01/03/2001
New Hanover County Health Department
Revenue and Expenditure Summaries for November 2000
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Revenues
Cumulative % 41.66% Month Reported Mon5of12 Nov 00
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal & State $ 1,323,298 396,915 926,383 29.99% $1,331,280 521 ,846 809,434 39.20%
AC Fees $ 523,044 218,375 304,669 41.75% $ 516,453 149,477 366,976 28.94%
Medicaid $ 941,900 66,378 875,522 7.05% $ 852,884 245,503 607,381 28.79%
Medicaid Max $ 153.479 (153,479) 100.00% $ 192,301 192,301 0.00%
EH Fees $ 312,900 106,012 206,888 33.66% $ 312,900 97,269 31.09%
Health Fees $ 112,015 60,692 51,323 54.18% $ 109,515 53,546 46.89%
Other $ 1,188,923 275,063 913,880 23.14% $ 775,172 351,367 45.33%
Expenditures
Current Year Prior Vear
Type of Budgeted Expended Balane.e % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
e Salary & Frlnge $ 8,122,368 $ 2,820,677 $ 5,301,691 $ 7,200,653 $ 2,651,653 '$4,549,000 36.83%
Operating $ 1,722,433 $ 555,789 $ 1,166,644 $ 1,488,405 $ 512,059 $976,346 34.40%
Cap~al Outlay $ 505,695 $ 154,152 $ 351,543 $ 666,377 $ 44,981 $ 643,396 6.53%
Totals $ 10,350,496 $ 3,530,616 $ 6,819,878
Summary
Budgeted Actual %
FY 00-01 FYOO-01
Expenditures:
Salaries & Fringe $8,122,368 $2,820,677
Operating Expenses $1,722.433 $555,789
Capital Outlay $505,695 $154.152
Total ExpendRures $10,350,496 $3,530,618 3411%
Revenue: $4,402,080 $1,276,914 29.01%
Net County $$ $5,948,416 $2,253,704 37.89%
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Revenue and EXllenditure Summary
For the Month of NOVEMBER 2000
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
e Date BOH Reo!!!!t!!"
Intensive Home Visitation Program
12/6/00 Ex ansion Grant - Smart Start
Childhood Asthma Management &
Control Interventions- NC Department of
Health & Human Services, Division of
11/1/00 Public Health, WCH Section $23,000
Cape Fear Memorial Foundation-Lice
Eradication Program $5,000 $5,000
Healthy Carolinians- Office of Healthy
Carolinians, Division of Public Health, North
10/4/00 Carolina Dept of Health & Human Services $10,000 $10,000
March of Dimes- March of Dimes Birth
Defects Foundation Eastern Carolina
Chapter $10,000 $10,000
Enhanced Counseling Program for HIV /
AIDS - Elton John Aids Foundation $48,000 $48,000
Smart Start applying for Cape Fear
8/2/00 Memorial Foundation Grant (MOW) $52,000 $50,000 $2,000
e Enhanced Counseling program- Z. Smith
Reynolds Foundation $48,000 $48,000
Teen Aids Prevention- Z. Smith Reynolds
Foundation $59,000 $59,000
March Toward TB Elimination- NC Dept
7/12/00 of Health and Human Services (DHHS) $10,000 $7,200 $2,800
Cape Fear Memorial Foundation (TAP
Program 2 ear request $55,000 er year $55,000 $35,000 $20,000
Diabetes Today - DHHS Division of Public
Health
Servicios Para Ninos-Rahab Therapy
6/7/00 Foundation $50,000 $50,000
Family Planning Outreach Initiative-NC
Division of Public Health- WPH Unit (Year
One $21,538 and Year Two: $22,615) $21 ,538 $21,538
Healthy Homes Initiative-NC Childhood
Lead Poisoning Prevention Program
Project Assist-American Legacy
Foundation Grant ($57,500 for each of 3
5/3/00 years) $57,500 $57,500
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As of 12/27/00
. Notification received since last report.
9
NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
e GRANT APPLICATION STATUS
MOW Sllrvicl!S (Infant Mortality)-NC
Healthy Start Grant Application (2yr Grant:
4/5/00 $85,000 yr 1 and $43,845 yr 2) $128,845 $128,845
Skin Cancer Screening- NC Advisory
Committee on Cancer Coordination and
Control $1,500
3/1/00 $5,590
Child Hllalth Consultant Grant- UNC Dept
of Maternal and Child Health- Contract with
NC Dept of Health and Human Services,
Division of Women and Children's Health $48,210 $29,275 $18,935
Hllalthy Carolinians Task Force- NC
11/3/99 Office of Health Carolinians FROZEN) $10,000 $10,000
Opllration Reach Women- Susan G
Komen, Breast Cancer Foundation $19,822 $19,822
North Carolina Chilhood Asthma
Initiative- NC Dept of Health and Human
Services, Women and Children's Health
e Section FROZEN
School Health Lice Grant- Carolina Power
and Light Company Corporate Contributions
9/1/99 Fund $4,900 $4,900
Growing Up Buckled Up- National
Highway Traffic Safety Administration
Cooperative Agreement $54,730 $54,730
Model Community Assessment Grant-
North Carolia Community Health Initiative-
Healthy Carolinians- Center for Disease
9/1/99 Control and Prevention $17,375 $17,375
Diabetes Today Community Planning
Initiative-NC Dept of Health and Human
Services - Diabetes Prevention and Control
Unit $10,000 $10,000
Hllalthy Women First- Community Health
7/7/99 Improvement Program $24,692 $24,692
Telln Aids Prevllntion-Cape Fear
Foundation Grant $50,700 $35,000 $15,700
i$962;9Q~ $'Ull;5QQ n~~;37);t $iJ~2;O~lt
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As of 12/27/00
. Notification received since last report.
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e BUDGET CALENDAR FOR FISCAL YEAR 2001-2002 (Preliminary)
2000
~ea1th Dept
peadlines:
December 12
Preliminary Budget Meeting and Lotus Notes Training on budget for
Department Heads and Budget Support Staff (mechanics)
Budget request information with instructions to departments and
outside agencies
December 15 Capital Improvement and Capital Project (CIP) requests to BUDGET
December 19 Departmental goals to BUDGET
2001
January
Planning session with County Commissioners on FY 01-02 Budget
Initial County Manager Meeting with Department Heads and Budget
Support Staff on FY 01-02 Budget
Preliminary performance measures and objectives to BUDGET
Ie 2001January 3
January 12 Expenditure and revenue printouts (through 12/31/00) to departments
(Information is available on LGFS)
January 16 Outside agency funding requests to BUDGET
Ian 11, 2001 New position, temporary salary, and overtime/on-call salary requests to
BUDGET
February 1 IT submits worksheet of all computer requests to BUDGET
~n 17,2001' February 15 Departmental line item budgets to BUDGET
(ALL REQUESTS IN EXCEPT SCHOOLS)
Departmental revenue projections to BUDGET
February 15 County goals to departments
March 19 Distribute revised budget requests and printouts to departments and
Board of Commissioners
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e BUDGET CALENDAR FOR FISCAL YEAR 2001-2002 (Continued)
il'ealth Dept
/)!adlines:
March 19.30 Departmental budget meetings with County Manager & Budget Team
(COMMISSIONERS INVITED TO ALL BUDGET MEETINGS)
f\\ar 9, 2001 March 30 Final performance measures and objectives to BUDGET
May 4 Budget to Board of Commissioners (informally)
May 7 Recommended budget information to departments and outside
agencies
County Manager presents Recommended Budget at Board of
Commissioners' Meeting (Commissioners establish work sessions on
budget?)
May 21
Public Hearing on Budget (night meeting will need to change)
June 4
..' 200lJune 30
Adopt budget
Departmental accomplishments to BUDGET
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~:.
~
Coastal ~ ~"",
e AHEC
COASTAL AREA HEALTH EDUCATION CENTER
2131 South 17th Street. Cameron Building
Post Office Box 9025 . Wilmington, NC 28402-9025
(910) 343-0161 . FAX (910) 762-9203
To'
From.
Cc:
Re:
Date:
Betty Jo McCorkle, New Hanovyt.-County Health Department
Sandy Diehl, Coastal AHEC .<l ()
Deborah Covington, Diana Woolley, Jim Shaw, Coastal AHEC
Contract
12/5/00
As we discussed by telephone, the March of Dimes is interested in working with Coastal
ABEC on a grant-funded project that will begin in 2001 We plan to develop and pilot
instructional materials on a variety of issues relating to preconceptional and prenatal
health that is appropriate for use in an English as a Second Language classroom setting.
We believe these materials will assist in effectively educating an increasingly diverse
population of women of childbearing age.
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The March of Dimes is unable to directly award the contract to Coastal AHEC because
part of the budget calls for funds to be used to offset a full-time staff member's salary at
AHEC. This is against current March of Dimes policy Awarding the contract to another
"intermediary" organization who in turn can contract with AHEC is acceptable however.
We are asking the New Hanover County Health Department to assist us by serving as the
intermediary organization.
This involves accepting the grant funds from the March of Dimes, and cutting one check
in the same amount to Coastal ABEC. ABEC will manage the funds. We estimate the
grant funds to total about $20,000
Please don't hesitate to contact me if you need further information or have questions. I
hope the Health Department will be able to assist us as we work to promote the health of
women in North Carolina. Thank you.
e
.
111 offiliorion wirh rhe UniversifY of Norr/1 Carolina School of ,\'Iedicine or Cllopel Hill
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March
of Dimes
Sall'ng bah;",s, togelher
M<r<Jtaf~
Bi"" D</tcu fooN/IUu,.
........ C4toIiM CMptu
~I<DiMon
4112 _Valley Rood. Suil. 208
Ralcip, NOftb CamIilll17612
,olopllooe (919) 781-2.481
paz (9J9) 71/.23]7
~: VfYfW.mAEdxUdi",",Q~~
x.,. 8. J-
E:ucutfw Di1'ectOp
David Rice, MFH, MA
Health Director
New Hanover County Health Department
2029 S. 171h Street
Wilmington, NC 28401
December 12, 2000
Dear Mr. Rice,
The March of Dimes in North Carolina and nationwide has placed a growing emphasis on
improving our grant program by funding innovative projects that have the potential of being
replicated on a statewide, even national basis. Sandy Diehl with Coastal AHEC, submitted a
grant application to our statewide gr.urt program this fall. Reviewers from across the state were
intrigued with the project and saw many ways it could impact women across the state. As such,
the state March of Dimes grant committee decided to fund the project at the $10,000 level with a
matching S10,ooo grant by the March of Dimes Eastern Carolina Division. This brings the total
grant support to $20,000. Funding for the project would begin in the spring of2oo1 and
continue for one year. The March of Dimes will continue to work with Coastal AHEC as a
partner throughout the grant time period.
The Coastal AHEC project will develop and pilot instructional materials on a variety of issues
relatlng to preconcepttonal and prenatal health that is appropria:te for use In an English as a
~'~ Language Classroom settl~. We believe tnese IlIlltClIlih wtll aSSIst III etlecttvely
ca Ing an mcreasmgly diVerse population of women of childbearing age. The National March
of Dimes office has granted Coastal AHEe permission to adapt two of its current national
curriculums to this end. Once this type of curriculum has been created, tested and evaluated, the
March of Dimes in North Carolina is in a unique position to help integrate the program into ESL
programs statewide.
The only challenge that we encountered with this project hinges around budget guidelines. The
March of Dimes is unable to directly award the grant to Coastal AHEC because part of the
budg~ calls for funds to be used to offs~ a full-time stafTmemher's salary atAHEC. We
understand that the specific AllEC staff member's (Sandy Diehl) professional expertise and time
is needed to successfully meet the grant deliverables, but it is against current March of Dimes
funding policy to provide additional funding for full-rime staff. However, awarding the grant to
an "intermediary" organization that can in turn reimburse Coastal AHEC is acceptable.
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We are asking the New Hanover County Health Departmem to assist us b servin as the
intermediacy organization. IS Inv e grant n s from the March of Dimes,
and cumng one check In the same amount to Coastal AHEC. Coastal AHEC will manage the
funds and complete all grant progress and accounting report fonns required by the March of
Dimes.
We hope that New Hanover County Health Department will be able to assist us as we work
together to promote the health of women in the local area that we serve. Please don't hesitate to
contact me if you need further information or have questions. Thank you for giving this request
your consideration. I hope we will be able to work together!
Saving babies, together,
.~~ V~i:.Q.oC:
Sarah Verbiest, MSW/MPH
Director of Program Services
(919) 781-2481
sverbiest@modimes.org
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March of Dimes Birth Defects Foundation
Statewide and Chapter Grant Proposal Application
Section I: Applicant Information
Applicant Organization:
Coastal AHEC
Agency Director:
Project Title:
William 0 McMillan, Jr., MD
Esperando /0 Mejor/ Expecting the Best Curriculum Development
Project Director:
Sandy Diehl, MPH Position: Research Associate
PO Box 9025
Wilmington, NC 28402-9025
County: New Hanover
Date: 9/8/00
Phone: 910-343-0161
Email: diehl@med.unc.edu
Fax: 910-343-9823
Type of Organization: _ Government_X_Non-profit _Other
Please attach tax exempt statement
Total Amount Requested from the March of Dimes: $_$47,249
P.roposal for Statewide Grant
Is this a proposal that will impact the entire state of North Carolina? Yes_ No _X_
Is this a proposal that serves one or more counties of the state but could serve as a pilot for replication
in other parts of the state? Yes _X_ No_
Section II: Proiect Overview
Which of the March of Dimes program's priorities does your project address?
This project directly addresses two statewide priorities: (I) increasing the number of
women who take a multivitamin with folic acid daily; and (2) improving the timing and spacing
of pregnancies. It also addresses two regional priorities for Eastern North Carolina, (3)
increasing the availability, use, and accessibility of pre conceptional health services and (4)
increasing the availability, use, and accessibility of innovative programs affecting prenatal
outcomes. The project, due to its broad scope, also provides educational information and referral
on two additional priority areas, sexually transmitted infections and substance use prevention or
cessation.
Please provide a brief summary of the project you are proposing: What will you do and
what difference will it make.
We would like to adapt the March of Dimes' Comenzando Bien@ curriculum for use in
an English as a Second Language (ESL) classroom setting and pilot the curriculum. Health
education literature suggests that ESL instruction provides a solid foundation for affecting
students' knowledge, attitudes, and behavior English acquisition is perceived as a valuable
commodity to participants, and influences how effectively a patient interacts with health care
providers, services, and her everyday environment, which in turn impacts health outcomes.
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Section III: Services/Prol!rams/ Activities
What services/programs will your project and March of Dimes funds provide that
currently are not available in your community or how will it make existing services reach
the under-served population?
This project will provide a model curriculum for Esperando 10 Mejor, a program
developed by Coastal AHEC, Cape Fear Community College, and other local partners, which is
scheduled to begin in Pender County in January, 200 I Esperando 10 Mejor is a health education
and social support class targeted toward Latina women of childbearing age. Please see Appendix
I for an overview of the program. The program will provide (l) health education on a host of
topics related to perinatal health in the context of an ESL setting, (2) additional ESL instruction
that will help promote functional literacy, (3) social support, and (4) referrals and encouragement
to seek appropriate ancillary services that promote healthy pregnancies. The program is targeted
at pregnant women, however the class will be open to any woman who wishes to come.
According to North Carolina State Center for Health Statistics data, births to Latina
women have grown rapidly in the last decade. In 1990, about 2% of births were to women who
identified themselves as Hispanic; by 1999, 9% of births were to women of Hispanic origin.
This percent is projected to increase in the future. The project will address a growing need for
improved communication and health education by adapting the existing Comenzando Bien@
curriculum into materials that are suitable for implementation in an English as a Second
Language classroom setting.
Research shows that health education concepts taught in an ESL environment can be
effectively understood and retained. There are no materials currently available from the March
of Dimes' national office that are tailored specifically toward ESL students or an ESL setting.
Although Comenzando Bien@ is printed in both English and Spanish, it is not intended to serve
as a language-learning resource. It lacks didactic exercises to teach and reinforce language
learning. Other materials which are intended to aid language acquisition, such as the De Madre
a Madre photonovela series, also lack teaching exercises. These materials unfortunately present
a barrier for easy incorporation in an English as a Second Language learning environment. This
project addresses this need.
ESL classes, by nature, are very similar to health education groups. Thus, they are a
natural "next step" to traditional health education classes in affecting knowledge, attitudes, and
behavior. The advantage, of course, is that they offer a long-term solution to communication
issues by teaching English skills. They combine conversation, role playing, writing, reading,
discussion and games in a supportive, non-traditional learning environment. Classes tend to
focus on building a student's ability to function in an everyday environment through learning and
practicing vocabulary in a specific context, learning about their immediate social environment.
and understanding American culture.
All North Carolina Community College ESL programs operate under a federal mandate
to provide "life skills" classes free of charge to participants. There is no standardized statewide
curriculum, therefore teachers can tailor the materials to the needs and interests of their students.
Students can enter the classes at any time, since there is no special sequence to the information
being taught. Language is effectively learned within a context; in this case, it will be presented
to pregnant women through a combination of complementary health education and "life skills"
modules.
The Esperando 10 J'vJejor curriculum will teach information on many topics that affect
maternal and child health, including nutrition, substance use, contraception, child spacing, folic
acid consumption, breastfeeding, and much more. Please see Appendix II for proposed prenatal
curriculum modules. The classes will alternate prenatal/health education with "life skills"
modules presented through materials that are currently in use in ESL classrooms. Please see
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Appendix III for examples of these materials. This teaching approach has several advantages: I)
it address health issues holistically - for example, it is important for a woman to know how to
communicate with providers, read instructions on a prescription bottle, shop in the grocery store,
etc; 2) it spaces the modules over the course of a pregnancy so that there is an extended period of
time to learn, make friendships, ask questions, etc; 3) it coincides with the community college
semester schedule. English instruction and acquisition is valued among the Latino community,
and this creates a strong incentive to attend classes. Furthermore, the classes will provide
individual encouragement and peer support to sustain healthy behaviors and modify unhealthy
behaviors.
Esperando 10 Mejor is a program that integrates health education and ESL instruction
through an agreement with our local community college. One major advantage of pursuing a
partnership with our community college ESL program is it ensures on-going program
sustainability if attendance goals are met. Our local community college will assume
responsibility for the classes after sufficient enrollment (10 participants) is reached. This creates
a wonderful solution to prenatal education programs struggling with sustainability issues.
This program, if successful, can serve as a model to other communities interested in
developing resourceful programs to meet the needs of Latina women. The Esperando 10 Mejor
curriculum has the potential to be replicated statewide. Our program, also titled Esperando 10
Mejor, will serve as a pilot site for the curriculum. Recently, we learned that another community
college in the Piedmont area of the state may be interested in serving as a concurrent pilot site.
The feasibility and details of this arrangement will be discussed during the project's planning
period. Please see the attached letter of support for more information.
In summary, the project I) provides information and instruction to meet various
communication, health education, and social needs of participants, and 2) provides a framework
for indefinite program sustainability through a partnership with a North Carolina community
college.
Please list the names of other organizations/groups you will collaborate with on this
project. Obtain letters of support from them and attach to this application.
Our main collaborator will be the English as a Second Language program at Cape Fear
Community College. We may also work with a community college pilot site in another area of
the state. We will collaborate with technical experts, such as medical consultants, ESL
consultants, and a curriculum evaluator Our advisory board will help identify individuals and
organizations with appropriate expertise and willingness to act as consultants or as an evaluator.
We will use the project planning period to further identify potential collaborators and roles.
Who will provide the services/carry out the activities of this project?
The project will be directed by Sandy Diehl, MPH, a Research Associate at Coastal
AHEC who specializes in Maternal and Child Health issues. Ms. Diehl holds a Research
Assistant Professor faculty appointment in the Department of Obstetrics and Gynecology, School
of Medicine, Chapel Hill. She has worked part-time for 9 years as an English as a Second
Language instructor for two North Carolina Community Colleges. Ms. Diehl will work closely
with Nikki DeUnger, M.Ed., Director of the ESL program at Cape Fear Community College (see
Appendix IV for CVs of Ms. Diehl and DeUnger). Ms. Diehl, in conjunction with a curriculum
specialist, will develop the curriculum models. Women in the Esperando 10 Mejor program and
the class facilitator will offer important feedback on curriculum content and learning exercises.
We will create an advisory board with at least one medical consultant, health educator,
English as a Second Language instructor, community college administrator, and Maternal and
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Child Health specialist. Individuals for this advisory board have been identified. The board may
grow as other key individuals are recognized during the planning, development, and pilot phases.
The Comenzando Bien@ curriculum is copyrighted material. During the planning phase
of our project, we will request permission to adapt the curriculum. Ifwe are unable to obtain
permission, we will create an entirely new curriculum that teaches and reinforces health concepts
that are universally recognized as contributing toward positive matemal and child health.
Will project staff have to be hired? Yes_X_ No __ If yes, what is your time frame?
We will hire a curriculum specialist to assist in the creation of the health education
modules by Jan 2nd. The curriculum will be developed and refined concurrently with the
implementation of the program. Technical consultants will be hired on a contract basis. We plan
to hire a class facilitator by December 15th Support for this position has already been received
through a separate grant from the March of Dimes. As mentioned earlier, the ESL program at
Cape Fear Community College will assume fiscal responsibility for the program after adequate
enrollment is achieved.
Section IV: Tar!!et Population
Who will be served by this project?
Latina women participating in the Esperando 10 Mejor program will be served by this project.
How will participants by identified and recruited?
The class facilitator will have primary responsibility for participant recruitment. We
have drafted a flyer (Appendix V) to assist in outreach. The Pender County Health Department
has agreed to post notices in public areas and in "goody bags" that women take home after their
first prenatal visit. Staff at the Health Department, including the Certified Nurse Midwives and
the bilingual Maternity Care Coordinator have also agreed to encourage women to attend. Other
outreach workers and instructors employed by the ESL program at the Community College have
agreed to distribute flyers in residential areas, post flyers in key businesses frequented by
Latinos, and discuss the program with key leaders to raise program awareness. A local Spanish-
language radio station has agreed to advertise the classes as a public service announcement.
These strategies could be easily replicated at other sites.
How many participants do you expect to serve?
Number per semester: 25 (10-15 women per class) Due to open enrollment, this figure is an
estimate of the number of women who will attend at least one class during the course of a
semester. About 10 women will attend regularly.
Number annually: 75 (Fall, Spring, Summer semesters)
This figure is based on projected enrollment at one pilot site (Pender County). The
numbers will increase if an additional pilot site is added. If the program is successful in Year I,
we will evaluate the potential for replication at additional sites in North Carolina.
Approximately 7,500 women would be served annually, if the program is implemented in all 100
counties.
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Section V: Obiectives
jectives Activities to Achieve Objectives Person!Agency Start!
Responsible End Dates
Objective 1 Activity 1.1 Project Director NovlDec 2000
Develop process to modify curriculum Obtain permission from the March of
(planning period) Dimes national office to modify copyright
materials
Activity 1.2 Project Director NovlDec 2000
Form advisory committee and schedule
meetings
Activity 1.3 Project Nov 2000-Jan
Recruit and hire curriculum specialist DirectorlESL 2001
Director
Activity 1.4 Project Director Jan 2001
Convene advisory board for meeting April 2001
August 2001
Activity 1.5 Project Director JanlFeb 2001
Contact potential project consultants
recommended by advisory committee
Objective 2 Activity 2.1 Project Director! Jan 2001-Dec
Prepare appropriate curriculum materials for Adapt and refme 8 existing Comenzando Curriculum 2001
asses Bien sessions concurrently with class Specialist
implementation
Activity 2.2 Project Director! Jan 2001-Dec
Develop and refme supplemental materials Curriculum 2001
to cover labor and childbirth, breastfeeding, Specialist
post-partum contraception, child spacing,
folic acid, and other related topics
suggested by participants and advisory
board
Activity 2.3 Project Director! Speakers
Identify and invite appropriate guest Facilitator already
speakers (see Appendix I) identified:
scheduling
within tst
month of each
semester
Activity 2.4 ESL Director! Jan 2001
Identify appropriate ESL textbook to use in Facilitator
class for general ESL skillbuilding classes
twice monthly
Objective 3 Activity 3.1 Project Director! Jan 2001-Dec
Ensure accuracy of materials Submit chapters for review to consultant(s) Consultants 2001
Objective 4 Activity 4.1 Project Director! Jan 2001-Dec
Ensure appropriateness and effectiveness of Pilot-test materials and modify accordingly. Facilitator 2001
aterials and exercises The curriculum will be repeated 3 times
over the course of the pilot year (spring
semester, summer semester, fall semester),
therefore there will be multiple
opportunities to refme materials.
