2009 Carteret County
Community Health Assessment
Carteret County 2009
Community Health Assessment
Dr. J.T. Garrett, Ed.D, MPH
Health Director
Carteret County Health Department
3820 Bridges Street, Suite A
Morehead City, NC 28557
Phone: (252) 728-8550
Fax: (252) 222-7739
Web site: www.carteretcountyhealth.com
1
2009 Carteret County
Community Health Assessment
Dedication
This report is dedicated to the residents of Carteret County. Thank you for your willingness to
share your thoughts and opinions on the health strengths and needs within our community. It
is our goal to use this information effectively to partner and develop projects and solutions
to the issues identified by (you) the community!
If you would like to learn more about Healthy Carolinians of Carteret County or are
interested in being involved in upcoming projects or initiatives, please visit their website at
www.healthycarteret.org
Acknowledgements
Carteret County Health Department would like to acknowledge the members of
the Community Health Assessment Planning Committee:
Andrea Boyd, Carteret Co. Health Department
Ann Baugham, Carteret Co. Health Department
Anne Hardison, Healthy Carolinians of Carteret County
Bev Stone, Healthy Carolinians of Carteret County
Bill Barrow, Hope Ministries
Bob Danehy, Town Commissioner- Pine Knoll Shores
Constance Sowers, Carteret Co. Partnership for Children
Corie Nunn, Carteret General Hospital
Dorothy Knight, Carteret Surgical Associates
Erin Brandt, Coastal Community Action Inc.
Gwen Littman, MD- Lumina Wellness Inc.
Jessica Forsberg, Carteret Co. Parks and Recreation
Johnna Whitfield, NC Oral Health Section
Mary Elizabeth Dixon, Leon Mann Jr. Enrichment Center– Senior Services
Mary Fournier, Carteret Co. Health Department
Pat Kellum, Carteret General Hospital
Regenia Bell, NC Cooperative Extension
Tanya Roberts, Coastal Coalition for Substance Abuse Prevention
Community Health Opinion Survey- Volunteers
Carteret County Health Department (CCHD) would like to extend a special “Thank you” to
Rachel Garnett, Technical Consultant with the PHRST Region 2 and the New Hanover County
Health Department!
CCHD Staff, Healthy Carolinians members and other community volunteers:
Andrea Boyd
Ann Baugham
Anne Hardison
Ben Kane
Brad Jones
Christine Nitt
Corie Nunn
Curtis Oden
Daniel Allen
Daniel Raeburn
Debbie Smith
Gwen Littman
Jerry Batten
Jesse Dail
Johnna Whitfield
Julie Harris
Justina Grady-Coker
Karrie Adams
Katrina Winters
Larry Smith
Mary Fournier
Molly Fullwood
Nicole Bruce
Pat Kellum
Patti Schweis
Regenia Bell
Sammy Graham
Sandra Malone
Stephanie Cannon (Onslow Co.)
Tanya Roberts
*Carmen Martinez (Interpreter)
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2009 Carteret County
Community Health Assessment
2009 Carteret County Community Health Assessment
Table of Contents
.
INTRODUCTION
PAGE
Community Health Assessment Overview
The role of the local Healthy Carolinians Partnership
CHAPTER ONE
iii
iii
Carteret County Community Profile
Geography
History
Demographics
Household and Income Data
Military Population
Government
Economy
Education
Crime
Faith Community
Child Care
Transportation
Environmental Data
1
2
3
4
5
6
7
11
14
15
15
16
18
CHAPTER TWO Inventory of Existing Health Resources
Broad Street Clinic
VA- Community Based Clinic
Carteret County Health Department
Carteret General Hospital
Onslow Carteret Behavioral Healthcare Services
Carteret County Domestic Violence Program
Carteret County Rape Crisis Program
Number of Active Healthcare Provider and Health Professionals in Carteret County
22
22
23
26
27
28
29
30
CHAPTER THREE Local, Regional, and State Health Data Comparison
Leading Causes of Death- “What’s killing us?”
Life Expectancy
Cancer Rates
Maternal and Child Health Data
Uninsured
Communicable Disease
Substance Abuse and Mental Health
Behavioral Risk Factor Surveillance System Data
31
35
35
36
37
37
39
42
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2009 Carteret County
Community Health Assessment
2009 Carteret County Community Health Assessment
Table of Contents
CHAPTER FOUR
PAGE
Primary Data Collection
Key Informant Survey Process and Results
Community Forums- Flyer
Community Forum Process Overview and Summary of Results
Community Opinion Survey Process
Community Opinion Survey Summary-Narrative
Statistical Analysis- Community Opinion Survey
CHAPTER FIVE
43
47
48
52
54
59
What’s Changed since the 2005 Assessment?
Healthy Carolinians Update
Emerging Issues- H1N1
69
71
CHAPTER SIX
72
CHAPTER SEVEN
Dissemination and Communication Plan
Next Steps
Determining Health Priorities
Developing the Community Action Plan
73
75
APPENDICIES
A. Expanded Community Health Resource Directory
B. Children’s Art Contest Registration Form
-ii4
2009 Carteret County
Community Health Assessment
INTRODUCTION
The Carteret County Health Department and
Healthy Carolinians of Carteret County are pleased to
present the 2009 Community Health Assessment. This
report fulfills the State of North Carolina’s requirement
for the local health department and the local Healthy
Carolinians Partnership to submit a community health
assessment document every four years.
A community health assessment is intended to
describe the county’s current health status, identify
emerging issues and needs in the community, and
develop strategies to address these issues. By using a
compilation of state and local statistical data, primary
data collected through key informant surveys, community
forums, and a door to door community opinion survey,
we hope to accurately represent the county’s strengths
and needs.
Carteret County is fortunate to have an active
Healthy Carolinians partnership to assist in the
community assessment process, by determining
priorities, helping conduct focus groups, and researching
community needs. Healthy Carolinians is “a network of
public-private partnerships across North Carolina that
share the common goal of creating environments that
promote healthy lifestyles for all North Carolinians.” The
local partnership consists of members of the public as
well as representatives of agencies and organizations that
serve the health and human service needs of the local
community, businesses, churches, schools
and civic
groups. For more information on Healthy Carolinians
Partnerships and their role in the Health Assessment
process please visit the State Healthy Carolinians website
www.healthycarolinians.org.
ACCREDITATION
STANDARDS
This report ensures Carteret
County Health Department in
meeting one of the key assessment
standards instituted as a part of the
North Carolina Local Public Health
Accreditation Program.
This program was established to
develop a mandatory, standard
based accrediting system for local
health departments across the state.
Local Public Health Accreditation
Program is a collaboration of the
North Carolina Division of Public
Health,
the
North
Carolina
Association of Local Health Directors
and The North Carolina Institute for
Public Health.
Carteret County
earned Accreditation Status in 2008.
Essential Function: Assessment
Essential Services:
1. Monitor health status to identify
community health problems
3. Inform, educate, and empower
people about health issues
4. Mobilize community partnerships
to identify and solve health
problems
10. Research for new insights and
innovative solutions to health
problems
Standard 1:
Conduct and disseminate results of
regular community health
assessments to monitor progress
toward health-related objectives.
-iii5
2009 Carteret County
Community Health Assessment
CHAPTER ONE
Carteret County Community Profile
Geography
Carteret County is a coastal community often referred to as “The Crystal Coast”. Centrally located on
the North Carolina coastline and bordered on the north by the Pamlico Sound and east and south by the
Atlantic Ocean, Carteret County is defined by water. Geographically this area is approximately 1,064
square miles, of which, 526 square miles are land.
Surrounding counties include Pamlico, Craven,
Jones, and Onslow.
Source: NC HWY MAP- NC Department of Transportation 2008
With an average elevation of nine
feet above sea level, Carteret
County is the southernmost portion
of the Outer Banks (Southern Outer
Banks, SOBX). Several protected
areas can be found in Carteret
County including: Cape Lookout
National Seashore, the Croatan
National Forest, and Cedar Island
Wildlife Refuge.
The climate in Carteret County is
seasonally mild, on average there
are 211 sunny days per year. The
July average high temperature is around 88 degrees, and in January the average low temperature is 36.
Annual rainfall amounts reach about 58.25 inches. Being on the coast Carteret County is no stranger to
hurricanes. However, over the past four years Carteret County has been fortunate to be spared by any
major storms.
Coloring Contest Entry
Name: Hallie
Age: 7
How can we make Carteret County a
healthier place to live? “We need to take
care of the trees and the environment, trees
give us oxygen.”
1
2009 Carteret County
Community Health Assessment
History
Nestled along the coastline of North Carolina, Carteret County is steeped in history and rich cultural
heritage. Carteret County was first home to Iroquois-speaking Tuscarora Indian Tribes who lived
between the Neuse and Pamlico Rivers in eastern North Carolina.
As early as 1706, white settlers of Huguenot, German, Scotch-Irish, French, and English descent arrived
in the region and slowing began forcing the tribes away from the coast. Most had migrated southward
from northern American colonies rather than from Europe. Early settler’s depended on fishing for food
and trade as these Indian trails or “trading paths” developed within the county. These narrow trails
widened over time with some being made into roads. Eventually the “Great Trading Path,” running from
the coast to the western part of NC, became part of a post road over which a mail and stage line was
established in 1789, running from Beaufort to Pollocksville.
Carteret County was formed out of Craven County in 1722. It is named in honor of Sir John Carteret,
who later became the Earl of Granville and one of the Lords Proprietors of North Carolina. Carteret
County participated in global trade almost from its beginning. Plantations produced goods such as
tobacco, grains, and salted meats and fish to export to England. Lumber was also a major export due to
the area’s vast forests. The most significant commercial industry was naval stores--tar, pitch, rosin, and
turpentine. Portsmouth and Beaufort served as the county’s major ports. Ships landed in Portsmouth,
and workers transferred cargo to smaller boats for transport to the mainland. However, as its depth
decreased, Portsmouth harbor declined as a port of entry, and the town was abandoned.
Beaufort, Carteret’s county seat, is the third oldest town in North Carolina. It was first known
appropriately as Fishtown because the fishing industry was and has been an important part of the
county’s history. Beaufort was later named for Henry Somerset, Duke of Beaufort.
Carteret County has faced it share of adversity over the years as the coastal area was both a target and a
haven for pirates. Blackbeard was known to frequent the waters and docks of Beaufort and remnants of
his ship “The Queen Anne’s Revenge” have been recovered off the coast. Residents have also witnessed
war in their backyards, many served in some role in all of the major conflicts from the Revolutionary
War, Civil War, and WWI and WWII. Carteret County’s history can be viewed up close by visiting Fort
Macon, a Civil War Fort located in Atlantic Beach, or by diving off the coast for shipwrecks.
The lumber industry was the most widespread and a very lucrative business in the county. Early
sawmills were established and operated in what is now Mill Creek and Newport. However, fishing and
other water-related activities were and continued to be a chief commercial activity in the county.
Through the years, whaling, menhaden fishing, mullet, sea trout, diamond-back terrapin, oyster, bay
scallop, crab and shrimp fisheries have played a part in the development and commerce of the county.
Morehead City was not established until 1858. It started as a railroad town and deep water port that
eventually attracted tourists. Today Morehead City remains the centralized “hub” of the County,
however all parts are seeing an increase in commercial and residential developments. Carteret County
will continue to grow and change, however still holding on to many of the traditions and values of the
past.
Source: Heritage of Carteret County Vol. 1- 2, North Carolina History Project
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2009 Carteret County
Community Health Assessment
Demographics
According to the US Census Bureau, Carteret County is
classified as a Central Micro-politan statistical area,
defined by having at least one urban cluster of at least
10,000, but less than 50,000 population. Based on the
2000 Census numbers approximately 62% of the county
is considered urban, and 37.7% is considered rural with
.3% rural-farm.
Table 1.1
Carteret County, North Carolina
Population 2000
Population Estimate 2008
% Change from 2000 - 2008
59,383
63,195
+6.4%
Source: US Census Quick Facts, Carteret County
Carteret County’s Population Estimate for 2008 was 63,195, with 51.2 percent of the population being
females and 48.8 percent males. Carteret County is racially composed of 90.1 percent White, 7.4
percent Black, 2.5 Hispanic, .5 percent American Indian, .7 percent Asian, and .1 percent Native
Hawaiian or Pacific Islander, and about 1.1 percent of the population identify with two or more races.
Carteret County is also a coastal destination with over 81 miles of beautiful beaches. During the
summer months the seasonal population increases dramatically. The seasonal population projection for
2010 is ~ 153,708, and for 2020 increases to~ 170,583.
~Seasonal population projections do not include permanent population figures.Source: Carteret County, Economic Development Council, US
Census Quick Facts, and EDIS NC Dept of Commerce County Profile August 2009
Percent of Population by Race, Carteret County, 2008
Figure 1.1
2.5%
White
7.4%
Black
0.5%
American Indian and Alaska Native
0.7%
Asian
0.1%
Native Hawaiian/ Pacific Islander
Hispanic/Latino
1.1%
90.1%
Two or More Races
Source: US Census Quick Facts, Carteret County
Percent of Population by Race, North Carolina, 2008
7.4%
White
Black
21.6%
1.3%
American Indian and Alaska Native
0.1%
Asian
1.9%
Native Hawaiian/ Pacific Islander
Hispanic/Latino
73.9%
1.2%
Two or More Races
Source: US Census Quick Facts, Carteret County
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2009 Carteret County
Community Health Assessment
Figure 1.2
Age Distribution Carteret County Residents, 2008
18,000
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2,000
0
0 -19
20 - 29
30 - 39
Ages
40 - 49
50 - 59
60 +
Source: EDIS Economic Development Intelligence System Carteret County Profile, August 2009 North Carolina
Dept. of Commerce Based on 2008 Population Estimates
.
.
.
Household Data
Total Housing Units in Carteret County were 46,733 in 2008, but the total number of households was
only 28,578. Of the 28,578, 76.8 percent were owner occupied houses and 23.2 percent were renter
occupied houses. Carteret County has a large number of vacation homes or “second homes” which
explains the discrepancy between the number of housing units and the number of households. 33.7
percent of the Community Opinion Survey respondents stated Affordable Housing as a major
community issue as well as participants of the Key Informant Survey. With Carteret County being a
vacation destination, affordable housing for the “working class” is sometimes difficult to come by. The
Carteret County Association of Realtors in partnership with the Chamber of Commerce is currently
working to address this issue. Source: EDIS NC Dept of Commerce County Profile August 2009.
Figure1. 3
Percent of Households in Carteret County By Type 2005 -2007
6%
1 Married-Couple Families
2 Other Families
28%
51%
15%
3 People Living Alone
4 Other Non-family Households
Source: US Census American Community Survey 2005- 2007
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2009 Carteret County
Community Health Assessment
US Census Quick Facts Income
Carteret Co
Persons per household, 2000
Median household income, 2007
Persons below poverty, percent, 2007
North Carolina
2.31
$47,064
10.7%
2.49
$44,772
14.3%
Source: US Census Quick Facts, Carteret County Profile
Military Population
.
There are three (3) military facilities in Carteret County, US Coast Guard Stations in Atlantic Beach and
Emerald Isle, and a USMC Auxiliary landing field at Bogue. Carteret County is also in close proximity to
Marine Corps Air Station Cherry Point (Havelock, Craven County) and New River Marine Corps Air
Station (MCAS) and Marine Corps Base Camp Lejeune (Jacksonville, Onslow County). Active military and
retired personnel, civilian employees and their families account for 16 percent of the county’s
population. Military Affairs Committees are currently preparing for 61,000 Marines, Sailors, and
Department of Defense civilians projected to arrive in the seven-county region surrounding Camp
Lejeune, MCAS Cherry Point, and MCAS New River between 2006 and 2011. Of the 61,000 about 7,800
of the expected influx have already arrived in the southeastern regions of North Carolina, however exact
estimates are still unclear of how many will live in Carteret County.
Figure1. 4
4500
Veteran Population by Age and Gender,
Carteret County 2007
3,930
Number of Veterans
4000
Men
3500
Women
2,741
3000
2500
2000
1500
1000
500
207 240
321
122
392
39
0
17 - 44
45 - 64
Ages
64 - 84
85 +
Source: VETPOP 2007, Veterans Administration Services 2006 data
S
5
2009 Carteret County
Community Health Assessment
Government
.
Carteret County is
governed by seven
county commissioners
and a county manager.
County Commissioners
are
nominated
by
district and voted on
county-wide. Carteret
County has eleven
municipalities, each of
which has its own town
council.
The type of government
structure varies from
town to town.
The
table to the right
provides
Municipal
Growth Estimates for
the years 1999, 2000,
and 2008. As you can
see in the chart to the
right, all areas of
Carteret County are
experiencing
a
population
growth
except Indian Beach.
Table 1.2
2008 Municipal Growth Estimates
GROWTH
MUNICIPALITY
*2008 Est.
2000
1990***
Amount
%
Atlantic Beach
1,800
1,781
1,938
19
1.07
Beaufort
3,984
3,771
3,808
213
5.65
Bogue
660
590
351
70
11.86
Cape Carteret
1,461
1,214
1,013
247
20.35
Cedar Point
876
817
628
59
7.22
Emerald Isle
3,887
3,488
2,434
399
11.44
Indian Beach
88
95
153
-7
-7.37
Morehead City
8,763
7,691
6,046
1,072
13.94
Newport
4,154
3,349
2,516
805
24.04
Peletier
542
487
304
55
11.29
Pine Knoll Shores
1,605
1,524
1,360
81
5.31
CARTERET
63,520
59,386
52,407
4,134
6.96
Source: Office of State Budget and Management Certified *2008 Municipal and County Growth Estimates.
***Data from 1990 is not factored into the amount or percent of growth for either Municipality or County.
Table 1.3
Carteret Voter Registration
as of September 30, 2009
# of Voters
% of Voters
Voter Registration
Total Registered Voters
46,731
100%
The table to the right
provides Voter statistics
for 2009 by Sex, Race,
and Political Affiliation.
Democrat
15,694
34%
Republican
18,987
41%
Unaffiliated
12,009
25%
Voter’s Race- White
43,042
92.4%
Voter’s Race- Black
2,525
5.4%
Voter’s Race- *Other/ Two or More
606
1.3%
Voter’s Race- Undesignated
190
.4%
Female
24,518
52.5%
Male
21,632
46.3%
584
1.2%
Undesignated
Source: Carteret County Board of Elections: Voter Statistics 2009
*Voter’s Race “Other” includes the following races: American Indian, Asian, and Other
6
2009 Carteret County
Community Health Assessment
Economy
Like many communities in North Carolina, Carteret County has had to adapt to the changes in the
economy. The economic base for Carteret County continues to diversify and is holding steady during
the rough economic times. Carteret County’s robust Tourism industry has far reaching impacts on the
local economy and has helped to keep it’s designation as a Tier 3 county (least economically distressed
area) by the N.C. Department of Commerce. These designations are determined by several factors
including county’s unemployment rate, median household income, and population growth and assessed
property value per capita.
