Novant Health Gaffney Medical Center Community Health Needs Assessment Cherokee County 2013-2015

Approved by the Novant Health Gaffney Medical Center Board of Trustees on December 2, 2013

Dear Community Resident:

It is our pleasure to share with you the 2013-2015 Novant Health Gaffney Medical Center Community Health Needs Assessment. On behalf of the Novant Health Gaffney Medical Center Board of Trustees, leadership, physician partners, and staff, we hope that you will find this information useful in planning and responding to the needs of our community.

This report contains data which was reported by the South Carolina Department of Health and Environmental Control; we sincerely thank the South Carolina Department of Health and Environmental Control and our various community partners and governmental agencies for their contributions to this report.

Novant Health exists to improve the health of communities, one person at a time. Along with our staff, physician partners, and volunteers, we are united by a promise to deliver the most remarkable patient experience, in every dimension, every time.

Responding to the health needs of our communities, especially to the most vulnerable among us, is central to the mission of Novant Health and other not-for-profit health care organizations. We strongly believe in our role as a good corporate citizen, which involves working with community agencies and organizations to make our communities better places to live and work. Novant Health employees and physician partners strive every day to bring our mission, vision and values to life. We demonstrate this commitment to our patients in many different ways including maintaining an active community health outreach program, demonstrating superior outcomes for many health conditions as indicated by our state and national quality scores, and creating innovative programs (many are recognized nationally) that address important health issues.

We believe that the data contained in this report will help us and our community partners in our planning and implementation strategies so that we can continue to effectively respond to the health needs of our community.

On behalf of Novant Health Gaffney Medical Center, thank you for taking the time to read this report. Again, we do hope that you will find this information useful in planning and responding to the needs of our community.

Sincerely,

Brian Yates, VP of Operations Mike Riley, SVP of Operations Harry Smith, President Novant Health Gaffney Medical Greater Charlotte Market West Novant Health Presbyterian Center Medical Center & Greater Charlotte Market

1530 North Limestone Street | Gaffney, SC 29340 | 864-487-4271 | www.novanthealth.org

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Table of contents

I. Introduction 3 a. Organization Overview 3 b. Our Community 4

II. Assessment Process and Methodology 6 a. Collaborative Community Partners and Public Health Input 6 b. Process & Methods 6 c. Assessment Data Used 10

III. Prioritized Health Needs 10

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I. Introduction

Novant Health Gaffney Medical Center, in collaboration with the South Carolina Department of Health and Environmental Control, and other community partners established a community health needs assessment in 2013 to identify the most pressing health needs in our community. The assessment is designed to identify the health needs of the Novant Health Gaffney Medical Center service area. a. Organization Overview Novant Health is the parent company of Novant Health Gaffney Medical Center and is a not-for-profit integrated health system consisting of 14 hospitals and a medical group consisting of over 1,000 physicians in over 350 clinic locations. In addition, Novant Health consists of numerous outpatient surgery centers, medical plazas, rehabilitation programs, diagnostic imaging centers and community health outreach programs. Novant Health’s 25,000+ employees and physician partners care for patients and communities in North Carolina, Virginia, and South Carolina.

Novant Health employees and physician partners strive every day to bring our mission, vision and values to life. We demonstrate this commitment to our patients in many different ways. Our organization: Maintains an active community health outreach program. Demonstrates superior outcomes for many health conditions as indicated by our state and national quality scores. Creates innovative programs that address important health issues. Many of our programs and services are recognized nationally. Believes in its role as a good corporate citizen, working with community agencies and organizations to make our communities better places to live and work.

At Novant Health Gaffney Medical Center, we strive to provide our community with exceptional care, close to home. In choosing a hospital, what's important to you is also important to us. Exceptional care, high quality standards, a talented team of physicians and a staff whose number one priority is you.

At Novant Health Gaffney Medical Center, we maintain our position at the forefront of technological care with a state-of-the-art emergency department, advanced surgical service lines, wound care, sleep lab, diagnostic testing and much more. Our well-trained physicians and other healthcare staff members stand by 24/7 to provide compassionate care with the latest medical treatments and technology. We are commitment to recruiting top physicians in key specialty areas to better serve you close to home.

For many serious life-threatening events–such as heart attack, stroke and trauma injury–time is of the essence when it comes to receiving medical care. Close-to-home care has the potential to save lives and provide follow-up treatment that is easily accessible. Even keeping up with routine care, such as annual exams, screenings and vaccinations, is easier when you visit local providers.

