Mission Statement:

The mission of Pitt County Health Department is to protect, promote and assure the health of all people in Pitt County.

Legend: Note: (VH) denotes CHNA activities funded by Vidant Health. BACKGROUND

The State of the County Health Innovation), as part of a regional Disease Prevention; Access to Medical Center Board of Trustees (SOTCH) Report is comprised CHNA in 33 Eastern North Care and Social Determinants and Vidant Health adopted the annually between Community Carolina counties. The Pitt County of Health; and Mental Health. same health priority areas as Health Needs Assessments CHNA team was comprised of the The data and the top health identified by Pitt Partners for (CHNAs) to highlight activities Pitt County Health Department, priorities selected by Pitt Partners Health. that address the selected health , and Pitt for Health and community Pitt County Health Department priorities. Every three to four Partners for Health. The team members were presented to the is pleased to present this 2019 years, local health departments collected community opinions Pitt County Board of Health and SOTCH Report which was within conduct a related to health in Pitt County Vidant Medical Center Board of completed in February 2020 CHNA as required by the North through community listening Trustees. The Board of Health and reflects activities that were Carolina Department of Health groups and an online community voted to focus on four of the conducted in 2019 by Pitt and Human Services and the opinion survey. In addition, nine identified needs as follows: County Health Department, North Carolina Local Health secondary data regarding leading Chronic Disease Control; Infant Vidant Medical Center, Pitt Department Accreditation Board. causes of death and illness Mortality Prevention; Risk Factor Partners for Health and other Not-for-profit are also were collected, reviewed and Reduction including Physical community partners. required by the Internal Revenue compared to data from other Activity, Nutrition; Tobacco and Service to conduct a CHNA every counties, North Carolina and the Substance Abuse; and Sexually three years. The purpose of the United States. Both secondary Transmitted Diseases. The Vidant CHNA is to examine the health and primary data were analyzed status of the community and to and summarized by an outside determine health priorities for vendor (Conduent).The data Community Distribution community health improvement were presented to Pitt Partners over the three to four years for Health whose members and following the assessment. community members reviewed To access the 2019 SOTCH report or the entire Pitt County’s 2018/2019 CHNA the data regarding Pitt County’s 2018/2019 CHNA: was completed by the Pitt significant health needs and County Health Department and voted on the top health priorities Visit the Health Statistics section of Pitt County Health Department’s Vidant Medical Center through for Pitt County based upon North website at www.pittcountync.gov/229/Public-Health or contact a partnership with the Office of Carolina’s 2020 Health Objectives. Amy Hattem at [email protected] or 252-902-2426. Health Access at the Brody School Pitt Partners for Health members Copies of both documents can also be viewed at each of Pitt of Medicine at East Carolina voted to focus on three of the County’s public libraries. Presentations to community groups are University, and Health ENC (now nine significant health needs a program of the Foundation identified during the CHNA available upon request. for Health Leadership and process as follows: Chronic 1 Mortality Leading Causes of Death (Year 2018), Pitt County Compared to NC Source: NC State Center for Health Statistics, NC Vital Statistics, Volume 2; Leading Causes of Death 2018 200

180 Leading Causes 160 140 of Death in 120 opulation Pitt County 100 According to the NC State Center 80 for Health Statistics, Heart Disease has remained Pitt County’s leading er 100,000 P