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Objective 5
Identify appropriate evaluator
Activity 5.1
In conjunction with advisory board, identify
and contract with appropriate external
evaluator
Activity 6.1
Present materials to collaborating
organization for formatting!
publication/dissemination/marketing (e.g.,
Aprendo Press, March of Dimes, Carolina
TESOL, North Carolina Community
College System, Division ofESL etc.)
Project
Director! Advisory
Board
Jan 2001
bjective 6
Ensure appropriate dissemination of
curriculum to interested agencies for
replication after accuracy, appropriateness,
effectiveness conflITned; following evaluation
results
Project Director
Earliest
possibility:
Jan 2002
(Year In
Section VI: Evaluatinl!: Proiect's Impact
What process evaluation of your project do you plan to include? (i.e. the number of classes held, the
number of women who attend, etc.)?
Our main deliverable for this project is a health educationlESL curriculum. We will measure progress by
setting deadlines to prepare modules and monitoring how closely we are meeting these deadlines. We
will also ensure that all objectives listed above are met in a timely manner
What outcomes do you expect for your target population and how will you measure it (control
group, pre and post test, before and after comparison, etc.)?
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The main outcome for this project is an educational, accurate, and engaging curriculum that appeals to
participants and is easy to implement in an ESL setting. There are various ways to measure this outcome.
We anticipate an outside evaluator with expertise in educationlESUcurriculum development to develop
measures with input from the advisory board.
The program evaluation, on the other hand, will be conducted by Coastal AHEC, with potential assistance
from the UNC School of Public Health or the NC Institute for Public Health. Some measures, for
example, change in knowledge of English, can be measured with a standardized instrument called
"CASAS" which measures pre and post-test knowledge. This instrument may be mutually beneficial to
both a curricular and program evaluation, therefore there will be close communication between staff
working on the curricular evaluation and staff working on the program evaluation. We will apply for
additional funding in Year II to support program evaluation.
STATEWIDE PROPOSALS:
Do you have a person on staff who does evaluation of your programs/projects?
Yes. Ms. Diehl is our main program evaluator Because she is involved in developing the curriculum for
the project, an outside evaluator will be hired. She will, however, be closely involved in the overall
program evaluation.
Do you currently use an outside evaluator to evaluate you programs/projects?
We typically perform evaluations using existing staff and use consultants as needed.
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MARCH OF DIMES BIRTH DEFECTS FOUNDATION
GRANT BUDGET FORM
Project Title: Esperando 10 Mejor/Expecting the Best
Project Director: Sandy Diehl
Responsible Agency: Coastal AHEC
BUDGET* Type directly into the spaces below to indicate budget and APPLICATION EXPENDED
justification for each expense type needed. Total .Budget IProg.Rprts Only)
A. Salaries
Position responsibilities, deliver ables, hours/week, supervision of
staff needed to support council administration or activities.
Project Director {.33 FTEI + benefits $19,219
ESL Curriculum Specialist {.20 FTEI + benefits $10,283
Technical Consultant ($27/hour, 320 hours) $8,640
Evaluator (11 % of budget prior to adding evaluation expensesl $4,682
Total Salaries $42,824
B. Materials and Supplies
l>onM. ., MOO. rn\ ." ..,,,,
.,.,~ rn\ ., '" M~h .A""
1~"+.. '_+M . A ~ rn\ A .,,, M~h .,QA
I"_~u 1 ~ rn\ A .,,, M~h .,,~
'" """ rn\ "~A ."A"
., h__~. rn\ 11 Ih. M_h ..,.,
1__- ., h..... rn\ 1 ~1R
. . -- ~1nn
Total Materials & Supplies $1,652
C. Travel and meetings..
"+0" ~;!oo fil1 .,.,~ ., no;':l
- 1 ";n . . ..Ho~ ~1 f\?n
Total Travel and Meetings $2,673
D. Recruitment - Curriculum Specialist $100
I TOTAL AMOUNT REQUESTED I $47,249 I I
*The budget is based on having at least 2 pilot sites.
**We plan to have three meetings - these funds will help cover advisory board/consultant
travel as needed.
22
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Appendix I
Esperando /0 Mejor Classes
Program Overview
What:
Combination Prenatal Education, Social Support, and English as a Second Language classes; that will begin as a
March of Dimes-funded pilot program of9 sessions, with Cape Fear Community College taking over program when
attendance requirements are met.
Who:
All Latina women, with a focus on pregnant women/women of childbearing age - target population is Pender,
Duplin, and Sampson county residents. We may explore in the future: 1. making the class multicultural like other
ESL classes and therefore serving pregnant women/women of childbearing age of other cultures and languages; and
2. creating at least one session targeted for both partners, where men can learn about pregnancy and related issues.
Where and When:
Long Creek Migrant Head Start (LCMHS) will host the classes on Thursday nights, 7:30-9:30 pm. 2 Esperando /0
Mejor classes will be offered monthly, alternating with 2 Broader ESL Classes monthly for the same group.
ESL Classes for oartners or other interested friends:
Same time, Rocky Point Baptist Church (RPBC) (2 miles away on same road).
Requirements for Pilot Session to become ESL sustained classes:
10 participants in attendance per class
Transoortation:
Once an ESL-administered program, participants are eligible for transportation to LCMHS from pick-up points in
Pender County Transportation from LCMHS to RPBC is also available for partners and others interested in ESL
instruction.
Childcare:
LCMHS is licensed to have kids on site. LCMHS has identified a childcare worker employed during the day at
LCMHS who is interested in providing childcare. She will also have responsibility for locking up the site at the end
of classes. Funding for this position will temporarily come from existing March of Dimes support. Other long-tenn
funding, including funding from the Pender County Partnership for Children, will be explored.
Facilitator:
Needs Bachelor's degree and eligibility to work in the United States. ESL experience, health education, health care
or group facilitation helpful. We are currently infonnally recruiting by word of mouth and key leader referral for a
facilitator and have a few strong candidates at this time. We plan to advertise the position in the fall, and have
someone hired by mid-December or earlier, 2000.
Curriculum:
Modified Comenzando Bien twice monthly', plus general ESL on alternating Thursdays, with the content up to the
instructor's discretion. Guest speakers will be invited to discuss special curriculum topics. Certified Nurse
Midwives providing prenatal care at the Pender County Health Departtoent will come once/month to Esperando /0
Mejor class nights.
Local Program Partaers:
. Coastal AHEC - Research, Evaluation, and Grantwriting Departtoent, and Obstetrics and Gynecology Departtoent
. Cape Fear Community College English as a Second Language Program
. Long Creek Migrant Head Start
. Pender County Health Departtoent
'We are requesting funds from the March of Dimes to adapt the curriculum to an ESL classroom setting.
23
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Appendb: II
Esperando 10 Mejor
Proposed Curriculum Modules
Like Comenzando Bien@, our curriculum will have a cognitive component that will provide
accurate and timely information in the area of prenatal care and pregnancy, and a behavior-
oriented component, which is designed to promote behavior changes or support existing
behaviors which promote healthy pregnancies. Additionally, the curriculum will have a didactic
component, which will include exercises, discussion activities, games, role plays, review
activities etc. that promote the health concepts being presented, as well as important vocabulary
and cultural information.
Session 1 The Importance of Having a Healthy Pregnancy
Session 2. Taking Advantage of Prenatal Care
Session 3: My Prenatal Care Visit (screening including STIs)
Session 4' Nutrition during PregnancylNutrition for your baby (including encouragement to
choose breastfeeding)
Session 5 Physical Stress During Pregnancy
Session 6: Relationships During Pregnancy (including domestic violence)
Session 7' Drug, Alcohol, and Tobacco Use
Session 8*: Labor and Childbirth (what to expect, tour of hospital)
Sessions 9/10*: Postpartum and Beyond (postpartum depression, planning future pregnancies-
contraception, importance of child spacing, consumption of Folic Acid, demonstration of
breastfeeding, referrals to parenting/child services)
Session 11 Celebration, recognition of participants
*this is supplemental to the current Comenzando Bien@ curriculum
24
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NEW HANOVER HUMANE SOCIETY
P.O. Box 4294
Wilmington, N.C. 28406-1294
Phone 918-763-6692
iA~
ft,. _
OFFERING
. Animal SIleIIeMg
. AdoplIons
. SPBY~ PIll\lI'IIlI
. Lost & Found -
. Eme<9oncy BeIYlCl
. Cruelly Inves1lg8llOft
De<::elllber 5, 2000
Jean McNeil. Director
N.H. Co. Animal Control Services
220 Division Dr.
Wilmington, NC 28401
e
Dear Jean:
This letter is to officially notify you that The New Hanover
Humane So<::iaty would like Joyce Bradley to <::ontinue as our
rapresentative on the Anilllal Control Advisory Board for another
term beginning January 2001.
Please let me know if further information is needed or if I
need to contact anyone else.
Thank you.
Sinurel\.'
~)J..&t\ ~'C.Q.~'E:....-
Judy Neale, President
e
" NON-PROFIT i:I1ARrril8LE OAG~NIZAT1ON SVPPI)R"'EO .:;CI.El"( THROUGI1 OONA1'IONS
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e
NEW HANOVER COUNTY BOARD OF HEALTH
Committee Assignments
2001
Executive Committee:
Dr. Wilson O'Kelly Jewell, Chainnan
Mrs. Gela N. Hunter, Vice-Chainnan
Mr Henry V Estep
Mr W Edwin Link
Mr William T Steuer
Bude.. Committee:
Member Division
Mr. William T Steuer, Chainnan Administration
Mrs. Anne Braswell Rowe Animal Control Services
Mrs. Gela N. Hunter Child Health Services
Dr. Melody C. Speck Communicable Disease
Dr. Philip Palmer Smith, Sr. Community Health
Dr. Wilson O'Kelly Jewell Dental Health
Mr. W Edwin Link Environmental Health
Mrs. Estelle G. Whitted Laboratory
Dr. Michael E. Goins Nutrition
Mr. Henry V Estep Women's Health Care
Environmental Health Committee:
Mr. W. Edwin Link, Chainnan
Dr Michael E. Goins
Mrs. Gela N. Hunter
Dr. Philip Palmer Smith, Sr.
Mr. William T Steuer
Personal Health Committee:
Mr. Henry V. Estep, Chainnan
Mrs. Anne Braswell Rowe
Dr. Philip Palmer Smith, Sr.
Dr. Melody C. Speck
Mrs. Estelle G. Whitted
Animal Control Services Advisory Committee
Dr. Melody C. Speck
Association of NC Boards of Health
Dr. Michael E. Goins
2.6
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Election of Board of Health Officers
Mr. Estep, Chairman, Nominating Committee, presented the following nominees for the Chairman and
Vice-Chairman of the 2001 New Hanover County Board of Health: Dr. Wilson 0 Jewell, Chairman,
and Ms. Gela N. Hunter, Vice-Chairman.
Mr Steuer asked for other nominations from the floor. There were no nominations from the floor
Motion: Dr. Smith moved, seconded by Dr Speck for the Board of Health to accept the slate of officers
as presented by the Nominating Committee. Upon vote, the MOTION CARRIED UNANIMOUSLY.
A ballot vote was taken. Mr Steuer requested Mr Rice tabulate the votes for the election of officers.
Mr Rice announced Dr Wilson O. Jewell was elected as Chairman and Ms. Gela N. Hunter was
elected as Vice-Chairman of the New Hanover County Board of Health for Year 2001
Mr. Steuer congratulated Dr Jewell and Ms. Hunter on their election as 2001 Board of Health Officers.
He thanked Mr. Estep, Chairman, Mr Greer, and Dr Speck for serving on the Nominating Committee.
Mr Steuer expressed his appreciation to the Board of Health for their support during his tenure as
Chairman. He stated serving as Chairman has been a rewarding experience and that he had the finest
Board of Health members. Dr. Jewell and Ms. Hunter thanked the Board for their vote of confidence.
('
L.iST OF TABLES
,~
.
United States and North Carolina
Table 1_ Demographic, Social, and Economic Indicators
Table 2. Work, Farm, Home, and School Statistics
Table 3. Social, Welfare. and Health Data
Table 4. Pregnancy Outcome Statistics
Table 5. Morbidity and Mortality Statistics
Table 6. Health Care Resources Data
North Carolina and Counties
Table 7 Demographic. Economic, and Health Resources Dala
Table 8. Selected Health Indicators
North Carolina
Department of Health and Human Services
Center for Health Informatics and Statistics
1908 Mail Service Center
Raleigh, North Carolina 27699-1908
(919) 733-4728
DATA SOURCES
.co,"',o.o,.
'"
o ~
x
.
g
,S;
Hc"hCO,.,II....P<l~IItH.."h
.-............-..-.
References for the various data Items are too numerous to list here but may be obtained
from the Center for Health Informatics and Statislics Forthe U,S, and N.C" comparisons
In Tables 1-6were largely abstracted or derived from the following: StatistJcal Abstracto!
the Umted States 1999 (Bureau ot the Census); Health United States 1999 (National
Center lor Health StallstlcS): National Vilal Statistics Reports, Births: Final Data for 1998
(National Center fOf Health StatisticS): Morbidity and Mortality Weekly Report, Vol47 No
53,1998 and Vol, 48, No 55-4, 1999 (Centers for Disease Conlrol). Slate and county
population data was provided by Ihe Slale Data Center, Office of Slale Planning
EXPLANATORY NOTES
December 2000
In most cases, table headings and footnotes provide definitions for the reported statistiCS
Additional Information needed for data clarification includes the following
Number of States Higher This figure IS given wherever the statistic or the required
numerators and denominators were available for states, NA means not available
Percent Change. Increases and decreases are generally expressed in terms of average
annual percentages computed as the lotal percentage change divided by the number of
Inlervenlngyears
Place of Event. Except as otherwise noted, data are by place of residence
Rates Some of the county-level rates of Table 8 have been adjusted for age Thus, the
differences observed are due to faclors other than the age distribution of the populations
For smaller counties, the measures in Table 8 may be unstable due to small numbers of
events
State of North Carolina
Department of Health and Human Services
Center for Health Informatics and Statistics
John M. Booker, Ph, D., Director
8,000 copies of this public document were printed
atacostof$1,505.70or19r;t per copy
"'"""
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NORTH CA~olINA
HEALTH STATISTICS
POCKET GUIDE - 1999
www.schs.state.nc.us/SCHS
"-
- More than 7,000 calculations -
I BIRTHS II CANCER I
CASES ~
I I ECONOMIC
DEATHS
INDICATORS G
I ABORTIONS II POPULATION I
00
HEALTH CHRONIC
MANPOWER DISEASE
COMMUNICABLE B
DISEASE
I ~I I - I
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"-
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Personal behaviors are one important
contributor to the health status of a
population. In North Carolina we can
measure health risks in the adult population
through the Behavioral Risk Factor
Surveillance System (BRFSS). The BRFSS
is sponsored by the Centers for Disease
Control and Prevention (CDC) and is carried
out in all 50 states. In North Carolina, the
Center for Health Informatics and Statistics
is responsible for the operation of this
survey The BRFSS is a random telephone
survey of persons ages 18 and older across
the state. Approximately 3,000 interviews,
each about 25 minutes in length, are done
each year The responses are weighted so
that the results are representative of the
entire adult population of North Carolina.
So far, the sample size has not been large
enough to produce estimates for specific
counties, though there are plans to redesign
the survey to produce estimates for
geographic sub-areas of the state.
The BRFSS asks a variety of questions
about behaviors and health issues that
affecllhe major causes of illness and death.
Topics covered include perceived health
status, health insurance, use of preventive
health care, oral health, smoking, physical
activity, diet, weight, health screening, use
of birth control, seat belt use, and disability
Health Risks in North CCina's Adult Population
Health was fair or poor
No health care coverage
There was a time during the last 12 months when they needed to see
a doctor but could not because of the cost
Did not visit a doctor for a routine checkup in the past 2 years
Ever told by a doctor that they had diabetes (excluding women told
only during pregf18ncy)
Had one or more pennanent teeth removed because of tooth decay or
gum disease (1999)
Current smoker
Engaged in no physical activities or exercise in past month (1998)
OvelWeight
Ever told by a doctor that they had high blood pressure (1997 & 1999)
Never had their blood cholesterol checked (1997 & 1999)
Among sexually active women, percent who are not using birth control
now (1999)
Women age 50+ who did not have a mammogram within the past
2 years
Women age 18+ who did not have a Pap smear within the past
2 years
Did not always use seatbelts when driving or riding in a car (1997)
Ever told by a doctor that they had arthritis (1998)
Someone ever forced or tried to force them to engage in unwanted
sexual activity (1997 & 1999)
Percent with some type of disability (self-perceived, activity limitation,
special equipment, or problem leaming, etc.) (1998-1999)
Note: Data is for 1997-1999, unless otherwise specified.
Percent
16.9
13.0
12.3
13.7
5.8
71.0
25.2
277
58.4
23.7
23.6
30.3
22.0
14.2
15.2
22.6
110
22.0
:J
For selected items, the percentages of
respondents reporting the risk factors are
shown here. Unless otherwise specified,
the data is for the period 1997-1999.
A limitation of the BRFSS data is that it
is based on self-reporting by the
respondents. Recall problems and the
tendency to report socially acceptable
behaviors may affect the results. Also,
persons withoullelephones are not included
in the BRFSS. Persons without telephones
are more likely to have lower incomes or to
be unemployed, and therefore the BRFSS
may under-estimate the prevalence of
certain risk factors.
A strength ofthe BRFSS is that new data
is available on an annual basis. This makes
the BRFSS a useful tool for monitoring
changes in health risks in the adult
population of North Carolina, and for
measuring the effectiveness of statewide
health improvement programs. Also, with
a similar design and a standard set of core
questions across all states, comparisons
can be made to other states or to the nation
as a whole for many of the measures. The
CDC web site provides state and national
prevalence data, as well as other useful
information about the BRFSS http://
www.cdc.gov/nccdphp/brfss.
.1
Table 1
Demographic, Social, and Economic Indicators
I
N_j
Carolina
7,5 I
1.6 I
75,2 I
22.3
1.6 I
1~:~ 1
Resident Population, 1996 (millions)
Annual Percent Increase 1986-1998
Percent of Total Population, 2000 Projection:
White
Black
Hispanic'
Percent Under 5 Years of Age, 1998
Percent Ages 65 and Over, 1998
United
States
270.3
1.1
Number
of Stat..
Higher
10
11
82.1
129
11.4
7.0
127
41
6
37
14
25
Projected Percent Changes 5.8
2000-2005 4.1 16
2000-2010 8.4 10.0 15
Persons per Househok:l, 1996 262 2.54 31
Pop. per SQuare Mile of land, 1998 764 154.9 16
Metropolitan Population, 1996 (millions)2 211.9 4.9 12
Percent of Total 79.9 66.8 31
Annual Percent Increase SInCe 1990 12 2.0 10
Nonmetropolitan Pop., 1996 (minions)U 53.4 2.4 1
Percent of Total 20.1 33.2 16
Annual Percent Increase Since 1990 1.0 1.3 16
Per Capita Personal Income, 1998 $26,412 $24,036 30
,
,
Median Household Income, 1997 $37,005 ;$35,840 25
Percent of Persons belOW Poverty Level, 1997 13.3 11A 27
Per Capita Federal Income Tax, 1996 $2,614 $2,181 32
Per Capila Total Stale Tax Collections,
1997' $1,659 $1,700 15
Per Capita State Government General Revenue,
1997' $3,048 $2,920 25
Per Capita State Government Debt
Dutstanding,1997 $1.705 $764 44
'Persons of Hispanic origin may be of any race. 'As defined by U.S. Office of Management and
Budgat. JExcludes New Jersey and District of Columbia 'Excludes District of Columbia.
Includes sales and receIpt taxes, fuel, beverage, and tobacco taxes: Individual and corporate
income taxes' motor vehicle ar~erators' licenses: and other state taxes. "From
intergovernme~tal (Federal and I~ ,___ 1rnment) and other sources, Including taxes
,"-Table 4
pregna~l ;utcome Statistics
(Data from State and National Reporting Systems)
Number
United North of States
States ,Carolina i Higher
legal Induced Abortions 1996 (thousands)' 1,2216 , 33.6 6
live Births 1998 (thousandslu 3,9416 111.7 10
White 3,1167 79.3 .
Black 6099 26.2 6
Hispanic' 734 7 6.1 13
Annual Percent Increase SInce 1988 01 1A 5
Number per 1,000 Population' 14.6 14.6 13
Number per 1,000 Women Ages 15-44' 65.6 66.6 17
Percent MinOrity 6irths 20.9 29.0 8
Percent HispaniC Births' 18.6 7.3 22
Percent 5 Pounds 8 Ounces or less' 7.6 8.8 7
While 6.5 7.0 12
Btack' 13.0 13.9 7
Hispanic'" 6.. 6.2 31
Percent 3 Pounds 4 Ounces Of less' ,.. 1.9 4
White 11 1.3 6
Black" 31 3.7 2
Hispanic'" 11 1.0 25
Percent Mothers Unmarned' 32.8 32,6 20
White 263 20,f1 42
Black" 691 66.7 23
Hispanic'" 416 40;7 16
Percentlate'INo Prenatal Care' 39 2.9 36
White 33 20 36
Black' 7.0 5.4 31
Hispanic'.' 6.3 6,6 22
Percent Prenatal Care Before Fourth Month' 626 84.5 17
White 846 6M 13
Black" 73.3 75.2 19
Hispanic'! 74.3 66.5 34
Percenl by Cesarean Delivery' 21.2 21.5 15
White 21.0 21.3 16
Black- 22.4 22.3 22
HispaniC'" 20.6 16.6 40
Teen Birth Rate, 1998' 51.5 61.0 11
Neonatal Deaths per 1,000 live Births. 1998 4.6 6" 3
Postneonalal Deaths per 1,000 Neonatal
Survivors, 1998 2.4 2.9 12
Infant Deaths per 1,000 live Births, 1998 72 9.3 4
'AS collected or estimated by the Centers for Disease Control 'Includes races other than
W'tllte and Black Wlite, Black, and Hispanic, where used, apply to race or Hispanic origin
of the molher. 'Persons of Hispanic origin may be of any race 5U.S. data excludes certain
states (usually 10 or less) with a small minOrity population. .Care beginning in 3rd
tfemester. 'BIrths to mothers ages 15 19 per 1,000 females ages 15-19
Table 2
Work, Farm, Home, and School Statistics
j Number
United North of States
States Carolina 1 Higher
CiVIlian Labor Force, 1997 (millions) 136.3 3.8 10
Participation Rate'
Males 75.0 75.8 24
Females 59.6 61.9 22
Percent Unemployad 4.9 3.6 40
Males 4.9 3.4 41
Females 5.0 3." 35
Employees in Nonagricultural
Estabtishments, 1996 (millions)' 1258 3.6 9
Percenl Employed ill Manufacturing 149 21.9 3
Avg Hourly Earnings of Manufacturing
Production Workers, 1998 $13.49 $11.64 41
Annual Percent tncrease Since 1990 3.1 4.3 2
AveraQa Annual Pay, 1997' $30,336 :$26,672 26
Futl-time Equivatent Employees of
Statell.ocal Government, 1997
State Employees per 10,000 Poputation"' 149 165 26
Local Gov. Employees per 10,000 Pop.5 382 395 10
Mo. payroll per State Employee (In March)'" $3,292 $2,969 24
Number of Farms, 1998 (thousands)' 2,192 58 14
Average Acreage per Farm, 1996' 435 162 41
Crop Value, 1997 (bIllions)'.' $108.6 $26 14
Number of Households, 1996 (millions) 96.8 2.8 9
Annual Percent Increase Since 1990 12 16 13
New Privately Owned Single Family
Housing Units Starte~, 1999 (thousands) 1,286.0 84.9 4
Public Elementary and Secondary Schools
Per Capita Expenditures, 1998" $1,210 $1,013 41
Average Expenditures per Pupil, 1996- $6.548 15,830 32
Average Salary of Classroom Teachers,
1996 (thousands) $39.4 $3a.3 36
'Persons 16 and older in the civilian labor force as a percent of civilian noninstitutional
population. 'Excludes proprietors, self-employed, farmworkers, unpaid family workers,
domestic workers, and Armed Forces 'Workers covered by unemployment laws; excludes
most agricultural workers on small farms, Armed Forces, elected officials, railroad, domestic,
and self-employed individualS 'Excludes the District of Columbia "Based on estimated
population as of July " 1997 -Monthly earroil'lgs for full-time employees. 'Excludes
Alaska 'In average daity attendance ( )
~,
Tabl~-'"
( ,
Morbidity and M,~,ity Statistics
(Data from State and National Reporting Systems)
Morbidity Rates 1998'
Reported Syphilis (all stages)'
Reported Gonorrhea (all sites)'
ChlamydIa'
Verified TuberCUlosis'
Hepatitis A
Hepatilis B
AIDS
United
States
140
131.6
223.6
66
66
3.8
17.2
I North
, Carolina
!28.3
254.8
294.2
6.6
1.7
3.2
10A
N._
afStates
Higher
5
5
7
16
41
18
23
North ~ollna
Wh.. White Minority Minority
Age-adjusted Mortality Rates 1999' 'Total Male .....Ie Male Female
All Causes :919.7 1064.8 713.6 1513.1 936.5
Heart Disease 255.8 315.7 192,9 382.0 254.4
CerebfovascularDisease 75.8 70_5 68,4 112.5 92.6
Atherosclerosis 6.8 5.2 5.1 11.1 6.6
Cancer 204.6 252.3 157.4 364..4 189,0
Diabetes Mellitus 266 23.4 16:-0- 55.5 55.9
Pneumonia/Influenza 25.7 30.4 22\4 35.6 22.5
Chronic Lower Respiratory Diseases 47.1 65.1 41.1 60:6 19,2
Chronic liver Disease and Cirrhosis 9.3 12,4 5.2 18.4 7.7
Nephritis/Nephrosis 15.1 14.5 9.8 37.1 28.9
Septicemia 13.4 12.6 10:1 306 206
HIV Disease 60 3.1 07 31.4 11.4
Motor Vehicle Unintentional Injuries 19,8 26.1 11.6 33,2 13.0
All Other Unintentionallnjufles 2.2.3 30.0 14.1 41.2 15.2
SuiCide 11.4 21.4 5.2 102 2.0
Homicide 8.. 7.0 2.5 32.1 82
'Cases per 100,000 populallon. Cases are from the Centers for Disease Control 'Cases
updated through July 19, 1999. 'Cases updated through June.3, 1999. 'Deaths per 100.000
population USing 10-year age groups and U.S. 2000 population as standard for direct age
adjustment. These rates will not be comparable to those in earlier editions of the Pocket Guide
due to the use of a different standard population for age adjustment. Some of these 1999 rates
will not be comparable to rates for 1998 and earlier years due to a change in the cause-of--<leath
cocMg system.