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We believe that people want to receive the care they need close to home and to their loved ones. We have selected highly-trained professionals to lead our clinical departments and to assist our medical team. One-call scheduling makes being proactive about your health less time-consuming and more user- friendly. You do not have to travel outside the county for many of the services and treatments that your families need. Our 125-bed acute care hospital is Cherokee County’s premiere healthcare provider. b. Our Community

Primary and Secondary Service Areas

Gaffney is a city in and the county seat of Cherokee County, South Carolina, United States, in the upstate region of South Carolina. Gaffney is also sometimes referred to as the Peach capital of South Carolina. The Primary Service Area for Novant Health Gaffney Medical Center includes the cities of Blacksburg and Gaffney. The Secondary Service Area for Novant Health Gaffney Medical Center includes the cities of Spartanburg, Chesnee, Cowpens, and Pacolet.

Novant Health Gaffney Medical Center Primary Service Area

Zip City County State 29340 Gaffney Cherokee SC 29341 Gaffney Cherokee SC 29702 Blacksburg Cherokee SC 29342 Gaffney Cherokee SC

Novant Health Gaffney Medical Center Secondary Service Area

Zip City County State 29307 Spartanburg Spartanburg SC 29323 Chesnee Spartanburg SC 29330 Cowpens Spartanburg SC 29372 Pacolet Spartanburg SC

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Population

The county seat of Cherokee County is Gaffney. The U.S. Census Bureau reports that Cherokee County has a total area of 397.2 square miles of which 392.7 square miles is land and 4.5 square miles is water.

Cherokee County Population By Race & Ethnicity (2012)

Cherokee County South Carolina

Population Estimate 55,662 4,723,723 Persons Under 5 Years 6.5% 6.3% Persons Under 18 Years 24.3% 22.9% Person 65 Years & Over 14.5% 14.7% Female Persons 51.5% 51.4% White Alone 76.9% 68.4% Black/African-American Alone 20.6% 28.0% American Indian & Alaska Native Alone 0.5% 0.5% Asian Alone 0.6% 1.4% Native Hawaiian & Other Pacific Islander 0.1% 0.1% Alone Two or More Races 1.3% 1.6% Hispanic or Latino 3.9% 5.3% Source: U.S. Census Bureau; Cherokee County (2013)

Cherokee County Demographics (2007 - 2011)

Cherokee County South Carolina

Households 21,012 1,758,732 Persons Per Household 2.58% 2.52% Per Capita Money Income In the Past 12 $17,910 $23,854 Months (2011 Dollars) Median Household Income $35,025 $44,587 Persons Below Poverty Level 20.4% 17.0% Source: U.S. Census Bureau; Cherokee County (2013)

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Ten Leading Causes of Death South Carolina Department of Health & Environmental Control (Region 2) (2010)

Septicemia 711 Influenza & Pneumonia 754 Nephritis, Nephrotic Syndrome & Nephrosis 958 Diabetes Mellitus 1,124 Alzheimer’s Disease 1,566 Accidents 2,249 Chronic Lower Respiratory Disease 2,263 Cerebrovascular Disease 2,285 Heart Disease 9,253 Cancer (Malignant Neoplasms) 9,323

Source: South Carolina Department of Environmental Health and Control Annual Report (2012)

II. Assessment Process and Methodology a. Collaborative Community Partners:

The Novant Health Gaffney Medical Center Community Health Needs Assessment 2013-2015 is based on the South Carolina Department of Environmental Health and Control Region 2 Annual Report 2012 and the South Carolina Department of Environmental Health and Control Upstate Region Focus Group Summary Report (2013). The Novant Health Gaffney Medical Center Community Health Needs Assessment 2013-2015 is a collaborative effort with the South Carolina Department of Environmental Health and Control and other community partners as outlined in this report. b. Process and Methods:

Novant Health Gaffney Medical Center partnered with the South Carolina Department of Environmental Health and Control Upstate Public Health Region to sponsor a focus group (see focus group participant listing below). Each participant received an invitation via phone and /or email. A discussion occurred about why it’s important to focus and prioritize health needs. As an example, an info-graphic regarding “What health factors make us healthy” and “What we spend on being healthy” was shared with the group. Healthy behaviors make up half of the factors that make us healthy, but we spend more than 80% of US dollars on medical services. Participants then received a presentation of Cherokee County secondary data. Overall Public Health Topics included: Access to Health Services, Chronic Diseases, Clinical Preventive Services, Infectious Disease, Maternal, Infant and Child Health, Nutrition, Physical Activity and Obesity, and Tobacco.