P 60 cause of death for the past three consecutive years, despite a 40 steady decline in the rate. In 2018, Pitt County’s Heart Disease rate 20 was 156.7 / 100,000 population 0 All Other Chronic Lower Kidney compared to 163.1 / 100,000 in Alzheimer’s Motor Vehicle Heart Disease Cancer Stroke Unintentional Respiratory DiabetesSepticemia Diseases and Disease Injuries 2017 and 165.3 / 100,000 in 2016. Injuries Diseases Disorders Cancer continued as the second Pitt County 156.7 144.5 55.6 37.2 31.7 31.1 28.9 12.8 12.2 11.7 185.4 189.7 48.8 43.1 51.7 43.4 29.1 14.7 15.3 18.6 leading cause of death in 2018. North Carolina Disease Cancer climbed from 136.0 / 100,000 in 2016 to 153.6 / 100,000 Pitt County North Carolina in 2017 and declined to 144.5 / 100,000 in 2018. Stroke remained Leading Causes of Death in Pitt County as the third leading cause of death climbing from 39.5 / 100,000 in 2016 - 2018 2016 to 41.3 / 100,000 in 2017 and Source: NC State Center for Health Statistics, NC Vital Statistics, Volume 2; Leading Causes of Death 2016, 2017, 2018 to 55.6 / 100,000 in 2018. Ranked as the fourth leading cause of death, the rate of Unintentional Injuries in 2018 was 37.2 / 100,000; a decline in comparison to the 2017 rate of 49.7 / 100,000, opulation and returned to the 2016 rate of 37.2 / 100,000. Chronic Lower Respiratory Disease, ranked as the fifth leading cause of death in 2018 (rate of 31.7 / 100,000), reflected a decline from the 2017 er 100,000 P rate (34.1 / 100,000), but was P still higher when compared to the 2016 rate (30.5 / 100,000).

Alzheimer’s Disease, was ranked All Other Chronic Lower Kidney Alzheimer’s Motor Vehicle Heart Disease Cancer Stroke Unintentional Respiratory DiabetesSepticemia Diseases and as the 6th leading cause of Disease Injuries Injuries Diseases Disorders death in 2018, declining to 31.1 2016 165.3 13639.537.2 30.5 33.3 24.3 12.4 12.4 10.7 / 100,000 in 2018 in comparison 2017 163.1 153.6 41.3 49.7 34.1 33.5 24 8.912.88.4 to 33.5 / 100,000 in 2017 and 2018 156.7 144.5 55.6 37.2 31.7 31.1 28.9 12.8 12.2 11.7 33.3 / 100,000 in 2016. Diabetes, 2016 2017 2018 although reflecting a rise in the 2018 rate (28.9 / 100,000) in 2017 and 12.4 / 100,000 in 2016. and Nephrosis) were ranked as Kidney Diseases and Disorders comparison to the 2016 rate Motor Vehicle Injuries ranked the 10th leading cause of death in 2018, Pitt County ranked lower (24.3 / 100,000) and the 2017 rate 9th in 2018 with a rate of 12.2 / in 2018 (rate of 11.7 / 100,000), than North Carolina for nine (9) (24.0 / 100,000), remained as Pitt 100,000 demonstrating a slight rising from a rate of 10.7 / 100,000 of the ten (10) leading causes of County’s 7th leading cause of decrease from the 2017 rate (12.8 in 2016 and a rate of 8.4 / 100,000 death. The exception was Stroke death. Septicemia was ranked 8th / 100,000) and the 2016 rate in 2017. Although Pitt County (55.6 / 100,000), as compared to and rose to 12.8 / 100,000 in 2018 (12.4 / 100,000). Kidney Diseases experienced increases in the rates North Carolina (48.8 / 100,000). following a rate of 8.9 /100,000 in (Nephritis, Nephrotic Syndrome for Diabetes; Septicemia; and 2 Morbidity and Mortality

Heart Disease and Stroke Know Your Numbers (1st and 3rd Leading Causes of BLOOD PRESSURE SYSTOLIC mm Hg DIASTOLIC mm Hg CATEGORY (upper number) (lower number) Death in Pitt County) NORMAL LESS THAN 120 and LESS THAN 80