Table 3
Social, Welfare, and Health Data
i Number
United ; . NOrth ofState.
States Carolina Higher
Federal Food Stamp Program.
Cost per Participant. FY 1996 $652 $799 33
National School lunch Program,
Cost per Participant, FY 1996 $192 $183 16
SSi' Payments per Recipient. 1997 $4,366 $3,622 47
Average Weekly Unemployment Insurance
Benefits, 1997 $193 $198 16
Average Monlhly SOCial Security BOflefit, 1997
Retired Workersl $765 $729 36
Disabled VVOrkers $722 $693 40
Widows and Widowers' $731 $659 44
TANF' RecIpients as a Percent of
ReSIdent POpUlation, 1996 2.9 2.1 25
Percent Current Cigarette Smokers, 19975 23.2 25.6 10
Per Capita Federal Aid to State and
Local Governments, FY 1998 $937 $863 29
Per Capita State Government ; $2,904
Expenditures, FY 1996- $3,059 29
,
Employment (HE) in Health, 1997
State Government (thousands) 163 2 22
local Government (thousands) 215 15 4
Employment (FTE) in Hospitals, 1997
State Government (thousands) 469 16 6
Local Government (thousands) 516 18 6
Hazardous Waste Sites on the Superfund
Priorities List, 1998 1,245 .. 16
Crime Rate per 100,000 Population, 1997' 4,923 5,492 14
Violent Crime' 611 607 14
Slate Parks and Recreation Areas, 1997
Acres per 1,000 Population 47 19 38
'Supplemental Security Income. 'Excludes special benefits. 'Nondisabled only 'Temporary
Assistance for Needy Families. "Among civilian population, 16 and over. "Excludes Nevada,
and District of Columbia. 'Offenses known to the pOliCE> ~der (including non-negligent
manslaughter), forcible rape, robbery, and aggravated a, \
. -C
~L.....
tJ
Table 6
Health Care Resources Data
I
I I Number
United North ! ef States
States I Carotina ~ Higher
Health Manpower i
Nonfederal Physicians per 100,000 Civilian
Population. 1997 245 225 22
Nurses per 100,000 Civilian Population, 1997 623 881 21
Community Hospitals
Number of Hospitals, 1997 5,057 116 15
Number of Beds, 1997 (thousands) 853.3 23.2 .
Occupancy Rate in Community Hospitals, 1997 61.8 68.2 8
Nursing Home.'
Number of Nursing Homes, 1997 16,052 384 16
Number of Beds, 1997 1.714,756 ,37,763 16
Percent of Beds Occupied, 1997 62.0 I 93.7 4
Insurance
Number of Persons without Health Care
Coverage 1997 (thousands)' 43,448 1,141 9
Percent of Poputation, 1997 161 15.5 "
Number of Persons Enrolled in HMOs, 1998' 76,634 1,269 20
Percent of Population in HMOs, 1996 286 171 2.
Medicare and Medlcald~
Number of Persons Enrolled in Medicare
(thousands). FY 1998 37,730 1,086 .
Benefit Paid per Enrollee, FY 1998 $5,538 ,$4,877 22
Number of Medicaid Recipients (thousands),
FY 1997" 33,579 1,113 .
Benefit Paid per Recipient, FY 19975 $3,679 53,404 26
Medicaid Recipients per 100 Persons
below Poverty level, 1996-97 .7 130 2
'Data based on a census of certified nursing facilities 'Data based on household interviews
of the civilian non institutionalized population 'Data based on a census of health maintenance
organizations. 'Data compIled by the Heatth Care Financing Administration.
"Excludes Hawaii.
Table 7
DEMOGRAPHIC, ECONOMIC, AND HEALTH RESOURCES DATA
Iccom. Health Care Personnel' 1998 - Percent of
Resident Population July 1, 1999 Levels ''''' Birthsto Medicaid.
ill
Percent ofT otal Population in Selected ~ ~. J2 ~
~m .~ 0 0'
Age-Race-Sex Groups h EO: i: E ,; " . -1 $
~ "C c 5 . 0 . ~ .!!!o
0- ~-. ~ 0 ~o D ~ J; 0" H
~ "Z .
0- .~ ~ :~ cf'~"u> ~a: . ~ 0 il. . ~~ o c
~3 g ~~ ~ => ~ 2S~~ ~ '06 .!!! ~ 'W
VvllrteMale WlileFema!e MinorilyMale MinofityFemaJe . ." ~
H H. . " . ~ 1; n ,,,,"2
-, it E~ .~ :SQ.~ c. C ~ ~12 u~
~ ~ ~~ o. g o. ~
0 . . ... ~ '0> ~ ~ oj; 0 "~ ~u
ResidentData Total ~~ Total <20 ... Total . q;lii Qili;.. o. . 0 U ~ 00 ~~
<20 1544 ... Total <20 ... Total <20 1544 ... ~ ~.!I ~o ~ow ~~ ~ I ~ ~~
NorthCarolina 7,650,699 1.7 37.2 9.6 43 386 92 16.' 64 11.3 4.2 0.8 129 41 5.9 t4 25,181 13.' 1238 1,198 "" 2,4n 111 41.8 19.' 41.1 15.6 $552 $3,542
'Aielrrla'U'-'--- '--'24042~ --1.6" -38.2 -. 9.9 '-'5,3 412 1- 95 16:1' 82 - 94 11 08 112 32 - 48 1.4" ,.... 94 1,824 1,"" 163 2,176 115 46.7 284 423 126 "" 4,W
........ 32:530 20 47.0 120 .0 46.7 11.3 196 70 ~O 1.0 02 3.3 1.1 1.3 04 21298 9.3 2fEl 2871 329 ~"" 116 437 11.3 392 laO 424 3254
-- 9,SE6 OA 47.6 103 a3 fIJ.7 10.3 16.7 126 08 02 01 09 01 03 02 n.687 144 1246 1,160 137 4,963 154 491 17.3 51.8 158 m 4Jl85
"""" 23.644 02 24.8 57 40 262 " 9.5 ao 221 80 21 289 61 11.3 4.1 20.496 202 1.987 1,924 "" 5,$1 161 61.7 31.6 ..5 27.0 1.044 3,875
- - ~ 23,966 - 09 - ...., 10.5 02 51.1 99 la7 11.0 04 0.1 0.1 04 01 - 01 01 20,161 15.5 1,644 1.798 "" 5,"" 142 54.9 la5 591 104 845 4,594
-A 15,964 08 493 13.3 7.1 49.4 11.6 19.3 94 09 03 01 04 01 02 00 22.328 160 "" "" 107 3,193 1n 483 12.2 54.7 17.6 916 5,198
.:,>;.", 44,158 05 332 8.2 46 357 7.7 13.0 7.1 14.' SA 14 17.1 51 7.0 27 20.340 19.2 1,766 1,703 110 3,397 141 fIJ.l 293 53.0 223 f!5I 3.650
Bertie 19,830 <J3 17.2 40 29 19.0 39 6.4 43 28.4 10.9 2.7 35.4 11.2 15.5 5.0 18,497 24.4 1.963 1.895 225 19,830 143 67.9 300 733 31.6 1,116 3.538
9_ 30,924 09 27.6 6.6 3.9 305 6.8 11.0 63 167 6B 20 Z32 70 92 33 19.sa! 209 2,379 2.242 178 6,185 1Z3 64.1 31.0 55.3 28.8 1.<"" 3,792
1ln=Nd< . -- 69,577 39 412 93 75 426 8.7 153 '4 7.5 26 0.7 8.7 2.6 3.7 11 19,731 15.2 2,244 2,157 241 4.093 135 "'.9 289 flJ3 180 585 3246
-......",." "94,353 1.2 4>5 '1.0 63 47.5 10.4 la4 9.4 4.3 1.6 03 - ,8 1:5 20 0.7 25,998 122 <II 793 '" 1.l'" 111 fIJ.7 14.8 4>1 152 007. 3.963
""'" 84."" 1.3 44.8 11.7 55 462 10" 183 02 4.5 20 03 4.5 1.6 1.7 0.6 20.644 11.1 1,057 1,031 91 3253 118 51.2 394 467 152 640 4;202
CoMN' 125,051 29 426 11.3 46 444 10,9 la2 7.2 62 23 OA 6.8 21 31 0.8 28,400 8A 1,107 1,081 101 3,678 131 35.7 15.8 30.5 11.3 475 4,200
CaldNell 75;862 08 464 11.8 5.3 47.7 11.5 193 1.6 29 1.0 0.2 ~O 0.9 12 04 22.060 11.4 1,765 1,715 ;m 4,216 118 51.0 284 46.7 14.9 895 3,937
Con"," ._'. - . 6.748 1.6 41.3 105 -. M 362. - 9.1 148 63 101 24 1.5 104 25 42 1.7 19,679 120 6,748 6,746 "'7. - 77 "'5 17.5 225 14.8 585 3,761
Cartere! 59,120 1.3 45.0' 102 6,9. 45.9 9.6 183 85 42 16 02 48 14 24 05 23,442 127 1,538 1,511 144 2.365 122 51.2 7.5 461 127 SZ1 4,142
Caswell 22.440 09 30.0 7.6 4.0 31.6 74 11.8 6.1 18.5 4.5 25 19.9 45 7.6 3.7 18,463 146 2244 2,163 316 5,610 51 447 206 478 178 093 3....
CaIawOO 134,126 t4 43.7 11.1 4.9 45.6 10.7 187 73 51 2.1 0.3 56 1.9 25 05 27,157 92 1,355 1.299 .. 2.439 "" 41.9 274 363 130 436 3.;]00
"""""" 47,264 24 38.7 9.7 53 40.7 86 158 78 97 30 10 110 29 44 1.7 27 489 84 1,525 1.464 219 4.726 '" 387 158 283 112 ." 4,115
~ .---. -- 23,072 16 457 107 69 497 109 17.5 11.2 24 07 0.2 2.1 05 07 0.5 17,469 185 1.099 1.069 115 3,296 128 559 103 582 216 918 4250
"()'Q,Va,.'- 14,036 04 "'.5 7.6 58 :n7 7.8 11.3 7.9 "8 6.1 1B 200 67 7.5 12 217-'8 19.0 1,404 1,385 107 3,509 124 561 33.5 5:14 237 "" 3,741
Clay 6,412 1.9 47.4 10,6 9.7 51.5 99 102 118 05 01 02 06 01 02 02 18,001 "4 1."'" 1.660 143 4.2lll III 30.3 15 51.5 168 724 4,321
c_ 92,590 10 37.6 9.7 '0 401 92 151 7.8 105 41 08 11.8 ~7 5.1 12 21,126 128 1.569 1.525 128 2,572 134 flJ1 437 51.1 17.8 .... 3.733
""""""' 52476 07 312 ., <1 34.5 7.7 13.1 6.6 15.6 6.1 15 188 59 7.9 27 20.046 226 2099 1.979 114 4,TIl 158 423 442 "'4 299 1,134 3,789
_Cmon -- - 69,730 . _1.1_. .- .37.1 93 45 361 93 1&3 .. 125 4.8 0.9 142 4.5 65 1.7 23.577 14.6 1229 1.193 "" 2087 130 365 11.3 532 161 553 >445
<Am""""" 291,897 07 324 9.5 2.3 289 85 n3 3.2 18.5 72 0.9 202 69 9B 15 24,104 15.0 1.242 1203 131 2,700 g) 347 129 476 162 443 2,729
CUITitucl<. 17496 3.0 455 121 52 449 11.5 169 64 47 t2 05 48 14 21 0.8 22,162 108 2,916 2.864 318 17496 41 299 15.5 267 13.4 419 3.045
0,,", 28,918 29 490 11.8 SA 48.7 11.2 21.7 64 n 06 01 16 06 07 02 n.099 B2 2.099 1.946 179 2.629 fIJ 250 141 167 95 3lll 4.069
"""""'" 142,722 14 442 115 50 451 108 183 7.1 5.1 18 OA 5.6 1.7 2.6 0.5 n.034 10.4 2.068 2."" ;m 5.489 100 436 18B 365 13.3 451 3.393
0... 32.968 2.0 448 110 60 464 10.5 17.9 8.5 43 1.5 04 4.4 1.3 t9 07 27,ro7 7.5 2,007 2,910 217 4,710 112 343 16.3 363 10.7 442 4,125
DUplin 44.502 1.3 :n4 91 4.0 :n9 8.7 127 62 150 " 15 17.8 .. 7~ 27 20,574 196 1936 1.897 100 4,945 136 as.8 252 552 237 70S 3.327
""""" 203,357 13 289 7.3 26 "'.7 7.0 14.5 4.3 18.5 69 to 21.9 69 10S 1.9 28,492 124 "" 464 43 1,576 102 37.0 188 334 14.6 502 3,649
Edgoo>nbe 54,034 <J.5 18" 4.6 26 206 4.5 7;4 42 285 11.0 1.9 34.4 11.0 151 4.0 19,349 226 3,178 3,071 100 4,912 147 n2 462 626 31.4 g;r 3,082
F""Ylh 291,846 1.1 349 90 4.1 383 87 '" 67 124 45 0.8 14.4 4A 67 14 31,304 108 <II 700 0; 1,790 112 41.4 41 34.8 125 ." 3.707
.Frwi<lin _ 45.332 2.6 :n6 90 M. 34.8. ., 15.1 5.2 14.6 " 13 17.0 4.8 72 25 20.932 14.6 3.022 2,970 210 ."" 103 461 29.3 37.5 175 .... 3,740
""IOn 181,362 OA 41.6 11.4 4.5 43.7 10.9 17.9 7.0 68 28 OA 7.9 27 35 08 23,210 11.3 1,417 1,381 140 2,879 100 40A 3a7 41.7 162 ,"1 3,641
Gale. 10,114 1.0 31.2 .8 4.2 301 7.2 12.2 5.3 181 53 16 _20.~ 64 B5 29 17.775 14.9 5,057 4.895 361 10,114 '" nA 4.5 261 17.2 - fI52 3.779
Grd"an------... 7,522 05 458 108 7.6 462 92 16.3 9.8 3.8 14 0.3 2.0 1.7 0.2 16,877 19.3 2,~7 2.352 ;m 7.522 129 719 362 730 ". -001 4.345
Granv" 45,450 2.0 "'2 83 32 322 62 13.6 4.8 17.4 5.1 1.7 50 7.7 2.7 21,007 12.7 1,420 1,378 100 2,841 91 423 21.2 41.1 166 3,774
G_, , 18,298 2.1 30.7 74 3.6 292 63 106 59 203 56 lA , 55 67 31 18,001 166 9,149 7.653 269 4,575 93 661 460 63.1 t4,A 3,544
-Guilfc.'----- 393,423' 14 33.7 ., 4.1 367. 7.9 15.4 a4 la7 5.1 DB ,- ' 01 7.7 1.5 29229 11.7 1;;sn 1,100 '" 1.1365 104 39.3 17.7 33.5 3,496
.....""~ 54,752 '()2 21.3 5.4 l> 231 50 8.1 53 280 9.8 23 '29:7 95 127 39 18,357 253 1.... 1,614 133 4.9l7 112 707 234 54.3 "" .... 2972
Hamel, 85,305 28 37.5 102 4.0 390 10.2 17.0 61 11.1 4.0 07 125 42 .6 1.3 19.129 153 2.509 2.406 253 ,,'32 100 450 57 47.2 186 "" 3242
.- 52,096 - 1:2 465 10. '4 51.5 -,10.1 17.4 124 -09 02 0.1 to 03 04 0.2~ -21,494 laB 1,371" 1.343 146 2368 135 47.7 "'7 462 161 637 3,951
_Heoderson__ ___.82.365_ _2.0 !~5.7 10.3 101 .500 97 la5 ...13.2 _.2.1 0.6 02 22 07 .1,0. 03 .26.115 11.3 1."" 1.W 100 2,112 149 526 230 44.8 14.3 $J 3,971
Hertforr' 21,260 <J.6 17.9 44 28 201 40 72 50 276 106 27 344 11.2 14.4 4.6 17,626 246 924 569 .. 2658 140 676 62 666 324 1,131 3.493
_r 31,102 40 224 64 22 20.6 5.8 02 33 281 10.3 16 r" 97 131 29 13,582 188 2,073 1."" 2T3 6220 III flJl 246 547 f-.....,~ 2,673
- 5,611 04 344 8.7 4.9 34.6 7.8 129 68 143 50 21 40 66 32 18,157 257 2."" 2.342 187 - 154 flJO 297 531 4266
IreeleD, 117,804 29 412 106 5.0 429 10.2 16.9 74 7.3 27 05 27 3.8 0.9 24,382 93 1267 1243 102 2."" 137 409 102 359 1. ~ 3.5.23
.-.,,- - - 29.800 1.2 41.6 10.8 59 459 104 19.4 87 63 25 0.4 , - 9.3 22 26 06 20m 17.3 852 824 100 2.293 03 643 9.9 544 16,._6ffl 4.004
-Jcmsloo--- . 112,154- -~42 409 -'1.0 42 421 10.1 176 - 64 78 29 0.6 29 4.0 t2 n298 133 2.492 2.414 "" 5,"" 102 37.9 164 295 163 "" 3:436
JonM a305 <J.t "'6 82 ~8 "'7 85 129 M 164 58 20 203 54 7.7 >5 19,100 19.4 fll6 658 292 153 00.7 21.4 589 225 917 4.009
... 49,247 21 36.9 9.7 53 584 93 1<5 72 11.5 42 09 132 45 58 1.4 24,563 13.5 1,331 1290 125 2,462 142 520 19.7 47.1 17.4 "" 3258
Lenot 58.208 02 28.3 7.1 39 303 67 11.0 62 181 7.1 1.6 n2 a7 99 3.3 21287 19.6 1.573 1,514 100 2.079 170 63.8 27.0 534 24.4 850 3,489
"""" "'.000 21 454 120 4.8 463 11.7 19,1 7.0 4.1 1.5 03 42 1.5 1.9 0.5 21,422 96 1.717 1,701 215 4.622 100 41.5 128 37.2 124 431 3);28
McDowell 40.644 1.5 465 116 63 483 104 18.9 9.2 26 O.B 0.3 2.6 DB to 0.4 18,657 11.5 1.935 1,837 11ll 3.695 115 "'3 378 524 245 852 3.""