Unemployment rates in Carteret County typically rise during the winter months when seasonal
businesses close down for the winter. Due to rough economic times, industries have had to either close
down permanently or lay off workers. Below are announced business closings and permanent layoffs
during 2008 -2009 as reported to the Employment Security Commission.
Table 1.4
Date
9/6/2009
6/24/2009
6/8/2009
6/2/2009
1/30/2009
10/3/2008
Announced Business Closings and Permanent Layoffs 2008 - 2009
Company
Big Rock Sports
Carteret County Schools
SPX Corporation
Boaters World
N.C. State Ports Authority
Atlantic Veneer Corp.
City
NEWPORT
BEAUFORT
NEWPORT
ATL. BEACH
MOREHEAD CITY
BEAUFORT
Product
Sporting Goods
School Admin
Filtration
Sporting Goods
Port Authority
Veneer
Affected
102
40
18
24
5
67
Reason
Relocation
Reduction in force
Economic conditions
Bankruptcy
Economic conditions
Declining demand
As with any seasonal community, unemployment rates peak in December and January in Carteret
County. The October 2009 unemployment figure was 7.8 percent, a slightly lower rate than the state
and national average of 7.9 percent. Carteret's labor force of 33,505 people has 2,613 unemployed. It
ranked the 24th lowest in unemployment of the state's 100 counties.
..
Figure 1.5
Unemployment Rates 2005 - 2009, Carteret County
12.0
2005
10.0
2006
8.0
2007
6.0
2008
4.0
2009
2.0
0.0
Source: Employment Security Commission, Job Link *2009 Statistics only available through Sept 2009
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2009 Carteret County
Community Health Assessment
Commerce and Industry in Carteret County
Tourism and commercial fishing play a major role in Carteret County’s economy, but a number of
domestic and international manufacturing companies call Carteret County home. New employment
opportunities are growing as new chains and businesses move to the area; offering residents a variety of
options when seeking employment. However, wages do not compete with those in metropolitan areas.
Atlantic Veneer Corporation is the world's largest manufacturer of hardwood veneers in North
America, with manufacturing facilities on three continents. It exports about half of its products.
Atlantic Veneer also operates a local retail outlet, which is an important source of lumber and
hardwoods for boat builders and cabinet makers.
Veneer Technologies a sister company of Atlantic Veneer, and produces three main products:
face veneers, flexible-sheet veneers and edge banding. Its products are sold throughout the
United States and around the world.
SPX Dehydration & Process Filtration, manufacturer of compressed-air treatment products,
which are used in a variety of industries, such as furniture finishing and painting.
Bally Refrigerated Boxes Inc., manufactures walk-in refrigerated units, coolers and freezers.
Bally specializes in custom cooler units ranging from 6 to 28 feet high. Its freezers are designed
to be stacked to create coolers as much as 100 feet high and as long as a football field.
Hospitals, restaurant chains, restaurant equipment dealers and refrigeration wholesalers make
up most of Bally's customers, and about 30 percent of its business is exported.
Creative Outlet Inc., a family owned-and-operated textile firm, makes a wide variety of apparel
for the healthcare industry — hospital gowns, scrubs, bed sheets, pajamas — that are sold
throughout the nation.
Open Grounds Farm, Carteret County's largest single landowner is a farming company. Of the
90,000 acres of farmland here, 44,000 acres make up Open Grounds Farm, one of the largest
farms east of the Mississippi. The Italian-owned farm tills about 35,000 of these acres, producing
corn and wheat for the poultry-feed and hog-feed industries, soybeans for in state processing
plants and cotton for North Carolina gin mills.
Parker Marine Enterprises Inc. specializes in the construction of fiberglass fishing and pleasure
boats. Boats are sold through authorized dealers.
Jarrett Bay Boatworks Inc., provides full-service for boaters specializing in the building of
custom Carolina sport-fishing boats, servicing boats up to 220 tons and brokering new and preowned boats.
Coloring Contest Entry
Name: Landon
Age: 7
What do you like most about living
in Carteret County? “Spending time
on my family’s boat”
8
2009 Carteret County
Community Health Assessment
ECONOMY, COMMERCE AND INDUSTRY CONTINUED
Port of Morehead City
Website: www.ncports.com
The North Carolina Port at Morehead City is the county's most visible industry. This 116-acre main
facility is just 4 miles from the open sea. With a 45-foot-deep entrance channel and deep bulk berths,
the Morehead terminal can accommodate the biggest ships in the industry. Its turning basin is one of
the deepest in any East Coast port. Established in 1945, the Port of Morehead offers a foreign trade
zone and direct rail service through Norfolk Southern Corporation. It is one of two state-owned ports.
North Carolina's ports link the state's citizens, businesses and industry to world markets. From
Morehead City, PCS Phosphate (Potash Corp. of Saskatchewan) exports phosphate-based materials
throughout the world and utilizes the Intracoastal Waterway to barge these materials to the port from
the company's mine in Aurora, North Carolina. Recycled steel for the Nucor mill in Hertford County
arrives at the port via ship or ocean-going barge and is transferred to barges for transport up the
Intracoastal Waterway to the mill at Tunis. Port of Morehead City is the second largest importer in the
country for natural rubber. Regional tire manufacturers rely on imports of raw rubber through
Morehead City from Southeast Asia and Indonesia. Manufacturers whose rubber passes across the
docks at Morehead City include Goodyear, Cooper, Michelin, Bridgestone and Continental.
The Port of Morehead City is the port of embarkation and debarkation for the Second Division of the
U.S. Marine Corps at Camp Lejeune. Military troops from Camp Lejeune often travel N.C. Highway 24
from Swansboro to Morehead City. Below are port statistics by trading partners and commodities
imported and exported for recent years.
Table 1.5
Table 1.6
MHC Port Top 5 Commodities by Year
Top 10 Trading Partners 2009
Import
Export
Country
Tonnage
Country
Tonnage
Venezuela
Bahamas
Indonesia
Brazil
Turkey
Mexico
Thailand
Poland
France
Russia
255,161
105,023
82,313
82,217
56,107
48,959
35,192
22,821
22,027
22,017
India
Brazil
China
Argentina
Colombia
Venezuela
Japan
Cuba
Puerto Rico
Guatemala
831,587
148,295
29,747
27,557
21,942
6,831
6,669
5,263
2,208
1,990
Year
Import
Export
Phosphate
Military
2009
Sulfur Products
Rubber
Gen. Merchandise
Scrap metal
Ore, Mica, Schist
Phosphate
Military
2008
Sulfur Products
Rubber
Scrap metal
Aggregate
Ore, Mica, Schist
2007
Sulfur Products
Rubber
Ore, Mica, Schist
Scrap metal
Aggregate
Phosphate
Forest Products
Military
Gen. Merchandise
Coloring Contest Entry
Name: Alex
Age: 7
What do you like most about living
in Carteret County? “I like watching
the Tug boats lead the big ships into
Port.”
9
2009 Carteret County
Community Health Assessment
ECONOMY, COMMERCE, AND INDUSTRY CONTINUED
The Carteret County Economic Development Council, Inc., (252) 222-6120 or (800) 462-4252, and the
Carteret County Chamber of Commerce, (252) 726-6350, can provide detailed information about area
businesses and industries.
Military
Marine Corp Air Station Cherry Point in Craven County, NC is the largest employer of Carteret County
residents outside of Carteret County.
1,743 civilian employees at Cherry Point (32.89%) reside in Carteret County and 4,517 family
members of Active Duty Military, Retired Military and Civilian employees also reside in Carteret
County.
453 Active Duty Military employees residing in Carteret County account for 5.22% of the total
active military population at Cherry Point. During Fiscal year 2008, MCAS Cherry Point salaries
were $1.27 billion.
Contracts awarded to NC companies reached $163 million in 2008 and have an estimated total
economic impact for the state of over $1.87 billion.
Source: Command Analysis and Review Office, MCAS, Cherry Point2008
Of the surrounding bases, the Marine Corps Air Station (MCAS) base at Cherry Point in Havelock has the
greatest impact on the Crystal Coast. One of the most valuable assets is the base's Fleet Readiness
Center (FRC) East. FRC East’s customers include: 202 different Navy and Marine Corps activities, 24
foreign nations, five U. S. Air Force activities, three U.S. Army activities and two other federal agencies.
As a service provider specializing in support of Marine Corps aircraft, engines and components, FRC is
the only source of repair within the continental United States for many jet engines and rotary wing
engines, as well as turbofan vectored thrust engines.
Marine Corps Auxiliary Landing Field
This 875-acre landing field fronts Bogue Sound. It is primarily used for field carrier landing practice, and
pilots perform many of these landings at night to simulate landing on an aircraft carrier. It serves as the
Marines' only East Coast site for such training and includes the maintenance and operation of an
expeditionary airfield.
Atlantic Outlying Field and Piney Island (Marines)
These two training facilities are in the Down East area of Carteret County. Atlantic Outlying Field is a
1,514-acre facility in the community of Atlantic. Piney Island, or BT-11 as the military refers to it, is a
10,000-plus-acre electronic practice range at the eastern tip of Carteret County. As part of the MidAtlantic Electronic Warfare Range (MAEWR), Piney Island is used by various military groups, including
active-duty personnel and reservists.
Coast Guard Sector North Carolina at the east end of Bogue Banks is the home port of one large cutter
and several smaller vessels. The base is charged with overseeing the waters from Virginia to the North
Carolina–South Carolina border. Coast Guard missions include homeland security, search and rescue,
and law enforcement.
Coast Guard Station Emerald Isle, located at the west end of Bogue Banks, patrol about 50 nautical
miles of the Atlantic Intracoastal Waterway, including Bogue Inlet, New River Inlet, White Oak River and
New River all the way down to Surf City and 30 miles offshore. The primary focus is on homeland
security, search and rescue, and law enforcement.
Source: Insider’s Guide North Carolina’s Central Coast and New Bern 2009
10
2009 Carteret County
Community Health Assessment
Education
Carteret County Public School System
Website: www.carteretcountyschools.org
Carteret County Public School System’s mission is to graduate all students prepared to be productive
citizens. Consisting of 17 schools, enrollment numbers for 2009-2010 school year include: 8,260 in
kindergarten through 12th grade and about 135 in pre-kindergarten. The school system ranks among
the top in the state for academic achievement. In 2009, 14 of the 17 schools, or 82.4 percent, also
qualified as High Growth schools, compared to only 39.4 percent across the state. The graduation rate
(four-year cohort) was 77.6% in Carteret County for the 2007-2008 school year, compared to 70.3% for
the state. Each year the NC Department of Public Instruction ranks each of the 115 public school systems
highest to lowest based on per pupil expenditure. During the 2007 – 2008 school year Carteret County
ranked 42th in the state for per pupil expenditure with $8,770 spent per student. Employing
approximately 1,200 individuals, the Public School System is the County’s largest employer.
Carteret County has 2 charter schools and 5 private schools serving close to 500 students as well as over
273 home schools educating around 500 more children.
Source: NC Department of Public Instruction Office of Charter Schools Year 08- 09, NC Division of Non Public Education School Year 08- 09
(Conventional), NC Division of Non Public Education School Year 08- 09 (Home School)
Table 1.7
SCHOOL YEAR
2008 – 2009
2007 - 2008
Carteret County Public School System
Percent of Teachers with Advanced Degrees
50%
50%
$46,461
20
3,145 or 37.49%
1,229 or 14.65%
1,235 or 14.7%
188 or 2.24%
$44,320
20
2,966 or 35.5%
1,333 or 15.9%
1,260 or 15.1%
188 or 2.3%
(Includes: Master’s, Doctorate, or National Board Certification)
Average County Teacher Salary
Average Class Size Kindergarten -5th Grade
Students Receiving Free and Reduced Lunch
Students with Disabilities
Students identified as Gifted
Students identified as Limited English Proficient
Source: Carteret County Public School System 2008 and 2009 Community Report
Table 1.8
SAT REPORT 2009 District and School Listing
School System
%
Math
CR
Writing
# Tested
and School
Tested Score Score
Score
Total
North Carolina
(All Students)
57,147
63.0
511
495
480
1486
Carteret County
287
55.5
528
524
496
1548
East Carteret High
Croatan High
70
114
54.7
71.3
500
536
508
528
472
509
1480
1573
West Carteret High
103
45.0
538
531
496
1565
Source: Department of Public Instruction, Accountability and Services Division Updated Sept. 14, 2009
11
2009 Carteret County
Community Health Assessment
EDUCATION CONTINUED
Table 1.9
High School Drop Out Rates
Year
Carteret
State
High School dropout rates continue to be a concern in Carteret
2003
7.0
4.8
County. Recently, the Boys and Girls Club, in Morehead City
2004
6.6
4.9
received a grant from the NC Department of Juvenile Justice and
2005
4.6
4.7
Delinquency Prevention to serve Carteret County students who
have been short-term suspended during the 09-10 school year.
2006
6.3
5.0
School administrators refer short-term suspended students to the
2007
6.5
5.3
program after receiving parent permission. While at the Boys and
Source: NC CATCH Portal State Center for
Girls Club students are required to complete all assigned work Health Statistics, Carteret County Profile
from classes as well as take part in remedial programs to improve
their reading skills. The program is open to a maximum of 12 students from 6th through 12th grade from
across the county who have been out-of-school suspended.
Educational Attainment Rates
In Carteret County, of the 6,769 individual’s age 25 - 34, 3.2 percent had less than a 9th grade education,
10.7 percent attended High School but did not graduate, and 29.1 percent graduated from High School,
29.8 percent had received some college education but did not earn a degree and 27.1 percent had
earned either a 2 year, 4 year, or graduate level college degree. Carteret County ranks 27 th in the State
for the percent of individuals with a college degree. The county in North Carolina with the highest
ranking is Orange County with 62.2 percent and the county with the lowest ranking is Warren County
with 13 percent.
Source: Lumina Foundation for Education, Policy Brief- “A Stronger Nation through Higher Education” June 2009
Highest Level of Education Attained Ages (25-34)
Table 1.10
Less 9th-12th
Than
Grade,
9th
No
Grade Diploma
High
School
Grad or
GED
% with
college
degree
# with
college
degree
NC
34.1%
410,514
USA
39.0%
-
-
-
-
-
Carteret 27.1%
1,832
6,769
218
728
*Craven
*Onslow
3,240
5,870
11,717
23,482
315
305
1,240
1,430
County
27.7%
25.0%
Total
Population
(ages 25-34)
Some
College
No
Degree
1,203,385 51,593 140,660 318,195 282,423
Associate's Bachelor's Graduate
Degree
Degree
Degree
92,608
246,339
71,567
-
-
-
-
1,972
2,019
566
1,017
249
3,452
7,459
3,470
8,418
1,046
2,140
1,834
3,044
360
686
Source: Lumina Foundation for Education, Educational Attainment by County NC Profile, 2009 * Based on Census 2000 data
Community College
Website: www.carteret.edu
Carteret Community College (CCC): CCC is a part of North Carolina's nationally acclaimed 58-campus
community college system. This fully accredited community college offers vocational, technical and
general education, including two-year college courses in affiliation with UNC system campuses. In
addition, the college offers comprehensive workforce development training for businesses and industry.
Carteret Community College enrollment numbers for the 2009-2010 school year experienced a 15
percent increase from Fall 2008 enrollment which is the single biggest increase the college has ever
seen. Most students are choosing Community College as a less expensive alternative, completing their
first two years, then transferring to a University or State College to earn their Bachelor’s Degree.
12
2009 Carteret County
Community Health Assessment
EDUCATION CONTINUED
NC Marine Training and Education Center (NCMARTEC): Operated by Carteret Community College, NC
MARTEC is the only comprehensive marine technology training center in the Mid-Atlantic Region
offering training programs for marine propulsion, boat manufacturing, fiberglass technology, marine
management and other related subjects.
College, University, and Research Affiliated Campuses
Carteret County’s close proximity to the ocean makes it an ideal location for Marine Science and Coastal
Research facilities maintained by a variety of Colleges and University and Government Research
Agencies. Below is a list and brief description of the facility. All of these campuses are an integral part
of the research community in Carteret County.
NC State University-Center for Marine Sciences and Technology (CMAST): is a consortium of research
scientists, extension specialists and other marine-related experts. Established in 1999, the Center
supports educational and applied research activities for faculty throughout the University system.
NC State University-Sea Grant Fisheries Program: Sea Grant promotes the wise use of our coastal and
marine resources through research, extension and education. Sea Grant operates a marine extension
office staffed with specialists in fisheries, marine business, seafood technology, and water quality. Sea
Grant also administers the Fishery Resource Grant Program and the Blue Crab Research Program for the
state legislature.
NC State University-Seafood Laboratory: The Seafood Laboratory focuses on seafood safety and
technology, seafood product development and seafood marketing. Personnel work with seafood-related
industries, public health professionals and consumer groups to promote seafood quality and safety
issues, nutrition and utilization, innovative processing technologies and value-added fishery products.
UNC-Chapel Hill- Institute of Marine Sciences: The Institute is an interdisciplinary teaching and
research laboratory with primary emphasis in the nature, use, development, protection and
enhancement of marine resources and the coastal environment.
.
Duke University Marine Laboratory: A research and education facility located on Pivers Island near
Beaufort. As part of the Nicholas School of Environment and Earth Sciences at Duke, with faculty
expertise in the fields of biology, ecology, biochemistry, oceanography, coastal environmental
management, and marine affairs and policy.
NOAA- Center for Coastal Fisheries and Habitat Research: The Center focuses research on injured
coastal habitats, harmful algal blooms, and living marine resources at sites throughout the Nation based
in facilities located in both North Carolina and Alaska. The Center supports NOAA's missions for
sustaining healthy coasts, coastal and fishery management. The Center maintains facilities for laboratory
and field research, including running seawater systems, SCUBA, and vessel operations.
.
NOAA- Weather Forecast Office: Located in Newport, this weather forecast office offers state-of-the-art
weather tracking and forecasting. Part of the National Weather Service, this facility includes a Doppler
weather radar system with advanced weather detection capabilities.