Contributing Factor: Blood Pressure ELEVATED 120-129 and LESS THAN 80 High Blood Pressure, that is not treated, is often a contributing factor to

heart attack and stroke. The American Heart Association defines high HIGH BLOOD PRESSURE 130-139 or 80-89 blood pressure as a consistently high force of blood flowing through (HYPERTENSION) STAGE 1 one’s blood vessels. Although nearly half of American adults have high HIGH BLOOD PRESSURE 140 OR HIGHER or 90 OR HIGHER blood pressure, many do not know it. Individuals should have their (HYPERTENSION) STAGE 2 blood pressure checked. If left untreated, high blood pressure can HYPERTENSIVE CRISIS HIGHER THAN 180 and/or HIGHER THAN 120 damage the circulatory system contributing to heart attack and/or (consult your doctor immediately) stroke. “Know Your Numbers.” Source: https://www.heart.org/en/health-topics/high-blood-pressure/ the-facts-about-high-blood-pressure

Pitt County 2020 Projected New Cancer Cases and Deaths of Selected Sites Cancer The North Carolina Central Cancer Registry defines Cancer as a group Cancer has remained as the 2nd leading cause of death of over 100 diseases that affect different parts of the body through in Pitt County for the past three consecutive years. the uncontrolled growth and spread of abnormal cells that damage healthy body tissues and organs. Cancer is not caused by injuries Cancer Type Projected New Cases Projected Deaths and it is not contagious. It is most often caused by a combination of Lung/Bronchus 130 83 factors including external factors (environmental substances such Female Breast as chemicals, radiation, or viruses) and internal factors (hormones, 168 22 immune conditions or genetic mutations). It is not clear why some Prostate 104 14 people develop Cancer and others do not, but as individuals age, their Colon/Rectum 68 24 risk for Cancer increases. Four out of every 10 North Carolinians will have some type of Cancer in their lifetime. Source: NC State Center for Health Statistics, NC Central Cancer Registry, 01/2020

Hospital Admissions Pitt County - FY 2019 Top Diagnosis for Vidant Medical Center Emergency Department Visits Resulting in Admissions

• Sepsis • Chronic Obstructive Pulmonary Disease (COPD) • Heart Disease • Major Depressive Disorders • Kidney Diseases and Disorders • Urinary Tract Infection

Source: Vidant Health Planning

3 Chronic Disease Prevention (Board of Health Priority) Progress and Interventions Goal: Reduce Chronic Disease with special emphasis on Diabetes Prevention and Control.