M~ 28,630 24 466 10.2 10.5 51.1 9.5 15.8 138 12 05 01 t2 0.4 0.6 0.1 19,522 14.3 1,245 1227 135 4.099 116 634 22.8 "'.7 11.3 422 3,752
Madison 18,978 1.3 49.1 126 7.7 499 11.2 193 9.8 0.6 0.2 00 05 01 02 01 21,191 17.7 2,100 2.049 351 9.489 91 48.5 17.7 523 12.9 flJl 3.883
Martin 25,708 03 213.3 64 3.5 287 64 104 60 206 7.7 22 244 7.0 9.9 3.8 18,599 19.7 1,036 1.794 2J2 5,142 199 524 705 55.9 34.7 1.249 3.605
~:::17~l!9 642,245 2.8 348 91 3.1 36.2 67 16.8 4.6 13.5 52 06 15.6 51 7.7 1.1 35,245 10.9 1,002 1,033 7'3 1,651 "' 16.8 5.6 252 12.2 395 m8
14,690 02 47,5 11.3 82 521 109 18.7 11.7 02 0.1 0.0 02 00 0.0 0.0 19,449 la9 1,049 1,020 121 2.936 148 59.0 15.4 59.0 la8 745 4,442
M01lgomlll)' 24,988 0.8 36.5 9.8 4.5 34.9 89 130 63 15.1 51 0.9 13.4 <3 al 16 19,789 16.7 2.499 2,330 225 4,165 128 62.8 100 49.3 209 725 3,473
M... 72,308 25 39.2 '9 9A 43.1 ..6 13.8 123 83 32 07 94 ~O 4.1 U 28.493 10.8 1339 1289 76 1,954 141 48.5 221 422 la8 514 3.739
Naoh 89,(64 1:8 332 85 18 354 ., 14.4 5.9 14.4 52 1.1 17.0 53 7.9 1.9 23,572 14,1 1254 1.213 112 2.545 '" 49.1 27.0 4>0 17.1 573 3,361
_ N~Hanov6l' _148,622 . 26 __38.2 92 47 41,3 91 _.17.6 a8 92 3A 0.8 11.3 35 ot 13 28.346 14,1 913 879 72 1.600 107 408 227 40.5 145 So16 3.770
-pion 20,949 0.1 209 42 4.1 21.3 41 69 54 27.0 8.9 32 308 66 12.0 56 18,452 24.6 3,49'2 3,275 2S2 20,949 113 77.9 354 707 326 1.060 3.296
0"",," 148,286 '()2 446 129 19 31.4 10.8 15.3 28 13.3 46 03 10.6 42 54 06 22,109 156 1.685 1.652 103 2.836 110 24.4 20.3 57.4 115 249 3,031
Oc""", 109,745 18 39.0 96 31 431 96 238 46 84 29 06 94 28 48 09 28256 104 346 339 52 ll25 7'3 27.5 67 241 7.3 326 4.49'2
Pamlioo 12,602 12 380 9.1 6.7 392 76 133 B9 9.9 14 16 12.9 33 50 25 21256 17.3 2.520 2,394 332 6,301 113 as4 64 flJ8 19.6 m 3.971
p- .- 34.650 12 289 79 3.8 32.1 6.3 127 5.9 17.7 74 16 21.4 69 102 2B 19,581 195 836 91B tI2 2.665 107 57.1 403 "'3 210 729 3.469
-P8ndllr'~- ~38,971- . a8 367 as ., 37,5 8.3 14.6 65 11.7 4.3 12 14.1 4.0 54 23 18,535 "7 5.$J 5.044 232 3."" 102 555 349 509 163 725 3.952
p~ 10,872 04 349 8.1 a7 35.8 7.7 125 ao la4 4.8 1.8 16.0 44 62 11 17,009 21.2 5.436 5.099 311 5.436 113 "'.1 35.1 622 21.6 852 3.(151
p""", 33,654 13 :n8 86 44 360 02 1<1 a7 142 4.9 12 16.1 4.5 .65 24 20,933 11.8 2,500 2538 212 4.009 119 456 n5 45.9 16.3 704 4.329
p~ 127,879 20 "" '8 27 :n9 86 17.2 4.3 154 62 10 106 al 89 1.9 22m 19.6 703 '"' 51 2.fIJl 102 51.4 31.3 46.4 la3 621 3.388
""' -- .16.925 __1.9 _ 434 93 104 498 9.6 14.8 14.4 3.2 1.1 03 ~6 09 14 0.8 28.614 90 2,116 2.665 119 2621 ro 426 14.8 358 129 "" 3.968
""""iih-- 126,316 20 457 12.7 50 47.4 11.9 19.8 7.3 33 1.1 02 3.6 11 t6 04 22.622 8.9 1,943 1.920 241 3.628 93 49.0 83 40.5 131 435 3,315
Rrhmond 45,158 02 323 86 4A 343 81 126 6.6 155 63 12 17.9 62 76 22 18,845 182 1.200 1,259 1Z3 3,763 20J 73.5 24.9 "'5 25.9 921 3.500
"""""" 115,333 1.1 161 4.1 2.1 17.4 41 67 33 310 121 1.9 35.4 12.1 15.8 3.6 17,179 24.1 1,671 1,594 "" 4,119 154 713 226 627 31.7 1.063 3,357
Rocki'lgham 89,745 0.5 378 96 51 41.0 9.3 15.6 78 97 32 08 11.4 32 49 1.5 20,866 12.8 1,693 1,654 163 3,324 132 53.0 1.6 472 167 009 4,179
R""'" - 125,800 15 40.6 10.6 54 420 10.0 16.4 8.1 B3 3.0 07 92 32 40 1.1 21,594 11.4 1,634 1.590 131 3,400 113 42.6 22.6 405 147 495 3.364
."""'- 00,508 0.7 429 11.4 60 454 10.9 172 '9 5.6 22 04 -6.1 20 26 0.8 20,183 13.4 1,476 lA55 162 4.654 100 54.7 40.2 51.8 17.8 So16 3,632
= 54.,155 ,6 31.7 04 4.1 :n6 83 12.7 64 156 54 1.7 19.0 5.5 8.1 28 19,800 18.3 2,579 2,441 157 8.769 138 00.1 27.0 5.68 24.0 850 3.576
34,824 0.3 257 7.1 27 284 7.1 11.4 4.7 204 '8 1.3 254 a8 11.0 26 19,026 19.4 1,451 1.406 129 5,004 133 "'.1 52.5 628 289 917 3.366
SlanIy 5.6,062 09 423 11.4 53 446 11:2 17.4 8.3 62 26 04 69 26 ~o 07 21,689 107 2,003 1,930 175 3.505 128 46.7 103 439 14.7 883 3,957
SIoko. 43,700 1.9 46.8 124 .4.8 452 11.4 2<>4 7.0 25 0.7 0.2 25 07 to 04 20,714 10,3 2,913 2851 2!!l "40 '" 421 0.6 386 11.9 463 3,874
Sorry 68.843 1.3 45.8 11.9 59 494 11.0 19.0 9.5 21 07 02 27 09 10 04 21,939 11.9 1,324 1.272 1Z3 2.648 149 525 0.6 444 15.3 628 4.099
Swan 12,311 1.0 343 8.0 62 34.2 5.9 119 83 16.5 7.3 0.8 150 5.5 6.8 13 16,156 24.5 879 ... 118 6,1$ 130 743 156 706 no B29 3.599
Transytvania 28,353 1.2 46.0 114 95 48.7 10.2 16.8 123 26 1.2 02 27 09 1.2 0.3 23,378 126 1,091 l.em 131 2,578 120 "'.8 32 594 144 500 3.895
Tyrrell 4,025 05 289 7.1 52 303 6.3 11.7 6.3 191 7.7 25 21.7 59 90 3. 15,475 255 2,013 1.946 252 - ltll 744 46.5 851 247 872 3.532
Union 115344 40 . 41.6 123 37 423 11.7 18.1 5.1 76 3.1 04 B.5 30 40 0.7 22.m 93 2,218 2,171 242 6,071 92 32.1 157 293 116 381 3;295
'Vi:lC8- -- ..~-4i271 0.9. 252 66 a3 27.7 61 10} 52 21.7 87 1.5 255 ., 11.5 29 19.C03 199 2.114 2,014 "" 4227 121 "'.7 203 fIJ2 283 <II 2,916
""" 592,218 '" 37.9 101 26 390 98 la9 4.0 109 '8 05 122 19 62 09 33.700 7.6 1,154 1.120 '" 1,707 0; 251 192 233 a6 291 3.394
Wamon 18,978 1.1 19.8 4.2 44 20.3 17 '8 ., 284 9.3 36 31.6 8.1 122 62 15,874 239 1.... 1,626 313 <745 81 "9 304 627 283 647 3224
- ''-850 <J.9 24.6 5.9 42 27.0 61 90 02 223 87 20 262 86 11.0 " 16.3<6 2<>7 3213 ~100 10; 4283 147 "'3 465 87.9 286 918 3.212
------ _~40,791 __1.1 _ 47.3 11.7 <9 49.8 124 28.3 _67 .1.5 0.4 01 1.4 05 1.0 0.1 20.986 157 1,133 1,111 115 1.854 '" 427 206 403 85 376 4.440
--- 112,954 09 35.2 85 32 313 78 111 48 156 55 12 179 54 7.8 21 19,710 167 1.&6 1.633 118 2.621 116 47.1 41.7 flJ6 19.0 "" 3.137
""'" 63,760 06 465 11.7 58 482 109 19.0 63 24 08 03 29 09 12 04 22,014 136 1.723 1.655 165 4.005. 127 53.1 12.3 491 163 707 4.341
"'..,., 69,n2 06 290 7.6 3.6 31.4 7.1 11.9 59 17.5 6.9 t3 221 69 99 26 n.623 194 1.938 1.863 1Z3 3.034 121 643 197 49.9 Z33 753 3.232
V_ 36,124 2.0 465 11.9 61 49.2 11.7 190 9.1 20 06 02 22 0.6 0.8 0.4 21,00) 10.5 2,125 2.05.3 "" 6,021 126 364 191 395 12.5 f{fl 4.060
Vwrsy 16,841 to 47.8 114 76 51.1 109 18.3 11.0 06 02 01 05 0.1 02 0.1 18.303 16.8 1,531 1.453 nl 4210 122 61.5 17.8 521 189 "" 4,163
'A dash (-) indicates county had no resource ofthe type slaled. Practitioners afe by county of practice October 1999. 1Aclive federal
and nonfederal phYSICIans in general or family practice, internal medicine, pediatrics, and obstetrics/gynecology. Physicians providing
very little direct patient care are excluded. 3Physician extenders are nurse practitioners and physician assistants, eachweighled as .66
of a phYSician and added to the number of primary care phYSICians. 'Active federal and nonfederal. "Based on county of residence
Ralesare per 1 ,OOOpopulalion, excluding estimated military in Cumberland, Onslow, Craven, endWaynecounlies. Numeralorsare 1999
discharges from nonfederalhospltals located in N C. Normalnewbombabiesareexcluded. Only N.C. residents served In N.C. hospitals
are included. Countieswitha large percentage of patients leavln9 NC. for hospital care are: Camden, Caswell, Clay, Currituck, Dare,
and Gates. "Measured by Medicaid payment for hospital stay of the newborn. lPercent receiving some prenatal care at ahealth
departm ent: percents for some counties may be low due to patients going to a public clinic not reporting data to the Health Services
Information System. 'PercentonWIC in prenatal period. 'Statefiscalyear 1998-1999 data
Table 8
SELECTED HEALTH INDICA TORS
, Perinatal and Population-based Age-adjusted Age-adjusted Communicable
Pregnancy, Tolal Pregnancy, Females 15-19 Infant Mortality Mortality Rates Cause-specific Death Cancer Incidence Disease Rates
1997-1999 1997-1999 1995-1999' 199$.1999 Rates,1995-1999u-', Rates, 1995-1997".11 1995-1999'.
Percenlof LlVe BIrths Percent of live Births
" J:
... .. u ... " . Ji
~ ~ ~ -.
... " 0 ~ ... " 0 -. . ~ ~ ~ "
" '" E 0 0 " '" E 0 0 " .. & . 0 .
~ . '" . 0 ." ~ " .. , " . 0 .
~ 0 0 E "0 .. 0 E ". " . ~ . .. 9
0 z ~ 0 Z " c " 0 ~. m . ~
c c ~ ~ 0 " 0 c .. ~ ~ .. 0 0 0 ~ . . E e
~ 0 ~ a . jj ~ 0 0 a ! jj '" " . ~ ; S E ~ -g~ . ~ t
t a ~ . t 0 "is . 0 ~ E . t .. E ~ .
~ ~ . ~ ~ . " .. 0 .. 0 0 c 0
0 c . 1; ~ ~ c . 1; ~ 0 ~ . " . Qj,~ E c e ~ D E n
t ~ ~ 0 " " t ~ ~ ~ " " . 0 ~ . 0 1; . , " . 0 " ,
Resident Data m ~ ~ ~ ~ m ~ ~ ~ z ~ ~ " I 0 00 ~ ~ ~ 0 ~ "' ~ 0 ~
North Carolina 660 172 037 28.9 .9 15.4 14.7 22.1 61.5 21.4 63.5 42.7 10.9 29.3 16.5 15.3 6.5 6.5 28 92 9.3 50.8 6A 273.7 208.0 76.8 461.5 145.2 74.3 53.9 150.9 3.2 26.3 1.0 24.8
07
Alamence - 86.. "20.3 87.8 22.4 8.7' 16.1 18.2 22.2 65.2 30.6 97.3 30.4 - 9.1 31.9 21.7 17.1 9.2 6.7 2.6 9.3 8.. 49.4 5.. 255.5 206.7 79.0 556.3 160.8 64:6 86.1 194.3 '-3,3 24.5
0:5 20.5 0.3
Alexander 54.6 74 n5 8.9 7.9 17.0 20.6 24.4 62.0 10.9 73.6 10.7 10.2 32.2 28.2 14.1 6.3 4.9 3.4 ..3 8.8 47.5 7.1 285.2 191.6 80.9 393.8 111.1 50.6 40.7 175,6 0.3 3.0 0.1 6.' 0.1
Alleghany 80.1 6.8 67.9 1.3 6.8 13.6 26.2 17.5 558 15.3 73.7 0.0 10.0 27.5 50.0 10.0 16.1 2.0 0.0 2.0 9.2 53.4 6.9 240.0 226.7 78.3 497.5 139.9 58.0 61.5 197.5 0.0 a.' 0.0 27
0.4
Amon 674 13.9 82.4 59.8 12.1 17.5 16.5 23.6 90.9 21.3 112.7 75.6 13.9 26.8 15.8 13.9 12.0 10.3 6.1 16.4 10.2 51.5 9.9 334.3 214.9 90.0 353.1 143.7 44.6 49.3 98.5 8.4 58.1 1.. ".2
0.4
""'. 4. _. .58.0 _4.4 _62.9 - 06 8.. 12.7 21.6 26.9 70.5 _ _7.3 77.8 0.7 16.3 25.9 21.5 17.0 4.7. 7.2 3.2 10.3. 8.7 48.2 6.3 239.9 190,0 71.3 413.7 120.2 59.3 SO.1 151.1 0.2 J.4 0.1
3.6. 0.2
'AverY--~ 54.6 85 63.6 0.8 11.4 108 222 27.0 39.2 6.' 48.0 lA 14.1 21.1 29.6 19.7 12.9 4.' 24 72 9.5 55.9 7.6 333.8 163.5 48.7 413.3 128.8 40.8 276 129.5 0.0 0.6 0.4 2.9 0.3
Beaufort 671 10.8 78.5 37,3 11.0 17.7 16.2 26.5 771 12.2 89.6 537 10.7 24.3 13.9 15.5 10.2 12.0 2.4 14.4 10.5 56.7 7.3 352.8 231.2 74.2 404.3 1203 83.9 46.0 124.8 3.8 32.9 0.9 25.9
a.'
Bertie 575 106 603 77.3 14.1 15.6 71 18.5 78.1 16.6 94.7 89.7 19.0 32.8 17 10.9 6.7 9.0 2.3 11.3 12.1 63.4 9.2 3286 268.2 66.3 470.0 1072 651 61.0 162.7 'A 26.2 22 30,0 17
Bladen 73' 12.8 86.9 43.6 10.3 274 17.8 24.3 76.5 15.0 925 557 9.' 44.3 13.2 15.3 87 78 23 101 11.0 55.4 6.' 327.0 211.3 116.6 360.0 131.6 616 463 118.1 2' 30.4 0.8 24.3 "
Brunswick -- 59.7 11.4 71.4 17.5 '.6 171 256 27.0 72.7 16.9 90.0 21.9 10.3 27.3 28.6 22.9 6.1 4.0 2.9 6.9 9.2 40.5 7.6 267.7 203.9 68.2 397.7 103.6 76.2 44.1 113.2 2.3 16.2 0.6 11.0
a.'
-Bl.lncombe-' 60:5 17:1" 78T 10.3 8:7 7:5 1TO 16.2 56.8 226 79.6 17:7 12:6 12:6 23.5 11.3 SA 6:3 2.. "8.8" -a.9 51.4 6.0 249.5 196.8 69;3 455:5 166.3 68:0 '49.1 113.1 . 0.4 16.2 1:4
15.9 0.3
..... 64:8 12.2 774 14.7 9.5 20.5 22.1 22;8 86.8 18.5 106.3 18.7 11.5 31,5 29.1 13.1 '.8 6;2 3.1 9.3 .. 47.6 5.5 261.6 193.6 61.1 431.7 109.2 72.4 45.5 140.6 1.6 9.0 03 '.2 0.3
Cabarrus 68.9 13.2 62.6 15.8 '.3 15,7 14.3- 22.2 60.1 16,6 77.2 29.7 10.1 31.9 20.5 12.5 5.6 5,1 10 6,1 9.0 51.4 5.5 281.0 200.2 59,4 479.4 151.4 74.6 53,4 159,8 0.9 15.5 0.6 13.3
OA
Caldwell 65,4 7,5 13,3 7.' 8.7 11.4 24,3 21.6 .... 11.0 98.3 10.5 12.5 19.2 32.2 12.5 5.2 6A 3.2 ... 9.1 49.5 6.2 291.7 194.0 75.0 466.1 113.2 74.8 58.8 178.7 0.5 11.4 0.3 10.9
0.2
Camden .-., 39.4 4:6 44.2 20.9 6.1 18.a - 122 21.6 40.5 5.5 46.0 31.6 16.2 36.4 227 31.8 74 .11,2 I5 18,6 10.0 50.8 5.9 258.5 281.1 82.5. 545.3 137.0 72.0 .67.2 181.5 .1.6 - " 1.2
5.0 0.0
'Carteret 50.4 10.6 61.2 11.7 6.9 11.5 18.5 25.4 43.9 15.3 59.3 14.7 '.6 20.7 24.6 155 52 49 30 7.' 9.5 49.9 7.3 301.4 228.2 66.3 466.3 154.3 61.9 56.7 136.7 O. ..1 0.2 '.1 OA
Caswell 58.6 14.9 74.4 34.1 10.6 13.9 23.2 21.6 64.5 24.9 69.9 44.5 15.1 27.7 27.7 20.2 '.1 14.6 2.5 171 ..3 50.1 6.6 2671 214.1 86.2 3500 82.4 67.2 40.0 136.6 1.7 20.0 05 249 0.1
Catawba 66.3 11.9 78.7 15.3 8.5 16,3 14.6 22.5 69.9 16.8 67.6 271 10.7 30.7 21.9 10.9 52 44 21 6.5 9A 517 63 2591 214.7 79.7 524.3 142.9 85.7 61.1 178.3 I.' 12.0 OA 18.1 0.3
Chatham 676 14.4 82.4 15.8 74 14.3 13.2 24.3 59.4 28.8 .93 2'4 87 28. 13.0 14. 4.9 62 4.3 10.5 8.6 474 71 243.0 192.4 75.6 371.7 142.8 474 .8. 995 3.3 14.5 04 14.7 0.5
Cherokee 635 12.4 764 3A 4.0 11.6 23.1 21.1 79.4 21.6 100.9 2.6 6.0 25,2 33,1 17.9 4.7 1.6 6.3 7.' 9.0 46.0 8.2 270.9 206.3 49.8 390.2 136.7 57.3 45.3 123.1 1.0 lA A. 2. 04
'Chowan 76.1 8.0 85.0 45.5 8.3 18.9 11.3- 28:0 98.8 10.5 109.3- 69.7 13.6 23.5 6.8 21.2 7.' 10.9 0.0 10.9' ..1 52.4 5.3 270.2 212.5 77.0 479.5 124.5 76.2 76.4 205.8 2.0 25.7 0.8
'9.6' 1.6
Clay 44.9 58 51.2 0.0 5.8 9.1 231 19.2 40.2 5.7 46.0 0.0 -7.1 21.4 32.1 17.9 5.9 11.9 0.0 11.9 8.8 47.6 6.7 262.3 216.5 57.7 215.6 51.8 22;8 16.2 92.1 0.5 0.2 0.0 0.5 0.0
Cleveland 67.7 11.0 79.1 26.1 ..1 16.6 20.2 22.7 84.4 14.2 99.2 37.8 10.5 31.4 23.9 171 6.5 7.4 2.8 10.2 9.7 51.6 7.5 320.8 193.8 79.2 455.6 1320 63.6 52.6 209.4 4.7 35.0 0.4 18.5
0.3
Columbus 73.5 13.9 ".1 41.1 9.6 29.3 18.1 22.2 88.6 20.2 109.6 503 83 42.7 16.6 17.2 5.9 B.7 3.' 12.1 10.7 54.3 10.0 376.0 219.9 67.5 379.7 108.4 73.9 39.9 114.9 3.7 30.0 1.3 23.4
1.0
Craven 82.4 14.0 96.7 29.5 7.9 17.9 14.6 25.5 79.7 21.4 101.5 43.0 10.7 33.3 14.8 HI.Q 3.5 5:3 2.2 74 9.7 .50.3 .5.9 __282;4 223.5 60.5 560,0 .1.47.9 @.8 54,7 232.9 2.0 28.6 0..
26.1 0,5
Cumberland 81.1 25.1 106.6 39.9 .A 13.9 12.9 17.9 74.0 27.7 102.4 51.7 12.2 28.4 14.1 11.0 5.0 7.' 2.' 10.8 10.0 49.6 7.0 290.4 227.6 69.9 501.9 147.0 96.2 59.6 179.2 4.9 35.2 10
407 07
Currituck 508 99 607 10.3 '.5 15.9 19.6 23.2 445 19.6 64.3 167 .7 264 36.1 16.7 0.0 10.0 5.6 15.5 9.9 50.7 5.7 266.8 252.8 67.3 373.7 110.7 01.5 46.9 92.5 1.2 60 OA 10.6 OA
Dare 49.0 12.2 61.4 4.6 6.0 12.9 17. 24.9 40.6 11.1 52.3 11.5 7.3 32.3 19.8 13.5 2.6 2.0 3.3 5.2 .. 45.6 5A 277.0 203.0 64.2 404.2 153.5 68.4 34.1 122.3 03 2.' 0.5 6.4 0.1
Davidson 60.7 11.8 73.0 12.5 90 13.9 22.9 23.2 68.7 21.3 90.8 17.7 11.6 25.0 32.4 16.8 5. 50 27 76 .. 480 57 279.4 191.3 79.8 395.3 110.8 72.0 42.6 134.9 1.0 12.1 OA 17.0 0.3
DaVie 62.7 11.2 74.4 74 '.1 ..5 20.2 20.5 60.8 21.6 83.1 12.5 9.2 171 32.9 171 57 47 1.1 5.' '9 51.7 5.B 291.6 1856 66.0 501.5 153.0 734 731 120.2 1.1 6.0 - OA 14.3 0.1
Duplin'" 84.4 13.3 . 96.0 27.9 7.8 22.5 12:2 26.8 886 21.4 110.5 36.7 . 9.2 32,3 .5 21.7 63 .6:9- 2.2 'S.O 11.0 -57.6 9.4 302:7 239,9 106:4 389.1 115.4 73.9 54.0 112.5 4.1 25.1 2.0
16.7 1.7
Durham 65.0 260 S3.6 49.4 10.3 11.9 7.3 22.4 52.0 32.1 54.' 66.8 14.0 26.2 6.5 17.2 7.5 6.3 3.' 10.1 10.5 60.0 5.7 276.6 244.9 709 507.6 169.4 91.1 52.9 166.8 3.4 50.6 20 42.0 a.'