13
2009 Carteret County
Community Health Assessment
Crime
The Crime Index Rate for 2008 in Carteret County was 3,995 per 100,000 population, this is up slightly
from 2007, but this does not indicate an abnormally high rate of crime for this area. Below are
descriptions and tables of various types of crime data.
Sex Offenders are required by law to register with the county sheriff’s department, their registration
information is updated in the statewide Sex Offender and Public Protection Registry. There are
currently 64 registered sex offenders in Carteret County. Source: NC State Bureau of Investigation, Division of Criminal
Information, Crime Statistics 2008
Table 1.11
County Offenses Ten Year Trend Data, Carteret County 2008
CRIME
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2
1
1
2
3
Murder
9
17
12
20
20
24
12
Rape
21
30
25
28
29
24
25
Robbery
90
86
98
120
87
116
164
Agg. Assault
526
495
539
498
461
529
439
Burglary
1,376 1,372 1,258 1,276 1,243 1,312 1,235
Larceny
51
74
83
83
72
99
89
MV Theft
Total
2,075 2,075 2,015 2,026 1,912 2,106 1,967
1
29
19
148
620
1,311
78
2
25
32
152
609
1,465
95
1
22
25
188
618
1,591
84
2,206
2,380
2,529
Source: NC State Bureau of Investigation, Division of Criminal Information, Crime Statistics 2008
Table 1.12
Table 1.13
Crashes Involving Alcohol
2003-2007
2007 Motor Vehicle Injury Data
Reported Crash Injuries
Carteret 2007
Statewide 2007
Non-Fatal Injuries
689
119,646
Fatal Injuries
17
1,694
Total Injuries
706
121,340
Alcohol Related Crash Injuries Carteret 2007
Statewide 2007
Non-Fatal Injuries
72
9,318
Fatal Injuries
5
485
Total Injuries
77
9,803
Carteret 2007
Statewide 2007
Non-Fatal Injuries
10.5%
7.8%
Fatal Injuries
29.4%
28.6%
Total Injuries
10.9%
8.1%
Percent Alcohol Related
Carteret
Total
Crashes
Alcohol
Involved
Crashes
%
Alcohol
Involved
6,429
447
7.0 %
56,760
5.1 %
Statewide 1,118,220
NC Alcohol Facts 2000-2007Highway Safety Research Center- UNC –Chapel Hill
NC Alcohol Facts 2000-2007- Highway Safety Research Center- UNC –Chapel Hill
Table 1.14
Concealed Handgun Permit - Carteret County 12/1/1995 thru 6/30/2009
Carteret County
Regular Permit
Applications
Regular
Permit (Valid)
Regular Permit
App.(Denied)
Regular Permit Applications
(Revoked)
3,7171
1,554
28
3
The number of permits issued, denied and revoked do not equal the number of applications due to applications being
processed. Source: NC State Bureau of Investigation, Division of Criminal Information, Crime Statistics 2009
14
2009 Carteret County
Community Health Assessment
Faith Community
Carteret County is fortunate to have an active and involved faith community. There are approximately
150 churches representing many denominations and religions. According to the Association of Religious
Data Archives (ARDA) 2000 Religion Survey; approximately 48.5% of Carteret County residents are
religious meaning they attend a church or participate in the congregation. Many area churches are
involved in mission programs world-wide but with tighter economic times, churches are opting to give
back locally through a new multi-church initiative known as “Mission Carteret”. This initiative provides
resources for specific projects that will benefit a person or organization in need in the local community.
Churches play an important role in the community not only for individual spiritual and emotional needs
but provide a haven for fellowship and faith-based outreach and ministry programs. Churches also
provide a central meeting place for their members and other community groups and organizational
events offering their resources and facilities for special projects and programs.
Several churches serve the community as certified preschool day-care and pre-kindergarten providers,
while other contribute money and volunteers to support the Hope Mission Soup Kitchen, Martha’s
Mission Food Cupboard, The Salvation Army, The Red Cross, Habitat for Humanity and other community
assistance programs.
Carteret General Hospital’s Parish Nursing Program trains nurses to provide health screenings and
health education and promotion activities within their home church.
Child Care
.
Child Care in Carteret County is overseen by the Carteret County Partnership for Children. This agency
offers information to parents looking for a childcare facility and provides technical assistance and
training to childcare centers.
According to the report, “Child Care Impact on Carteret County,” child care centers employ
approximately 208 teachers.
Carteret County Partnership for Children’s Resource and Referral Program states that, “Affordability of
child care services is the main problem facing parents in Carteret County.” As of September 2009, there
were 198 families on a waiting list for the child care assistance program administered by the
Department of Social Services; however this number changes from week to week. Many parents
working at lower wage jobs may be paying one third to one-half their income to cover childcare costs.
Since the stressed economy, many parents were forced to take their child out of childcare to save
money and currently all licensed childcare facilities have spaces for children.
Figure 1.6
CHILD CARE QUICK FACTS CARTERET COUNTY
39 Licensed child care programs
• The average weekly cost of child care in centers
• The average weekly cost of child care in Family Child Care Home (FCCH)
• Average starting pay for assistant teachers
• Average starting pay for lead teachers
• Average starting pay for lead teachers with 2-yr degree
• Average starting pay for lead teachers with 4-yr degree
• Average starting pay for Administrators
• Yearly income for Family Home Providers
$139.00
$122.00
$8.00
$9.00
$9.00
$12.00
$14.00
$32,656
(Before Taxes)
Source: Child Care Resource & Referral (CCR&P) - Carteret County Partnership for Children 2009
15
2009 Carteret County
Community Health Assessment
Transportation
Transportation in Carteret County is accomplished mainly by vehicle or boat. With many parts of the
county separated by bodies of water and accessible only by bridge, travel by foot or bicycle is often
difficult and not practical. Several communities have installed bicycle paths and extended bike lanes to
provide a safe travel for individuals who bike. Nonetheless, Transportation remains an issue for many
people in the County and was identified as a community issue during Community Forums held in both,
Eastern and Western locations, as well as the Key Informant Survey.
Carteret County Area Transportation System (CCATS) provides public transportation for a minimal fee.
While there are no scheduled routes or bus stops, CCATS will provide address to address transportation.
To ride will require a 24 hour advance reservation by calling the Ride Request Line at (252) 240-1043 or
TDD/TTY: 1-800-735-2962. CCATS held a Transportation Forum on March 4th, 2009 to discuss changes to
CCATS operating protocol and to identify community needs input from this forum will be use to devise a
plan to better serve the transportation needs of the county.
Below are some statistics from the March 2009 CCATS Transportation Forum:
62.1% believed that there is not enough public transportation service available
• 87% assigned a high or medium importance to the need for extended hours of service
• 59.7% believed there is a need to increase service to fill the gaps in underserved areas
• 82.4% assigned a high or medium importance to coordinate between transportation providers
to provide cross county trips
• 76.2% felt that there was too much advance planning needed in order to get transportation
(high and medium importance).
• 65.1% assigned a high importance to the need for education on available services, programs
and eligibility requirements.
• 70.3% assigned a high or medium importance to the issue of communication issues (language
barriers, non-existent web site or difficult to find/use, inconsistent information provided)
• 67.7% assigned a high importance to the need for advertising of the service.
• 85.2% assigned a high or medium importance to the need for users to have the option to
make reservations for service after business hours.
Prioritization of Transportation Needs
1. Need fixed routes
2. Lack of night/weekend/holiday services
3. Lack of marketing/advertising
4. Current cost to ride too high
Commuting Data
Based on the 2000 Census data, the average travel time to work was 23 minutes, and about 74 % of the
workforce stay within the County to work. The remaining 23.9% travelled outside of Carteret County to
go to work, and about 1.9% travel outside of North Carolina to work.
16
2009 Carteret County
Community Health Assessment
TRANSPORATION CONTINUED
Roads
Highway 70 serves as the main corridor through the county and runs east to the Atlantic coast, west
toward Raleigh, and to Interstates 95 and 40. Highways 101, 58, 24, 12 are the other highways located
within the county. There are no interstates that run through Carteret County.
Figure 1.7
TRAFFIC COUNTS AVERAGE DAILY COUNTS, 2007
Hwy 70 & Camp Glenn, Newport
Hwy 70 & Hwy 24, Morehead
Hwy 70 & Hwy 101 West, Beaufort
Hwy 70 & Gallants Channel Bridge
Morehead Ave & Fort Macon Blvd, East
Morehead Ave & Fort Macon Blvd, West
Hwy 70 & Harkers Island Rd
Carteret/Craven County Line
Hwy 70 & 23rd St, Atlantic Beach Bridge
Hwy 58 at Salter Path
Hwy 58 at Emerald Isle, Emerald Isle Bridge
Hwy 24 & Hwy 58, Cape Carteret
29,000
32,000
8,300
19,000
6,200
15,000
5,200
21,000
26,000
54,100
13,000
20,000
Federal Highways:
US 70 (four lane)
State Highways:
NC 24 (four lane)
NC 58
NC 101
NC12
Closest Interstate:
I-40 (63 miles)
I-95 (105 miles)
Source: NC Dept of Transportation, Traffic Counts by County
Airports
Commercial Air Travel is available at Coastal Carolina Regional airport, located in New Bern, NC about 30
miles from Carteret County. US Airways Express offers daily flights to Charlotte, NC and Delta offers daily
flights to Atlanta, GA for connecting flights.
Coastal Carolina Regional Airport
Website: www.newbernairport.com
Hwy. 70, New Bern, NC 28560
Serving Airlines: USAir Express to Charlotte and Delta to Atlanta
Daily Flights: 7
Length of Runway: 6,000 feet
The Beaufort Airport is named in honor and memory of Michael J. Smith, Commander of the
ill-fated Space Shuttle Challenger, and a native of Beaufort, NC. The Beaufort Airport is operated by
Segrave Aviation and provides: Chartered flights, Aircraft Rental, Pilot Training, and Air Tours.
The Beaufort Airport: Michael J Smith Field
Website: www.beaufortairport.com
Hwy 101, Beaufort, NC
Length of Longest Runway: 4,249 feet
Ferries
Website:
www.ncdot.gov/ferry
For years, ferries have played a vital role in transporting residents and visitors to Eastern North Carolina.
Ferry transportation began in the mid 1920's and today extends over 7 routes with 21 operating ferries.
Cedar Island Ferry, in Carteret County, is a popular option for individuals wanting to explore Ocracoke,
Hatteras, and the Outer Banks of North Carolina.
17
2009 Carteret County
Community Health Assessment
Environmental Data
Solid Waste and Recycling Management
Carteret County operates the 12 Convenience Sites to collect Solid Waste from the residents living in the
unincorporated areas of the county as well as collect recyclable materials from all citizens. There is no
on site charge to residents for the services offered at the convenience sites. See map below.
Figure 1.8
Residents can safely dispose of materials during the Household Hazardous Waste Collection Days held
each year in the county. For a more information on Carteret County’s recycling program, as well as, an
operating schedule for collection sites please visit the County website at
www.carteretcountygov.org/waste_recycle.asp
Coloring Contest Entry
Name: Amber
Age: 10
How can we make Carteret County
a “Healthier” place to live?
“Recycling helps the environment by
saving extra materials.”
18
2009 Carteret County
Community Health Assessment
Figure 1.9
Solid Waste Disposal Report, Carteret County 2000 - 2008
140,000
Calculated Tons
120,000
100,000
80,000
60,000
40,000
20,000
0
99 -'00 00 - '01 01 - '02 02 - '03 03 - '04 04 -'05 05 - '06 06 - '07 07 - '08
Year
Source: NC Department of Environment and Natural Resources, Division of Waste Management, Solid Waste
County Disposal Report 2000 -2008 Higher numbers may be related to Debris Pick-up during a disaster*
Water Quality
Drinking Water
Drinking water in municipal districts is over seen by a Town’s Public Utilities or Water Department.
Annual Water Quality Reports are available for each municipality, and can be accessed on the town’s
website or requested from Town Hall. But for individuals who reside outside of municipal water
sources, a well provides the water for the household. During the summer of 2006, the North Carolina
Legislature mandated that rules be developed to regulate private drinking water well construction. The
North Carolina Department of Environment and Natural Resources Private Drinking Water Well Rules
took effect on July 1, 2008. The change from county rules to state rules was essentially undetectable by
the public. The process for application, permitting, inspection and analysis have remained the same, and
will be similar to that of obtaining an on-site wastewater permit.
As of July 1, 2008 all well applications shall be submitted to the Health Department for all proposed
private drinking water wells in Carteret County.
Coloring Contest Entry
Name: Haley
Age: 10
What do you like most about
living
in
Carteret
County?
“Nature”
19
2009 Carteret County
Community Health Assessment
ENVIRONMENTAL DATA CONTINUED
Recreational Water
In 2008, over 20 coastal counties, including Carteret, adopted revised Coastal Storm Water Rules.
Environmental advocates say stricter requirements are needed to further protect the coastal waterways
but economic development interests are concerned specifically about the impact it will have on the
construction industry than actually improving water quality. Nonetheless storm water run-off remains
the largest source of water pollution in Carteret County.
When analyzing the 2009 Community Opinion Survey data 14.9 percent of the respondents felt that
pollution was an important community issue, specifically water pollution and littering, in Carteret
County that needed to be addressed.
There are many agencies and local organizations that work to protect the natural resources in Carteret
County. For example the NC Recreational Water Quality Program is responsible for monitoring both
ocean and sound side beaches. Under the federal Clean Water Act all states are required to develop a
list of waters not meeting water quality standards, or those which have “impaired” uses, to the
Environmental Protection Agency every two years. Potential pollution sources for the impaired water
bodies are “urban runoff: storm sewers, or may be unknown.” The following data was taken from the
N.C. 2006 303(D) REPORT. In Carteret County over 100 water bodies covering 26,000 acres and 9 miles
are deemed too polluted to meet their best and highest use. All waters listed must be prioritized, and a
management strategy must be developed to mitigate the pollution. To review the complete data set
for Carteret County refer to the NC Coastal Federation, State of The Coast Report 2008.
Coloring Contest Entry
Name: Maggie
Age: 8
What do you like most about living
in Carteret County? “I love going to
the Cape and swimming in the water
and playing on the beach!”
20
2009 Carteret County
Community Health Assessment
ENVIRONMENTAL DATA CONTINUED
Wastewater Management
Carteret County lacks centralized sewer systems outside the major municipalities of Beaufort, Morehead
City, and Newport. In Carteret County, the use of onsite wastewater systems or decentralized
wastewater systems, commonly known as septic systems, make up the remaining method of
wastewater collection and treatment. An on-site wastewater system involves the collection, treatment,
and disposal of wastewater in single or multiple components. These include a privy, septic tank system,
public or community wastewater system, mechanical or biological wastewater treatment system, any
other similar system, and any chemical toilet used only for human waste. A person owning or controlling
a residence, place of business or place of public assembly shall provide an approved wastewater system.
The Carteret County Health Department regulates the installation, collection, treatment, and disposal of
septic systems and other types of wastewater systems in order to render them ecologically safe and to
protect public health. Governing regulations include The Laws and Rules for Sewage Treatment and
Disposal Systems of the North Carolina Department of Environment and Natural Resources, Division of
Environmental Health (NCDENR-DEH).
As of January 1, 2009 Carteret County Health Department implemented a new inspection program to
ensure that after installation these systems continue to perform correctly.
ON-SITE WASTEWATER INSPECTIONS PROGRAM
IV (Low pressure pipe), Inspected once every three years
V (Over 3000gpd conventional and pre-treatment units) Inspected once per year
VI (Over 3000gpd package plants)
# INSPECTED
49
155
31
These numbers do not include all inspections, specifically on systems under construction.
Table 1.15
ON-SITE WASTEWATER PROGRAM– Carteret County Environmental Health
COUNTY ON-SITE ACTIVITY REPORTS
2008 2007 2006
Construction Authorizations - New, Revision, or Relocation
Construction Authorizations - Repair/Replacement of Malfunctioning System
Improvement Permits Denied (Documented)
Improvement Permits Issued - New or Revision w/ Site Plan (Valid 60 mos)
On-Site Consultative Contacts
Permits Revoked (Notice)
Sewage Complaints Investigated
Site Visits (Includes all OSWW field activities not included below)
Sites Evaluated (includes sites evaluated or re-evaluated for any purpose)
394
75
69
659
3920
33
74
2176
1178
564
12
55
572
2224
12
62
1327
1753
963
77
208
1217
7343
25
83
3878
2454
Source: NC Department of Environmental and Natural Resources, Division of Environmental Health, On-site Water Protection Section
In 2009 the NC National Estuarine Research Reserve partnered with the Carteret County Health
Department to produce an educational video entitled “Making Sense of Septic Systems.” This DVD
informs the viewer on how a septic system works, how the Health Department tests the soil, and also on
septic maintenance. Copies of the DVD are available to Realtors, Homeowners, and anyone interested
in learning more about Septic Systems. For more information contact the Carteret County Health
Department by calling (252)728-8499.
21
2009 Carteret County
Community Health Assessment
CHAPTER TWO
Inventory of Existing Health Resources
Access to Care continues to be a priority health issue for residents in Carteret County. Information
provided in this section is a brief description of Existing Health Resources available in Carteret County.
An expanded resource directory is provided at the end of this report (see Appendix A).
Website: www.broadstreetclinic.org
Broad Street Clinic
The Broad Street Clinic is a private, non-profit, free health clinic serving adult residents of Carteret
County and surrounding areas. Founded in 1993, its mission is to provide access to medical care for the
uninsured, low income population in the community. Broad Street Clinic physicians and all medical
support staff volunteer their time. For each dollar given the Clinic is able to provide nine dollars of
services. From June 2009 to October 2009 the clinic has seen an increase of 100 new patients.
Statistics ending Fiscal Year July 1, 2008 to June 30, 2009
Number of Patients:
550
Number of Patient Doctor Visits:
1895
Weekly Average of Patients for Pharmacy Day:
125
Prescriptions Filled in Pharmacy:
13,059
Total Amount Worth of Prescriptions Provided:
$1,500,365
Total Cost of Labs Provided:
$40,000
Top medicines prescribed:
Hydrochlorothiazide for Hypertension (1229)
Glucophage for Diabetes (709)
Qualification is determined by medical and financial need:
Medical Need- The Broad Street Clinic is a chronic care clinic treating the four chronic disease of
diabetes, high blood pressure, heart and/or lung disease. All patients applying for the clinic services
must have a diagnosis of at least one of those diseases.