Pitt County Health Department and marketing campaign in mi- Diabetes Prevention Program nority communities; provide (DPP): In July 2019, another Dia- community screenings for pre- betes Prevention Program (DPP) diabetes and referrals to Diabe- began for Pitt County Govern- tes Self-Management Programs; ment employees with 10 partic- and offer the Centers for Disease ipants completing the first six Control and Prevention Lifestyle months of the program. Partici- Classes “Prevent T2” and “Preven- pants lost a total of 65.2 pounds. ga el T2” to minority communities This program is supported by across North Carolina. Individ- funds provided by the Healthy uals, who enroll into NC MDPP, People, Healthy Carolinians grant can make realistic and achievable awarded to Vidant Medical Cen- lifestyle changes that can reduce ter / Pitt Partners for Health. their risk of type 2 diabetes by up to 58%. Participants of the pro- Pitt County Health Depart- gram learn to incorporate health- ment, Diabetes Self-Man- ier eating and moderate physical agement Education (DSME) activity, as well as problem solv- Program: The overall objective ing, stress reduction, and coping of this ADA-recognized DSME strategies into their daily lives. program is to support informed Since the 2016 -17 fiscal year, NC decision-making and promote MDPP has screened over 3,000 self-care behaviors to patients individuals for prediabetes; a total with diabetes, pre-diabetes, or of 416 participants have been en- gestational diabetes. The DSME rolled into the program; and a to- program aims to primarily serve tal of 105 participants have been those who are uninsured or enrolled in the 2019 classes. In underinsured and who other- August 2019, Pitt County Health wise may not receive diabetes Department completed a class self-management education. In series with one class graduating 2019, the DSME Program provid- 13 participants who lost a total ed numerous one-on-one and Pitt County Health Department and Pulmonary Rehabilitation. of 141.3 pounds. In September group education sessions with a Diabetes Support Group: This Physical activity stations were set 2019, Pitt County Health Depart- total of 189 contacts. A total of support group assists persons up around the room, giving par- ment began another class of 15 157 provider referrals were re- with diabetes, pre-diabetes or ticipants a chance to be active in participants who to date have lost ceived from various healthcare those who support someone with the moment. There were a total a total of 36.4 pounds. providers in 2019. The DSME these conditions to implement of sixty five (65) participants in program is also open to Pitt and sustain behaviors needed to attendance. Overall, the support County Government Employees. manage the disease on an ongo- group continues to thrive with Employees are provided with a ing basis. The group meets once a core group of 8-10 attendees blood glucose meter and diabe- a month for an hour and a half monthly and additional attend- tes testing supplies. Blood sugar educational session including a ees on a fluctuating basis. A total values are uploaded from these cooking demo / healthy recipe of 212 contacts were made with meters to an application on the to share. Some topics covered support group attendees in 2019. user’s phone, and into a portal, al- in 2019 were the new food label, lowing a Certified Diabetes Edu- saving money on medications, Pitt County Health Department: cator to review employees’ blood diabetes friend or foe, disaster North Carolina Minority Dia- sugars on a regular basis and planning with diabetes, holi- betes Prevention Program (NC help identify patterns, trends, day tips for healthier eating, and MDPP): NC MDPP is a regional evi- and to problem solve. Eleven physical activity. Recipes fea- dence-based diabetes prevention (11) Pitt County employees com- tured this year included salmon program targeting African-Ameri- pleted the full 10 hours of DSME patties, Mediterranean nachos, cans, Hispanic/Latinos, and Amer- in 2019. The average A1C point olive oil deviled eggs, avocado ican-Indians. NC MDPP currently decease was 1.3 among individ- lime chicken soup, and pumpkin serves individuals in Pitt, Craven, uals who completed the DSME chili. National Diabetes Month Beaufort, Lenoir, Wilson, Greene, program in 2019. For every 1.0 was celebrated in November with Wayne, and Jones Counties. In Pitt point decrease in A1C, microvas- a “Move Your Way to