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After the data presentation, a discussion of the data ensued that concluded with the selection of health priorities. Participants were asked “What do you feel are the Public Health concerns/issues in Cherokee County?” Next, the participants were asked to consider resources available, what entity, if any, were working on the concern and write a potential response (not solution) to that concern. All of this information was captured on half-sheets and discussed as a group. The following Public Health categories and subcategories were discussed:

Access to Healthcare

Lack of transportation Lack of knowledge of resources available Lack of Physicians who accept Medicaid patients Lack of insurance

Obesity

Obesity in general Lack of exercise resources Diet/nutrition education Childhood obesity concerns

Chronic Disease

Diabetes (Education & Resources) Stroke Cancer (Education & Resources) High Blood Pressure

Maternal Child Health

Teen Pregnancy Access To Prenatal Care Infant Mortality

Social/Economic Health

General Issues (Job, Education, Etc.) Educational Opportunities For Drop-Outs

Alcohol, Tobacco, and Other Drugs Drug Abuse Smoking Tobacco (Smoking Cessation, Teen Smoking Concerns)

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Infectious Disease STD/HIV

Other Sleep Apnea Apathy

In the second phase of the session, the group categorized the concerns as noted above. Finally, participants were given three (3) color dots to ‘vote’ for the top three (3) concerns they felt were important to be included in the hospital’s implementation strategy. The data will inform those participating in the strategic planning process and will assist in the broad-thinking capacity needed to develop the implementation strategies. The input from the discussions included the following:

1. Access to Care The group felt that public transportation is a major issue There is a lot of inappropriate use of the ER No emergent care available to provide a safety net for the ER

2. Obesity Too many fast food locations No education on the preparation of healthier food options Need more access to farmer’s markets Need finance education and budgeting to plan healthy meals A large number of the obese population has diabetes Maybe partner with the YMCA to offer discounts

3. Diabetes Should have been selected because most chronic disease is secondary to it Gaffney Medical Center has a Diabetes program Number one issue with Diabetic patients is eye concerns Seeing large numbers of Type 2 in children Need better Diabetic nutrition education

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South Carolina Department of Health & Environmental Control Upstate Region Focus Group Participants

First Last Organization Title

Joe Bonner Fullerton Foundation Executive Director Beth Daily Cherokee County Community Resident Cherokee County Oscar Fuller Executive Director Foundation Cherokee County Pam Foxx Executive Director Chamber of Commerce Hermenia Gardner Healthy Cherokee HSCI Grant Coordinator Melissa Green Iron City Ministries Executive Director SC Dept. of Health & Community Team Lillie Hall Environmental Control Health Educator Upstate Region Novant Health Rebecca Larue Marketing Specialist Gaffney Medical Center Director of Operations Mark Martin Novant Health Community Partnerships Cherokee County School Health Services Evelyn Nelson School District Coordinator Cherokee County Beth Powell Alcohol & Drug Executive Director Commission SC Dept. of Health & Community Team Page Rogers Environmental Control Health Educator Upstate Region Mae Francis Sarratt Cherokee County Community Resident Novant Health Vice-President of Brian Yates Gaffney Medical Center Operations

Representatives with special knowledge/expertise in public health:

Hermenia Gardner, Healthy Cherokee Lillie Hall, South Carolina Department of Health & Environmental Control Upstate Region Rebecca Larue, Novant Health Gaffney Medical Center Mark Martin, Novant Health Community Partnerships Evelyn Nelson, Cherokee County School District Beth Powell, Cherokee County Alcohol & Drug Commission Page Rogers, South Carolina Department of Health & Environmental Control Upstate Region Brian Yates, Novant Health Gaffney Medical Center

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Representative or leader of medically underserved, low-income and minority populations and populations with chronic disease needs:

Melissa Green, Iron City Ministries: A non-profit organization which helps people in Cherokee County, SC with needs such as food, clothing, and medical payments. c. Assessment Data Used

Governmental Data: U.S. Census Bureau Population Data (2013) American Community Survey South Carolina Department of Health & Environmental Control Region 2 Annual Report (2012) South Carolina Department of Health & Environmental Upstate Region Focus Group Summary (2013)

Public/Private Research Data: United Way of the Piedmont Community Impact Agenda (2011 – 2015)

Internally Conducted Research: Novant Health Gaffney Medical Center Emergency Department Utilization Data (2012) Geographically Defined Primary Service & Secondary Service Areas

III. Prioritized Health Needs

The top three prioritized health needs of the community are as follows:

1. Access To Healthcare 2. Obesity 3. Diabetes

The top three prioritized health needs of the community were collectively reviewed by the Novant Health Gaffney Medical Center Board of Trustees. The Board evaluated each documented need and its intersection with the organization’s vision, commitments, and key strengths. Subsequently, the team further prioritized the health needs agreeing upon the top two health priorities:

1. Diabetes 2. Obesity

Novant Health Gaffney Medical Center is working to address each of the identified areas of need through resource allocation and support of the following programs:

1. Diabetes: Blood glucose screenings; diabetes education 2. Obesity: Body Mass Index Screenings

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