Financial Need- Qualification depends on where your household income stands in relation to the
Federal Guidelines of the Poverty Level established for any given year. Broad Street Clinic does NOT
accept Medicaid patients.
VA Community-Based Outpatient Clinic
The VA Community-Based Outpatient Clinic provides primary care services for veterans in the Morehead
City and Coastal North Carolina areas.
Services provided include:
Behavioral Health services such as: individual, group and family counseling, and programs like
QuitSmart, a Smoking Cessation program.
Personal Care: Highly qualified primary care providers, specialty care referrals to the Durham VA
Medical Center.
Laboratory: Blood drawing services available.
Prescriptions: Routine prescriptions processed through the mail or My HealtheVet.
For more information about services provided or eligibility contact the Veteran Administration Offices.
(See Appendix A)
22
2009 Carteret County
Community Health Assessment
Website: www.carteretcountyhealth.com
Carteret County Health Department
The Carteret County Health Department has served this area since 1937, providing Screening,
Treatment, Surveillance, Regulation, Education, and Support for a variety of Clinical and Environmental
Public Health concerns. Funding for Health Department programs come from the County, State, Federal
and special grants. Foreign language assistance is available for individuals who do not speak English the
Health Department employs 1 full and 1 part-time Spanish Interpreter. For more information on
specific programs/services, fee schedules or to download permitting applications, please visit the
Carteret County Health Department website. Below is a general list of programs and services:
Clinical Services
o
o
o
o
o
o
o
Adult Health Clinic- Diagnose and Treat Chronic Diseases
Child Health Clinic- Well Child Check-Ups, School, and Sports Physicals
Immunizations- International Travel Clinic, Vaccines for Children Program, General Vaccines
Communicable Disease Program- STD, HIV, and TB testing, counseling, education, treatment
Family Planning- Pregnancy Tests, Pelvic Exam, Contraceptive and Birth Control Methods and
Education, Vasectomy Counseling and Referral
Maternal Health- Prenatal and Postpartum Care
Breast and Cervical Cancer Control Program (BCCCP)- Provides Cervical Cancer screenings and
Mammograms to women ages 18 – 64
Community and Case Management Programs and Services
o
o
o
o
Maternity Care Coordination- Baby Love Medicaid eligible women
Newborn Postpartum Home Visiting Program
Child Service Coordination- Developmental education and screenings for children 0 – 5
Community Care Plan of Eastern Carolina- Medical Home Case Management program for
Medicaid recipients
Additional Programs
o
o
o
o
WIC Women Infant and Children Program- Nutritional support program for infants, children and
pregnant, postpartum and breastfeeding women.
Mobile Dental Unit- Provides screening, treatment, and dental education
Public Health Preparedness and Response- Emergency and Bioterrorism Preparedness
Health Education and Promotion- Promotes Policy and Environmental change that affects
Physical Activity, Nutrition, and Tobacco Prevention and Cessation in schools, worksites, and the
community
Environmental Health
o
o
Private Well Program- Permitting, inspection, and water sampling of private wells
Onsite Wastewater Program- Permitting and Inspection of large wastewater systems
o
Food, Lodging and Institutions Program ensures the public of safe and sanitary food service
establishments and other establishments including Hotels, Child Care Centers, Public Swimming
Pools, Tattoo Parlors, Nursing Homes and several others as required by state and local law.
23
2009 Carteret County
Community Health Assessment
Coloring Contest Entry
Name: Hunter
Age: 7
What does your family do to be
healthy? “Eating vegetables is a way
to eat healthy!”
Table 2.1 Carteret County Health Department Food and Other Establishment Inspections 2009
Type of
Establishments
# of
Establishments
# of
Inspections
Restaurants and Food Stands
290
923
Frequency of Inspection 4 per year
Frequency of Inspection 3 per year
Frequency of Inspection 2 per year
Frequency of Inspection 1 per year
152
44
89
5
608
132
178
5
Meat Markets
Institution Food Services
School Lunchrooms
School Buildings
Child Care Centers
Adult Care Centers
Motels
Bed and Breakfast Homes
Bed and Breakfast Inns
Local Confinement
Resident Camps
Residential Care Homes
Nursing Homes
Hospitals
Pushcarts/ Mobile Food Units
Catered Elderly Nutrition Site
Limited Food Service
Temporary Food Establishment
Tattoo Artists
TOTALS
20
6
16
24
24
2
36
9
3
1
1
10
9
1
4
1
14
42
9
522
60
24
64
24
48
2
36
9
6
1
1
10
18
1
8
4
14
42
9
1304
24
2009 Carteret County
Community Health Assessment
CARTERET COUNTY HEALTH DEPT. CONTINUED
Pest Management Division
o
Mosquito and Vector Control unit educates the public and monitors the county’s mosquito
population
o Animal Control unit responds to public complaints that take place outside of Municipal
limits. Carteret County Animal Control Officers work diligently to educate the public and
protect the health of both animals and humans.
o Investigate and prosecute cases of animal abuse and neglect
o Investigate all public complaints
The following report is for all calls and cases handled during July 2008 – June 2009.
Table 2.2
SPECIMENS SENT TO STATE LAB
ANIMAL CONTROL
TOTAL
TOTAL
Specimens Sent to State Lab
Cat traps
1498
(a) Dogs
11
Cats Picked up
1444
(b) Cats
14
(c) Raccoon
15
95
Dog traps
Dogs Picked up
640
Animal Running at Large
802
3975
Patrolled Areas
4463
Premises visited
BITE REPORTS
TOTAL
Bite Reports itemized
7
Total Positive Rabies Cases
ANIMAL CRUELTY/NEGLECT
166
(b) Cats
54
(c) Other
7
(d) Not an actual bite
5
69
(e) Not our Jurisdiction
Grand Total
301
3
4964
TOTAL
Cruelty/Neglect
346
Abandonment
203
2250
Warnings
(a) Dogs
Follow-ups
Grand Total
45
24
Wildlife/Miscellaneous
Citations issued
5
(d) Other
14254
Phone Calls
51
Medical Ass't/VET
124
Law Enforcement Asst.
WEST NILE VIRUS
TOTAL
Dead Bird Calls
(a) Eastern Part of County
10
(b) Western Part of County
1
Grand Total
18
25
2009 Carteret County
Community Health Assessment
Website: www.ccgh.org
Carteret General Hospital
Carteret General Hospital is a not-for-profit 135-bed hospital located in Morehead City. Since opening in
1967, Carteret General Hospital has grown from a small organization to a full-service hospital. Carteret
General is fully accredited by the Joint Commission for the Accreditation of Healthcare Organizations
(JCAHO). Employing approximately 1,075 individuals, Carteret General Hospital is the County’s second
largest employer.
2008 Statistics (September 30, 2008)
Opened:
1967
Inpatient surgeries:
2,470
Licensed beds:
135
Outpatient surgeries:
2,551
Admissions:
7398
Births:
717
Employees:
1075
Average daily census:
80.2
Registered nurses:
278
Average length of stay:
4.0 days
Volunteers:
99
ER visits:
38,310
Excellence Programs
o Carolinas Center for Joint & Spine Surgery
o Diabetes
o Stroke
o Heart Failure
o Breast Cancer
o Lap Banding
Specialty Services
o Brady Birthing Center
o CGH Imaging Center
o CGH Learning Center
o CGH Specialty Clinic
o Cardiac Rehabilitation
o Coleman Cancer Center -radiation treatment services
o Raab Oncology Clinic -chemotherapy treatment
o Eastern Carteret Medical Center
o Home Care - Home Health of Carteret County and Hospice of Carteret County
o Mobile Lithotripsy
o Radiological Services-CT, MRI, Nuclear medicine, Imaging Center, Digital Mammography
o Sleep Disorders Lab
o Surgical Services
o Taylor Extended Care in Sea Level
Community Services
o Carolina Donor Services-donor services
o CGH Learning Center for Diabetes, Stroke and Heart Failure Education
o Healthy Living Community Education
o Outpatient Diet Program-nutrition and diet education
o Parish Nursing
o RN scholarships by Hospital Foundation
o Safe Refuge-assistance during a disaster by Carteret Home Health
o Speakers’ Bureau-experts sharing information on a variety of health care topics
26
2009 Carteret County
Community Health Assessment
Website: www.ocbhs.org
Onslow Carteret Behavioral Healthcare Service
Onslow Carteret Behavioral Healthcare Services (OCBHS), is an accredited public agency established
under North Carolina General Statute 122-C, serving individuals who are in need of mental health,
developmental disabilities, or substance abuse services. OCBHS is an Area Authority, and as an Area
Authority they plan, develop, implement and monitor service requirements of the Division of
MH/DD/SAS. This includes supports for both insured and uninsured individuals.
Services provided include:
o Substance Abuse Services-Provides individual, group and family counseling, crisis prevention
and intervention, adolescent counseling, and substance abuse prevention to individuals and
their families whose lives have been affected by substance abuse.
o Emergency/Access Service-Provides 24-hour emergency/access services to persons in need of
mental health, developmental disabilities and substance abuse services. These services include
intensive case management, medication administration, detoxification from alcohol/drugs and
triage to a variety of internal and external services
o Adult Mental Health Services-Provides a variety of treatment options to meet the needs of
adult citizen with mental health problems
o Children & Family Services- Provide assistance to youth who are having emotional, behavioral,
and/or psychiatric problems. Services are available to all youth between the ages of 3-18 and
their families who live in Onslow and Carteret Counties
o Treatment Accountability for Safer Communities (TASC)- Specialized agent equipped to work
with offenders who are sentenced to Probation and/or who are involved within the criminal
justice system, TASC identifies the offender's needs and matches them with available treatment
services within the Area Authority and other community resources
o Developmental Disabilities Services
Early Childhood Intervention Services(ECI)-Provide referrals to parents of children
with developmental delays or at high risk for atypical development
o Prevention and Education- Personal growth and exploration program for young people,
teaching a combination of health information, general life skills, and drug resistance skills
o Speaker's Bureau- Free service provides seminars, educational presentations, and information
related to mental health, developmental disabilities and substance abuse issues to community
agencies
o Groups- Substance Abuse Prevention and Education and Anger Management
Coloring Contest Entry
Name: Devon
Age: 6
What do you like most about living
in Carteret County? “Daddy Surfing”
27
2009 Carteret County
Community Health Assessment
Website: www.carteretcountydomesticviolence.com
Carteret County Domestic Violence Program
Carteret County Domestic Violence Program (CCDVP) is a private non-profit agency which provides safe
shelter and supportive services for victims of abuse and their children. The Carteret County Domestic
Violence Program has been providing services to victims of abuse in Carteret County since 1988. The
mission of the Carteret County Domestic Violence Program is to provide temporary emergency
assistance and increase the capacity of victims of domestic violence to become self sufficient. The
Carteret County Domestic Violence Program provides the following services to victims of abuse and their
children:
Safe shelter
24 Hour crisis lines
Counseling and support group
Court Advocacy
Case management for shelter residents
Extended case management after exit from shelter
Limited emergency financial assistance
Limited emergency medical assistance
Transportation
Clothing and furniture
Community education on elder and teen abuse
Safe date program for middle school students
Food Pantry
Business Line: 252-726-2336
Fax: 252-726-8996
24 Hour CRISIS LINE: 252-728-3788
CCDVP Annual Statistical Report 2008/2009
Hotline calls – 694
Sheltered individuals – 274
Race/Ethnicity of individuals:
White
210
Black
50
Hispanic
14
Sex of Adult Individuals:
Female 179
Male
4
Average Age : 18-40
Services Provided:
Information/referral
Advocacy
Transportation
Counseling (hours)
Hospital Accompaniment
Court Advocacy
677
196
266
344
12
86
28
2009 Carteret County
Community Health Assessment
Carteret County Rape Crisis Program
The Rape Crisis Program provides free counseling for victims of sexual assault and abuse for adults,
teens, children (and family members). The Rape Crisis Program partners in the community to raise
awareness and provides training for law enforcement and other professionals, as well as prevention
education in schools.
Rape Crisis Advocates will work with victims of sexual assault to file Victim Compensation Assistance
with the state office. Funding provides payment of medical bills or other emergency and healthcare
needs resulting from assault. Transportation is provided to all related services and legal procedures if
needed. There are no costs for services and services are provided to individuals of all ages.
Eligibility Requirements - Victims or family of victims of sexual assault or child sexual abuse.
Days/Hours of Operation - 24 hours/7 days per week Telephone: 252-504-3668
Office Hours: 9:00 am - 5:00 pm Monday-Friday, or by appointment in evenings.
3722 Bridges Street Suite 201, Morehead City
24 HOUR CRISIS PHONE: 252-725-4040
Rape Crisis Program Statistics 1987- 2008 Number Primary Victims: Data does not reflect the number of family
members and/or any other secondary victims served by the Rape Crisis Program.
Total Clients Served by Rape Crisis Program
by Age Group, 1987 - 2008
Figure 2.1
700
600
500
400
300
200
100
0
Children 12 and
Under
Figure 2.2
Teens
Adults
Percent of Total Clients Served by Rape Crisis
Program by Gender, 1987 - 2008
Men
Women
29
2009 Carteret County
Community Health Assessment
Active Health Care Professionals:
Carteret County 2000, 2005, & 2007
Table 2.3
Physicians
Non Federal Physicians
Primary Care Physicians
Family Practice
General Practice
Internal Medicine
Obstetrics/Gynecology
Pediatrics
Other Specialties
Physicians per 10,000 Population
Primary Care Physicians per 10,000 Population
Federal Physicians**
Dentists and Dental Hygienists
Dentists
Dental Hygienists
Nurses
Registered Nurses
Nurse Practitioners
Certified Nurse Midwives
Licensed Practical Nurses
Other Health Professionals
Chiropractors
Occupational Therapists
Occupational Therapy Assistants
Optometrists
Pharmacists
Physical Therapists
Physical Therapy Assistants
Physician Assistant
Podiatrists
Practicing Psychologists
Psychological Associates
Respiratory Therapists
2007 2005 2000
92
46
17
3
10
10
6
46
14.5
7.3
4
89
42
13
2
12
9
6
47
14.3
6.7
1
84
37
12
6
9
6
4
47
n/a
n/a
1
2007 2005 2000
36
45
35
45
33
33
2007 2005 2000
497
27
0
181
449
21
0
190
424
14
0
164
2007 2005 2000
9
13
2
9
61
32
12
19
3
6
1
41
10
n/a
n/a
6
48
27
12
16
3
6
2
37
9
n/a
n/a
9
45
20
5
10
1
8
1
n/a
**Includes NC Medical Board Licensed federal physicians in the armed services, US Public Health
Service, Indian Health Service, and the Department of Veteran Affairs.
Source: 2008 UNC Sheps Center for Health Services Research
30
2009 Carteret County
Community Health Assessment
CHAPTER THREE
Local, Regional, and State Health Data Comparison
Leading Causes of Death- “What’s Killing Us?”
The following data represents the leading causes of death for 2003 – 2007. The table includes Carteret
County’s five-year total number of deaths associated with each of the leading causes of death and
provides a comparison for the age adjusted death rates per 100,000 population for both Carteret County
and North Carolina.
Table 3.1
*Age Adjusted Death Rate per 100,000 population
Carteret County vs. NC Comparison 2003-2007
Cause of Death
1
Number
of Deaths
*Age Adjusted
Death Rate
*Age Adjusted
Death Rate
Carteret Co.
197.2
206.6
52.4
North Carolina
194.9
210.7
57.6
178
40.5
47.5
138
40.6
27.8
28.5
17.1
28.3
26.4
Carteret Co.
878
874
220
5
Cancer
Heart Disease
Stroke
Chronic Lower Respiratory
Illness
Unintentional Injuries
6
Alzheimer’s
7
Diabetes
116
74
Motor Vehicle Injuries
68
22.1
19.1
65
15.8
21.4
65
15.1
18.5
11
Pneumonia and Influenza
Nephritis, Nepthrotic
Syndrome, and Nephrosis
Suicide
56
17.3
11.8
12
Chronic Liver Disease
48
10.9
8.9
828.9
875.3
2
3
4
8
9
10
Source: North Carolina Vital Statistics Volume 2 Leading Causes of Death “2003-2007
TOTAL CAUSES
3,448
Since the 2005 Community Health Assessment, Cancer has replaced Heart Disease as the leading cause
of death in NC and Carteret County. After reviewing mortality data above it was noted that the ageadjusted death rates for the leading causes of death in Carteret County continue to be very similar to
the State’s rates except in the following areas:
Unintentional Injuries death rate of 40.6 per 100,000 population for Carteret County is 46.0 %
higher that the state’s rate of 27.8 per 100,000 population
Suicide death rate of 17.3 per 100,000 population for Carteret County is 46.6% higher than the
state’s rate of 11.8 per 100,000 population.
Diabetes death rate of 17.1 per 100,000 population is 35.5% lower than the state’s rate of 26.4
per 100,000 population.
31
2009 Carteret County
Community Health Assessment
LEADING CAUSES OF DEATH CONTINUED
During the 2009 Community Opinion Survey, residents were asked to select the “top 5 Health Issues in
the community.” Three of the top health concerns are also leading causes of death for Carteret County.
Of the Survey respondents: 76.1 percent selected Cancer, 59.8 percent selected Heart Disease
(specifically High Blood Pressure 26.9 percent), and 57.2 percent selected Diabetes.