Edgecombe 654 17.0 63.3 63,3 11.6 31.1 13.5 19.7 91.6 19.9 112.9 79.0 126 41.0 9.7 11.4 ..9 5.7 3.4 9.1 11.5 59.0 8.0 325.2 250.1 107.8 .0197.9 146.5 63:3 57.9 203.8 ... 106.8 2.2
58.0 I.'
'''''t'h 65.7 20.0 86.1 29.6 10.1 11.4 15.5 18.5 55.5 26.9 82.6 43.7 10.9 22.6 19.4 12.6 5.1 9.1 3.1 12.2 ..1 51.4 5.3 2527 208.1 76.2 569.1 197.9 81.1 54.8 196.4 7.0 395 1.4 45.2
0.6
Fran !in -- J~'7. 14' .- 737 .32.4 '.3 15.1 10.1 24.8 .51.3 19.2 71.6 49,4 11.1 26.4 11.1 11.5 ~;~ ..3 0.7 7.0 ..2 50.0 7.4 2564 2f12..7 54.' 353.3 86.8 66.2 .48.2 101.5 1.2 23.7
0.7 .18.9 0.3
. Gaston -" 13.6 80.8 19.6 ..9 121 21.3 21.0 703 202 9.' 26' 101 201 27.0 13.9 ~,", 6.3 2.4 .6 10.5 56.5 6.' 320.7 2299 70.6 4780 1280 .73 543 171.6 2A 23.~ ltlt-2 259 0.3
Gates ( , 12.2 64.7 462 89 122 125 232 46.6 26.5 73.0 75.0 18.2 29.5 6.' 9.1 )'. 1.9 7.1 11.1 58.9 '4 321.1 240.8 92.6 418.9 147.6 64.8 71.3 187.2 5.' 10 '--"~ 10. 04
Graham '.4 774 ... 6.4 '.B 24.7 20.7 80.8 3.2 84.0 12.0 '.0 5.0 180 12.0 00 21 21 10.4 551 102 2656 225.0 554 426.2 121.7 734 49.7 120.3 0.3 ( , 4.0 1.1
Granville 201 '17 35.3 '.8 15.1 15.5 24.3 63.0 292 927 .96 67 279 150 150 '--- 5 0 3.6 '.5 10.1 53.6 7.0 2874 2168 77.7 447.0 1474 793 .71 133.3 2.2 "~ 24.4 05
Greene -- fl.1 14.0 85.4 47.7 9.' 172 120 20.7 882 22.1 110.9 74.3 B.3 25.7 6.3 11.6 '.3 ..2 4.2 13.4 9.1 46.5 .3 244.5 196.6 79.1 390.9 146.3 54.1 15.8 151.9 4.1 312/7 472 23
Guilford- 61.2 23.3 54.9 .39.0 ..0 13.3 12,4 22.7 44.5 26.7 71.7 56.' 11.6 27.5 171 15.2 6.3 7.0 2.9 9.9 ..0 49.6 6.0 2386 210.8 60.2 532.5 171.1 79,7 58.4 190.9 6.1' 37.0 1.7 41.6
0.7
Halifax 64.3 16.8 ,81.9 65.2 11.1 18.0 13.5 25.2 90.3 ,21.8 113.3 78A 10.1 25.7 11.3 19.3 10.2 11.1 2.' 14.0 11.0 55.9 7.3 346.6 236.7 90.5 455.5 129.5 03.0 85.5 152.1 4.2. 41.4
1.6 42.2 1.7
Hamell 73.2 16.0 89.8 26.5 'A 201 17.9 24.6 68.2 18.1 87.0 39.9 10.6 36.4 20.2 18.6 61 6.3 3.0 ..3 ..4 46.6 8.1 275.4 '220.0 69.6 409.7 120.5 86.2 52.1 134.4 4.5 16.9 0.5 11.0 1.3
Haywood 58.4 10.9 69.6 2.0 '.0 8.. 26.3 20.1 64.5 14.6 79.6 1.7 8.3 19.2 39.6 12.1 5.. 4.8 4.9 9.7 '.2 46.5 5.6 260.0 183.8 55.2 358.6 123,0 547 31.8 80.7 0.5 2.2 0.5 6A 0.2
. Henderson .&::Cj~, 10.7 80.4 5.6 7.. ..9 18.6 21.4 63.6 .171 ,61.4 7.8 11.3 17.4 29.8 19.0 33 6.8 2.6 9A. 8..1 _45.2 ,6.2 219;7 189.6 ..61.6 485.6 .150.9 68.4 52.2 148.2 ".0.3
_51' ''''8 to.9 0.2
Hertford 14.5 74.1 72.5 12.5 169 5.0 18.1 75.8 13.3 90.2 81.0 11.7 22.9 3A 13.2 , \16.1 2.1 18.2 10.9 56.9 ..2 297.8 251.0 82.4 451.1 144.3 62.9 80.5 179.6 27 15.~1 11.5 2.6
Hoke 16.6 111.6 461 8A 16.9 12.0 171 1136 15.0 129.9 63.1 10.4 26.6 10.1 10.7 ,5.9 4.2 10.0 9.2 45.5 .6 2426 209.3 72.0 376.8 115.8 62.4 58.8 111.9 3.7 3~ J 2.' 1.6
Hyde , ,.7 57.2 36.8 .. 21.1 105 243 33.1 '.3 455 750 12.5 31.3 12.5 31.3 \ -------::,' 74 37 11.0 10.0 56.5 5.2 406.6 193.9 650 396.4 72.1 563 643 42.2 74 8. >. ______ ~ 5 10.4
OA
Iredetl -eit4: 120 80.8 17.5 '.6 18.6 16.4 24.1 64.4 17.0 81.6 32.9 11.6 38.2 26.1 16.3 '-'.j' 5.6 3.2 8.' 9.0 48.6 6.' 280.2 191.5 79.8 4671 130.7 68.5 62.1 178.7 3.0 16.2 0.5 14.2
0.2
Jackson - 50.0 '.0 59.6 17.7 5.3 99 20.6 20.5 32.3 87 41.6 241 34 200 28.3 11.7 10.4 6.' 3.1 9.9 '.7 48.7 62 2392 201.3 57.8 404.3 112.1 55.8 54.6 207.7 0.3 2.3 0.3 90 0.1
Johnston' 76.3 14.8' 93.5 18.2 8.0 23.5 126 '24.9 70.5 21.6 92.6 31.9 11.0 45:6 20.7 15.6 51 5.. 2.0 7.. '.5 50.3 7.7 30tl5 211:1 '75.2 425.6 139.1 81.1 44.5 125.8 2.5 19.1 07 12.0'
-'1.7
Jones 56.3 11.2 68.1 39.1 10.4 23.2 19.3 33.0 70.2 16.4 67.7 50.0 10.0 31.7 18.3 23.3 13.3 3.8 9.7 13.5 11.5 62.4 8A 325.8 244.2 111.5 546.4 149.6 00.1 67.1 208.8 2.6 15.5 1.1 9.7
1.7
Lee 60.2 18.4 99.2 25.1 '.4 22.0 14.6 23.2 80.9 21.9 103.4 37.0 '.9 38.5 14.0 19.4 5.4 7.6 3.9 11.5 ..1 45.2 7.7 270.0 208.4 58. 470.5 140.5 87.5 60.2 144.6 3.1 28.7 0.6 20:9 1.1
Lenoir 86.9 18,4 86.1 49.6 12.2 25.5 16.3 26.9 91.5 27.5 119.7 70.5 12.1 38.2 14,7 22.0 8.2 8.9 '.3 13.2 10.8 55.1 7.5 320.2 214.1 108.6 523.7 154.0 03.0 58.9 203.1 6.6 44.6 2.5
42.6 1.7
Lincoln - 65.1. _10.0 .75.5 , ~:~ 7.6 14.3 19.1 26.7 64.4 14.2 78.7 14.0 8.. 29.4 24.3 18.6 5.7 4.2 2.. 7.0 8.0 ".9 6.7. 297.5 192.2 72.4 406.3 133.2 73.4 56.4 122.8 0.6 ..4 0.3
13.2 .0.3
McDowell 63.4 7.7 71.6 8.' 11.9 26.3 21.7 61.0 9.1 90.7 7.7 10.4 174 34.7 16.6 5.6 5.3 4.5 9.7 '.6 47.9 6.1 2468 2089 72.1 421.4 124.7 73.6 53.9 94.3 0.5 5.0 07 73 02
Macon 63.2 7.. 71.3 2.2 6.5 '.6 22.1 21.2 75.8 12.5 ." 20 7.2 15.8 27.6 164 '2 35 21 56 7.9 45.5 59 241.9 171.5 53.8 426.7 158.5 574 472 157.0 0.3 1.6 03 3.5 0.2
Madison 60.7 89 70.3 1.0 8.7 SA 252 104 55.1 11.6 66.2 0.0 '.3 11.0 26.6 12.6 3.7 6A 1.' 8.3 '.6 52.0 6.0 227.3 186.3 68.5 416.4 177.2 55.2 44.0 125.2 0.2 1.7 0.' 6.6 0.1
Martin 66.3 9A 76.2 54.2 11.0 16.8 14.3 26.2 74.5 14.0 89.6 69.8 .A 30.2 15.1 16.1 7.2 7.' '.2 12.0 10.3 55.4 6.3 3096 2152 69.7 383,3 117.7 69.6 41.2 82.8 3.1 37.5 1.6 '02 1.3
Mecklenburg 66.9 24.6 92.1 35.6 .9 11.3 .9 21.7 50.0 26.9 I. J7 4 630 13.1 274 12.7 153 65 45 21 6.6 9.0 502 5.2 244.6 201.2 74.7 468.4 162.7 68.1 539 1574 4.1 33.4 1.7 25.9 13
-MitcheU- 58.4 -.6~6 '65.7 0.2 7.6 9.4 26.9 22.4 58.4 10.1 .74 0.0 "7:5 224 29.9 20.9 7.5 7;6 1.3- 8:8 ..1 52.6 5.4 298:7 200.6 66.2 368.9 151.6 630 30.6 119.4 0.1 0.3 0.0 4.6
03
Montgomery 85.6 11.6 98.4 26,4 9.3 26.5 13.7 23.8 97.3 15.5 113.7 35.2 ..6 36.5 15.5 13.7 9.. 4.6 3.6 8.1 ..7 49.9 8.' 285.1 218.8 58.0 465.6 142.2 90.8 52.7 177.2 4.2 21.2 0.9 24.8
0.4
Moore 71.9 15.6 88.0 23.6 ..0 20.5 16.1 24.1 86.8 18.3 85.8 41.0 ..0 39.2 16.4 19.2 7.5 76 3.5 11.0 7.9 39.8 65 226.9 193.9 72.2 536.2 172.2 72.8 77.9 169.6 1.7 14.5 0.3 155 04
Nuh 59.9 16.1 76.8 39.5 9.7 22.5 12,6 19.8 61.2 24.5 66.8 57.3 10.9 36.7 12.6 12.6 9.7 7,7 3.6 11.3 97 507 6.3 282.3 203.7 63.4 478.2 152.7 80.8 62.5 154.6 5.0 41.4 12 333 0.9
New Hal'1over - 56.4 22.9 _79.8 26.3 1~} 16,1 .15.1 23.0 .42.1 ,28.7 7_',6 50.. 12.5 33.0 19.6. .12.9 __ 7.0 . 4.8 ,2.0 ..8 '.8 48.5 4.5 269.5 200.9 _76.8 449.8 146.0 79,9 47.4 90.6
1.7 26.2 1.3 22.4 0.7
Northampton 65.3 107 76.8 68.2 16.9 12.4 236 88.1 15.0 103.6 64.6 12.6 26.4 8.' 19.2 '.2 14.8 1.6 16.3 10.7 53.0 9.2 298.4 227.2 99.0 415.3 145.9 60.1 73.2 119.0 26 50.3 I.' 42.5
16
Onslow 103.8 20.5 125.0 21.6 71 9.7 13.0 16.4 88.8 25.5 114.7 25.9 ..3 16.3 14.4 11.2 5.4 53 2.3 76 10.3 560 57 3083 240.0 72.7 494.2 129.9 95.9 54.5 168.6 1.0 25.4 OA 468 0.6
Oran~e 36.5 17.9 54.7 22.8 75 9.8 11.1 22.8 175 19.0 366 .07 130 300 233 19.3 4.. 7.' 2.0 ..7 '3 47.9 4A 206.1 218.1 734 514.0 2023 736 56.8 155.9 2.0 96 OA 19.2 OA
Pamlico 496 130 62.6 29.6 10.1 22.2 213 201 53.2 22.7 75.9 46.3 16.7 33.3 24.1 13.0 I.' 5A 0.0 5A 9.1 47.8 '.0 251.6 223.8 800 403.9 116.7 72.6 34.6 174.3 1.5 16.4 0.3 12.1 05
Pasquotank - 55.6 10.6 66.5 48.1 9.9 19.0 12.8 24.2 52.6 15.6 68.1 64.6 .A 30.5 12.1 14.8 2.3 12.5 24 149 9.7 54.6 45 2965 219.7 83.2 446.2 154.7 56.3 55.6 181.0 5.7 262 08 203 04
Pender' 58.2 11.0 69.6 24.6 10.1 19.8 18.3 22.6 61.2 121 73.3 34.. 10.9 33.3 16.1 13.5 8. 32 2.7 5.. ..0 45.9 66 261_9 203.3 94.7 391.0 99.4 74.7 44.7 10tH 1.2 11.8 0.7 13.1' 0.5
Perquimans ".0 107 65.7 35.3 7.5 16.2 13.2 311 61.0 11.3 74.2 49.2 7.7 20.0 10.8 20.0 '.8 10.6 1.8 12.4 9.7 50.1 7.2 268.2 241.4 102.3 453.4 111.0 70.3 72.3 150.5 2.6 13.5 1.1 12.4
0.7
Person 63.0 18.1 81.9 33.0 ..5 13.1 17.2 23.1 67.9 23.5 91.7 474 11.9 29.4 13.9 10.8 9.5 8.2 1.8 10.1 9.2 51.7 5.8 2686 196.2 103.0 426.0 128.7 74.7 58.6 103.5 0.7 22.9 0.3 19.0
0.3
PiU 55.8 18.5 74.7 44.1 10.7 15.2 10.8 20.9 45.7 21.5 67.7 70.9 14.1 31.2 '.6 14.0 ..1 10.2 2.3 12.5 10.3 56A 64 265.0 225.9 96.8 448.4 132.9 76.8 52.6 125.5 3.1 57.6 2.1 50.7 1.3
Polk ,61.4 11.6 742 6.. 5.1 142 186 22:7 55.2 14.5 _ 72.3 9.. 5.6 24.6 180 19.7 95 10.8 3.6 14.3 8.2 474 5.4 218.2 192.2 61.9 380,6 125.9 49.8 42.6 126.2 0.1 4.0 1.1 5.. 0.1
Randolph- 864 11.5 78.4 6.8 7.5 16.0 20.0 24.0 71.6 16.2 88.1 6.0 '.6 27.3 24.3 17.9 6.2 4.2 3.2 74 'A 46.6 6.0 2707 1949 61.1 4162 121.0 70.4 51.1 148.7 2.2 13.2 0.2 11.0 0.3
Richmond 71.9 12.8 85.1 404 10.4 23.5 22.3 26.2 102.2 20.5 122.7 48.9 9.3 30.6 21.1 17.2 71 01 4.2 12.2 10.8 55.8 '7 359.9 215.4 69.2 377.7 102.9 70.5 47.8 951 5.5 41.0 0.7 28.5
1.3
Robeson '02 145 95.4 70.6 10.7 33.9 224 203 103.2 14.4 116.7 774 11.1 42.2 21.3 24.9 82 ..1 4.0 13.1 11.5 57,9 107 356 0 229.7 95.9 433.0 125.2 85.4 539 135.4 7.' 43.9 12 364 1.0
Rockingham 61.7 13.7 75.7 23.0 9.. 13.9 22.1 22.6 69.0 19.1 89.2 26.6 11.2 22.3 22.9 20.5 7.7 6.3 4.1 10.4 97 53.2 71 269.7 226.1 93,2 436.6 130.9 740 53.6 118.5 1.3 151 0.6 11.7
0.2
Rowan 64.3 12.5 774 21.1 9A 20.9 19.3 20.9 64.7 17.5 82.8 33.0 9.' 36.6 20.2 14.0 7.5 5.3 2.' '.1 9.3 52.8 6.5 293.6 202,4 72.1 3471 1074 53.0 44.5 68.2 1.5 21.2 a.' 20.0 OA
Ruthe'rford 66.3 10:1 76:7 13.6 8.4 13.7 22;6 20.7 73;2 14.1 66,1 15,1 74 22.3 30.2 13.1 5.' 6.3 2. 9.1 10.0 55.3 7:1 310.4 210;8 80.9 398.8 104;8 75.3 47.7 154.4 2.1 18.5 0.7 14.5
0.2
Sam~son 76:1 14.3 91.7 32.9 '.3 26.1 12.6 28.0 79.5 19.7 99.7 44.8 10.6 41.5 11.0 22.3 8.7 6.3 2.9 ..2 10.3 55.0 ... 279.0 211.0 106.0 406.8 134.6 73.5 46.7 150.2 3.2 23.0 0.9 15.4
1.5
Scot and 69.3 11.4 81.3 55.4 10.9 20.8 15.1 23.0 68.4 15.5 104.6 63.9 12.5 31.6 13.0 13.5 7.5 8.3 4.4 12.7 11.2 57.3 8.. 3776 215.6 92.6 448.7 134.7 54.7 862 231.6 '.0 55.2 0..
... 1.3
Stanly 62.9 10.2 73,4 17,9 '.0 15.7 14.0 27.3 58.5 13.8 72.6 26.7 9.7 27.0 15.1 22.S 5.9 5:6 3.4 9.0 9.9 55.S 7.2 331.4 210.6 92.4 432.4 133.8 59.1 57.9 130.9 3.5 12.1 0.3 10.0
0.4
Stokes ----- -- 56.4 .9.5 66.4 ..5.1 9.2 6.9 28.1 19.7 51.3 14.0 65.6 7.0 9.1 .15.5 36.4 8.0 5.8 4.7 1,6 6.2 .9.0 52.0 6.4 24U 203.9 106.1 475.9 121.4 69.6 60.6 161.9 05 60 0.2 11.3
0.0
-Surry' 67.8 8.3 76.4 5.1 '.1 15.4 25.0 21.7 70.9 14.3 85.4 7.3 B.5 26.1 33.2 17.6 4.' 4.. 2.4 7.3 94 52.4 6.. 288.6 209.9 78.0 522.3 157.5 93.8 62.1 127.2 0.2 '.7 03 10.6 0.1
Swain 724 117 84.1 440 62 142 24.2 19.4 105.8 10.6 116.3 60.0 10.0 22.7 25.5 17.3 2A 2.4 1.2 3.7 10.2 53.8 9.7 314.5 2026 61.6 537.6 1619 67.6 66.6 189.7 a.' 3.7 1.0 14.0 07
Transylvania 53.5 10.2 63.9 8.2 7.3 12.4 21.2 21.2 52.4 12.3 647 103 110 213 22.6 18.4 43 .6 36 122 7.9 44.7 3.8 2374 196.1 574 474.5 175.7 79.9 39.8 1155 0.4 5A 01 0.5 0.1
Tyrrell 53.6 7.0 61.4 34.4 9.9 16.6 23.7 221 41.2 2A 43.6 41.2 11.6 17.6 0.0 17.6 9.' 24.6 0.0 24.6 93 51.1 5.0 255.9 2171 66.3 367.3 171.7 26.3 29.1 171.7 2.6 11.5 0.5 17.8 05
Union 78' 10.9 90.0 16.8 7.5 13' 12.6 21.0 52.8 11.9 65.5 33.0 10.3 30.9 18.9 11.9 71 5.6 27 8.3 9.4 51.0 6.5 3162 199. 63.5 3438 134.1 49.1 41.7 81.2 2.1 17.2 06 130 04
'Vance - '71:4 19.3 91.8 54.7' 11.8 25.0 15.7 25.4 93.5 26.9 122.0 66.0 13.6 35.5 10. 16.1 12.4 6.7' 5.2 11.9 11.7 61.8 74 338.9 262.8 117.0 419.1 108.7 70.8 51.4 153.9 3.7 56.5
1.9 29.6 0.6
Wake 62.0 21.6 841 27.5 7.5 12.3 6.5 21.0 31.2 25.5 57.1 48.6 10.3 346 12.7 11.7 5.7 5.9 2.1 8.0 8.3 47.7 4.' 233.4 189.0 77.6 533.3 173.9 78.6 58.6 1671 2.2 26.5 lA 24.8 07
Warren 802 18.8 79.7 72.4 11.5 17.1 13.1 24.2 75.9 24.1 100.0 77.5 14.0 25.6 6.2 18.6 6.1 4.1 2.0 6.1 '.9 45.3 7.7 227.3 215.7 65.7 360.2 95.2 61.8 47.9 141.0 ..2 37.2 0.4 27.8
0.5
Washington 64.2 9.8 74.6 80.7 9.4 22.1 12.5 31.4 71.0 18.5 90.2 75.0 8.3 34.4 15.6 19.8 7.6 9.8 5.5 15.3 10.5 ".1 8.0 327.6 270.6 50.0 402.5 107.3 74.0 43.6 144.4 4.4 15.5 2.7 29.5
1.2
Will8uga - .30.1 11.7 42.0 1.. 7.0 10.6 13.2 27.3 12.0 11.2 23.4 2.2 12.0 26.1 25.0 14.1 74 52 ..3.5 .,5 7.7 44.1 .5.1 231,1 183.3 65.8 478,0 J54.6 86.1 58.3 208.1 0.0 1.7 0,1
7,5 0.1
Wayne 71.3 15.2 87.2 35.5 8.3 30.6 14.9 21.5 76.3 21.8 101.6 516 ..1 50.1 15.9 13.3 6.2 67 2. 95 10.5 53.9 6.' 322.5 239.1 85.3 459.8 156.3 793 559 109.4 6.4 21.9 1.2 21.1 a.'
Wilkes 62.6 79 70. 5.3 82 11.5 240 274 80,6 11.6 93.1 6. 94 188 30.6 21,4 71 52 3.9 9.1 '.8 407 71 250.5 188.4 68.6 415.4 102.5 649 49.0 140.4 0.2 40 0.2 7.6 0.2
Wilson 71.5 16.5 89.0 48.2 9.5 19.5 10.6 19.1 63.4 "4 103.1 66.5 110 29.3 8.1 10.0 11.6 a3 2.3 10.6 11.2 57.9 7.5 3274 215.4 9.3 420.7 1680 67.3 43.4 132.7 13,7 67.9 1.6 53.9 15
Yadkin 67.3 10.4 7B2 3.7 9.3 8.0 22.6 17.9 64.9 14.0 80.0 7.6 11.9 18.4 30.6 10.8 4.6 4.5 a.' 5.5 '.1 45.7 6.6 240.7 176.4 58.8 462.6 133.9 76.6 45.2 151.7 0.. 4.' 0.5 10.3 0.1
Yancey 58. 61 65.2 1.3 69 9.6 195 18.4 63.8 5A 69.3 12 85 171 24.4 9.' 11 3A 3.4 6.7 7.7 43.7 64 2122 172.7 71.3 357.3 90.6 545 457 78.9 0.0 1.1 02 5.7 0.1
'live .births per 1 ,000 females 15.44 (15-19). 'Legal induced abortions per 1.000 females 15.44 (15.19) 'Pregnancies (reported
abortions, fetal deaths. and hvebu1hs) per 1 ,000 females 15-44 (15-19). "Based on race of mother. s5lbs. 8 oz. or less. "Late care
defined as flrst VIsit after third month. Information often based on maternal recall. 'Includes pnmary and repeat C-sectlon. 'All rates
ere average lor the5-yearperiod. 1995-99. "Slillbirthsof20+ weeks gestalionper 1.0oodeliveries (live birthS plus stillbirths) '"Deaths
under 28 days per 1.000 births. "Deaths 26 days to 1 year per 1.000 neonatal survivors (live births less neonatal deaths). "Deaths
under 1 year per 1.000 live births. URate age-adjusted to the 2000 U.S. population. "Deaths per 1.000 population. .$Oeaths per
10.000 population; consists of homicides, suicides. unintentional injUries. legal interventions "Deaths per 1 00,000 population. "1995-
97 reported cases per 100.000 population. The lemale breast cancer rate uses the female population and the prostate cancer rate
uses the male population In the denominator. "Cases per 10.000 population.
...
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STRATEGIC PLANNING PRIORITIES
December 19, 2000 Update
I. Access to health care
(Issues #7,11 & 5)
-+ Health Disparities: Lynda Smith is attending a statewide meeting December 12-13 entitled:
"The Great Divide: Understanding and Eliminating Health Disparities."
-+ Wilson Jewell and David McDaniel will meet with the New Hanover Community Health Center
Dental Advisory Committee on 1-18-01 to discuss the Strategic Planning Retreat and the issue of
access to dental care in New Hanover County We will discuss ideas of building additional
resources for providing dental care in our community such as adding another dentist to the staff of
the NHCHC Dental Program, expansion of treatment at Cape Fear Community College Dental
Programs, etc.
-+ WlC Caseload Increased: Right now we are 122% over our current case load assignment and
even 112% over last year's assigned caseload 12/5/00.
-+ Women's Health Additional Clinics: Additional clinics have been added to decrease the
backlog of 6 week waiting list/time frame
-+ Health Choice Waiting List: Enrolled over 69,000 (of the 71,000 projected eligible) children in
North Carolina for Health Choice Insurance since October 1998. Beginning Jan 2001, a waiting
list will be created. All re-enrolling families (renewals) will be honored, but the state may not be
able to add children.
. Beth Jones spoke with a dentist in the community who is one of few who sees Medicaid
clients. (Attachment 2)
. NHCHB approved a part-time school health nurse on November 1, 2000.
. Wilson Jewell met with the Wilmington Tri County Dental Society at their regularly scheduled
meeting on November 7 They discussed the need for more Dental services for Medicaid eligible
children in New Hanover County The group responded favorably to the possibility of the Health
Department providing dental care for this population in the future. Dr Jewell will talk to New
Hanover Community Health Center and Tileston Clinic about the possibility of expansion of their
dental services.
. Information on the cost of contract interpreter services and the need for the interpreter to be a
Health Department employee (Attachment 3).
. New Hanover Community Health Center' Brochure listing NHCHC staff and board was
distributed.
. Speech and Hearing Clinic: Has been discontinued at the Development Evaluation Center
(DEC). Resources redirected to newbom screening.
