, youth-serving agencies, civic and volunteer organizations, religious groups, mental health/substance use treatment programs, parents, and youth. C.A.R.E. is the recipient of a 5-year Drug-Free Communities grant and was awarded a new 4-year STOP grant for further work to prevent underage drinking.
Transylvania Public Health continued its partnership with the C.A.R.E. Coalition to reduce misuse of prescription medication through safe storage and disposal messages. The following progress was made in 2017 on our action plan interventions for substance abuse in Transylvania County.
These efforts seem to be having an impact on the community. A community survey conducted by C.A.R.E. in 2017 showed that 20% of respondents said they locked up medications (compared with 18% in 2014) and 28% disposed of medications properly (compared to 22% in 2014). However, less than 10% of respondents who take a prescription said that their doctor or pharmacist had spoken with them about safe storage or disposal, so there is still room for improvement here.
Additionally, the following progress was made in 2017 on substance abuse in Transylvania County.
Mental health is a new health priority for Transylvania County, related to mortality and morbidity statistics, an understanding of the relationship between substance abuse and mental health issues, and a lack of necessary mental health treatment and counseling options in the county, especially for those who have little income or no insurance.
Mental health is closely tied with many other health issues. One study suggested that more than 68 percent of adults with a mental disorder had at least one medical condition. (Goodell, Druss, & Walker, 2011) Medical disorders may lead to mental disorders, mental conditions may place a person at risk for certain medical disorders, and mental and medical disorders may share common risk factors. It is also closely tied with our first priority: substance abuse, and with our three causes of death that rate higher than the state average.
Transylvania County has experienced much economic turmoil in the past decade, resulting in a lack of good-paying jobs for those without higher education. Although some sectors of the community are quite wealthy and the county attracts many tourists and retirees, many others in the community are stuck in poverty with no job prospects and no way to improve their life circumstances.
Mental health issues in Transylvania County are compounded by the lack of adequate mental health care facilities, especially for those who have additional barriers to care such as lack of health insurance, poverty, and lack of transportation. When talking to employers, social workers and law enforcement, the issues of mental health and substance abuse are often identified as problems that have not be adequately addressed in Transylvania County or North Carolina.
Support improvements to mental health care through screening, referrals, and collaborative care
Provide information about navigating the mental health care system to community members
The following progress was made in 2016 on Mental Health in Transylvania County.
The following progress was made in 2017 on our action plan interventions for mental health in Transylvania County.
Additionally, the following progress was made in 2017 on mental health in Transylvania County.
Nutrition, physical activity, and health are closely related to cultural norms and traditions, and well as geography and the economy. A rural county with a limited number of well-paying jobs and high cost of housing results in long commutes, less money for groceries and recreation, and limited access to stores that sell nutritious foods.
Although we have an environment conducive to outdoor activity, a large percentage of our community does not have an active lifestyle. Bike riding is a popular recreational activity and actually draws a number of visitors to the county, and some residents are drawn to the county based on the downtown’s “walkability.” However, among some populations, riding a bicycle or walking as a form of transportation may be seen as evidence of being unable to afford a car.
Transylvania County has a long history of self-sustenance, and it is popular to grow a small garden for fresh herbs and vegetables and visit the thriving Farmer’s Market. However, for some of the population, eating out is still a symbol of prosperity. For others, a busy lifestyle, long distances to and from work, and lack of knowledge about how to properly prepare nutritious foods contribute to a “fast-food culture.” Cooking home-style foods with an emphasis on red meat and potatoes may be expected and appreciated by others. Families who are stretching their grocery budget may not see how they can afford nutritious food, or may not be able to travel to stores that sell nutritious items. Families who must rely on food pantries may not have access to much more than the shelf-stable items available from those sources.
This issue, too, is related to the other selected health priorities. Stress contributes to weight gain and a desire for foods that fill an emotional rather than nutritious need. However, physical activity can reduce stress and contribute to better mental health.
Provide Social Support for Physical Activity
Support the Local Corner Store Initiative
The following progress was made in 2016 on Physical Activity, Nutrition & Weight in Transylvania County:
The following progress was made in 2017 on our action plan interventions for nutrition, physical activity & weight in Transylvania County.
Additionally, the following progress was made in 2017 on nutrition, physical activity & weight in Transylvania County.