Figure 3.1
*Number of Deaths Attributed to Leading Causes of Death,
All Ages - Carteret County, 2003 - 2007
1 Cancer
1000
900
2 Heart Disease
878 874
3 Stroke
Number of Deaths
800
4 Chronic Lower Respiratory
Disease
5 Unintentional Injuries
700
600
500
6 Alzheimer's Disease
400
300
220
200
7 Diabetes
178
138 116
100
74
8 Motor Vehicle Injuries
68
65
65
9 Pneumonia & Influenza
0
Nephritis, Nepthrotic Syndrome,
Nephrosis
Figure 3.2
Figure 3.2
*Number of Deaths Attributed to Leading Causes of Death
Ages 0 - 19, Carteret County, 2003 - 2007
10
9
2-Prenatal Conditions
9
3-Unintentional Injuries
8
Number of Deaths
8
7
6
5
4
3
2
1-Motor Vehicle Injuries
4-Birth Defects
5-SIDS
6
5
6-Cancer
4
7-Suicide
3
8-Septicemia
2
1
Heart Disease
1
0
Pneumonia & Influenza
* Number of Deaths Attributed to Leading Causes of Death: Source: North Carolina County Health Data Book 2009, Department of
Health and Human Services- Division of Public Health, State Center for Health Statistics, “2003-2007 Ten Leading Causes of Death by County
of Residence and Age Group: Ranking, Number of Deaths, and Death Rates per 100,000 Population”
32
2009 Carteret County
Community Health Assessment
Figure 3.3
*Number of Deaths Attributed to Leading Causes of Death
Ages 20 - 39, Carteret County, 2003 - 2007
35
2-Motor Vehicle Injuries
3-Suicide
31
30
4-Heart Disease
5-Cancer
25
Number of Deaths
1-Unintentional Injuries
6-Homicide
21
19
20
7-HIV Disease
16
15
Stroke
13
Kidney Disease
10
10-Diabetes
5
3
2
Chronic Lower Respiratory
Disease
Pregnancy, Childbirth
1
0
Birth Defects
Figure 3.4
*Number of Deaths Attributed to Leading Causes of Death
1-Cancer
Ages 40 - 64, Carteret County, 2003 - 2007
300
250
2-Heart Disease
3-Unintentional Injuries
246
Number of Deaths
4-Stroke
200
5-Liver Disease
172
6-Suicide
150
7-Motor Vehicle Injuries
100
50
8-Chronic Lower Respiratory
Disease
9-Diabetes
48
30
28
23
20
19
18
11
10-Septicemia
0
*Number of Deaths Attributed to Leading Causes of Death: Source: North Carolina County Health Data Book 2009, Department of
Health and Human Services- Division of Public Health, State Center for Health Statistics, “2003-2007 Ten Leading Causes of Death by County
of Residence and Age Group: Ranking, Number of Deaths, and Death Rates per 100,000 Population”
33
2009 Carteret County
Community Health Assessment
Figure 3.5
*Number of Deaths Attributed to Leading Causes of Death
Ages 65 - 84, Carteret County, 2003 - 2007
1-Cancer
600
2-Heart Disease
517
3-Chronic Lower Respiratory Disease
500
Number of Deaths
434
4Stroke
400
5-Alzheimer's Disease
300
6-Diabetes
200
7-Nephritis, Nepthrotic Syndrome,
and Nephrosis
8-Unintentional Injuries
124
108
100
48
43
39
32
9-Pneumonia & Influenza
28
21
10-Parkinson's Disease
0
Figure 3.6
*Number of Deaths Attributed to Leading Causes of Death
1-Heart Disease
Ages 85+, Carteret County, 2003 - 2007
2-Cancer
300
3-Stroke
251
250
Number of Deaths
4-Alzheimer's Disease
200
5-Chronic Lower Respiratory
Disease
6-Unintentional Injuries
150
100
50
7-Pneumonitis
99
80
8-Nephritis, Nepthrotic
Syndrome, and Nephrosis
9-Diabetes
66
34
30
21
18
14
12
10-Pneumonia & Influenza
0
*Number of Deaths Attributed to Leading Causes of Death: Source: North Carolina County Health Data Book 2009, Department of
Health and Human Services- Division of Public Health, State Center for Health Statistics, “2003-2007 Ten Leading Causes of Death by County
of Residence and Age Group: Ranking, Number of Deaths, and Death Rates per 100,000 Population”
34
2009 Carteret County
Community Health Assessment
Life Expectancy Rate
Table 3.2
Carteret County Life Expectancy Comparison by Race
RACE
White
Black
YEAR (1990- 1992)
76.2 years
69.3 years
YEAR (2005- 2007)
78.1 years
72.5 years
AMT +/+1.9 years
+3.2 years
Source: Life Expectancy: North Carolina 1990-1992 and 2005-2007, State and County. State Center for Health Statistics
Cancer Rates
Cancer is a group of more than 100 different diseases, but all are characterized by uncontrolled growth and
spread of abnormal cells. Cancer risk increases with age, and varies by gender and race. As the average age of
the population increases, the incidence of cancer will increase as well. Currently in North Carolina, cancer is the
leading cause of death for people under the age of 85. Cancer is expected to surpass heart disease and become
the leading cause of death in the nation by the year 2015. The majority of cancer deaths occur at five sites: lung,
colon, female breast, prostate, and pancreas. It is generally accepted that over 60 percent of all cancers are
related to personal lifestyle or environmental factors, such as smoking and diet, and are therefore preventable.
Other factors such as age, gender, and family history of a specific cancer are also associated with the
development of cancer and aid in the identification of people at high risk. Carteret County’s percentages of
Cancer Death by Site report were very similar to North Carolina’s Cancer Death by Site report.
Table 3.3
Table 3.4
2007 Percent of Cancer Deaths in Carteret
County and North Carolina
.
Carteret County .
26.5%
vs.
2009 Projected Cancer Cases for
Carteret County and North Carolina
North Carolina .
23.0%
Lung/ Bronchus
Colon/ Rectum
Female Breast
Prostate
Pancreas
Figure 3.7
Cancer Death by Site, Carteret County
2007
All Cancers
Carteret
County
79
48
73
76
11
471
North
. Carolina .
7,307
4,672
7,781
6,800
1,077
46,417
6%
Colon Rectum
Lung/Bronchus
Female Breast
30%
43%
Prostate
Pancreas
Other Cancers
9%
5%
7%
Source: Cancer Profiles: Carteret County August 2009, North Carolina Central Cancer Registry - State Center for Health Statistics
35
2009 Carteret County
Community Health Assessment
Maternal and Child Health Data
Table 3.5
Maternal, Infant and Child Health Data
County State
Year
% Live Births Delivered by Caesarean-Section
33.9%
31.3%
2008
% Medicaid Births
58.2%
52.6%
2008
% of Births to WIC Mothers
42.8%
41.8%
2008
% of Births where Mothers Received Maternity Care Coordination
7.4%
14.9%
2008
% of Births where Mothers Visited Local Health Dept.
8.8%
20.8%
2008
% of Live Births That Were Less Than 2,500 grams
7.1%
9.1%
2008
18.9 %
11.5%
2004-2008
Total Infant Death Rate (less than 1 year old, per 1,000 live births)*
5.6
8.4
2004-2008
Total Live Birth Rate (per 1,000 live births)*
10.3
14.2
2004-2008
Pregnancy Rates (per 1,000 Population Girls 15-17) Race- White*
30.7
27.4
2004-2008
Pregnancy Rates (per 1,000 Population Girls 15-17) Race-Minority*
55.9
48.2
2004-2008
% of Live Births Where the Mother Smoked During Pregnancy*
*Source: 2010 NC County Health Data Book, State Center for Health Statistics (2004- 2008)
Source: NC Catch Portal- State Center for Health Statistics Carteret Profile (2008)
Number of Outcomes
Figure 3.8
*Pregnancy Outcomes by Age, Carteret County 2007
200
180
160
140
120
100
80
60
40
20
0
189
164
Induced Abortions
144
Live Births
79
Fetal Deaths
54
46
30
27
13
1
10
4
13
1
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 & UP
Induced Abortions
1
27
46
30
13
10
4
1
Live Births
0
79
189
164
144
54
13
0
Fetal Deaths
0
0
3
1
1
1
0
0
Table 3.6
Mother’s Education Level, Carteret County 2002 - 2007
NC 02- 07
Carteret 02- 07
2002
2003
2004
2005
2006
2007
Total
Pregnancies
909619
4647
703
733
787
823
818
783
Less than
H.S.
Education
196466
734
105
117
121
120
147
124
H.S.
Graduate
268756
1509
246
244
258
269
258
234
Some
College
207710
1379
195
215
219
249
256
245
College
Graduate
140088
622
101
100
108
110
98
105
Master’s
or Higher
76651
356
46
46
76
68
53
67
Unknown
19948
47
10
11
5
7
6
8
Source: NC Catch Portal, Maternal Child Health Cube, State Center for Health Statistics 2009
36
2009 Carteret County
Community Health Assessment
Uninsured Rates
.
Table 3.7
Area
County-Level Estimates of Non-Elderly Uninsured
Children (0 – 18)
Adults (19 – 64)
Non-Elderly (0 – 64)
Carteret County
North Carolina
Number
Percent
Number
Percent
Number
Percent
1,000
345,000
7.6 %
11.3%
9,000
1,232,000
22.2%
19.5%
10,000
1,578,000
18.0%
19.5%
Source: NC Institute of Medicine 2006-2007 (Data Snapshot 2008 – 2)
Communicable Diseases
Certain diseases or illnesses that are declared to be dangerous to the public health are required to be
reported to the state within a specified time-period after the disease or condition is reasonably
suspected to exist. Reporting requirements range from immediately, up to 24 hours, or within 7 days
depending on the disease. There are over 71 diseases that must be reported including but not limited to
the ones identified in this section of the Community Health Assessment. The Carteret County Health
Department is also responsible for investigating disease outbreaks and implementing control measures
to minimize further transmission of disease. During 2007, the EPI Team investigated an outbreak of the
Adenovirus and in 2008, two outbreaks both linked to salmonella cases. The tables and graphs below
indicate the # of newly reported cases by disease and year:
Table 3.8
DISEASE
Campylobacter Enteritis
E. Coli 0:157
Ehrlichiosis
Group A Strep
Heamophilus Influenza
Hepatitis A
Hepatitis B Acute
Hepatitis B Chronic Carrier
Hepatitis C Acute
Listeriosis
Lyme Disease
Malaria
Rocky Mountain Spotted Fever
Salmonellosis
Shigella
TOTAL:
REPORTED CASES
2008
10
1
1
1
1
3
5
1
2
1
4
1
2
28
1
62
37
2009 Carteret County
Community Health Assessment
COMMUNICABLE DISEASE CONTINUED
HIV, AIDS, TB and Syphilis Reported Cases
Carteret County 2004-2008
Reported Cases
Figure 3.9
10
9
8
7
6
5
4
3
2
1
0
9
Syphilis
AIDS
6
4
4
HIV
4
3
2 2
1
3
TB
2
1
1
1
2004
2005*
2006
2007
2008
Syphilis
1
0
0
4
3
AIDS
4
0
1
1
2
HIV
6
0
2
4
9
TB
0
0
2
1
3
About the data:
Syphilis cases are reported by stage of infection Primary, Secondary, and Early Latent Cases; together these three stages
occur within the first year of infection are called ‘early syphilis’. Case numbers reported are for early syphilis diagnosis only.
AIDS and HIV cases are the number of cases reported for that year and does not include year of diagnosis or the number of
individuals that are living with the disease. 2005* No reported cases may have resulted from reporting issues.
Sources: 2008 HIV/STD Surveillance Report- Communicable Disease Branch NC Department of Health and Human Services.
TB Cases and Case Rates by County 2004-2008, NC Electronic Disease Surveillance System (EDSS) NC TB Control Program
Figure 3.10
Chlamydia and Gonorrhea Reported Cases
Carteret County 2004-2008
200
Chlamydia
Reported Cases
163
150
100
131
134
122
86
68
Gonorrehea
134
70
50
50
32
0
Year
2004
2005
2006
2007
2008
About the data:
Chlamydia and Gonorrhea case reports represent persons who have a laboratory-confirmed infection. Changes in the
number of reported cases may be due to changes in screening practices. Case numbers represent both Male and Female
patients.
Source: 2008 HIV/STD Surveillance Report- Communicable Disease Branch NC Department of Health and Human Services.
38
2009 Carteret County
Community Health Assessment
Substance Abuse and Mental Health
Table 3.9
Carteret
Peer
State
Estimated Persons with Developmental Disabilities Age 3-17
310
365
59,559
Estimated Persons with Developmental Disabilities Age 18+
365
349
55,200
Estimated Persons with Severe Emotional Disturbance Age 0-17
1,162
1,362
222,906
Estimated Persons with Severe Emotional Disturbance Age 18+
2,822
2,614
378,594
Estimated Youth with Substance Abuse Age 12-17
328
346
57,885
Estimated Youth with Substance Abuse Age 18-25
1,001
1,018
204,759
Estimated Youth with Substance Abuse Age 26+
3,212
2,943
405,331
Mental Health/ Substance Abuse Statistics 2008
Source: NC Catch Portal, NC State Center for Health Statistics, Carteret County Profile
Peer Counties are counties which have similar demographic composition.
Age Adjusted Death Rate- Intentional Self-Harm (Suicide) 2001 – 2006
Figure 3.11
Source: NC Catch Portal, NC State
Center for Health Statistics, Carteret
County Profile
Communities That Care Youth Survey
Table 3.10
Grade Level
The Communities That Care Youth Survey was completed by
the Carteret County School System in October 2008. 3,679
students participated in the survey.
This survey was designed to identify the levels of risk and
proactive factors that predict problem behaviors in youth
such as alcohol, tobacco, and other drug use, poor school
achievement, and delinquency. In addition to measuring risk
and protective factors, the Communities That Care Youth
Survey also measures the actual prevalence of drug use,
violence and other antisocial behaviors among the surveyed
students.
The information provided by this survey will help to guide the
work of school administration, our local Healthy Carolinians
Substance Abuse Task Force and other community agencies
and organizations.
.
Source: 2008 Pride Survey Full Report – Communities That Care Youth Survey,
Carteret County Public Schools
39
2009 Carteret County
Community Health Assessment
SUBSTANCE ABUSE AND MENTAL HEALTH CONTINUED
The graph and table below is data collected using the Communities That Care Youth Survey. These
illustrate areas typically of most interest for the school systems. Which include demographics,
prevalence of 30 day use, and percentage of 30 day vs. lifetime use.
.
Figure 3.12
Figure 3.13
30 Day Use by Substance and Grade Level
Percent Usage by Substance 30 Day vs. Lifetime
40
2009 Carteret County
Community Health Assessment
SUBSTANCE ABUSE AND MENTAL HEALTH CONTINUED
Communities That Care Youth Survey (Figure 3.13) found that youth in Carteret County are reporting
higher lifetime usage of prescribed painkillers (for non-medical purposes) than their peers throughout
NC, 16.3% in Carteret County vs. 7.2% for North Carolina.
Source: 2008 Pride Survey Full Report – Communities That Care Youth Survey, Carteret County Public Schools
Prescription Drug Disposal and Turn-in Event
Prescription drug abuse is a serious and growing problem in Carteret County. According to a 2006
Substance Abuse and Mental Health Services Administration (SAMHSA) Survey, 70 percent of
prescription drug abusers got prescription medication from a friend or relative. In 2008, Carteret
County Sheriff Asa Buck with the help of the local Substance Abuse taskforce brought together
municipal police departments to discuss a possible prescription drug turn in event“Pills Can Kill”. Since then, three prescription drug turn-in events have been held. By eliminating the
availability of drugs in the community and providing the community a safe way to dispose of unneeded
and/or expired medicines it will substantially
reduce the risk of abuse.
Figure 3.14
This picture was taken during the October 10th, 2009- Pills Can Kill Drop Off
in Newport, NC. Carteret County Sheriff Deputies are required to count and
record of all medication turned in.
Pills Can Kill- Date and total doses collected
September 27, 2008- 40,000 doses
May 2, 2009- 38,000 doses
October 10, 2009- 68,000 doses
The Rx Disposal handout (Figure 3.14) was created by Healthy Carolinians of Carteret County’s Substance
Abuse Prevention Task Force. During drop off events (Pills Can Kill), Healthy Carolinians members
provided this handout to the public on how to lock up prescription medications as well safe disposal.
41
2009 Carteret County
Community Health Assessment
Coloring Contest Entry
Name: Ansley
Age: 6
What does your family do to be
healthy? “Fruits and vegetables
have lots of nutrients that will help us
grow healthy bodies”
Behavior Risk Factor Surveillance System (BRFSS) Data
.
The Behavioral Risk Factor Surveillance System (BRFSS) is a random telephone survey of state residents aged 18
and older in households with telephones. The North Carolina Division of Public Health has participated in the
BRFSS since 1987. Through BRFSS, information is collected in a routine, standardized manner at the state level on
a variety of health behaviors and preventive health practices related to the leading causes of death and disability
such as cardiovascular disease, cancer, diabetes, and injuries. BRFSS interviews are conducted monthly and data
are analyzed annually (on a calendar-year basis). For counties with smaller populations, data collected is
regionalized into Western, Central, and Eastern Regions. Carteret County data is generalized for the Eastern
Region of North Carolina. When applicable Community Opinion Survey data was also provided, however not all
questions were asked in the same manner as BRFSS, therefore the comparison would not be accurate.
Behavioral Risk Factor Surveillance Data, 2008
Table 3.11
Physical Activity Status
Regional
State
Opinion Survey
% Activity Recommendation Status - Meets Recommendation
41.5
44.0
78.7
% Activity Recommendation Status - Physically Inactive
16.6
14.3
31.4
Regional
State
Opinion Survey
% of Adults (< Age 65) Who Currently do not have health insurance
22.2
21.0
-
% of Adults that do not have any kind of health care coverage
18.7
17.8
-
% of Adults who are disabled
35.1
31.7
-
Regional
State
Opinion Survey
% of Adults Who Currently Smoke
22.5
22.9
20.2
% of Adults Who Reported Binge Drinking Past 30 Days
12.4
12.9
-
Regional
State
Opinion Survey
Diabetes (Not while Pregnant)
10.2
9.3
-
High Blood Pressure
30.8
28.8
-
Overweight
36.0
36.2
-
Health Status
Substance Abuse
Risk Factors for Chronic Disease
Source: NC CATCH Portal, State Center for Health Statistics 2009, New County Profile
42
2009 Carteret County
Community Health Assessment
CHAPTER FOUR
Primary Data Collection
Key Informant Survey Process and Results
A “Key Informant” is an individual from the business, government, education, religious, neighborhood,
or non-profit sector who is considered a leader in the community or knowledgeable about the needs in
the County. Individuals identified as “Key Informants” were nominated by members of the Community
Health Assessment Planning Committee.
Utilizing the free online survey builder SurveyMonkey.com a 10 question survey was created and
distributed to 90 individuals identified as Key Informants in the community on November 5 th 2008. Of
those selected, 54 completed the survey making the return rate 60%, with a majority of respondents
being from Morehead City, Beaufort and Newport.
Responses from questions 1-5 were used to gather hometown/zip code, sex, race, age and affiliation.
Responses are in table form below.