Prevent and County, classes are held at ECU Pitt County Health Department: cular complications are reduced Manage Diabetes” event which Family Medicine, First Presbyte- Diabetes Outreach: Outreach is by 22%. The program is funded was open to the community and rian Church, and Mount Calvary provided to the community and by Vidant Health and Pitt County featured guest speaker Jessica Church. The goal of the program to healthcare providers on an Government Employee Wellness Trahan, clinical exercise physiol- is to provide a pre-diabetes and ongoing basis to increase aware- Program. (VH-in part) ogist with Vidant Cardiovascular diabetes prevention awareness ness of diabetes and prediabetes, 4 and the services available to help and identified Heart Disease and tions. Focus areas for the series tation, and cancer treatment-re- treat and manage these illnesses. Stroke as a priority and as a re- include: handling fatigue; anxiety lated expenses. Outreach activities include health sult, a blood pressure station was and depression; improving com- fairs, grocery store tours, talks for placed in their main building and munication with family mem- Vidant Medical Center (VMC) church groups and other events in their warehouse site. Through bers and health care providers; Chronic Disease Screenings: including partnership with the the Faithful Families Program, commitment to an exercise plan VMC provided health screenings local and health affiliates. Saint Mary’s Church, Haddocks and healthier diet; and gaining for various community and church In 2019, the DSME program’s out- Church, Hollywood Presbyterian self-confidence. The program groups screening 297 individuals. reach activities served nearly Church and Mt. Calvary Church consists of six, 2 ½ hour sessions Chronic Disease screenings were 1,000 individuals in the communi- completed assessments. Had- meeting one time per week. In also provided to 147 Pitt County ty. Additional outreach was pro- docks Church determined that 2019, a total of five CDSMP partic- Schools faculty and staff. ipant workshops were offered. A vided through radio, television, Heart Disease was a priority area Vidant Medical Center (VMC) total of 23 participants completed social media, and newspapers / and was given a blood pressure Neuroscience Stroke Team: the series. This programming was magazine articles. monitor, signage for a walking The Neuroscience Stroke team is provided in partnership with the trail, and attended the Know It, committed to community out- Pitt County Health Depart- Mid-East Commission Area Agen- Control It Hypertension Coach reach, awareness, and screening ment, Prevent Blindness NC cy on Aging and the Pitt County Training. Hollywood Presbyterian activities. The Team participat- Partnership (PBNC): In collab- Council on Aging. Church identified Heart Disease ed in the American Heart and oration with PBNC, the diabetes as a priority and received a blood Rebuilding Together Pitt Coun- Stroke Walk; Strike Out Strokes education program hosted a free pressure monitor. Mt. Calvary ty – Safe at Home: Volunteers with the ECU baseball team; and Retinal Screening for members Church also identified Heart Dis- worked to improve the home a Stroke awareness basketball of the community in July 2019. ease as a priority and received a environments of low-income game again sponsored by ECU to Grant funding from PBNC sup- blood pressure monitor. A blood homeowners at risk for illness due kick off Stroke Awareness Month ported these screenings to check pressure monitor was also placed to mold, moisture or other toxic observed in May. In collaboration for eye damage such as diabetic at Sheppard Memorial Library. hazards. Twenty (20) low-income with VMC Community Health retinopathy, glaucoma, cataracts, The Know It, Control It Hyperten- homeowners received services Programs, the Team served 745 and other problems. Participants, sion Coach Training Program was that created healthier home envi- individuals with screenings for without vision insurance cover- also attended by dietitians from ronments. (VH) blood pressure, blood sugar and age, could apply for a voucher both Pitt County Health Depart- for a free eye exam and/or eye- cholesterol lipids that are known ment and ECU Family Medicine. Transforming Christian Min- risk factors for Stroke. Screening glasses. Forty-two (42) individuals The Vidant Cardiovascular and were screened and of those, 57% istries, Healthy Lives Healthy