. Flu Vaccine: Yesterday was largest day in recent years with 371 shots given. Additional
shipments expected over the next two weeks. Assistance from other clerical and nursing staff
requested to provide relief in Communicable Disease. See Beth Jones or Kim Roane. Vaccine
now available for the general public and Health Department employees.
. Registration Area: New renovation being well received by customers. Thanks to Lynda and
Beth.
. Issues Associated with Treating Adolescents: An informational sheet from the Institute of
Government was copied to OD's (Clinical and legal issues to consider).
. Lenscrafters Vision Van: At the mall November 21-22. Exams and glasses are being
provided to students who have been unable to obtain an appointment.
.
II. Preventive services & lifestyle-related risks
(Issues #12 & 15)
-+ Commit to Quit: Registration begins January 1, 2001 Requirements for smoke-free testing
1
during February 1 to March 15. Celebration scheduled for March 15.
. NHCHB approved an asthma initiative grant application on November 1, 2000.
. Healthy Carolinians Conference: Lynda Smith, Elisabeth Constandy, and David Howard
attended on October 17-18. Healthy Carolinians 2010 N. C. Plan for Health and Safety, a Report
of the Govemor's Task Force for Healthy Carolinians, manual was passed around for review
. Diabetes Today' Ginny Peterson has replaced Trish Snyder as facilitator of this grant.
. Diabetes Coalition: Ginny Peterson, Diabetes Coalitions Coordinator, of second year grant
funding activities. UNCW nursing students to distribute Diabetes information on November 7 at
election poles. Sugar Angels Support Group meets monthly (2nd and 4th Saturday) to assist
patients and families with managing Diabetes.
. Asthma Task Force: Task Force to meet and review grant application for grants addressing
Asthma interventions and environmental issues affecting children with Asthma.
. Flu Vaccine: Three Categories (I, II, and III) have been established to determine the
administration of the limited supply of flu vaccine. Category 1 (those over 65 years of age or those
having chronic diseases) is the first group now receiving vaccine. Categories II (providers of care
for those in category I and others who are at risk based on care giving) and III (the healthy
population who want flu vaccine protection) should all be able to get the vaccine in the near future
(a week or two). General Clinic averaging 300 flu injections daily There should be enough flu
vaccine to supply all three categories. Flu injections were offered at County Fun Day to county
employees as traditionally done. Master cards had to be pulled for county employees. Health
Department employees are asked to get their vaccinations at the health department rather than at
the county fun day, which makes the workload issue easier IE pulling master cards and off-site
injections. The goal of the Communicable Disease Division is to get people immunized against
influenza. A compliment was extended to the General Clinic staff for their courteous, efficient
service from a client receiving a flu injection
. Inter City Rabies Clinic: To be held Saturday, November 4 at 5 Point Community Center
.
III. Communication, education & marketing (promotion)
(Issue #1 & 4 in part)
-+ Health Promotion: A handout was distributed to Management Team regarding the WAAV
Radio spots and the Airport displays.
-+ Wilmington International Airport: Became smoke free on December 18.
-+ Car Seats: Please advise customers to call David Howard (6636) or Elisabeth Constandy
(6658) for an appointment to receive a car seat. Walk-ins are difficult to manage.
-+ Communication, Education and Marketing Sub-Committee met on December 6, 2000
(Attachment 7).
-+ New Health Promotion Brochure: Available through Pat Johnson
-+ TV Spot-pet adoption: TV spot last night (12/4) regarding adoption of pets as holiday gifts.
Not good to do because many are returned later (Will mention again on Thursday on WAAV )
-+ World AIDS Day-TAP had activities in high schools. TAP peer educators and Jessica Nakell
attended Govemor's Volunteer Recognition in Raleigh on 11/28/2000.
. A concern was addressed from staff that management team meeting information was not
being shared consistently throughout the department. It was recommended that we publish
minutes from our management team meetings each week and distribute to staff. The first official
minutes were distributed to staff on October 17
. Group #3 Task Force (Communication, Education & Marketing (promotion)) met November 1
Our plans are as follows: Investigate specific signage for consistent display of prevention
messages; Discussed infant car seat instruction; discussed Latino education and the need for
emphasis on English as a second; and established a regular meeting time - monthly - immediately
following BOH meetings.
. Communicable Disease Division educational messages (Attachment 4).
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. Cold Weather Care of Animals: Press release on October 9.
. 2nd Case of Rabies in 2000: A child is being treated for a raccoon bite.
. Latino Fest: Volunteers needed on November 4.
. Health Fairs: Health Promotion is screening events for participation by Health Department.
. Seafood and Jazz Festival: Laboratory and CDD staff provided STDIHIV testing and
counseling at the Seafood and Jazz Festival on October 21
. Web Page Update: Submit web page updates to Dave Rice.
. Child Health Month: More than 200 outreach contacts made during October
. Maternity Wellness Fair' Scheduled for November 1 at Health Department.
. Mundo Latino: Advertising in monthly newspaper discussed.
. "Eat for Pete'" Fund-raiser for Animal Control Services Trust Fund, November 5-11 at
participating restaurants.
. Maternity Wellness Fair "9 Months & Then" was a very successful event.
. Health Department Display at Airport: Changed to Smoking Prevention on November 6
. General Waiting Area Bulletin Board:
. FY 1999-2000 Annual Report: Going to printer today Will be available on December 6.
. WAAV Radio Vacancies: January 2 and 30, February 13 and 27 available.
.
IV. Facility utilization & Information technology
(Issues #6 & 4 in part)
-+ NHCHD Parking Lot: Lighting of the parking lot is an ongoing issue. Health Director will
discuss with Assistant County Manager
-+ Meeting Room Committee: Will address security of NHCHD building due to after-hour
meetings.
-+ Personal Computers: Some of the ordered PCs are expected to arrive this week,
December 22.
. Formed two task forces regarding issues relating to facilities and information technology
Facilities Task Force members: Betty Creech, Beth Jones, Nancy Nail, Lynda Smith, Tom Stich,
Diane Vosnock, and Edwin Link. Information Technology Task Force Members: Frances DeVane,
Cindy Hewett, Susan O'Brien, Jean McNeil, Betty Jo McCorkle, Sharon Neuschafer, and Marilyn
Roberts.
. Updates on Facilities Task Force (Attachment 5).
. IT Strategic Planning Committee met on November 14 (Attachment 6)
. New Hanover County IT Training Center' Operational. Health Department is documenting our
needs.
. Information Technology' Installation of fiber line at New Hanover Network is complete. Staff is
working with ICD9/CPT Code conversion daily
. SEMH Facilities: Letter drafted to County Manager regarding the status of Southeastern
Mental Health facilities, should they become available in the (distant) future.
. Information Technology Task Force: Developing an assessment tool for input on information
technology issues.
. Tracking Database: Currently working with NHC IT Department to implement tracking
database for staff to use related to computer issues.
.
V. Water quality, storm water management & drainage; & Air
quality (Issues #3 & 8)
. Dianne Harvell is assembling a listing of county & state agencies other than NHCHD who
monitor air & water She plans to contact them & request their data/interpretation of their data.
This should paint a picture of what is now known re: quality of our environment & should give us
some direction as to where we should proceed. Also, She is working wlmanagement support staff
3
to develop new systems of managing data we now receive, i.e. groundwater contamination, sewer
spills, etc.
.
VI. Emerging health risks
(Issue #13)
-+ Shigella Outbreak: Two childcare facilities are involved. Working proactively to identify cases
and exclude positives before the epidemic stage.
-+ Listeriosis: Latino/Hispanic population needs to be educated about making homemade cheese
from unpasteurized milk. Fetal deaths have occurred in Forsyth County
-+ Polio Outbreaks in the Dominican Republic and Haiti: People immigrating to NHC should have
immunization status assessed
. Mosquito Control: New wetland sites that breed mosquitoes are being located for next year's
plan of attack.
. West Nile Virus: Health officials announced a dead crow found by a biologist at Jordan Lake
last month tested positive for the West Nile virus (the first incidence of the mosquito-borne disease
in N. C.).
. Rabies: 3rd positive case in 2000 (59 since 1996) confirmed. Located on North Hampton.
. Public Health Preparedness Grant through UNC-SPH.
.
VII. Population growth & diversity
(Issue #2)
-+ HOLA Educational Meeting: At 12noon 12/5 at Canterbury Annex; all welcome; speakers
Danny McComas and Ken Hatcher (Attorney) on Hispanic issues.
. Mundo Latino: Advertising in monthly newspaper discussed.
. Information on the cost of contract interpreter services and the need for the interpreter to be a
Health Department employee (Attachment 3).
. The Great Divide: Understanding and Eliminating Health Disparities Conference on
December 12-13.
.
VIII. Discontinued services picked up by Health Department
(Issue #9)
. Child Birth Classes from NHRMC and Coastal AHEC.
. Discussions regarding Home Health and Coastal Diabetes
.
IX. Staff Development & continuing education
(Issue # 14)
-+ Budget Training: Health Department staff attended the NHC Budget Refresher Training on
December 12.
-+ Disciplinary Action Training: Rescheduled for January 23, 2001
-+ Performance Appraisal Workshop: Attended by some supervisors the week of December 4
-+ Food Safety Workshop: Public Health Ground Rounds will broadcast a national workshop on
January 26, 2000 from 2-3 pm. Dianne Harvell will contact Coastal AHEC for arrangements.
. Substance Abuse Workshop: November 3 in Auditorium.
. Health Directors' Legal Conference: on October 18-19.
. Employee Training and Development Program: Supervisors are encouraged to focus on the
Supervisory Training. A basic supervisory course is a prerequisite to other training opportunities.
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. New Hanover County IT Training Center' Operational. Health Department is documenting our
needs.
. Disciplinary Action Training: Scheduled on December 19 after Regular Management Team
meeting at 8:30 a.m. in Conference Room at 9:00 a.m. in the Health Department Auditorium.
John Beasley, training facilitator Copies of Disciplinary Action Section, Personnel Manual of
Local Government Employees SUbject to the State Personnel Act, to be distributed during the
training. All Health Department supervisors should plan to attend.
. How to Help Kids Succeed: Child Health staff participated in parental in-service on Saturday,
October 30, and reviewed book entitled How To Help Kids Succeed.
. Health Insurance Portability and Accountability Act (HIPPA): Seminar on November 1-2.
. American Public Health Association Annual Meeting: David Rice circulated the meeting
sessions to Division Directors for review. He handed out information on performance standards
and Healthy People 2010.
. Environmental Health Supervisors Association Annual Meeting: Alicia Pickett presented our
experience with the Food Grading Pilot Project. Mixed reviews of the project across the state of
NC.
. Public Health Series: On Public Events Network. Begins November 16 at 9:00 pm. Will
continue on 2nd Thursday of every month.
. Asthma and Indoor Air Quality issues: Tom Stich attended this workshop in Greenville N.C.
. Volunteers: volunteers with public health background asking for relevant assignments.
Volunteer recognition event has been scheduled for February 8, 2001
.
X. Evaluation of services
(Issue #16)
-+ Pay and Classification Study' New Hanover County will implement results of the study during
the January 23 - February 5, 2001 pay period.
-+ Medicaid Cost Study' Scheduled December 13, 2000. We are still waiting an answer as to
whether July-September 2000 data will be included. We are proceeding as if it is.
-+ Perinatologist (Dr Hag): @ NHRMC is researching perinatal stress events related to
hurricanes. Questionnaire/regional coordination with assistance by Health Department
. Organizational Capacity. Yesterday, the AEIOU Team reduced the number of indicators to
evaluate to 23. Staff improvement teams will be formed when opportunities are identified from
these indicators. Please contact an AEIOU Team member for more information.
. Strategic Planning Priorities: Displayed on walls of Health Department Conference Room,
Auditorium, and on bulletin boards. Facilities Committee will meet in Mid-November and discuss
health department signage. Information Technology (IT) Committee plans to meet also in
November
. Fee Policy Update: Will be distributed to Staff after NHCBH approves.
. Medicaid Cost Study' Reports for this study will be printed and distributed.
. Volunteer Hours: Should be tracked for all divisions. Committee formed to address this issue.
. FY2000-01 Vacancies and Overtime Information: Information being gathered for the Budget
Office.
. Travel Expenditure Reports: Appropriate reporting by employees and the review of reports by
supervisors was discussed.
. WIC On-site Printing of Vouchers: Vouchers are now being printed, effective November 20.
Training has been provided for Health Department employees. HSIS identification is being set up
for staff requesting access to W1C data.
. AEIOU Team: The form for suggestions was again discussed and will be made available at
Staff bulletin boards.
. Pay and Classification Study' New Hanover County will implement results of the study during
the January 23 - February 5, 2001 pay period. According to The Morning Star, the Health
Deoartment will receive $353,338 of the $1.8 million allotted to implement the pay and
5
classification study in FY 2000-01
. Credit Cards: A demonstration relating to the use of credit cards will be held November 29 at
10am.
. Community Health Assessment: Will be submitted to State this week.
. Volunteers: Committee met to discuss method of reporting volunteer hours worked.
Recommendation was for every Division to use draft form and submit it to Kim Roane monthly
Management Team approved the form.
. Management Team Composition: Dave Rice announced the composition of the Management
Team, effective December 5, 2000. The members are: Frances DeVane, Jean McNeil, Beth
Jones, Betty Creech, Dianne Harvell, Lynda Smith, Betty Jo McCorkle, Janet McCumbee, Nancy
Nail, David McDaniel, Susan O'Brien, Cindy Hewett, Elisabeth Constandy, and Dave Rice.
.
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17m STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
Everywhere. Everyday. Everybody.
DAVID E. RICE, MP.IL, MA.
Health Director
LYNDA F. SMITH, MP.A.
Assistant Health Director
December 11, 2000
Dear Betty.
Please share our concerns and suggestions below with Mr Rice and the Board of Health as appropriate.
As school nurses, we see many students in need of dental care. Since dental reimbursement is minimal and most
~tists will not accept Medicaid and/or Health Choice, neither of these pay sources has really impacted dental services
.. the children. The need for dental care for children continues to be enormous. Changes need to be implemented.
As health care providers and concerned citizens, we urge your support in encouraging legislation to improve
reimbursement rates to dentists. Also, we would encourage your support in asking every dentist in New Hanover County
to provide dental services to children who receive Medicaid and/or Health Choice. This would greatly improve the dental
services for the children in New Hanover County Since transportation and keeping appointments is a problem, maybe
the Department of Social Services could issue transportation vouchers and encourage parents to keep their appointments.
As school nurses, we certainly are supportive and encourage good dental care for all children. We solicit your
support and the support of every dentist in New Hanover County
/#/-/:1, .cJ"O
Sincerely,
&rwJ, ~ ~ ~ ~~ ~~ ~\\~
tl f#U/I Dd ~ ~ School Health Nursing Team
()u(.cl p~1 ~ ;6ccuc/. Community H i sinn
j4>....<vcv.&.J ~ ~ t:J~~;:J ~
1 wcu::U ~ At~JziJ ~4- ~~ I iW
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~:t~ ~"YourHea1 -Our9n~riti'O ':r;;N
/ ~ ~
. J~ ~1.10J
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MEMO
To: Mr. David Rice
From: Jessica Nakell
Subject: Information about the Ryan White National Youth Conference for Board of Health
Members
Two peer educators from the Teen AIDS Prevention (TAP) program recently won full
scholarships to attend The Ryan White National Youth Conference on my and AIDS in Denver,
CO in February. The two peer educators, Bridgette Jamison and Megan Phillips, wrote essays to
the Ryan White conference committee, and, based on the quality of their essays, received
scholarships to the conference. Over one hundred adolescent peer educators nationwide sent in
essays to the scholarship committee, and only fifteen of these students won scholarships. Out of
the fifteen winners, two of them are from the TAP program, based in the New Hanover County
Health Department.
The conference coordinator, Mr. Robert Warren, stated that he was impressed by Megan's and
Bridgette's well-written essays. The essays listed the numerous activities that both Megan and
Bridgette have accomplished as peer educators. Both Megan and Bridgette are founding peer
educators of TAP, and have been in TAP since it began almost two years ago. Both women have
helped to train two successive groups of peer educators, and serve as role models and leaders for
the newer peer educators. They have given TAP presentations at sites such as the following:
Oirls, Incorporated, New Hanover Health Network's OB/OYN teen clinic, the Derek Davis
Recreation Center, the Nesbitt Courts Recreation Center, the Adolescent Parenting Program, the
Hope Baptist Church youth group, the Grace United Methodist Church youth group, all "J'i' and
8th graders at Noble Middle School, UNCW, and Cape Fear Community College.
The Ryan White National Youth Conference on my and AIDS is the only national conference
solely dedicated to building the skills of young AIDS activists, youth peer educators, and those
who work in support of young people. Through interactive breakout sessions and peer-led
workshops, the goal of the conference is to increase awareness about the threat my infection
poses to young people, to identifY and share effective resources to help in the fight against mv
among young people, and to comprehensively develop youth appropriate services to those who
are infected or at risk. In her essay, Bridgette wrote: "I expect to contnbute my open mind and
ears to this conference in order to gain knowledge from the speakers to take back to my fellow
peers. With an open mind and ears, I will be like a vessel (ship) at the dock of the bay; just
waiting for someone to come aboard and fill me with cargo (information) needed to go out on the
open sea."
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e
National Association of Local Boards of Health
r
"-.."
Published for Members of Local Boards of Health
President's
Message
By Vaughn Upshaw, EdD, DrPH
November 2000
Boards of Health
and the Public
Health Workforce
Over the past few years, attention to the needs of the public health work.
force at national, state and local levels, and questions about the quality
and capacity of the workforce in public health have become more press.
mg. In this article, I want to raise a few of the workforce issues that
need to be addressed by local boards ofhealth, including:
. Why should local boards of health be concerned about the public
C health workforce?
I What do we still need to know about the public health workforce?
. Who is responsible for preparing and equipping the public health
workforce?
. How can NALBOH help local boards of health in fulfilling their
responsibilities for the public health workforce?
. What can local boards of health do to affect public health workforce
issues?
So, why should local boards of health be concerned about the public
health workforce? We are all aware of increasingly complex public
bealth issues. Our ability to reduce health disparities, lower rates of pre.
mature death and disability, protect the environment, and respond to
natural (or man-made) disasters depends upon our ability'to access mul.
tiple resources. including new technologies, methods, and money Re-
gardless of the issues we want to address, the development of sound
strategies and programs designed to positively affect current and emerg.
ing public health issues requires highly skilled people who are able to
anticipate and respond to these challenges.
There are many things that we do not know about the public health
workforce. For instance, we do Rot really know how many people actu.
ally work in public health. Should we inclnde people employed in hospi.
tal.based community outreach programs in the public health workforce?
If so, how do we track and enumerate all of these individuals? At pre-
sent, there are no reliable data describing the size, composition, or distri-
bution of public health workers. Nor is there information about whether
public health workers are employed in the public. nonprofi~ or private
e (Continued on page 1)
New Tools for Preventing Youth Violence
By Centers for Disease Control and Prevention
COC's National Center for Injury Prevention and Control (National
Injury Center) recently released two new resources to support pub-
lic health professionals as they work to prevent violence among oW"
nation's youth. The first is a web-based youth violence prevention
resoU1Ce center and the second is a best practices sourcebook. Both
resources provide ready access to materials the Nationa1lnjury Cen.
ter has developed over two decades of efforts to identitY, imple-
ment. and evaluate prevention strategies to reduce the spread of
youth violence.
Violence among children and adolescents is a significant public
health concern. In 1998, violence claimed the lives of more than
3,400 Americans ages 19 and under-that's an average of9 deaths
per day As a result, local public health practitioners are increas.
ingly involved in identitYing and implementing interventions to
prevent youth violence. The National InjUl)' Center's new tools can
help them do that job more effectively
The National Youth Violence Resource Center, designed and
developed in partnership with the White House Council on Youth
Violence, features a toll.free hotline, web site, and fax-on-demand
service. The Resource Center offers a single point of access for im-
portant infonnation about preventing youth violence and suicide.
Many of the materials and interventions are designed to assist pub.
lie health officials in addressing and raising awareness of youth
violence and suicide at local. state, and national levels.
The Resource Center's website is www.safeyouth.org. In addition
to serving the public health community. the site includes separate
sa:tions for parents and teens. The hotline is available Monday
through Friday. 8 a.m. to 6 p.m. EST, by calling 1.866.968-8484.
After hours and on holidays, callers can leave a message for follow.
up on the next business day The fax-on-demand service is available
anytime. Both the hotline and web site are presented in English and
Spanish.
Best Pramces of Youth Vwlence Prevention: A Sourcebook for
Community Action offers insight into what works to prevent youth
violence. It is the ftrst publication of its kind to look at the effec.
tiveness of specific practices in four key areas: parent- and family-
centered activities. home visits, social and conflict resolution skills,
and mentoring.
(Continued on page 2)
November 2000
NALBOH Newsbrief
Presidents Mellsage_. (Continued from page 1)
for profit sectors; what types of organizations they work for; what types
of training and education they have; and what the pay scales are for pe0-
ple working in public health.
Why should local boards of health be interested in these issues? Well,
in many jurisdictions, local boards of health have authority to hire,
evaluate and fIre public health professionals. In addition, local boards
may be responsible for rewarding the efforts of public health employ.
ees, adopting policies that affect public health workers, hearing griev.
ances, and establishing pay scales. In summary, many local boards of
health are on the front lines of assoring that their communities employ,
retain and reward qualifIed public health professionals.
How is NALBOH involved in these issues? Your NALBOH represen.
tatives are participating in 8 number of activities and are working to
include our members' concerns and priorities in public health workforce
discussions. Efforts are underway to develop specific competencies for
public health professions - for instance, what specifically, should a
qualified environmental health specialist be able to do? In many eases
the basis for judging quality work is determined locally, resulting in
high variability and inconsisteney across a region or state. If, as a local
board of health member, you are responsible for evaluating the quality
of a public health employee's work, do you have the information you
need?
Currently, there are initiatives focused on creating standard credentials
for public health professions. As a multidisciplinary profession, there
are some employees in public health who receive a credential that pro-
vides evidence that they posses certain skills and knowledge. For exam.
pie Community Health Education Specialists (CHES) receive certifica.
tions, nurses and physicians must be licensed, environmental health spe-
cialists must be registered. Would your board of health support addi.
tional "certifIcation, registrations or licenses" for other public health
employees? As these discussions unfold, you can be assured that NAL.
BOH members are participating in discussions and are making certain
that the needs and concerns of local board of health members are in.
cluded in decision making.
How can you and your local health board participate in this effort?
First, you can assist NALBOH by helping us collect data on the public
health workforce in your jurisdiction. NALBOH is interested in getting
information about the people performing public health activities who
are employed within and outside traditional health departments. For
example, are school health nurses in your jurisdiction employees of the
health department or of the local school system? Ldcal boards of health
can also assist with this process by advocating and promoting a highly
trained and qualified public health workforce.
The NALBOH New,Brief
is published by the
National Association of Local
Boards of Health
1840 East Gypay Lane Road
Bowling Green. OH 43402
Phone: (419) 353.7714
Fax: (419) 352-6278
E-mail: nalboh@na1boh.org
Website: www.nalboh.org
NALBOH Officers
President
President-Eloct
SecretaJyffreasurcr
Past President
President's Message...(Canfinued)
Local boards of health understand that quality public health ~
programs at the local level depend, in large measure, on the '0
capabilities of the local public health workers. As local board
members, we can help raise awareness among the general public
and among our elected officials about the need for a strong public
health workforce. Your efforts at the local level are critieal in
assuring that public health can attrac~ recruit, and retain the best.
trained public health work force. Only with high quality
professionals can we establish and maintain cost-effective
prevention and early intervention programs that are able to
improve public health outcomes for the entire popu1ation. 0
Preventing Youth Violence... (Continued from page 1)
The sourcebook is designed to help communities develop and im.
plement violence prevention programs. The information it shares is
drawn from the experiences of public health professionals and ad.
vocates who have successfully worked to prevent youth violence in
their communities.
Best Practices of Youth Violence Prevention: A Sourcebook for
Community Action is available free through the National Violence
Prevention Resource Center by ealling \.866.968.8484 or by visit.
ing the Resource Center online at www.safeyouth.org. A Spanish
version of the sourcebook will be available soon.