Demographic Comparison (Sex)
Survey Respondents
49.1 %
Male
48.9 %
Female
50.9 %
Female
51.1 %
* Source NC-Catch Portal– State Center for Health Statistics
Based on 2007 Population Estimates
Demographic Comparison (Race)
*Carteret County
Black
15 %
Black
7.4 %
Latino
2%
Latino
2.5 %
White
84 %
White
90.3%
* Source U.S. Census Bureau: State and County Quick Facts. 2009
Reported Age
30-39
40-49
50-59
60-69
70-79
% of Survey
Respondents
Morehead City
50 %
Beaufort
17 %
Newport
15%
*Down East Communities:
8%
*Carteret County
Male
Survey Respondents
Survey Respondents
Reported Hometown
% of Survey
Respondents
9.4 %
26.4 %
47.2 %
13.2 %
3.8 %
*Age groups with no respondents 18-29 or 80+
Straits, Gloucester, Otway,
and Atlantic
*Beach Communities: Atlantic
11 %
Beach, Emerald Isle, and Pine
Knoll Shores
(*Combined percentages)- % of Survey Respondents is rounded up.
Survey Respondents
Reported Affiliation
% of Survey
Respondents
Health Professional
32.1
Elected Official
State/County/Municipal
Employee
Business Owner
7.5
24.5
Church/ Spiritual Leader
5.7
School Administration/Teacher
5.7
Community Agency/ Nonprofit
20.8
Retired
3.8
1.9
*Military, Student, and “Other” Affiliations were not selected*
43
2009 Carteret County
Community Health Assessment
Key Informant Survey Results continued
On questions 6-10 Key Informants were asked to rank specific issues as a major problem, somewhat of a
problem, not a problem or I don’t know. There were several questions which also prompted the survey
participant to select five (5) of the most important issues to address. Survey participants were provided
a list of items to choose from. Below are the top responses from questions 6 – 10.
.
Survey respondents were asked to designate health issues as a major problem, somewhat of a problem,
not a problem or I don’t know. The following are the top five issues that were identified as a major
problem.
.
Q - 6. What are the major health issues or problems in Carteret County:
1
Illegal Substance Abuse
2
Prescription Drug Abuse
3
Drunk Driving
4
Diabetes
5
Cancer
.
Survey respondents were asked to rank the list of environmental issues as major problems, somewhat of
a problem, not a problem or I don’t know. None of the issues listed were considered a major problem,
therefore the top five responses were taken from the “somewhat of a problem” column.
.
Q - 7. What are the top environmental issues or concerns in Carteret
County:
1
Littering
2
Water Pollution
3
Indoor Mold
4
Wastewater/ Sewage Disposal
5
Stray/ Feral Animals
Survey respondents were then asked to rank a list of community issues as a major problem, somewhat
of a problem, not a problem or I don’t know. The following are the top five issues that were designated
a major problem as to whether or not they were difficult to find or use within the community.
.
Q - 8. Which of the following are difficult to find or use in Carteret
County:
1
Public Transportation
2
Affordable Housing
3
Drug and Alcohol Treatment
4
Mental Healthcare Services
5
Specialized Medical Care
44
2009 Carteret County
Community Health Assessment
Key Informant Survey Results continued
.
Additional Comments for question # 8: In your opinion, is it difficult to find or use any of the following
in Carteret County?
1. Lack of "social" recreation opportunities (as opposed to mostly physical recreation) ... especially for
pre-senior adults.
2. Affordable dental services are needed, and after hours medical centers are needed so people don't
jam up the emergency room which is costly to the tax payers.
Survey respondents were asked to select five topics from a list of the most important issues to address
in Carteret County.
.
Q – 9. What are the most important issues to address in Carteret County:
1
Job Opportunities
2
Obesity/ Overweight
3
Alcohol and Drug Abuse
4
Uninsured/ Underinsured
5
Mental Health Services
Additional Comments for question # 9: Of the topics listed below please select the top five most
important issues for the community to address.
1. Affordable Housing
2. More social groups offering organized activities are needed – water-sports, outdoor
clubs, dances/dance instruction, bicycling, aerobics, yoga, etc. These help promote physical, social,
emotional and mental health. What activities are here are usually for-profit; more
is needed through parks and recreation, the community college, and perhaps CCHD.
Also, more support/interest groups - not just for problem areas, but also for healthy social interaction
(language groups, spirituality, music, travel, etc.). We tend to focus on health "problems", mostly
physical. While this is important, we also need to stress wellness, especially beyond physical (i.e.
social, emotional, mental, etc.). Most importantly, these activities promote "community" wellness
and overall quality of life. A healthful, vibrant community will in turn generate any number of
improvements in personal health, as well as economic prosperity.
3. Developing parents to love and lead their children.
4. Workforce Housing. Many of the problems listed above are the result of lack of job opportunities and
good paying jobs. Our economy is heavily dependent on low-paying, seasonal jobs related to the large
dependence on tourism. Addressing the underlying problem (low wage, low skill jobs) which leads to
many of the problems listed above is the most important (and hardest) thing to do. The community
has great education systems (K-12, community college, universities); however the lack of good-paying
jobs leads to many of the problems.
.
5. Ways to keep our area green.
45
2009 Carteret County
Community Health Assessment
Key Informant Survey Results continued
6. Environmental issues with water and wastewater treatment and disposal. Assuring the systems we
permit continue to function properly.
7. Issues pertaining to smart development, storm water, septic, local health (people are moving because
of perceived lack of quality health care), rules and regulations for restaurants, economic development
and lack of good paying jobs.
8. Overweight children leaning towards diabetes and the lack of daily fresh air and exercise. Maybe
dancercise in the schools 2 times a day as a break from the desk would help! In good weather they
could be outside. Our population is more than 50% over 50 with health issues arising; we don't need
to add to the burden with having the young people also in poor health. Who will work and support
the aging population?
Q-10: Feel free to write other comments regarding this survey…
1. The County and its municipalities should continue to pursue additional sidewalks and pedestrian/bike
paths to provide safe alternative modes of transportation and exercise opportunities for their
citizens. Improvements in this area have been made in recent years, but continued improvements are
still needed immensely.
2. Thanks for asking these questions and allowing me to participate.
3. Lack of affordable housing is a big concern. People are forced to live in substandard housing full of
mold issues and other concerns that contribute to asthma conditions and other incidences of poor
health. Therefore, they live utilizing medicines daily because they cannot find other housing. These
old trailers and singlewides should be condemned, but landlords continue to charge high rent and
people continue to rent them because there is not enough housing available under $500 per month.
46
2009 Carteret County
Community Health Assessment
Community Forum Flyer
47
2009 Carteret County
Community Health Assessment
Community Forum Process
Community Forums (focus groups) were used to solicit individual perspectives about the community as a
whole. Forums were open to the public and meeting times and locations were varied to provide every
opportunity for the public to participate. A series of nine community Forums were held during 2009,
compared to only two held during the
2005 CHA.
.
Forums were advertised mainly in the
local news paper, Carteret News Times,
but also appeared in the Chamber of
Commerce Newsletter as well as The
Gam (a small local newspaper). When
the forums first began in January,
Carteret County Health Department
taped a show which featured information
about the assessment process on the
Health Department’s cable access TV
program “Lookout for your Health”.
Forum dates and locations were further
explained and information was posted as
to location and times of upcoming
forums. A radio interview was conducted
during March to announce the remaining
forum dates and times and also discuss
the types of questions that would be
asked.
.
Flyers that provided details about Forum
locations and times were emailed to Key
Informants and various community
agencies in the county. They were asked
to display them for the public to view but
were also encouraged to attend the
forums.
Churches in the areas
surrounding the forums were mailed a
flyer in advance and asked to post
somewhere visible, announce at the next church gathering, or insert in their church newsletter.
Even with continuous promotion and advertising, forum attendance was low. To encourage
participation $10 Gift Certificates to Wal-Mart were given to participants. Raffle tickets were used to
keep track of attendance as well as providing a means for giving away the door prizes.
Forums lasted about 1 hour and were overseen by a moderator. Forum responses were recorded using
a small tape recorder which allowed for accurate transcription of the individual responses.
48
2009 Carteret County
Community Health Assessment
Community Forum Summary of Responses
Statements made during the community forums are completely anonymous; therefore
responses have been summarized and combined with input from all 9 Community Forums.
1. Question–What do you like most about living in Carteret County?
Beach and Water
Aquarium at Pine Knoll Shores
Outdoor Recreation- Fishing and
Boating
Free Concerts in the Park (Summer)
Nature and Wildlife– Croatan
Forest
Lower Cost of Living (Compared to Up North)
Cape Lookout National Seashore
Growing Metropolitan Area– More shops,
stores, and restaurants
Pleasant Weather, Sunshine,
Temperature
Strong Sense of Family Values
Laid Back Community, Slower Pace
of Life
Friendly People and Sense of Community
Minimal Traffic, Quiet, Safe
Close to Family
2. Question– What do people in this community do to stay healthy?
Go to Fitness Centers and Gyms
Recycle More
Exercise- Walking, Running, Biking
Go to the Senior Center
Use Walking Trails at Parks
Drink More Water
Wear Sunscreen
Kayak, Swim, Golf
Get Regular Health Screenings
Watch their Diet
Lower Stress
Eating More Fresh Fruits and Veggies
Quit Smoking– Support Smoke Free
Environments
49
2009 Carteret County
Community Health Assessment
Community Forum Responses Continued
3. Question– What does it mean to be healthy?
Limited Pain
Free of Disease
Feeling Well
Able to Get Around– Being Energetic
Not Dependent on Medication
Peace of Mind
Healthy = Good life
Self Supportive– Independent
4. Question– What would a “healthy community” look like?
Clean Air and Water
Organized Clubs and Community Events
Safe Places for all ages to be
Physically Active.
Easy access to Healthcare Services, Treatments,
and Therapy
Support for Parents and Caregivers
Safe Neighborhoods
Community Center: Classes and
Activities for all Ages.
Access to Fresh Fruits, Veggies, Seafood and
other locally harvested food.
5. Question– Where do you get health information?
TV
Word of Mouth– Family and Friends
Internet
Doctor
Pharmacy/ Drug Store
50
2009 Carteret County
Community Health Assessment
Community Forum Responses Continued
.
6. Question– Which assets in the community positively affect health?
Community Workshops and Seminars
Leon Mann Jr. Enrichment Center
Carteret Community College
Health Professional Degrees
Food Assistance Programs: The Soup Kitchen,
Martha’s Mission, etc…
Carteret General Hospital’s
Community Education and Support
Broad Street Clinic Services for Uninsured
with Chronic Diseases
Relatively Close Proximity to Large
University Hospitals and Specialists
CCATs– Carteret County Area Transportation
System- transportation to local areas.
Carteret County Health Department
7. Question– What are some of the serious health issues you see in the
community?
Heart Disease- High Blood Pressure and Cholesterol
All Cancers
Obesity
Smoking and Tobacco Use
Allergies
Stroke
Asthma
Depression/ Anxiety
8. Question– What are some community issues that should be addressed?
Lack of Mental Health and Substance Abuse Treatment Providers in the County.
Individuals without Insurance using ER with no alternative
Healthcare Costs Too High
Lack of Out-of-Town Transportation to Medical Care
Lack of Youth and Family Activities
Substance Abuse- Drug and Alcohol among teens and seniors
Lack of decent Affordable Housing
Lack of Sidewalks in Communities
Lack of “User Friendly” Public Transportation
51
2009 Carteret County
Community Health Assessment
Community Opinion Survey
Administering a county-wide door to door survey took months of
preparation, technical support, and cooperation from various partners,
health department staff and volunteers. Primary data collection for the
2009 Community Opinion Survey was completed using GIS/GPS technology.
The 2009 CHA Planning Committee selected the modifiable survey created
by the State Office of Healthy Carolinians. However, during the Planning
Committee’s April meeting, revisions were made to reformat the survey and
tailor questions to meet the needs of our community. The final draft of the
survey was approved in May and emailed to Rachel Garnett, Technical
Assistant with the Public Health Preparedness and Response Team, Region 2
Trimble RECON Handheld Unit
(Wilmington, NC.) Rachel Garnett provided all of the GIS/GPS technical support throughout this project.
On May 18th – 19th, 2009, the Community Opinion Survey was administered. Trimble RECON handheld
computers were used to collect the responses when out in the field. These computers have GPS
capabilities and eliminate double data entry while
enabling the randomization of surveying locations.
A two-stage cluster sampling method (30 x 7) was
used in which the population is split into 30 distinct
geographically groups, then a selection of 7
households within each of the groups are surveyed.
This method is statistically accurate and produces a
sample data that can be generalized for the county
without having to survey the entire county.
.
Survey teams consisted of two people, a
Health Department Staff, County Employee, or
volunteer from our local Healthy Carolinians
Partnership.
Name tags were worn by all volunteers
County vehicles were driven to identify survey
administrators as agents of the County
Government
Technical assistance, training and support
were provided by Rachel Garnett prior to the
field survey dates as well as the day of each
survey.
“Getting Ready to Head Out” From left to right: Patti Schweis,
CC Board of Health Member and Molly Fullwood, R.S.
Environmental Health Specialist
Survey Day 1- May 18th,
2009.
52
2009 Carteret County
Community Health Assessment
COMMUNITY OPINION SURVEY PROCESS CONTINUED
Presentations took place each morning relating to proper interviewing techniques, survey
administration, house selection, and safety precautions. Lunch was provided both days for volunteers
as well as drinks and snacks for each team member. This field survey was implemented as a
preparedness exercise utilizing ICS Command Structure and Rapid Needs Assessment strategies. Teams
were asked to report in every two hours to the command base not only as a safety precaution, but to
provide an update on the number of surveys completed. Survey Teams left after lunch on day one and
around 9:30 am on day two, returning each day by 5:00 pm to turn in equipment and supplies.
Over the two day field study, teams were able to collect all but 35 of the 210 surveys needed. Some of
the barriers experienced on survey days was limited staff, bad weather, and survey equipment
malfunctioning. We had originally planned for 15 survey teams that would collect 14 surveys totaling
210 surveys. However, we only had enough volunteers to make 11 teams, as several individuals were
unable to volunteer due to illness or changes in schedules.
Overall the public was very receptive to the Community Opinion Survey. However, some households did
not want to participate as the unseasonably cold, windy, and rainy weather discouraged them from
standing on their porch and answering questions which occurred on both May 18th and 19th. If an
individual did not want to participate the survey teams were told to move to the next available address.
Technical difficulties also may have played a small role as to why we were unable to collect the full 210
surveys during the field study. The cloudy weather, made GPS capabilities stop working, however this
situation was handled in a timely manner.
The Health Department staff and volunteers who administered the survey stated how much they
enjoyed getting out in the community. Door to door surveys provide the opportunity to hear and see
directly what the issues, needs, and concerns are in the community. One survey volunteer stated, “It’s
not something we get to do as much as we should, I feel this method of data collection, although
tedious, is a wonderful tool to get straight answers from the community.”
The remaining 35 surveys were collected July 20th, 21st, and 24th, 2009. Within one week a statistical
report was generated and response rates were calculated for each of the questions in the 2009 Carteret
County Community Opinion Survey. A complete list of survey volunteers is available at the beginning of
this report. For more information on data collection or survey administration, contact Andrea Boyd at
the Carteret County Health Department 252-728-8550.
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2009 Carteret County
Community Health Assessment
Community Opinion Survey Summary-Narrative
The Community Opinion Survey consisted of 5 sections. Primary data collected through this survey
revealed the survey participants opinions on a variety topics. Survey data was collected using a twostage cluster methodology; therefore the data described therein can be generalized for Carteret County.
Survey Process
A two-stage cluster sampling technique was used to collect the Community Opinion Survey Data. This
technique was developed by the World Health Organization and is commonly used when conducting
public health surveys. A random sample of clusters involves dividing the specific population of interest
into geographically distinct groups such as neighborhoods or census blocks and then randomly sampling
a set number from that area.
For example: 30 census blocks would be randomly selected and then 7 randomly selected households
from the census blocks would then be interviewed. This would yield 210 surveys.
Census blocks were “weighted” based on population size, and several of the larger census blocks would
contain more interview sites depending on the number of households. The computer randomly selected
the addresses to participate in the Community Opinion Survey, however specific instructions were given
to eliminate empty parcels of land or households were there were no full time residents. Updated
addresses and information was transferred from the County Tax Department as well as Carteret County
Emergency Services.
The survey tool was modified from the Healthy Carolinians Community Opinion Survey Template, after
input from members on the Community Health Assessment Planning Committee. Several Meetings
were held to discuss and revise the questions and selections offered in the survey. Keeping with the
original template form there are 5 sections of the 2009 Carteret County Community Opinion Survey:
1.
2.
3.
4.
5.
Quality of Life
Community Health Problems
Personal Health
Emergency Preparedness
Demographics
Section 1 Quality of Life:
Overall survey respondents agreed there was a good health care system in Carteret County, when
considering the cost and quality of care as well as the number of options available. It was also evident
that the majority of respondents also felt that Carteret County was a safe place to live, raise children,
and grow old. When asked if they felt there was plenty of help for individuals and families during times
of need, 69.1 percent agreed. However, when asked if they felt that there was plenty of economic
opportunity in Carteret County about half or 50.7 percent disagreed and 14.2 percent strongly
disagreed. This was understandable due to increases in unemployment, as well as the number of
business closings and layoffs.
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2009 Carteret County
Community Health Assessment
Section 2 Community and Health Problems:
In this section, survey participants were handed a list of health and community issues and were asked to
select the 5 most important health issues, unhealthy behaviors, and community issues from a list. The
following are the top 5 answers for each question.
HEALTH ISSUES
1. 76.1 percent selected Cancer- Lung, Breast, and Skin
2. 62.0 percent selected Obesity/ Overweight
3. 59.8 percent selected Heart Disease- High Blood Pressure
4. 57.2 percent selected Diabetes
5. 48.1 percent selected Substance Abuse- Alcohol Abuse
UNHEALTHY BEHAVIORS
1. 79.7 percent Alcohol and Drug abuse
2. 67.9 percent Smoking and Tobacco use
3. 61.6 percent Poor Eating Habits and Nutrition
4. 49.5 percent Reckless/ Drunk Driving
5. 47.2 percent Lack of Physical Exercise
COMMUNITY ISSUES
1. 56.2 percent Affordable Health Care
2. 51.4 percent No Insurance or Underinsured
3. 41.8 percent Affordable Prescription Medication
4. 39.6 percent High School Students Dropping Out
5. 39.5 percent Availability of Family and Teen Activities
Many of these issues mirror topics identified during the Community Forums as well as the Key Informant
Survey.
Section 3 Personal Health:
In this section, survey participants were asked questions about their personal health status, health
insurance status, physical activity level, as well as medical history. Participants were reminded that their
answers would be confidential and their responses will only be reported as a cumulative summary.