participants also received BEFAST Pulmonary Rehabilitation Pro- Choices (HLHC): HLHC is a faith- magnets along with stroke aware- did not pass the screening mean- gram was given patient education ing they required further eval- based chronic disease screening, ness literature. A Stroke Regional materials related to heart disease referral and case management Resource guide was published. uation of their eye health by an and stroke. (VH-in part) optometrist or ophthalmologist. program in partnership with Af- Vidant Medical Center (VMC) Participants were provided with Pitt County Health Department, rican American churches in Pitt Pediatric Asthma Program: This applications for the free vision Breast and Cervical Cancer County and coordinated by lay program received 381 referrals exams and eyeglasses, which was Prevention: In 2019, NC DHHS health advisors. The program con- and provided case management processed through PBNC. awarded Pitt County Health De- ducted 37 screening events and services to 64 patients. Families partment with funding to screen provided services to 254 people. were assisted with obtaining for breast and cervical cancer (VH) medications as needed. Health among low income women. A to- Promotion activities were pro- tal of 231 women were screened Vidant Medical Center (VMC) vided for 345 children. Asthma and five (5) of these women were Cancer Care: Blitz Days were held and assessed diagnosed with breast cancer. Four (4) breast cancer screenings for uninsured women includ- 1,144 children. Additional Community ing clinical breast exams, mam- Vidant Medical Center (VMC) / mograms and education were Partner Progress: Pitt Partners for Health (PPH) held with 57 women screened. Chronic Disease Initiative: First Born Community Develop- The PowerUp event was held in The PPH Chronic Disease Initia- ment Center, Diabetes Educa- November 2019 featuring 16 tive Team partnered with the PPH tion and Nutritious Food Boxes: breast exams; 16 prostate exams; Physical Activity and Nutrition With the help of volunteers from 61 head and neck screenings; Action Initiative to implement nu- local churches and community 65 skin screenings; and referrals merous activities. Park Rx events Pitt County Health Department members, this program helped made for six mammograms and were held at the Greenville Town Heart Disease Prevention Initia- to keep diabetic clients compli- 10 colonoscopies. A total of 122 Common and Alice Keene Park. tive: Funding from the NC DHHS ant with their nutritional require- community events and presenta- The Kids in Parks poster rotated and Vidant Health supported the ments through the monthly dis- tions with 12,403 in attendance; to various locations in Grifton and implementation of Blood Pres- tribution of diabetic-friendly food 9 broadcast and media aware- Fountain to bring awareness to sure Stations in the community boxes to 172 people on a monthly ness events; 11 screenings with new trails in those communities. and worksites to help people basis. Educational sessions on ex- 320 people screened were also PPH members also participated self-monitor their blood pres- ercise, nutrition and healthy reci- held. The Cancer Prevention Clin- in the West Greenville Juneteenth sures. For Heart Health Month, a pes were part of this distribution. ic served 91 patients. Tobacco Celebration. self-monitoring blood pressure (VH) cessation served 43 patients. The station was provided for Kash Navigation Team at VMC provided Vidant Medical Center Winning and Karry for patrons to use. Mid-East Commission Area over 6,600 encounter visits and with Diabetes: This successful Pitt County Government (PCG) Agency on Aging: The Living intervened with 260 of these pa- event featured guest speakers completed a CDC scorecard and Healthy With Chronic Disease tients to prevent them from hav- and reached nearly 100 indi- placed a blood pressure station Self-Management Program (CDS- ing to go to the emergency room; viduals. Healthy lunches, health at each of the 14 worksites with- MP) assists participants in gaining and 1,700 patients were referred screenings and interactive sta- in PCG. Mayne Pharma complet- self-management skills to han- to programs that provide assis- tions were provided for partici- ed the CDC Worksite Scorecard dle symptoms of chronic condi- tance with medications, transpor- pants. 5 Risk Factor Reduction: Physical Activity and Nutrition (Board of Health Priority) Progress and Interventions