"Unfortunately, we believe that violence will continue to be an
important issue in public health practice," said Rodney Hammond,
Ph.D., director of the Division of Violence Prevention for the Na.
tional Injury Center. "The Resource Center and our sourcebook
provide valuable support and promising interventions for commu. ~
nity.based initiatives." J
For more information, contact the Division of Violence
Prevention at 7704884646. 0
Check Out Our New
Improved Webtite!!!
www.nalbob.org
If you have not checked out our website, then now is the time.
With the help of Grace Serrato & Jennifer O'Brien, our website
has really expanded. We are trying to meet the needs of all
NALBOH members.
We welcome suggestions on how to improve our site.
Remember our goal is to assist local boards in
providing up to date infonnation and training.
Marie M. Fallon, BS
Edwin "Ted"Pm.tt, Jr.,
MPA
Rebecca Edwards, MPH
Sorah Chord. MA
Sylvia Beck, MPA
NALBOH Trustees
North Atlantic Richard Kanoff: ID (MA)
Mid Atlantic John C. Saccenti, MA (NJ)
Southeast 1. Frederick Agel (GA)
East Great Lakes Jim Rccchio (OH)
West Great Lakes Ken Hartke (IL)
Midwest Diane Wartgow (CO)
West Connie Tattoo (llT)
State Affiliate Phil Lyons (UT)
State Affiliate Ned E. Baker, MPH (OH)
Vaughn Upshaw, EdD, DrPH (NC)
Harvey Wallace, PhD(MI)
Stephen Papenbcrg (NJ)
Grace Duncan, RN, BSN (OH)
NALBOHSlatT
Executive Director
Director of Liaison and
Governmental Relations
Project Director-Tobacco
Project Director-Training
Director ofMembcrship
Services
Program Coordinator
Administrative Assistant
The production and distribution of tld8 publication are
supported by funds from the Centers fur Di5eue Control.
lUlCI. Prevention.
~
Page 2
Jennifer O'Brien, MPH
Gnoce Serrato
NALBOH Newsbrief
November 2000
Your Untapped Resource
By John Saccenti
O~everal }ears ago, NALBOH establishedthe membership category of
), retlfed board of health member. By dOIng so It allowed local board
- of health members who leave active board service in their community
to maintain a professional membership and keep up with public health
trends and training for a mere $10 per year.
Now don't think that I am rushing you out the door and selling you on
joining NALBOH as a retired member when you leave your board.
(Although keep this in mind for future reference.) Rather, what I want
to point out to you is the often untapped resource in your community
consisting of former members of your board of health.
People leave board service for a variety of reasons: changing political
fortunes, relocation, personal or business commitments to name a few.
However, for the most part, people serve on a board of health because
of a heart felt interest in public health and community services.
These individuals have developed a wealth of information, ideas and
experience through their service that often gets lost when they leave a
board. Most retain their interest in public health and may be willing to
serve as a community resource for your board.
It is time for you to reach out to them as needed to assist you.
Potential activities include:
I. Organizing community support for your budget;
2. TestifYing at local and state level hearings when public health
ordinances or bills are being considered;
3. Participating in round table discussions to assist in identifying
community needs;
Writing articles on public health related issues for local newspa-
pers~
Serving as volunteers at clinic and outreach programs.
o
5
The list of potential ways of utilizing your "retired" board member is
limited only by your imagination. So reach out and expand your pub-
lic health community resources. 0
Request for Articles and Meeting Dates
NALBOH would like to receive papers and articles for future
issues of the NewsBrief If you have a topic which would be of
interest to other local boards of health, please let us know We
would also be interested in publishing upcoming conference an-
nouncements and meeting dates. The next publication deadline is
January 1,2001.
Please mail your items to NALBOH at 1840 East Gypsy Lane
Road, Bowling Green, OH 43402, fax to (419) 352-6278, or
e-mail us at marie@nalboh.org. 0
c
I,
I
:1
Report from Washington
By Edwin "Ted" Pratt, 'r,
Director of Uaison and Gouernmental Relations
I al\ended the All-American Quarter Horse Congress in Colum-
bus, Ohio last week for a couple of days, my wife being a hunter
under saddle rider. While there I observed a vet using the indus-
trial solvent DMSO on a horse's leg to relieve some form of
arthritis pain that was bothering the poor animal. Knowing that
DMSO is a known carcinogen and not for use on humans, I asked
the vet how he could use it on a horse. I was quite opse\ about it
until he pointed out that with an anticipated life span of less than
30 years, the horse did not live long enough to be threatened by
the possible effects of DMSO. This left me musing about the
implications posed by increasing human life span for those of us
who are charged with developing and implementing policies to
protect the public's health.
Take environmental tobacco smoke (ETS), for example. In the
mid-1930s average life expectancy in the US was just about 60
years, which might yield an average working lifetime of 35 years.
Since the effects of ETS may generally take longer to affect
health status than the direct use of tobacco, it probably had only a
very modest impact on the working life span of Americans. In
addition, in the era before antibiotics and most vaccines, ETS
certainly was not a public health priority. Now fast forward to
today, where adult Americans have an average life expectancy of
over 72 years, with their children and grandchildren hearing of
the promise of that increasing to even greater lengths. I have
heard the age of 100 meotioned as a plausible average expected
life span for some elements of the US population in two or three
generations. That would be our great-grandchildren, who many
ofus will live to see born!
Such an increase would also represent a near doubling of the ex-
pected years of life since the 1930.. The average working life-
time in 2040 would then be longer than the average toIal number
of years lived in 1930. And so, exposure \0 ETS suddenly has the
very real possibility of cutling off not just a few last years of
some lives, but many years out of the working life time of a sig-
nificant number of those exposed to its effects. This would be
especially true for the very young, the new members of the up-
coming long-lived generations. These children are heing born
today. They need protection today!
""
The same will be true for exposure to man-made chemicals in the
environment and in food, exposure to ultraviolet radiation result-
ing from ozone depletion, and the mental health effects of stress
and socioeconomic factors. We in public health have to shift the
paradigm in which we think and act. We must help the public
that we serve to better understand that the primary guide to medi-
cal practice "fITS\, do no harm" must become our society's guide
for the introduction of new products, the expansion of existing
activities, and the review of what we actually do currently We
all must remember that the promise of increased years of life only
makes that which can cut them short through disease, poisoning,
violence and mental illness a greater threat to the public health.
After all, if horses today lived only as long as humans did in
1930, no responsible vel would use DMSO to treat their pain. 0
Page 3
November 2000
NALBOH Newsbrief
A Look at the Membership
,.-1
Q>
NALBOH Membership Continues to Grow
The year 2000 was a banner year for NALBOH membership. 603
boards of health enjoy a voting membership in NALBOH. Ten state
associations of boards of health also are members. Associate mem-
berships number 50 for a total of 663 memberships. This represents
approximately 4000 individual board of health members.
The year 2000 was also a very successful year for NALBOH involve-
ment. Under the guidance of NALBOH President, Vaughn Mamlin
Upshaw, NALBOH has been able to accomplish the following:
. Live telecast of the first Ned E. Baker Lecture Series from
Bowling Green State Univer.;ity presented via live telecast to
boards of health across the country and video distribution to all
NALBOH members
. Pilot tested Governance Standards in collaboration with COC,
APHA, ASTHO, NACCHO, and PHF, as part of the National
Public Health Performance Standards Program
. ,Produced and distributed a state-by-state guide on Legal Au-
thority for Tobacco Control in the United States in hard copy
and CD
. Established a Government Liaison Representative in Washing-
ton, DC
. Developed an environmental health primer for local board of
health education
. Releasing a board of health governance training video tape in
partnership with HRSA
. Convened the 8" Annual NALBOH Conference in Raleigh,
North Carolina and,
. Developed a public health resource guide to the internet,
available on our website
The Membership Committee has set a goal of 800 board of health
members for the 200 I membership year.
Member Sponsorship Opportunity!
Any current member who sponsors 3 new NALBOH members
prior to June 1,2001 will receive an tItra 10% reduction in regis-
tration for the Annual Conference in OeveIand, OH. Simply send
in the names of the boards you are sponsoting as new members, with
a contaet person for each. Your new sponsorees must also complete
and mail in membership forms for confmnation. For more contest
information, refer to the NALBOH website: <www.nalboh.org>
For those of you who have not yet experienced the benefits and
camaraderie of meeting with other NALBOH board of health
members from all over the country, just try it - you'll like it. See
you in Cleveland.
Proactive Steps by Local Board Help
Resolve Wastewater Treatment Issues at
Important Recreational Area
Joan Miles, Health Officer
S_ /(jlbreath, R. S
Alicitl Pichette, Chair
Lewis and Clmk City-County Health Department
Canyon Ferry Reservoir lies 15 miles southwest of Helena, Montana
below the headwater.; of the Missouri River. In the late 1950., the
Montana Department of Fish, Wildlife and Parks, the managing en-
tity for the U.S. Bureau of Reclamation (BOR), initiated a lease pro-
gram which allowed for the development of 265 recreational sites
along the perimeter of the lake. All but two of the parcels were cre-
ated on less than one acre, most of which were located on steep,
rocky slopes adjacent to the lake.
Cabin construction on many leased parcels occurred during the next
15 to 20 years, prior to the time that regulations had been estab.
Iished for individual wastewater treatment systems in Lewis and
Clark County. The facilities which were installed to serve the cab-
ins ranged from open-pit outhouses or seepage pits to small, steel
tanks with limited drainfields. Because of physieal limitations,
many were located within 50 feet of the lake or in close proximity to
drinking water wells. Adequately sized concrete tanks and drain-
fields which would effectively treat sewage and protect public
health were the exception to the rule. Although the uriginal intent of
the leases was for seasonal use only, many cabins were soon used
year round or as permanent residences. This further complicated the
inadequacy of treating large volumes of sewage in this very sensi-
tive lakeside environment
o
In 1973, even before the State of Montana developed minimum
standards, the Lewis and Clark City-County Board of Health
adopted local regulations for the installation of septic systems serv-
ing private dwellings. Nevertheless, since many sites had already
been developed at Canyon Ferry by 1973, these systems, even
though they did not meet minimum standards, were "grandfathered"
in until needing replacements.
Two events took place in the last five years, however, which have
drarnatieally improved sewage treatment in Canyon Ferry The flISt
was significant assistance from the BOR in 1995 when it took over
management of the leased sites.
In an effort to protect the lake from sewage contamination, the BOR
instituted a lease requirement that all septic systems, including those
previously grandfathered, be evaluated and permitted by the health
department. Systems that did not meet requirements either had to be
upgraded or new systems installed by September of 2000.
For the next several years, staff of the Lewis and Clark Health De-
partment methodically researched records and physically reviewed
the sites. It was determined that only about 70 of the 265 sites had
valid permits issued sometime between 1973 and 1995 which met
standards. Approximately 65 other sites were issued permits to up-
grade or relocate septic systems or wells in order to comply with the
board of health's regulations. But almost 130 sites were determined J
to be inadequate to support standard septic systems which met pub-
lic health standards. In some instances, staff encouraged the lessees
to consider the use of alternative technologies or advanced systems.
(Continued on pQge 5)
Page 4
NALBOH Newsbrief
November 2000
c
Proadive Step. (Canlinuedfrom page 4)
In other cases, the lessees and BOR were encouraged to consider the
possibility of leasing adjacent land for individual or multi-family sys-
tems. Without incentives to pursue some of these options, however,
little progress was made and the problem sites remained just that-a
problem.
The second, and most important, event was a fannal fooetion taken
bv the board of health following the 1998 passage of federal legisla-
ti;'n which allowed for the sale of leased lands at Canyon Ferry and
transfer into private ownership. (The sale of properties has not yet
begun, but by statue, it is to commerce no later than November 29,
2000.) This legislation was the "wake up " call for the board of
health. With the likelihood that more cabins could be converted to
year-round homes equipped with appliances generating wastewater,
the board recoguized that permanent solutions needed to be found for
sewage treatment on these parcels before the sites went into private
ownership.
In a strongly worded resolution passed on January 18, 1999, the
board stated its intent to not approve requests fOT variances or exemp-
tions from minimum public health standards for septic systems at the
Canyon Ferry cabin sites. While some interim measures such as use
of holding tanks, would be allowed, the board clearly put the
community and the BOR on notice that inadequate and noncompliant
septic systems would no longer be allowed at the lake.
co
Equipped with this strong directive from the board, staff was able to
bring the involved parties together to work toward viable, long term
solutions for the wastewater situation at Canyon Ferry As stated by
the staff person primarily responsible for this area, ") was able to do
my job and do it correctly without pressure from the public. By rely-
ing on the board's resolution, I had the confidence to work through
difficult solutions and say 'no to the lessees when necessary I just
had to show them the board's statement and then they were ready to
look at other options." The board"s decision to clearly inform the
lessees that public health standards would not be waived finally pro-
vided the impetus for fmding better solutions for the remaining 130
lots not able to accommodate standard, on-site systems.
As a direct result of this resolution, 82 individuals systems were
moved appropriate distances from the lake or utilized alternative
technologies to meet standards. There are now 13 multiple family
systems serving from 2 to 4 residences, and plans are being finalized
for a 14 unit shared system which will convey wastewater away from
the lake to an area where proper treatment can take pla~e. To accom-
modate for some of these larger systems, the BOR has dedicated mul-
tiple areas in perpetuity for pennanent wastewater treabncnt sites.
The fmal provision of the resolution calls for the board to revisit the
issue in January 200 I '"10 determine ilS effectiveness and whether
long-term solutions have been established for the Canyon Ferry cabin
sites." It is already clear the answer to both of those questions will be
a resounding '.yes." 0
Showcase Your Efforts
(I
NALBOH is interested in learning about local boards of health
involvement in reducing health disparities within their jurisdic-
tions. Please e-mail <marie@nalboh.org> or fax a short de-
scription of your efforts and contact information at (419) 352-
6278
'I
:1
Flu Season News Flash
L. Fleming Falton, 'r., MD, PhD, DrPH
Recent news reports of a potential flu vaccine delay and shortage
could discourage many Americans from receiving their 8IUlual flu
shots. This could result in many people being at risk for life threaten-
ing influenza and pneumonic infections, especially for the nearly 16
million Americans with diabetes and other chronic diseases.
As boards of health, you can help encourage and inform the at risk
population of the importance of getting their flu shots as early as pos-
sible, butlatcr is better than not at all.
This is the season for influenza and other respiratory diseases such as
pneumonia. The makers of over-the-counter preparations have their
products ready The experts have made their predictions about the
strains of influenza and pneumonia that will attack in the months
ahead.
The Centers for Disease Control and Prevention reminds everyone
that fall is the time for an 8IUlual influenza vaccine. Pneumonia im-
munizations are also available. A flu shot is free for those 65 years
and older who are enrolled in Medicare Part B.
The Centers for Disease Control and Prevention offers both data and
guidance on this issue, as follows:
.
Experts recommend that anyone over the age of 50 should be
immunized for influenza and pneumonia. Further. people with
chronic conditions such as diabetes, heart disease, breathing
problems, cancer or AIDS should be immunized. It is highly
recommended that those in regular contact with the elderly or
frail get influenza or pneumonia shots.
Between 50 and 60 million people will become ill with influenza
or pneumonia before summer. This translates to about one per-
son in five in the United States. While pneumonia or the flu is
an inconvenience to many. it has the potential to kill others.
About 6,000 people die from influenza each year in the United
States.
Over 125,000 people are hospitalized with pneumococcal pneu-
monia each year and 10,000 die from it annually Pneumococcal
refers to a strain of bacteria. Viruses can also cause pneumonia.
People with diabelcs are at increased risk of attack from these
two diseases. These persons are about three times more likely to
die from pneumonia or influenza than are those without diabetes.
The same people are more likely to be hospitalized doring an
influenza or pneumonia epidemic. The presence of cardiovascu.
lar disease further increases the risk..
Adequate sleep is important. Limited or interrupted sleep pat-
terns are stressful to the body A vOld extreme exercise or rapid
weight loss. All of these activities can weaken the immune sys-
tem.
The fIrst line of defense against any infection is good hand
washing. .
Eat a well-balanced diet. This provides the body with nutrients
needed for health. Drink plenty of water or other fluids.
.
.
.
.
.
.
~
.
For further background information on CDC's Diabetes Flu!
Pneumococcal Campaign. visit their website at www.cdc.gov/
diabeteslprojectsledc-flu.htm or call 770-488-5131.0
Page 5
r
November 2000
NALBOH Newsbrief
NALBOH's 9th Annual Conference Update
Cleveland, Ohio
July 25-28, 2001
Ohio Association of Local Boards of Health
Welcomes NALBOH Conference Attendees
in 2001
By Grace Dunam, RN, BSN
As President-Elect of the Ohio Association of Local Boards of
Health, I would like to invite each and every one of you to the Annual
Conference to be held in Cleveland, Ohio, July 25-28th, 2001. Ohio
has a great deal to olTer, so plan your family vaeation around the con-
ference and take time to enjoy the Buckeye State.
I recently spent some time in Scotland and found an article in one of
their newspapers describing the many attractions of Ohio. According
to this article by Phil Lanning, Ohio has:
. Six amusement parks.
. The Ohio National Gold Medal awarded State Park,
. Seven botanieal gardens, and
. Sixteen art attractions and museums.
Ohio-nicknamed the "Mother of Presidents" because eight presidents
called it home-also proudly calls itself the Hall of Fame capital of the
world. There are no fewer than 13 museums in the state including:
. The Neil Armstrong Air and Space Museum,
. The Motorcycle Hall of Fame, and bizarrely,
. The Hoover Historical Centre (yes, vacum cleaners).
The U.S. Air Force museum in Dayton includes the first aircraft ever
to get 01T the ground and the incredible Stealth bombers. The Rock
and Roll Hall of Fame is equally fascinating. It is located in Cleve-
land on the shores of Lake Erie, and there are four floors of nostalgia
which literally take your breath away
There is much more about Ohio in Mr. Lanning's article, but there
isn't enough room to cover the entire article. As an Ohio resident, I
would like to add to what the above reporter wrote. In Cleveland,
you will find:
. The Cleveland Zoo and Tropical Rain Forest,
. Jacobs Field (home of the Cleveland Indians),
. Cleveland Science Museum with Omnimax Theater,
. Rock and Roll Hall of Fame,
. Crawford Auto--A viation Museum,
. Western Reserve Historical Society, and
. Cleveland Art Museum.
Within two hours of Cleveland there are:
.
.
.
.
Cedar Point Amusement Park,
Sea World of Ohio and Six Flags of Aurora,
Pro Football Hall of Fame in Canton,
Inventure Place in Akron and Quaker Square (the converted
Qu!lker Oats factory) that consists of a hotel, restaurant and spe-
CIalty shops,
Stan Hywet Hall, a magnificent 64 room Tudor Revival Manor,
once t1ie home of Frank Seiberling, founder of Goodyear Tire
Company, and
WaIriut Creek, an Amish community olTering tours and buggy
ndes.
.
.
On behalf of the Ohio Association of Local Boards of Health, I hope
we will see you in Cleveland on July 25, 2001. 0
The NALBOH Conference Experience: Why
you should attend NALBOH's 9th Annual
Conference in 20011
o~'
NALBOH members from coast to coast who participated in the Year
2000 Conference in RBIeigh, North Carolina shared their perspec-
tives. We appreciate their thoughts and look forward to meeting old
and new friends next year in Cleveland.
"I have attended several NALBOH Annual Conferences and each
time I find the most interesting aspect for me to be the opportunity
to compare and contrast the different configurations of boards of
health, particularly how boards around the country are dealing with
some of the same problems that my board faces." -- Mary A//en-
Carey, MD., Chair Oklahoma-City Board of Health, OK
"It was very well organized and olTered gnidance and advice on all
facets of public health. It provided a great opportunity to interact
with board of health members from other communities and compare
policy and procedure being used by other boards. NALBOH is to be
congratulated on a job well done in organizing this conference."u
Roy L. Matthews, Chairman, Wayne GJunty Board of Health, WV
"The Annual Conference in Raleigh went very well. I always like
the comments and down to earth presentations by Ned E. Baker of
NALBOH. The keynote speaker, North Carolina Senator Perdue
gave an outstanding speech on disaster preparedness. Concurrent
sessions I attended were well presented and beneficial to me. Most O.
helpful were those on bioterrorism, food safety, and Hurricane
Floyd."u Farrell Daniels, Chairman, Southeast District Board of
Health, lD
"The formal educational sessions were very informative, and the
speakers outstanding. I did get a much greater understanding of
public health from informal discussions." -- Donald Beeler, Health
Planner, Indiana State Department of Health, IN
"This was my first NALBOH Conference. I attended to leam more
about the roles of local boards of health. I was struck by what I
learned, in that we need to be more educated about our authorities
and responsibilities. On my return from RBIeigh, I am working with
my board to be more proaetive utilizing the information I learned
such as developing a mission statement. envirorunental health
primer, seeking to understand operations of the health department,
preparations in advance of catastrophic events, and strategic plan-
ning.
The importance of good communications skills in working with
health department staIT and respecting the individual strengths and
dilTering perspectives of Board members, were underscored for me
at the Conference. Board members can be the eyes and ears on the
community and helpful link between elected officials and the health
department. All board members benefit when they are active in
NALBOH and their own professional organizations." -- Deborah
Kleckowski, Chair New Britain Board of Health, Connechcut
(Continued on page 7)
J
Page 6
NALBOH Newsbrief
November 2000
NALBOH's 9th Annual Conference Update
Cleveland, Ohio
rr\ July 25-28,2000
,~...)
'. . /' The NALBOH Conference Experience... (Continued from page 6)
"We arrived in Raleigh and were immediately greeted by Rebecca Edwards, staff, and made to feel a part of the NALBOH Conference. Both
my wife and I attended, so we would get a chance to attend morc sessions. I was representing the Wisconsin Association of Local Health De-
partments and Boards (WALHDAB). We reported back to WALHDAB on eacb session. This gave the whole state knowledge of meetings we
covered. Because of this information, a doctor on our local health board reported fully on bioterrorism to our COWlty board of health.
I am also a T abaeea Fellow and found the value in these sessions was a chance to see how we, on our local boards, could advance the srnoke-
free air concept. The ideas I gained from interacting with others and their ideas were brought back to our local health board and our COWlty
board of supervisors. Since I am a menlber of both, I can relate to how something can be accomplished.
I would certainly reconunend attendance at NALBOH as a way to learn the issues facing our nation and to work toward solutions to these prob-
lems. The sessions were organized in such a way that no time was wasted. Everything was scheduled in such a way as each session was given
opportunity to finish and cover the intended material.
The ideas we were given an opportunity to hear from our health colleagues nationwide were very valuable. I hear from some on a personal ba.
sis to keep in contact.
In Wisconsin, I have passed out NALBOH material to our state W ALHDAB members. On a COWlty level, I have met with the Sank COWlty
tobacco coalition. We are presently getting all of the village, town, city, and state ordinances to see if they need improving. We will be con-
'taeting restaurants to get them on board as smoke-free restaurants. We will also approach our state tobacco board to help shape how the to-
bacco settlement money is used.
Surely the NALBOH Conferences are valuable, and I would all boards of health to take part in the Cleveland Conference in 200\." -- Lowell
Haugen, Board afDirectors Wisconsin Association of Local Health Depts. And Boards
"Raleigh was the best gathering of its kind I have ever attended. Speakers and presenters were timed so sessions were on schedule, but not
rushed. The hotel accommodations were fine. The foom was comfortable, the sessions were easy to get to, and the food and food service were
I1r\ excellent, with round table seating, which permitted an opportwtity to meet with morc people. Planned evening activities were relaxing and
V enjoyable. I fOWld the Raleigh Conference a rewarding experience, and I am glad I was able to attend." -- Shirley Haugen. Banahoo. WI
i
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Page 7
November 2000
NALBOH Newsbrief
NALBOH's Strategic Goals 1999-2001
Strategic Goal I :
To influence public health policy via local, state and national govern-
ments and organizations.