However, several participants were hesitant to answer certain questions, stating they felt these
questions were too personal. The following is a brief overview of the responses. For a complete
description please view the Community Health Opinion Survey Results Section.
When asked “How would you rate your own Health,”22.1 percent stated very healthy, 47.9 percent
stated healthy, 25.1 percent stated somewhat healthy, 4.3 percent stated unhealthy, and 0.60 percent
stated very unhealthy. Around 28.2 percent stated they were unable to do usual activities such as
driving, working around the house or going to work due to physical pain or health problems.
When asked to identify any illnesses (diagnosed by a doctor) in which the survey participant or someone
in their household currently has, Heart Disease (47.2 percent High Blood Pressure, 47.1 percent High
Cholesterol) Diabetes (37.7 percent), and Obesity (31.9 percent) were the most common.
The majority (78.2 percent) of the survey participants would go to a doctor’s office if they were sick or
needed advice about their health, whereas 6.3 percent would go to the Emergency Room, and 12.1
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2009 Carteret County
Community Health Assessment
SECTION 3 PERSONAL HEALTH CONTINUED
stated they would go seek help or advice from a family member. Around 67.1 percent have some form
of private insurance, 27.2 percent receive Medicare, and 30.5 percent pay out of pocket.
When asked “In the past 12 months, did you ever have a problem getting the health care you needed,
filling a medically necessary prescription, or getting dental care”, the majority of survey respondents
answered NO. Approximately 5 percent stated they did have difficulty filling their prescription or
receiving dental care, their responses were that they didn’t have dental insurance, or they couldn’t
afford the co-pay or full cost.
Survey participants were also asked who they would tell a friend or family member to talk to if they had
a drug or alcohol problem. The majority of respondents would suggest they talk with their doctor (34
percent), a Minister/Religious Leader (22.2 percent), or a Private Counselor (27.6 percent), and 19.0
percent stated they didn’t know who to tell them to talk to.
The Community Opinion Survey also contained several behavior and lifestyle questions including:
“During the normal week other than your regular job, do you engage in any exercise that lasts at least a
half an hour?”, 68.6 percent said YES and 31.4 percent said NO. Of the 68.6 percent who said YES, 38.2
engaged in physical activity 5+ times a week, 11.9 percent stated 4 times a week, 28.6 stated 3 times a
week, 15. 7 stated 2 times a week, and 5.6 stated 1 time a week.
Of the 68.6 percent, almost half (41.2 percent) exercise at home, followed by 16.5 percent exercise at
the park or beach and another 16.4 percent use their membership at a private gym.
Of the 31.4 percent who do not exercise, some of the top reasons given were: I don’t have enough time
to exercise, I’m too tired to exercise, I don’t like to exercise, my job is physical or hard labor, or I’m
physically disabled.
When comparing physical activity levels to time spent watching television, playing video games, or using
the computer around 47.1 percent stated they watched between 2 and 3 hours of television, 23.2
percent watch between 4 and 5 hours a day, and 12.5 percent watch 6 or more hours of television a day.
A question was also asked about the number of fruits and vegetables consumed each day. “How often
do you eat fruits and vegetables in an average day?” Around 39.5 percent ate at least 2 servings of
vegetables per day and 35.0 percent ate at least 2 servings of fruit per day.
In regard to tobacco use, survey participants were asked, “Do you currently smoke?” Around 20.2
percent stated YES and 79.8 percent stated NO. This compares closely with the Regional Behavioral Risk
Factor Surveillance Data for 2008 which found that 22.5 percent are current smokers. Of the 20.2
survey respondents who currently smoke, 18.0% stated they would quit “Cold Turkey”, 9.1 percent
stated they would go to their doctor, and 4.1 percent stated they did NOT want to quit. No one
however, stated they would call the NC Quitline, which could indicate a lack of knowledge with regard to
available community smoking cessation resources.
Before the passage of House Bill 2 this year, which prohibits smoking in restaurants and bars, survey
participants were asked if they would support legislation for tobacco free restaurants and worksites,
68.8 percent stated YES, they would support legislation, and 33.2 percent stated NO they would not
support legislation. And when asked about exposure to secondhand smoke, 30.2 percent are exposed to
it in restaurants, 18.4 percent are exposed at home, and 10.1 percent are exposed in the workplace.
These numbers are significant and to help to gather support for the new anti-smoking laws in Carteret
County and North Carolina.
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2009 Carteret County
Community Health Assessment
SECTION 3 PERSONAL HEALTH CONTINUED
22 percent of the survey participants indicated they had children between the ages of 9 – 19 years old.
To provide parents with up to date information on youth health issues, Parents were asked which of the
following health and behavior issues would you like more information. The most popular choices were,
Prescription Drug Abuse, Illicit Drug Abuse, Sex Education/Abstinence, and Alcohol and Tobacco Use.
Section 4 Emergency Preparedness:
Of the survey respondents, 63.1 percent stated they have both a working smoke and carbon monoxide
detector in their house. When asking if their household had a family disaster or emergency plan, about
60 percent said YES they did have a plan in case of an emergency as well as 66.4 percent also had a basic
emergency supply kit. Individuals who had the supply kit about 82 percent had enough supplies to last
between 3 days to 1 week.
Section 5 Demographics:
The fifth and final section of the Community Opinion Survey reveals general demographic,
socioeconomic, and other information about each survey respondent. Collectively this data represents
the community as a whole, subject to of course to some degree of bias which is inherent in the sampling
technique. The complete breakdown of age, race, marital status, and gender comparison is shown in
table below:
Race Comparison
African American/ Black
American Indian
Asian or Pacific Islander
Caucasian/White
Latino
Ethnicity- Hispanic (YES)
Gender Comparison
Male
Female
Ages
18 – 19
20- 24
25 – 34
35 – 44
45 – 54
55 – 64
65 – 74
75 +
Marital Status
Single Never Married
Married
Divorced/Separated/Widowed
Carteret
County
2009 Survey
Sample
7.4%
0.50%
.80%
90.1%
2.5%
2.5%
2.9%
0.85%
96.1%
.085%
1.2%
Carteret
County
2009 Survey
Sample
48.9%
51.1%
48.4%
51.6%
Total
Population
2009 Survey
Sample
63,195
~
5.5%
12.3%
13.4%
15.5%
14.2%
10.1%
9.3%
Carteret
County
17.8%
60.8%
23.1%
210
0.83%
7.1%
6.1%
13.1%
12.1%
28.6%
22.7%
9.5%
2009 Survey
Sample
11.8%
70.9%
17.3%
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2009 Carteret County
Community Health Assessment
SECTION 5 DEMOGRAPHICS CONTINUED
Reported Income and Household Support
An analysis of survey participant’s total household income last year before taxes, showed 6.9 percent
earned less than $14,999, 7.2 percent earned between $15,000 and $24,999, 18.1 percent earned
between 25,000 and $34,999, 27.5% earned between $35,000 and $49,999, 20.2 percent earned
between $50,000 and $74,000, and 20.1% earned over $75,000. When asked, “How many people does
your income support?”, 15 percent of the survey participants supported 1 person with their income,
51.5 percent supported 2 people, 16.5 percent supported 3 people, 12.1 percent supported 4 people,
and 3.1 percent were supporting 5 people with their income.
Of those being cared for in the household approximately 5 percent of the households were caring for
elderly parents and 7 percent were grandparents or other non relatives caring for minor children.
Employment Status
Sample data revealed that retirees represented the greatest number of survey participants (40%),
followed by individuals employed full-time (25 %), and then individuals who were self employed (10%).
Surveys were collected during both day and evening hours, since many individuals are at work during
the day, our survey sample may be skewed slightly due the majority of responses coming from retired
individuals.
Employment Status
Employed Full Time
Employed Part Time
Retired
Military
Self-Employed
Unemployed
Student
Disabled
Stay-at-Home Parent
Survey Sample
11.8%
20.4%
24.9%
18.3%
17.7%
6.7%
Survey
Sample
25%
7%
40%
1.5 %
10 %
7%
2%
2%
3%
Educational Attainment
Some High School- No Diploma
High School Diploma or GED
Some College (No Degree)
Associates Degree or Vocational Training
Bachelors Degree
Graduate or Professional Degree
Carteret County
5.4%
14.7%
15.1%
4.2 %
7.6%
1.8%
Education attainment numbers for Carteret County are not a complete representative sample. The
above mentioned numbers are for individuals ages 25 -34 and were tallied using 2000 educational
attainment data. However it does provide some level of comparison. Respondent’s education level
appears to be higher and more educated than the county population in general.
Internet Access
The final question of the 2009 Community Opinion Survey asked “Do you have internet access at your
residence?” 80 percent of the survey respondents answered YES, and 20 percent answered NO.
After completing the survey, respondents were thanked for giving their time and opinion, and were
offered a small incentive gift for participating. The responses are automatically saved on the handheld
computers and the survey teams would move to the next address to implement the survey again.
58
2009 Carteret County
Community Health Assessment
Community Opinion Survey Results
2009 Carteret County Community Health Assessment
PART 1: Quality of Life Statements
The first questions are about how you see certain parts of Carteret County life. Please
tell us whether you “strongly disagree”, “disagree”, “agree” or “strongly agree” with
each of the next 6 statements.
How do you feel about these statements?
1. “There is a good healthcare system in Carteret County”?
Consider the cost and quality, number of options, and availability of healthcare in
Carteret County.
2. “Carteret County is a good place to raise children”?
Consider the quality and safety of schools and child care programs, after school
programs, and places to play in this county.
3. “Carteret County is a good place to grow old”?
Consider our county’s elder-friendly housing, transportation to medical services,
recreation, and services for the elderly.
4. “There is plenty of economic opportunity in Carteret County”? Consider
the number and quality of jobs, job training/higher education opportunities, and
availability of affordable housing in Carteret County.
5. “Carteret County is a safe place to live”?
Consider how safe you feel at home, in the workplace, in schools, at
playgrounds, parks, and shopping centers in Carteret County.
6. “There is plenty of help for individuals and families during times of need
in Carteret County”?
Consider social support in Carteret County: neighbors, support groups, faith
community outreach, community organizations, and emergency monetary
assistance.
Choose a number for each statement below.
1
2
3
4
Strongly
Disagree
Disagree
1.8%
15.7%
69.1%
13.1%
.5%
5.1%
62.2%
32.2%
1.5%
7.1%
54.2%
37.2%
14.2%
50.7%
33.7%
1.4%
0%
.6%
69.9%
29.5%
3.8%
13.3%
69.1%
13.8%
Agree
Strongly
Agree
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2009 Carteret County
Community Health Assessment
PART 2: Community Problems and Health Issues
7. This next question is about health issues that have the largest impact on the community as
a whole. Please look at the list. In your opinion, what are the 5 most common health issues in
Carteret County?
Health Issues
16.9% Asthma
3.2% Birth Defects
76.1% Cancer- Which kind?
29% Lung
.96%Testicular
26.9% Skin
16.1%Prostate
46% Breast
2.8% Cervical
20.5% Colon
1.4% Other
15.3% Dental Problems
57.2% Diabetes
59.8% Heart Disease- Which kind?
16.9% High Cholesterol
26.9% High Blood Pressure
18.8%Heart Attacks
1.5% HIV/ AIDS
4.6% Infectious Contagious Diseases (TB, Flu)
18.8% Lung Disease (Emphysema, COPD)
26.9% Mental Health (Anxiety, Depression, Bipolar, Suicide)
1.7% Neurological Disorders (Multiple Sclerosis, A.L.S, Muscular Dystrophy)
62.0% Obesity/ Overweight
8.6% Sexually Transmitted Diseases (STDs)
20.7% Stroke
48.1% Substance Abuse- What kind?
24.1% Alcohol
13.1% (Rx) Prescription Drugs
11.0% Marijuana (Illicit Drugs)
.
8.
In your opinion what are the top 5 unhealthy behaviors in Carteret County.
.
.
Unhealthy Behaviors
79.7% Alcohol / Drug Abuse
61.6% Poor eating habits and nutrition
26.7% Having unsafe sex
6.1% Not getting prenatal care during pregnancy
47.5% Lack of physical exercise
9.5% Not getting immunizations to prevent disease
49.5% Reckless/ drunk driving
6.9% Not using child safety seats properly
5.5% Suicide
29.3% Not going to the dentist for check ups
15.3% Not wearing seat belts
42.2% Not getting yearly physicals and screenings
67.9% Smoking/ Tobacco use
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2009 Carteret County
Community Health Assessment
9.
In your opinion what are the top 5 community issues in Carteret County.
Community Issues
24.1% Animal Control Issues
56.2% Affordable Health Care
41.8% Affordable Prescription Medication
17.4% Availability of Child Care
39.5% Availability of Family/ Teen Activities
9.2% Availability of Healthy Food Choices
5.7% Gang Activity
2.6% Violent Crime (Rape, Murder, Assault)
39.6% High School Students Dropping Out
12.3% Disaster/ Emergency Preparedness
4.2% Racism
33.7% Lack of Adequate Affordable Housing
21.5% Lack of Recreational Facilities (Sidewalks, Parks, Community Centers,)
2.6% Lack of Culturally Appropriate Health Services
8.3% Homelessness
14.9% Pollution- If so what kind- “Water Pollution and Littering”
10.0% Lack of Health Care Providers- If so what kind- “Specialists” .
51.4% No insurance or Underinsured
10.3% Neglect and Abuse
1.8% Elder Abuse
5.8% Child Abuse
3.0% Domestic Abuse
17.9% Teen Pregnancy
12.7% Unsafe or Unmaintained Roads
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2009 Carteret County
Community Health Assessment
PART 3: Personal Health
10.
How would you rate your own health?
22.1% Very Healthy
11.
47.9% Healthy
25.1%Somewhat Healthy
.60%Very Unhealthy
Where do you get most of your health-related information? Please choose only one.
13.2% Family or Friends
.81% School
63.1% Doctor/ Nurse/ Pharmacist
0% Help Lines
10.2% Internet
7.1% Books or Magazines
2.3% Hospital
3.3% Television
0%
12.
4.3%Unhealthy
Church
0% Other
Where do you go most often when you are sick or need advice about your health?
(Mark all that apply.)
78.2% Doctor’s Office
1.2% Health Department
6.3% Hospital (Emergency Room)
0.93% Broad Street Clinic
3.5% Urgent Care Center
12.1% Other- Family Member
.
13.
How do you pay for healthcare services? (Mark all that apply.)
67.1% Private Insurance
4.2% Medicaid
27.2% Medicare
3.2% NC Health Choice
9.7% TRICARE
5.2% VA Healthcare
30.5% Pay Out of Pocket
14.
In the past 12 month, did you ever have a problem getting the health care you
needed from any type of health care provider or facility?
.
13.9% YES
15.
86.1% NO (If NO, skip to question 16)
Since you said “yes” which of these problems did you have? You can choose as
many of these as you need to. If there was a problem you had that is not listed
please tell us and I will write it in. (Mark all that apply.)
a) 1.9% I didn’t have health insurance.
b) 3.1% My insurance didn’t cover what I needed.
c) .45% My share of the cost (deductible/ co-pay) was too high.
d) 1.5% The Doctor would not take my insurance
e)
0% Hospital would not take my insurance.
f)
0% I didn’t have a way to get there.
g) 1.2% I didn’t know where to go.
h) 5.2% I couldn’t get an appointment.
i) 0.51% Other
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2009 Carteret County
Community Health Assessment
16.
In the past 12 months, did you have a problem filling a medically necessary
prescription?
4.3% YES
17.
95.7% NO (If NO, skip to question 18)
Since you said “yes” which of these problems did you have? You can choose as
many of these as you need to. If there was a problem you had that is not listed,
please tell us and I will write it in. (Mark all that apply.)
a) .41% I didn’t have health insurance.
b) 2.7% My insurance didn’t cover what I needed.
c) 2.9% My share of the cost (deductible/ co-pay) was too high.
d) 0% The Pharmacy would not take my insurance
e) 0% I didn’t have a way to get there.
f)
0% I didn’t know where to go.
g) 0 .49% Other
18.
Was there a time during the past 12 months when you needed to get dental care,
but could not?
5.4% YES
19.
94.6% NO (If NO, skip to question 20)
Since you said “yes” which of these problems did you have? You can choose
as many of these as you need to. If there was a problem you had that we do not
have here, please tell us and I will write it in. (Mark all that apply.)
a) 4.5% I didn’t have dental insurance.
b) 0.81% My insurance didn’t cover what I needed.
c) 0% My share of the cost (deductible/ co-pay) was too high.
d) 0% The Dentist would not take my insurance or Medicaid.
e) 2.3% I couldn’t afford the cost.
f)
0%
I didn’t have a way to get there.
g) 0 % I didn’t know where to go.
h) 0% I couldn’t get an appointment.
i) 0 .57% Other
20.
If a family member or friend needed counseling for a mental health or a drug and
alcohol problem, who would you tell them to call and talk to? (Mark all that apply.)
a) 27.6% Private Counselor or Therapist
b) 17.1% Support Group such as (AA, Al-Anon, NA)
c) 4.2% School Counselor
d) 34.3% Doctor
e) 22.2% Minister/ Religious Leader
f) 19.0% I Don’t Know
g) 10.4% Other
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2009 Carteret County
Community Health Assessment
21.
During the normal week, other than your regular job, do you engage in any
exercise activity that lasts at least a half an hour?
68.6% YES
22.
Since you said “yes” to question 21, how many times would you say you engage
in exercise or physical activity during a normal week?
1 Time
2 Times
3 Times
4 Times
5+ Times
23.
31.4% NO (If NO, skip to question 24)
5.6%
15.7%
28.6%
11.9%
38.2%
Where do you go to exercise or engage in physical activity? (Mark all that apply.)
a) 41.2% Home
b) 16.5% Park or Beach
c) 6.3% Parks & Recreation Center
d) 16.4% Private Gym
e) 2.1% Senior Center (Leon Mann Jr. Enrichment Center)
f) 15.2% Other
24.
Since you said “no”, what are some of the reasons you do not exercise for at least 30
minutes a day during a normal week? (Mark all that apply.)
a) 4.6% My job is physical or hard labor
h) 4.0% I don’t like to exercise
b) 0.82% Exercise is not important to me
i) 3.0% It costs too much
c) 1.4% I don’t have access to a facility
j) 1.4% I have no safe place to exercise
d) 4.2% I don’t have enough time to exercise
k) 6.3% I’m too tired to exercise
e) 2.2% I would need child care
l) 1.5% I don’t know
f) 0 .96% I don’t have an exercise partner
m) 2.2% Other
g) 7.1% I’m physically disabled
25.
