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H e r t f o r d C o u n t y D e m o g r a p h i c s P o p u l a t i o n, 2 0 1 3 2 4, 4 3 1 White Persons, 2013 36.4% Black persons, 2013 59.7% American Indian & Alaska Native Persons, 2013 1.8% Asian Persons, 2013 0.7% Persons of Hispanic or Latino Origin, 2013 3.7% H E R T F O R D C O U N T Y State of the County Health Report 2014 Back Ground About this Report This publication provides an update of progress made in addressing the priority health issues selected following the release of the 2012 Community Health Assessment. During the years between community health assessments (CHA), local health departments conduct and provide an abbreviated State of the County Health Report (SOTCH Report) for county residents. Health priorities help guide the planning of programs and services for the community. Since 2012, Hertford County Public Health Authority (HCPHA), and our Community Partners have worked to address several community health concerns in Hertford County. This document summarizes the status of our combined efforts. High School graduates, % of persons age 25 +, 2009-2013 77.5% Bachelor s degree or higher, % of persons age 25+, 2009-2013 15.4% Population Status The majority of the population in Hertford County is African American. The Hispanic, American Indian and Asian populations in Hertford County are very small compared to other NC counties. Per Capita money income in past 12 months, 2009-2013 $17,863 Demographic data derived from www.census.gov

P a g e 2 2009-2013 Top 5 Causes of Death Causes of Death # of Death Deaths Rate Cancer All Sites 293 238.5 Heart Disease 277 255.9 Diabetes 75 61.2 Stroke 71 57.9 Chronic Lower Respiratory Disease 51 41.6 NC Center for Health Statistics- www.schs.state.nc.us/ Major Morbidity and Mortality Data From 2009-2013, there was a total of 293 deaths in Hertford County due to cancer with lung cancer exceeding all other cancers. The cancer death rate in Hertford County continues to be higher than the NC rate. Deaths due to heart disease has steadily increased over the last 4 years. Hertford County rate now exceeds NC rate. Heart disease continue to be the second leading cause of death in Hertford County. The death rate in Hertford County due to stroke continues to show a downward trend. Stroke is the 4th leading cause of death in Hertford County and continues to remain slightly above the NC rate. NC Dept. of Health and Human Services Division of Public Health/State Center for Health Statistics

Major Morbidity and Mortality Data P a g e 3 From 2006-2012, the mortality rate due to diabetes have remained steady with a slight drop from 2009-2013. Hertford County rate continues to be twice as high as the NC rate. The gap between the Hertford County rate and those of NC rate has been getting wider over time. The infant mortality rate in Hertford County shows an increase over the last 4 years. There was a total of 5 infant deaths in Hertford County in 2013. The infant mortality rate in Hertford County exceeds that of the NC rate. The graph above shows a steady decline in the teenage pregnancy rate from 2010 to 2012 but shows a slight increase in 2013. The Hertford County rate remains higher than that of the NC rate. There was a total of 34 pregnancies in Hertford County in 2013. NC Dept. of Health and Human Services Division of Public Health/State Center for Health Statistics Community Health Priorities Identified from 2012 Community Health Assessment 1. Access to Care (need for specialty care, lack of evening/weekend hours for health services, need to link people/population to needed personal health services) 2. Adolescent Health (teen pregnancies, STDs, violence, drugs abuse, childhood obesity, youth tobacco use prevention) 3. Chronic Disease Prevention (diabetes, prostate cancer) 4. Social Determinants of Health ( high percent of single head of household, shortage of employment opportunities, children in single parent households, children in poverty, teen pregnancies)

Access to Care, Progress to Date: Hertford Health Maintenance Alliance partners continue to meet and collaborate to identify available resources for potential uninsured patients. P a g e 4 Patient navigators continue to navigate patients through the network and provide case management. Total of 418 patients have been served by Hertford Health Access Network. There are a total of 339 active clients enrolled in the Hertford Health Access Network Hertford Health Access implemented a new electronic health information system called Fhases to better navigate clients through the network. Adolescent Health, Progress to Date: The School Based Health Center has expanded it services to reach high school students. Herford County Public Health Authority s Health Educator implemented a Bullying and Intimate Partner Relationship Program to middle school students. Middle school students are accessing Behavioral Health Services at the School Based Health Center. Chronic Disease Prevention, Progress to Date: Herford County Public Health Authority and the Community Health Center is collaborating with the University of NC at Chapel Hill to implement the CHANGE (Carolina Heart Alliance Networking for Greater Equity) Program. The program focuses on reducing the risk of cardiovascular disease in rural and medically underserved communities. Hertford Health Maintenance Alliance partners continue to refer uninsured individual into the Hertford Health Access Network. Hertford County Public Health Authority continue to lead and support the Region Nine HIV/AIDS Disease Management Network. Partners continue to provide health information regarding varies chronic diseases at community events. Roanoke Chowan Community Health Center and Vidant Wellness Center Diabetes Education Program continues to provides an inpatient nutrition and diabetes program. Hertford County Public Health Authority received additional funding to continue providing the Breast and Cervical Cancer Prevention Program.

Social Determinants of Health, Progress to Date: P a g e 5 The Community Health Center/Hertford Health Maintenance Alliance received start up funds to explore the concept of Community-Centered Health Homes. This concept will look at bridging the gap between health services and community prevention. New Initiatives Hertford Health Maintenance Alliance will be exploring Community-Center Health Homes. Herford County Public Health Authority and the Community Health Center is collaborating with the University of NC at Chapel Hill to implement the CHANGE (Carolina Heart Alliance Networking for Greater Equity) Program. The program focuses on reducing the risk of cardiovascular disease in rural and medically underserved communities. Hertford Health Maintenance Alliance will be exploring Project LAZARUS (Prescription Medication overdose program). Hertford County Public Health Authority is now implementing the Triple P, Positive Parenting Program. Hertford County Public Health Authority is now implementing the ASK 4 CARE, HIV Program. Emerging Issues Child Poverty Child Abuse Youth Diabetes Youth Obesity Prescription Medication Abuse

HOW CAN YOU GET INVOLVED? For more information contact the Health Promotion Division with Hertford County Public Health Authority at (252) 358-7833 or go online to www.hertfordpublichealth.com Hertford County Board of Health Howard Hunter III, County Commissioner Chairman Terry Hall, D.M.D. Vice Chair Rhonda Harrington Westelle Cherry, RN, F.N.P. Retired Susan Mitchell, RN, MSN, MBA Charles Reynolds Jamie Udwadia, MD Rebecca Greene Katrina Eley, PA-C Hertford County Public Health Authority Locations & Services Administrative Office, Environmental Health and Health Promotion Services 801 North King Street Winton, NC 27986 252-358-7833 (252)358-7869 fax Personal Health Services 828 South Academy St. 252-332-6650 Chronic Disease Management and Outreach Services 714 Evans Street 252-332-6650 Hertford Home Health Agency 704 Evans Street 252-332-6747 WIC Services 718 Evans St. Compiled By: Crystal Dempsey Health Promotion Supervisor Published By: Hertford County Public Health Authority Health Promotion Division