Goal: Increase opportunities for physical activity and healthy food choices.

Pitt County Health Department, healthy living while participating the EFNEP series. (VH) 5,700 adults and more than 6,400 Healthy Food Small Retailer in daily physical challenge games senior adults in a variety of quality NC Cooperative Extension, Mak- Program: Funding from the NC to increase their levels of physical recreation programs were served . ing Pitt Fit Community Garden: DHHS and Vidant Health sup- activity and knowledge about nu- A Gardening Coordinator taught ported the implementation of trition. (VH) Pitt County Schools (PCS) – Eat gardening skills to 426 youth the Healthy Food Small Retailer Smart, Move More: The PCS Child Community Crossroads/Green- and 360 adults. She worked with Program with the purpose of in- Nutrition Program continued to ville Community Shelter Nutri- adults interested in starting or creasing access to healthy foods meet the dietary needs of all stu- tious Breakfast and Transpor- maintaining daycare, school and at small retail stores through re- dents and provided accurate, eas- tation Program: The Healthy community gardens across Pitt imbursements for refrigeration, ily accessible information that en- Balance Nutrition Program pro- County. (VH) shelving, etc. Michelle’s Commu- couraged the community to eat vided 20,157 breakfasts to shel- nity Store in Fountain completed NC Cooperative Extension, Pitt smart. PCS is fortunate to employ ter residents. In addition, 13,148 the NC Healthy Food Retail As- County Farm and Food Council: qualified professionals to develop bus tickets were provided for sessment and received shelving The Pitt County Farm and Food and analyze menus for a diverse residents to attend medical, vo- which is now filled with fresh pro- Council developed the Pitt Food population of students, develop cational and educational appoint- duce and signage to market the Finder App and website to help accurate resources for caregivers ments. (VH) healthy food choices. This store residents find food resources, and students with special dietary will soon implement a produce Food Bank of Central and East- farmers markets, or an agritour- needs, and develop educational stand. Michelle’s Community ern North Carolina – Pitt County ism experience in Pitt County. materials and provide training for Store #2 in Ayden also completed Branch: The Food Bank helped to There were 653 downloads in staff and students. the NC Healthy Food Retail As- fight hunger among Pitt County 2019. The Council was instrumen- Project Anna, Your Health Mat- sessment and received shelving and surrounding county residents tal in establishing the weekly, sea- ters Nutrition and Wellness for additional space for produce. who struggled with food insecu- sonal G-Circle market where farm Program: This program provid- The Stop Shop-Greenville com- rity. A total of 4.8 million lbs. of vendors sell at the Pitt County ed supplemental food, health/ pleted the NC Healthy Food Retail nutritious food and produce were Health Department and Human nutrition education sessions and Assessment as well. (VH-in part) distributed. (VH) Services campus. Vendors accept health screenings for individuals SNAP payments. (VH) Pitt County Health Department, Hope of Glory Ministries, Com- living below the poverty level, Water Refill Stations:To encour- munity Food Co-Op: This pro- Operation Sunshine, Genera- serving 5,000 individuals. (VH) age and increase water consump- gram, which addressed food in- tion Y Striving to be Fit: The Op- Raising Young Men (RYM), 360 tion, Water Refill Stations were security, served thirty-three (33) eration Sunshine after school and Fit Nutrition and Physical Activ- placed at the Greenville Public families resulting in $64,775 in summer program for economical- ity Program: RYM incorporated Works Department, Pitt Coun- grocery savings that participants ly challenged females ages 5-13 360 Fit, a nutrition and physical ty Government Developmental were able to apply toward meet- provided health and nutrition activity program for young men, Services Building and Oakwood ing their financial goals of paying education and physical activities providing them with an all around School. This initiative was sup- off debts and/or establishing a for 25 girls during the school year awareness of a healthy lifestyle. ported by funding from NC DHHS savings account. Families re- and 35 girls in the summer pro- (VH) and Vidant Health. (VH-in part) ceived healthy foods, attended fi- gram. (VH) nancial management classes and Support Team for Active Rec- Pitt County Community Schools Note: Additional Pitt County Health were mentored by staff.