How many hours per day do you watch TV, play video games, or use the
computer for recreation?
17.2% 0-1 Hour
47.1% 2-3 Hours
23.2% 4-5 Hours
12.5% 6+ Hours
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2009 Carteret County
Community Health Assessment
26.
Not counting, juice, iceberg lettuce, or potato products; about how often do you
eat fruits and vegetables in an average day?
# Servings of Vegetables
27.
# Servings of Fruits
0- 4.9%
0- 5.2%
1- 19.7%
1- 32.2%
2- 39.5%
2- 35.0%
3- 23.2%
3- 14.3%
4- 6.2%
4- 7.6%
5+5.7%
5+3.2%
Are you exposed to secondhand smoke in any of the following places? (Mark all that apply.)
a) 18.4% Home
b) 10.1% Workplace
c) .85% Hospital
d) 30.2% Restaurants
e) .85% School
f)
3.6% Other
g) 49.0% N/A I am not exposed to second hand smoke
28.
Do you support legislation for tobacco free restaurants and worksites?
68.8% YES
29.
33.2 % NO
Do you currently smoke?
.
20.2% YES
79.8 % NO (If NO, skip to question 31)
Since you said “yes”, where would you go for help if you wanted to quit?
30.
(Mark all that apply.)
a)
31.
0% Quit Now NC (Telephone support)
g) 0.47% Hospital
b) 9.1% Doctor
h) 0%
c)
i) 1.9% I don’t know
0% Pharmacy
Health Department
d) .52% Church
j) 4.1% N/A I don’t want to quit
f)
0% Internet Program
k) 18.0% Other- Quit “Cold Turkey”
e)
0% Private Counselor
During the past 30 days, have you had any physical pain or health problems that
made it hard for you to do your usual activities such as driving, working around the
house, or going to work?
28.2% YES
71.8% NO
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2009 Carteret County
Community Health Assessment
32.
33.
Have you or anyone in your household ever been told by a doctor, nurse, or other
health professional that you have any of the following conditions:
a. Asthma
15.1% YES
b. Depression/ Anxiety Disorder
21.2% YES
c. High Blood Pressure
47.2% YES
d. High Cholesterol
47.1% YES
e. Diabetes (Not during Pregnancy)
37.7% YES
f. Osteoporosis
9.3%
g. Overweight/ Obese
31.9% YES
h. Cancer (Any type)
26.5% YES
Do you have children between the ages of 9 – 19?
22.0% YES
34.
YES
78.0% NO (If NO, skip to question 35)
Which of the following health and behavior topics, as a parent, would you like
more information on? (Mark all that apply.)
7.0% Alcohol Use
8.0% Sex Education / Abstinence
5.0% Body Image
7.0% Tobacco Use
11.0% Prescription Drug Abuse
1.5% Other
6.0% HIV
9.0% Illicit Drug Abuse
12.5% None
5.0% STDs
5.0% Mental Health Issues
6.0% Eating Disorders
4.5% Reckless Driving/ Speeding
PART 4: Emergency Preparedness
35.
Does your household have working smoke and carbon monoxide detectors?
63.1% YES, BOTH
36.9% NO If NO, Which one DO you have?
Smoke 57.9%
36.
Does your household have a Family Disaster or Emergency Plan?
59.6% YES
37.
40.4% NO
Does your family have a basic emergency supply kit?
66.4% YES
38.
Carbon Monoxide 11.2%
33.6% NO (If NO, skip to question 39)
Since you said “yes”, about how many days do you have supplies for?
44.0% 3 days
38.0% 1 week
9.9% 2 weeks
8.1% more than 2 weeks
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2009 Carteret County
Community Health Assessment
PART 5: Demographic Questions
The final set of questions is general population questions, which will only be reported as a
summary of all responses given by survey participants.
39.
How old are you?
.83% 18 – 19
6.1% 25 – 34
7.1% 20 – 24
13.1% 35 – 44 28.6% 55 – 64 9.5%
40.
Male 48.4%
41.
What is your race?
or
2.9%
12.1% 45 – 54 22.7% 65 – 74
75 +
Female 51.6%
African American/ Black
.85% American Indian/ Alaskan Native
0%
Asian or Pacific Islander
96.1% Caucasian/ White
.85% Latino
0%
42.
Other
Are you of Hispanic origin (Ethnicity) 1.2% YES
43.
98.8% NO
Do you speak a language other than English at home?
.
7.9% YES, (If YES, what language do you speak at home?) German 1.9%
Spanish 6.0%
92.1% NO
44.
45.
What is your marital status?
11.8% Single/ Never Married
5.5% Divorced
70.9% Married
10.4% Widowed
1.4% Separated
What is the highest level of school, college or vocational training that you have
finished?
11.8% Some High School- No Diploma
20.4% High School Diploma or GED
24.9% Some College (No Degree)
18.3% Associates Degree or Vocational Training
17.7% Bachelors Degree
6.7% Graduate or Professional Degree
0% Other
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2009 Carteret County
Community Health Assessment
46.
47.
What was your total household income last year, before taxes?
6.9% Less than $14,999
27.5% $35,000 - $49,999
7.2% $15,000 - $24,999
20.2% $50,000 - $74,999
18.1% $25,000 - $34,999
20.1% Over $75,000
How many people does this income support?
1 Person- 15.0%
2 People- 51.5%
3 People- 16.5%
4 People- 12.1%
5 People- 3.1%
48.
Are elderly parents being cared for in this household?
5.0% YES
49.
Are there any minor children being cared for by grandparents or other non
parental relatives?
7.0 YES
50.
51.
95.0% NO
93.0% NO
What is your employment status? (Mark all that apply.)
a) 25.0% Employed Full-time
d) 1.5% Military
g) 2.0% Student
b) 7.0% Employed Part-time
e) 10.0% Self-Employed
h) 2.0% Disabled
c) 40.0% Retired
f) 7.0% Unemployed
i) 3.0% Stay-at-home Parent
Do you have internet access at your residence?
80.0% YES
20.0% NO
END OF SURVEY
#####
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2009 Carteret County
Community Health Assessment
CHAPTER FIVE
What’s changed since the 2005 Community Health
Assessment?
Healthy Carolinians Update
Over the past four years, Healthy Carolinians of Carteret County (HCCC) has worked diligently to address
the priority issues identified in the 2005 Community Health Assessment.
1.
2.
3.
4.
5.
Physical Inactivity
Obesity
Mental Health
Substance Abuse
Access to Care
Healthy Carolinians board has been successful in achieving objectives and has updated the strategic plan
due to strategies being completed prior to proposed timelines. These accomplishments have facilitated
new partnerships in the faith community as well as the school system that encourage the participation
of youth on key issues. Issues of Substance Abuse, Access to Care, Physical Inactivity and Obesity are
the foundation for several task force and coalitions and have led to new projects and initiatives, not only
in our community but also in surrounding counties.
It is evident that Carteret County is seeing the effect of “true” community collaboration all of which is
helping to fill gaps and bring needed resources into Carteret County.
Carteret County Substance Abuse (SA) Task Force
The SA Taskforce is working to raise community awareness surrounding the issues of underage drinking
and prescription drug abuse.
The taskforce continues to partner and support learning opportunities targeting parents, youth,
substance abuse professionals, medical providers, and other community agencies and organizations in
the County. Below are several of the task force sponsored activities:
State of the Child Conference in Carteret 2008 and Craven County 2009
Annual Recovery Celebration- Real People Real Recovery
Faith Works Best Together Training
Safer Opioid Prescribing Workshop
Addressing Substance Abuse in Pregnant and Postpartum Women Training
The Prescription Drug Campaign entitled “Pills Can Kill” has held three prescription drug drop-off events.
Approximately 100,000 pills were collected by Law Enforcement as the community cleaned out their
medicine cabinets. The drug drop off model has been used throughout the state of NC by other Healthy
Carolinian partnerships and substance abuse prevention coalitions. This effort was a successful
partnership with the local sheriff’s department, local law enforcement agencies, the schools, community
volunteers and Food Lion grocery stores throughout the county.
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2009 Carteret County
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HEALTHY CAROLINIANS UPDATE CONTINUED
Healthy Carolinians has sponsored several education outreach programs in Carteret County for
physicians, physician assistants and nurse practitioners such as, Safer Opioid Prescribing and Addressing
Substance Abuse; During and Following Pregnancy, feedback from both workshops have been positive,
and both have been replicated in other parts of state.
The Carteret County SA Task Force is a member of a regional five-county task force working on policy
and environmental change – the Coastal Coalition for Substance Abuse Prevention (CCSAP). As a
member of CCSAP, Carteret County will benefit from resources generated by the regional coalition.
CCSAP also expanded to include Onslow County this year and now serves as the implementation
organization for the county’s Substance Abuse funding for alcohol-related crashes. The focus of CCSAP is
underage drinking and youth prescription drug use. The Carteret County task force, along with the
CCSAP and Craven, Jones and Pamlico counties, successfully completed the PRIDE Surveys in all middle
and high schools, establishing baseline data for risk factors and protective factors regarding substance
abuse for youth. This was an overwhelmingly successful partnership with all the county school systems
in the region. CCSAP also received the NC Prevent Underage Drinking Initiative funding in May 2009
which will be utilized throughout all five counties. As noted, the successful regional partnership with
CCSAP has extended the county’s ability to enhance resources in our local community.
Eat Smart, Move More Coalition (ESMM)
The ESMM Coalition continues to promote healthy eating and physical activity campaigns and
partnerships throughout the community. The ESMM coalition provides assistance and support to
encourage individuals, worksites, and organizations to adopt healthy habits. For two years, the ESMM
Coalition promoted a community health awareness campaign entitled “CountDown Carteret.” This
campaign was changed to an individual Health Pledge that worksites or schools could use as a wellness
activity, because it is easy to implement and easy to manage.
This past year the ESMM Coalition has been focused on developing worksite wellness committees for
County Government Employees as well as the Carteret County School System Employees. In 2009 the
Eat Smart, Move More Coalition of HCCC received $20,000 funding from the Eat Smart Move More, NC
Community Grants program in partnership with County Parks and Recreation for establishing a walking
and activity trail at a new park in the western part of the county.
Access to Care and Information and Referral System Task Force
Access to Care: Taylor’s Down East Resource Center is a referral program which will qualify an individual
for free medical care. This program is a collaboration of Carteret General Health Ministries, Carteret
County Health Department, Cooperative Extension, Healthy Carolinians, Broad Street Clinic, ACORN
Center for Families and Taylor Extended Care – Sea Level, NC. Taylor’s Down East Resource Center
provides tertiary, secondary and primary care to the uninsured, underserved populations in the down
east community. Future plans include a similar resource center in the western portion of the county.
Partnering with the Duke Endowment and through their support of the Care + Share Program in North
Carolina, Taylor’s Down East Resource Center received grant funds to support the implementation and
evaluation of this project over the next three years.
Individuals who do not have insurance or are underinsured that qualify will receive free medical care to
treat existing health conditions but will also receive prevention education and a health risk assessment
to encourage lifestyle changes that will improve their health and help prevent further illnesses or
diseases. Individuals who do not qualify will still receive the prevention education and health risk
assessment but will be given a referral to other community programs and services.
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2009 Carteret County
Community Health Assessment
HEALTHY CAROLINIANS UPDATE CONTINUED
Information and Referral: Healthy Carolinians has partnered with the Area Agency on Aging and has
plans to update and improve the NC CareLink Information and Referral Website which is a web-based
and phone-based information and referral system. This system will link all services (tertiary, secondary,
primary care and primary prevention).
Members on the Access to Care task force are also involved with providing facilitation and strategic
planning services for the local System of Care Collaborative in Carteret County. System of Care is a
community collaborative which advocates for families and children. Plans are to establish a system of
care among community agencies, in which an individual can receive guidance from a case manager who
will help them acquire the services and information they may need. It is the hope that this system will
make services more readily and easily available to those seeking services and provides them with an
advocate for identifying and obtaining the help they need, thereby improving access to care.
Healthy Youth, Healthy Families (HYHF) Initiative
This partnership involves the Boys & Girls Club of Coastal Carolina, local law enforcement, parks and
recreation, local churches and local schools, as well as youth and parent volunteers from the
community.
HYHF has taken a leadership position in the development of a skateboard park initiative in the
community. Through the work of this group, land has been identified and approved by the county for a
skateboard park. This work is still under development and is requiring quite a bit of community
mobilization in order to move this project forward.
The HYHF initiative continues to work with SA Task Force to implement the Take It Back- an underage
drinking prevention campaign- as well as work with local schools to implement consistent programming
for substance abuse prevention education during school and in after school programs.
Emerging Issues- H1N1
The H1N1 Novel Influenza pandemic, which began in spring 2009, definitely qualifies as a major
emerging issue for all public health departments in North Carolina.
Over the past months, Carteret County Health Department has worked closely with NC Public Health to
begin to provide H1N1 vaccination to those in our county in high-risk groups.
We will continue to commit our time and resources to provide accurate and up to date information to
the community, as well as continuing our vaccine efforts.
If you have questions or would like more information about the H1N1 Virus, please contact the Carteret
County Health Department at (252)728-8550.
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2009 Carteret County
Community Health Assessment
CHAPTER SIX
Dissemination and Communication Plan
The Carteret County Health Department will disseminate the 2009 Community Health Assessment
throughout the community. A press release will be dispersed to all media contacts in the community and a
representative from the health department will be available to present findings from this report as
requested by community groups and organizations.
The complete report will be accessible for download on the Health Department’s website as well as printed
copies in each Public Library in the county. An executive summary will be completed in June 2010 that will
be emailed to all community leaders, local agencies and organizations.
Coloring Contest Entry
Name: Emily
Age: 6
What do you like most about living
in Carteret County? “Playing at
school on the playground”
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2009 Carteret County
Community Health Assessment
CHAPTER SEVEN
Next Steps
.Determining Health Priorities
Carteret County continues to evaluate and identify current and emerging health priorities in the
community. Using the data provided in this report, members of Community Health Assessment Planning
Committee will be invited to review the information and deliberate the health priorities to address over
the next four years. Members of this committee represent a diverse group of individuals with varying
expertise and knowledge and will remain as objective as possible when selecting priorities.
The priorities which are selected will become the foundation for Healthy Carolinians Community Action
Plan in 2010. The Community Action Plan will be the road-map which will guide the work of the coalitions
and task forces as they initiate policy and environmental changes.
Both primary and secondary data will be evaluated to accurately depict the county’s current needs and pre
existing issues. Secondary data such as that from the State Center for Health Statistics, CDC, or other
National or Regional agencies will be weighted with primary data such as that from the Key Informant
Survey, Community Opinion.
Practical questions to be asked of each issue include:
1. What is the magnitude of the problem?
2. What are the consequences of NOT addressing this problem?
3. What is the feasibility of correcting or reducing this problem?
Answers to these questions can then be rated 1 through 5 by each group member on all issues being
considered. Once each member votes on the issues of his/her choice, results will be tallied for the group
as a whole, and issues will be ranked by a numerical score. It is important for members of the decision
making body to consider the “weight” of each data source, as well as the importance or “value” of the
issues, with regards to the “type” or nature of the issue.
Once this process is completed a numerical ranking should depict the most critical health issues for the
community identifying a rational, balanced set of health priorities that truly reflect a “best fit” picture for
the community.
The chart on the following page depicts the top issues identified by both the Community Forum Data as
well as the Community Opinion Survey Data. After reviewing this chart as well as secondary data sources,
the Priority Health Issues will be determined.
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2009 Carteret County
Community Health Assessment
Determining Health Priorities
Environmental Health Factors and Community Infrastructure
RANK Survey Data
Forum Data
Job Opportunities
Public Transportation
Availability of Family and Teen Activities
Affordable Housing
Lack of Sidewalks and Recreational Facilities
Job Opportunities/ Economic Development
High School Students Dropping out
Availability of Family and Teen Activities
Affordable Housing
Lack of Sidewalks and Community Centers
RANK Behavioral Health Factors
Survey Data
Forum Data
Poor Eating Habits and Lack of Physical Exercise
Drunk Driving
Substance Abuse
Substance Abuse
Smoking and Tobacco Use
Reckless and Drunk Driving
Not Getting Yearly Physicals and Screenings
RANK Illness or Disease Related Factors
Survey Data
Forum Data
Cancer- Lung, Breast, and Skin
Diabetes
Diabetes
Substance Abuse- Illegal Drugs & Rx Drugs
Heart Disease- High Blood Pressure
Cancer
Obesity- Overweight
Obesity
Substance Abuse- Alcohol
Asthma
RANK Health Services or Access to Care Issues
Survey Data
Forum Data
Affordable Health Care
Transportation to Medical Services
Affordable Prescription Medication
Mental Health/ Drug and Alcohol Treatment
No insurance or underinsured
No insurance or underinsured using ER
Affordable Health Care
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2009 Carteret County
Community Health Assessment
Developing the Community Action Plan
Once health priorities have been identified and approved by the full board of Healthy Carolinians, existing
taskforces and coalitions will be mobilized. If needed new coalitions may be created to address emerging
issues. These groups will develop appropriate interventions, identify resources in the community, and
determine timelines and objectives. Individuals that currently serve on the Healthy Carolinians Board will
identify key people in the community who may also have an interest or expertise on the issues. Some
issues may have more than one underlying cause and may be related to lifestyle issues or environmental
factors, therefore taking time to understand the priority issues will be the first key step in respect to
addressing these issues. During this process gaps in services or other barriers could be identified leading to
alternate issues. The benefits will be weighed against time and cost restrictions in order to maximize
efficiency and avoid duplication of services.
Specific interventions will be designed to take place on an individual level, organizational level, or possibly
targeting the entire community through changes in policy, the environment, or the community
infrastructure. All interventions will link back to Health Carolinians 2010/2020 Objectives.
Once the Community Action Plan is completed and approved by the board, copies will be submitted to the
Office of Healthy Carolinians/ Health Education. Implementation will begin. These plans will guide the
working progress of initiatives developed to address the health needs of Carteret County and will satisfy
requirements of the Healthy Carolinians partnership for recertification. Progress towards completing
stated objectives will be reported to the Board of Health and the community over the next four years.
If you have questions or concerns about topics represented in this report, or if you would like more
information on becoming involved with new projects or initiatives, please contact the Carteret County
Health Department at 252-728-8550.
Coloring Contest Entry
Name: Greyson
Age: 6
How can we make Carteret County
a Healthier place to live?“If kids
would eat lots of fruit and vegetables
our county would be a better place to
live.”
75