. Add a new state association to each region within the next three
years
. Diversify funding sources
. Develop membership data base with the capacity for real-time
analysis and interaction with membership
. Assure quality of work products released to membership
Strategic Goal 2:
To improve the capacity of local governing bodies as thcy develop
and implement public bealth policy
. Improve NALBOH's capacity to provide assistance to local
boards of health
. Link with HRSA funded Public Health Training Centers
. Link with CDC funded Public Health Preparedness Centers
. Link with National Public Health Leadership Network
. ' Develop web site capabilities
. In conjunction with the Annual Conference, develop certificate
training programs for BOH members and otTer CEUs for
professionals
Strategic Goal 3:
To foster the development of individual projects on public health is-
sues that support NALBOH's ODre values.
. Articulate NALBOH's core values
. Pursue new projects that are consistent with NALBOH's core
values and mission
. Renew existing cooperative agreements and expand them (e.g.
CDC, HRSA)
. Identify funding sources to support new and existing projects
. Develop a Project Committee to provide status reports to Board
of Direetors and NALBOH members
. Continue to develop bioterrorism and Health Alert Network
information and education for local boards of health
. Continue to participate in the Council on Linkages and explore
opportunities to expand involvement for boards of health
. Continue to develop the public health coin bill that will generate
revenue for NALBOH projects
. Continue to expand NALBOH's tobacco etTorts with coc's
Office of Smoking and Health and other national tobacco control
organizations (e.g. ANR, Tobacco Free Kids)
. Develop genetics education and information for NALBOH
members
0&"
Strategic Goal 4:
Expand NALBOH membership, develop services and membership
programs.
. Have Emeritus committee follow up with former, current and
potential NALBOH members in their regions
. Create a searchable database with information about local boards
of bealth (including a standardized profile for local boards of
bealth)
. Create a membership directory for all NALBOH members
. Enhance relationships between NALBOH, NACCHO, ASTHO,
and state boards of health
Strategic Goal S:
Establish a Board of Health Training Institute (BOHT!) to improve
the etTectiveness of local boards of health.
. EJ;tablish a fundamental framework for all BOHT! activities
. Create training programs that can aCODmmodate board members
at multiple levels of experience and with varying degrees of
knowledge
. Develop mechanisms to obtain feedback on board of health
training and educational needs
. Develop and continue to expand in-house educational programs
otTered by NALBOH
. Cooperate and collaborate with partner organizations (state
associations, leadership networks, etc.) to offer governance
training programs 0'
. Develop outreach programs for disseminating NALBOH's > I
educational programs
Strategic Goal 6:
Expand and strengthen NALBOH's organizational infrastructure.
. Expand and improve teehnology to meet the present and future
needs of the NALBOH office, board, members and others inter-
ested in local boards of health
. Develop policies and procedures for NALBOH's organizational
structure, including current job descriptions. financial
management, and partnership agreements
. Develop a succession plan for NALBOH board members and
staff
. Provide training for NALBOH staff and board on fundraising
and grant development
. Identify and expand the pool of potential NALBOH board
members
NALBOH Values
. EtTective public bealth policy making
. Public health for all
. Citizen involvement in the public health policy process
. Collaboration with multiple public bealth partners
. EtTective public health workforce
. Quality educational programs and services
)
Page 8
I NALBOH Newsbrief
NALBOH Activities
,:(J
Web Directory Now Available
By Jennifer O'Brien> MPH
My internship project, developed this past summer, was to assist
the organization in publishing a web directory of public health
websites. With supervision from Sarah Chard and input from
everyone in the office, I spent time looking at the design and
content of major public health websites.
While visiting the sites, links were put into a database,
cross-referenced for topics, and a short description of the site was
written. The topics were then revised and each topic page was
linked to the index. The result is a topical index of over 70 sub-
jects that contain links to 423 ditTerent sites. Topics range from
Adolescent Health to Violence. The index can be viewed from the
NALBOH homepage (www.naIboh.org) by selecting the Web
Directory link. After selecting the topic, the specific page appears,
with relevant sites and descriptions.
I enjoyed participating in this project, appreciated the opportunity
to intern at NALBOH: and hope that the resource will be useful to
NALBOH members. 1 invite recommendations for additions to the
directory as wen as suggestions and comments for existing content.
Please ernail them to me at jennifer@nalboh.org. 0
NALBOH Tobacco Committee Chair in
Washington
I ({O
John Saccenti attended the NACCHO Tobacco Committee meeting
as an ex officio member. Areas of discussion included:
I. Distribution of Joint Policy Statement and its use
2. Presentation by the Legacy Foundation on their goals and pro-
jects and input from NALBOH on local public health, and
3. Areas of future cooperation. 0
NALBOH visits Great Falls, Montana
Connie Tallon, West Regional Trustee and Sylvia Beck, Director
of Membcnhip Services, both attended the Montana Public Health
Association (MPHA) meeting in Great Falls, MT in September
2000.
For the first time, MPHA invited local health board members to
their meeting. A number of them came from across the state to
participate..
Connie and Sylvia provided advice and outlined the potential bene-
fits of having local boards of health join NALBOH. They dis-
cussed current concerns and gave them a vision of an optimal
board of health role. It was suggested that MPHA invite the board
members to this meeting every year.D
NALBOH in Phoenix, Arizona
i(
Diane Wartgow, Midwest Regional Trustee, attended the PACE
EH meeting organized by NACCHO in September 2000. An intro-
duction to the PACE EH document, a tool for health assessment
and planning, was given along with reports and comments from
pilot sites. 0
L
November 2000
NALBOH meets with the American Legacy
Foundation
By John Saccenti, Chair, NALBOH Tobacco Committee
The creation of the American Legacy Foundation (ALF) is one of the
most significant components of the Master Settlement Agreement on
Tobacco. Many of you are already familiar with one of their activities,
the Truth Campaign, anti tobacco ads on television and the press.
I recently had the opportunity to meet with Cheryl Healton, President of
the American Legacy Foundation and Mitch Zeller, formally of the
Food and Drug Administration and now Vice President at Legacy in
Washington., DC, in order to explore potential areas of mutual coopera-
tion between our two organizations.
In addition to collaborative etTorts between ALF and NALBOH, we
hope to develop comprehensive, unified approaches to tobacco control
in conjuction with our partners in the Association of State and Territo-
rial Health Officials and the National Association of County and City
Health Officials with the support and assistance of the American Legacy
Foundation.
We will keep you informed on future progress in these are8S.O
East Great Lakes Regional Trustee visits
Barberton, Ohio
Jim Recchio, East Great Lakes Regional Trustee attended the Annnal
Ohio Association of Boards of Health Regional Conference, September
7,2000 that was held in Barberton, Ohio.
At this mecting, Jim Recchio informed the audience that NALBOH's
9th Annual Conference will be held in Cleveland, Ohio July 25-28,
200 I. He expressed his hope that the attendance will be the highest
ever. 0
NALBOH in Vernal, Utah
Ned Baker, NALBOH State Affiliate, was the keynote speaker at the
Utah Association of Local Boards of Health 13th Annual Symposium,
September 2000. Ned discussed Public Health in the new millennium
It was an excellent example of a state association meeting. NALBOH is
fortunate to bave such Board of Health leaders as Warren Jensen,
Connie TallOn, Phil Lyons and others involved. 0
CDC Project Officer Visits NALBOH
NALBOH's CDC Project Officer, Monica Eischen, from the Office of
Smoking and Health visited NALBOH ,in October to discuss how to
continue serving local board of health members the most etTectively 0
November 2000
NALBOH Newsbrief
Pilot Testing of Environmental Health
Primer to Begin - Volunteers Needed!
By Sarah Chard, MA
Over the past year, NALBOH and the National Environmental Health
Science and Protection Accreditation Council (EHAC) have been
developing an environmental health primer for local boards of health.
The goal of the CDC-funded project is 10 create an introduclory man-
ual that provides basic education on environmental health issues and
that examines the role of local boards of health regarding environ-
mental health. The twelve topics included in the primer are:
. Air Quality
. Bioterrorism
. Drinking Water
. Food Safety
. Hazardous Wastes
. Solid Wastes
. Special Environmental Health Programs (lnjury Prevention,
Housmg, Occupational Health and Safety, Recreational Waters,
Radiation)
. Vector Control
. Wastewater
. Investigative Tools: Epidemiology, Microbiology, and Toxicol-
ogy
. Management Tools
. Risk Assessment
Before formally publishing the primer Ibis spring, NALBOH would
like to "test" the document by having board of health members re-
view the helpfulness of the content and format. Feedback from Ibis
review will then be used to further revise the primer. This review
process is critical to ensure that the primer is both an informative and
useful environmental health tool for board members.
If you and/or your board members are interested in evaluating the
primer and offering feedback 10 NALBOH, please contact Sarah
Chard, Project Direclor, by phone at (419) 353-7714 or by email at
<sarah@nalboh.org>
New CDC Guidelines Newsletter Available
The fm;t issue of Update: Tips for Implementing CDC School Health
Guidelines is now available on-line at: <www.eta.aed.org> The
newsletter provides assistance and support 10 state and local efforts 10
carry out CDC guidelines on promoting lifelong physical activity and
healthy eating and preventing tobacco use and addiction. Each issue
will focus on one of the three guideHne topics. The premier issue
focuses on the "new" physical education, a new philosophy centered
on gelling young people interested and involved in physical activity
for a lifetime. For more information. call Susan Stine at (202) 884-
8839 or watch for her article in the February NewsBrief
NALBOH's Training Videotape Update
The NALBOH videotape, Assessment, Policy Development, and As-
surance: The Role of the Local Board of Health. has now been sent to
every board of health in the country If your board has not received a
copy, please contact the NALBOH office. We welcome any com-
ments you have or suggestions for future films: Many boards of
health have indicated that handouts 10 accompany the videotape
would be helpful. We are developing an outline, worksheet and dis-
cussion points, which can be used by boards of health as they review
the fIlm. If you would like copies of these materials, please contact
the NALBOH office.
NALBOH welcomes Jennifer O'Brien,
New Project Coordinator
As part of her requirements for the Master of Public Health degree,
Jemufer served at NALBOH as a graduate intern from May-August
2000. Her internship projects included developing a web database
on public health topics and working on a survey regarding the
legislative authority of local boards of health. She joined NALBOH
in October as a Project Coordinator, working with Sarah Chard on
the HRSA training grant. In addition 10 having an MPH, Jennifer is
wor~mg on completing a Master's of Arts in History by writing a
thesIs on the comparative policy responses to cholera epidemics of
the 19'" century and the early responses 10 the 20~ century AIDS
epidemic in Great Britain, France and the United States.
CDC/ATSDR Strategic Plan for Public
Health Workforce Development
The Centers for Disease Control and Prevention (CDC), the Agency
for Toxic Substances and Disease Registry (A TSDR), and partner
organizations believe that the people who practice public health are
public health's greatest resource. The health of our communities is
~ependent upon the expertise of physicians. nurses, environmental-
ISt, health educators, microbiologist, and program managers - the
approximately 500,000 health professional who make up the na-
tional public health workforce.
ln 1999, Jeffrey P Koplan, M.D., M.P.H., Director, CDC requested
that CDC and A TSDR form a task force \0 develop a strategic plan
for the development and training of the public health workforce.
This Task Force on Public Health Workforce Development includes
representatives from CDC, A TSDR and other Federal agencies;
State and local health departments; laboratories; Schools of Public
Health, and all key entities involved in training and deploying the
public health workforce including NALBOH.
The plan outlines six strategic elements to attain the vision of "an
integrated life-long learning system for frontline public health prac-
titioners." The elements are: (1) Monitor workforce composition,
(2) Identify competencies and develop curriculum, (3) Design inte-
grated learning systems, (4) use incentives 10 assure competency,
(5) Conduct evaluation and research and, (6) Assure financial sup'
pori.
To synergize all partners' efforts and move us to action collabora-
tively, CDCI A TSDR convened an expert panel workshop on Public
Health Workforce Development on October 31,November 2, 2000.
The purpose of the workshop was to facilitate the development of a
national action agenda for strengthening the public health work-
force, building on the recommendations outlined in the Strategic
Plan. NALBOH representatives who participated in this workshop
include, Fred Agel, Marie Fallon, Ken Hartke, Ted Prall, Jr., and
Vaughn Upshaw. Walch for further updates on progress in future
NALBOH NewsBriefissues.
~
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5))
l Page 10
NALBOH Newsbrief November 2000
:c
NALBOH Needs You!
NALBOH is in the process of searching for new committee members for the 2001 membership
year Below is a list of all NALBOH committees and a summary of the objectives for the
coming year. Please indicate which committee(s) you have an interest in serving on by checking
the box and fill the information at the bottom of the page. Fax (419) 352-6278 or mail to NAL-
BOH 1840 East Gypsy Lane Road, Bowling Green, OH 43402. Please return your response no
later than December 15, 2000. Thank you for your support.
DAwards Committee
Directs the search for award nominations through the
NffilSBrief and the Regional Trustees. Reviews
nominations and selects recipients for Executive Board
approval. Coordinales awards and presentations at
annual conference.
o
DBoard of HealthTraining
Institute(BOHTI)
Works to assist state and local boards of health to
understand the importance of state associations and
helps in the development of establishing a state
association. Coordinales and reviews all educational ef-
forts.
,..
DBudget Committee
Oversees the development and implementation of
financial policies and procedures. Explores additional
income opportunities. Reviews and approves quarterly
and annual financial statements.
D By-Laws Committee
Annually reviews NALBOH By-Laws and submitted
draft and proposed amendments. Presents revisions to
the Executive Board and the association membership, for
vote at the annual conference.
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D Communication Committee
Directs, promoles and develops modes of communica-
tion for training and education in support of NALBOH's
mission, goals and objectives.
D Legislative Committee
Develops procedures for proposing legislation and pro-
grams to keep national legislators informed on public
health issues. Encourages legislative efforts at the state
level to promote local public health advocacy efforts.
D Membership Committee
Plans and organizes the annual membership drive and
all follow up activities. Establishes targeted member-
ship drives and explores joint membership ventures.
o Nominating Committee
Provides a slate of candidates for open Executive Board
positions and presents ballots for voting.
D Program Committee
Plans, organizes, and initiales the annual conference;
reviews past evaluations; presents draft conference
schedules to the Executive Board for approval.
DTobacco Committee
Guides the development of NALBOH's tobacco control
policies and advocacy efforts on a national level. Pro-
motes anti tobacco efforts, oversees grants, works with
NALBOH Tobacco Fellows and other national public
health and anti-tobacco organizations.
NAME
BOARD OF HEAL rn
(
ADDRESS
E-MAIL
FAX
PHONE
Page 11
November 2000
NALBOH Newsbrief
I[OBACCO.FREE uSJJI
~ ~
Join Other Local Board of Health
Members for Tobacco Control
Conference Calls
Monday, March 12, 2001
Monday, May 14, 2001
12 noon -1 p.m. Eastern Standard Time
Toll-Free Bridge # 1-800-713-1971
Conference Code # %3574
NALBOH will moderate discussions on various to-
bacco control issues relevant to local boards of health. 0
Tobacco Control Resource for Policy Makers
The New Mexico Department of Public Health has put together a CD-
ROM that contains multimedia presentations, journeys through real
interventions, resources and more. Some of the material is New Mexico
specific but the CD-Rom goes far beyond New Mexico in its applicabil-
ity
The infonnation found in the CD.ROM is easy to follow, answers ques-
tions that you have long been asking yourself, and is comprehensive in
scope. Contact NALBOH if you would like a copy
Below is a sample counterpoint section from the CD:
Aren't tobacco products already over regulated?
Tobacco is not over regulated. In fact, policymakers often have treated
tobacco products with kid gloves because of the political clout of the to-
bacco industry Tobacco products are the only legal prooucts that kill
when used as intended. Despite the fact that they are far deadlier than any
other legal consumer product, tobacco products 'are exempted from most
consumer safety legislation. Tobacco is specifically exempted from: the
Consumer Product Safety Act. the Fair Labeling and Packaging Act, the
Federal Hazardous Substances Act, the Toxic Substances Control Act.
and the Controlled Substances Act. 0
Why blame the tobacco companies for health problems associated
with tobacco use? What about personal responsibility?
Many factors affect a person s decision to use tobacco, including persua-
sion and manipulation. The tobacco industry tries to make its products
especially appealing to young people and has deceived the public for dec-
ades about the health hazards associated with smoking. Producers alter
tobacco leaves and add dangerous chemicals like ammonia to make ciga-
rettes even more addictive. They influence policymakers with [mancial
donations. Preventing tobacco use and helping individuals quit is a com-
plex task that requires both education and public policy initiatives. 0
MODEL ORDINANCES
Model Tobacco Control Ordinances are available for inter-
ested board of health members by contacting N ALBOH.
Surgeon General's Report
The Executive Summary of "Reducing Tobacco Use: A Report of 0;.,'
the Surgeon Genera\" has been sent to all NALBOH members. If
anyone else would like copies they may request additional copies
from the Centers for Disease Control and Prevention's (COC)
Office on Smoking and Health, at telephone (770) 488-5705
Additional copies of the full report (SIN 017-001-00544-4) may
be purchased from the U.S. Government Printing Office,
Washington, D.C. or call 20402-9328, (202) 512-1800. Copies of
the full report, Executive Summary, and AI A Glance may also be
downloaded from COC's website al <www.cdc.gov/tobacco> 0
Database Assistance Requested
Please help NALBOH build a database of local board of health
members who are interested in tobacco control. If you have any
interest in receiving special mailings regarding tobacco control
please take a moment to e-mail rebecca@nalboh.org the follow-
ing information: NAME; board of health you represent; address
(one that will allow materials to get to you within a day of receiv-
ing them); phone number; fax number and an e-mail address that
you can check regularly NALBOH is trying to be better prepared
to direct tobacco control materials that pertain to your state or
locality to you directly NALBOH wants you to be able to receive
tobacco specific materials in a timely manner. 0
Tobacco Legal Authority Document:
Watch for yours in the mail
NALBOH has sent copies of the Legal Authority for Tobacco
Control Document via mail. Watch for your copy to arrive soon! CJ)
NCI Monograph Available to Members
The National Institutes of Health's, National Cancer Institute
has recently published its II" Monograph on Smoking and
Tobacco Control. The title of the August 2000 publicalion is
"State and Local Legislative Action to Reduce Tobacco Use."
NALBOH has several copies for distribution 10 local board of
health members. If you are interested in obtaining a copy.
please send NALBOH your contact information and the num-
ber requested .0
m
OHIO Smoke-Free Restaurant
Campaign Site on the Web
,J)
www.cmhhealth.org/smoke-free
[page 12
NALBOH Newsbrief
Noyember 2000.
:c
MARK YOUR CALENDAR!
Investing in Tobacco Control: A Guide for State Decisionmakers
A Public Health Training Network Satellite Broadcast
February 15, 2001
1 :00 p.m. - 3:00 p.m.
This live interactive broadcast will promote CDC's Office on Smoking and Health's rec-
ommendation that States establish tobacco control programs that are comprehensive, sus-
tainable and accountable. Staff members from the Centers for Disease Control and Pre-
vention, Office on Smoking and Health (CDC - aSH), State Tobacco Control Program
Managers and State decisionmakers will share information on why a long - term commit-
ment for State tobacco control programs is necessary and beneficial. In addition, this
broadcast will illustrate what States can expect to achieve by following CDC's Best
Practice guidelines.
Audience
This broadcast will provide clear, concise information to people responsible for making
decisions about long - term commitment to tobacco control programs. This group includes
State health officials, State health department staff, board members and staff of new State
tobacco control foundations and commissions, officials involved in State budget issues,
Gubernatorial staff, legislators and legislative staff, local board of health members,
partner organizations, and community participants.
Registration Information
Registration is free. Further registration and site selection information will be
forthcoming.
Sponsors
Centers for Disease Control and Prevention, Public Health Training Network.
Mark your calendars now
to view this beneficial program!
Please contact Rebecca Edwards at (419) 353-7714 or email at:
<rebecca@nalboh.org>, for more information.
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I November 2000 NALBOH Newsbrief ~
I Calendar of Events I
0\
2nd Symposium on Medical and Public Health
Response to Bioterrorism
November 28-29, 2000
Washington, DC
For more information, call Andrea Lapp at (800) 431-5638
or visit <www.hopkins-biodefense.org>
The 15th National Conference on Chronic Disease Prevention and Control .
Living Healthier, Living Longer: The Will and the Way
November 29-December 1, 2000
Washington Hilton and Towers
Washington, DC
For more information, call Estella Lazenby at (301) 588-6000 or visit
<www.cdc.gov/nccdphp> or <www.astcdpd.org>
Measuring Food SafetyjMeat & Poultry Inspection Program Effectiveness
December 8, 2001
Atlanta, GA 0
For more information or to register, call (770) 488-4180 or email <cth4@cdc.gov>
Second NSF International Conference on Indoor Air Health
Trends and Advances in Risk Assessment and Management
January 29-31, 2001
Radisson Deauville Hotel
Miami Beach, FL
For more information call Susan Hollowell at (734) 827-6865 or email <hollowell@nsf.org>
NALBOH's 2nd Annual Ned E. Baker Lecture Series
Available via Satellite to all Local Boards of Health
Friday, Apri16, 2001
7:30 p.m. Eastern Standard Time
More information in the February 2001 NewsBrief and on our web at <www.na1boh.org> \
r
NALBOH's 9th Annual Conference I
Boards of Health: Building Healthy Communities Through Partnerships And Policies
July 25-28, 2001
Sheraton Capital Hotel 0
Cleveland, OH
For more information, contact NALBOH at (419) 353-7714 or visit <www.na1boh.org>
I Page 14 I
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I
NALBOH Newsbrief
November 2000
The Grass Roots cifPublic He4I.lth
DITORIAL BOARD FORMATION
The Communication Committee will be forming an Editorial Board to assist in the development, content and layout of:
NALBOH's NewsBrief If you are interested in being considered as a member of this board, please complete the following
and fax or mail to the NALBOH office by December 15th:
N=.
Addrcll
..~
Fu
E.aml
DInterested in Chair position
D Interested in Board position
DCurrent board of health member
DRetired board of health member
Qualifications: (attach additional sheet if needed)
ATeas of lnterest/Expertise:
DEnvironmental Health
DPublic Health Policy
DBoard of Health News
DClinical Services
DGovemance
DHealth promotion
Dlnjury Prevention
DOther'
c)
National Association of Local Boards of Health
1840 East Gypsy Lane Road, Bowing Green, OH 43402
Phone: (419) 353-7714. Fax: (419) 352~278
E-mail: na/boh@na/hoh.org; Wehsite: www.nalhoh.org
~--------------------------------------------------------------------------
ApPLICATION FOR MEMBERSHIP
Date
Membership Year 2001
Board of HealthlOrganizationIName
Address
City
Telephone
ConUlCt Person
Type of Membership
State
Fax
Zip Code
E-mail
Title
.
Institutional (Dues $100. or $75 if you belong to a State Association of Local Boards of Health that is an Affiliate Member of
NALBOH) local board of health or other governing body that oversees local public health services or programs
Affiliate (Dues $250) State association oflocal boards of health
Associate (Dues $50) Individual
Retired Board of Health Member (Dues $10)
Sponsor (Nonprofit $50; For-Profit $250) Organization, agency or corporation
.
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I .
I
I .
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Mail this form, with payment of dues to:
NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH 43402
Page 15
NALBOH's 9th Annual Conference 01
Join Us!!
NALBOH's 9th Annual Conference
July 25-28,2001
Cleveland, Ohio
In cooperation with
Rock & Roll Hall of Famp
OHIO ASSOCIATION OF
BOARDS OF HEALTH
Board of Health: Building Healthy Communities Through Partnerships and Policies
. Effective Governance
. Emergency Response
. Environmental Health
. Health People 2010 Initiatives
. Injury Prevention
Conference Hiahliahts
. Local Public Health Strategic Planning
. National Public Health Performance Standard Update
. Tobacco Control Efforts
. Training the Public Health Workforce
AND MUCH MORE
For more information contact the NALBOH office at:
Phone: (419) 353-7714; Fax: (419) 352-6278
E-mail: <nalboh@nalboh org>; Web: <www.nalboh.org>
National Association of Local Boards of Health
r- ---------.. J 1840 East Gypsy Lane Road
I" N A L B 7; ~1 Bowling Green, OH 43402
o::,;-v~
NONPROFIT ORG,
U. S, Postage
PAID
Bowling Green, OH
Permit No, 47
o
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