(VH) reation (STAR): STAR enhanced and Recreation: Over 6,800 stu- Department Physical Activity and the quality of life for individuals NC Cooperative Extension, dents were served in youth sports Nutrition initiatives are featured in with disabilities through educa- Family and Consumer Scienc- and special programs. Over 480 other sections of this report. tion, socialization and adapted es: A NC Cooperative Extension students were served in ten (10) recreation activities providing agent helped adults with culinary schools through the After School Additional Community physical activity opportunities nutrition skills: 611 increased and Summer Enrichment Pro- for approximately 65 individuals. Partner Progress: their food safety, preparation gram. Students participated in (VH) A Time for Science: The SAGE or preservation skills; 237 low- nutrition lessons, engaged in 60 Sisters program served middle ered their sodium intake; 293 minutes of physical activity daily The Little Willie Center – Healthy school girls providing them with increased their physical activity; and enjoyed healthy snacks. Tai Meals Initiative: The Little Willie opportunities to learn about and 351 increased their intake of Chi for Arthritis, Pilates, Function- Center after school program pro- healthy lifestyles, and increased produce. (VH) al Stretching and Aerobic Line vided tutoring and mentoring opportunities to participate in Dance were held for community to latch-key children and served various types of physical activity. NC Cooperative Extension Ser- dwellers. Staff worked with the 3,111 nutritious meals to children. The program also helped to im- vice, Healthy Communities “Aktion Club”, “STAR” and commu- Supplemental food supplies were prove their social skills by inter- EFNEP: Healthy Communities nity sponsors to provide activities also distributed to 450 families. acting with their peers and pro- Expanded Food and Nutrition Ed- designed to introduce people (VH) gram mentors. (VH) ucation Program (EFNEP) provided with disabilities to positive recre- lessons on nutrition; healthy food ation activities. Staff continued to Vidant Medical Center (VMC) Boys and Girls Club - Pitt Coun- preparation; and food safety to be the Lead Agency for the Gren- Eastern Carolina Injury Pre- ty Sites, Triple Play Program: low-income families and children. ville-Pitt County Senior Games vention Program Physical Ac- This program served over 1,300 Over 1,500 youth increased their Program and provided year- tivity Events: The following ac- youth among five club sites. Youth physical activity and produce con- round sports and recreation for tivities promoted physical activity learned about the importance of sumption after participating in people 50 years and older. Over (numbers reached following each 6 event: Walk to School Day (3,600); Vidant Medical Center / Pitt West Greenville Health Council: status and works as an indepen- Bike to School Day (600); Bike Hel- Partners for Health, Healthy With foundational support orig- dent, community-driven health met Fittings for 4th grade students People Healthy Carolinas (HPHC) inally from a $15,000 Blue Cross group. The WGHC continues to (780); Bike and Pedestrian Safety grant: This $150,000 grant award- Blue Shield Foundation grant, the meet monthly, participates in the Summer Camps (180); Bike and Pe- ed to Vidant Medical Center / Pitt Pitt County Health Department, City’s Adopt-a-Street program, an- destrian Safety Workshop for Phys- Partners for Health supported the Pitt Partners for Health, and ac- nually hosts the West Greenville following activities / programs: ical Education Teachers (40); Walk ademic partners from the East Juneteenth celebration, commu- CATCH (Coordinated Approach to at School Program-Walk Across Carolina University Departments nity wellness programs, and re- Child Health): 10 sites /385 partic- America Program (600); Sports of Public Health and Kinesiology, cently collaborated with the ECU ipants; Walk Wise NC: 2 sites / 96 Departments of Public Health and Safety Clinics and community worked with local residents to participants; Kids in Parks Track create the West Greenville Health Family Medicine to conduct pa- events (over 1400); Arthritis Foun- Trails: 4 trails; 253 participants; Council (WGHC). The WGHC sup- tient and researcher/clinician cur- dation Exercise Program (1,000); New TRACK Trail sites were im- ports the work of concerned West riculum development and train- Remembering When Program plemented though a mini-grant Greenville citizens to identify and ing through a Patient-Centered (falls and fire education and as- process (5 municipalities submit- prioritize local health issues and Outcome Research Institute (PCO- sessments conducted through 25 ted proposals); Implemented two address health inequities. The RI) Engagement award. The Coun- home visits); Falls Awareness and new Trails in Fountain and Grifton; WGHC has met monthly since cil also provided monthly health Prevention Fair (70 individuals); Walk With A Doc: walks; Track RX: February 2017 and has supported education sessions based on the World’s Largest Swim Lesson (200); 6 practice sites / 66 participants; the implementation of two inter- National Health Observances in Devontae Dortch SwimSafe Pro- Cooking Matters at the Store: 6 ventions – WalkWise NC and the various venues throughout West gram (340 second grade students). tours / 68 participants; Healthy Minority Diabetes Prevention Pro- Greenville. Food Pantry / 50 participants at gram in the local community. The the Joy Soup Kitchen. Council has since received 501c3 Risk Factor Reduction: Tobacco and other Substance Abuse Prevention and Control (Board of Health Priority) Progress and Interventions Goal: Contribute to the reduction of teen tobacco use. Tobacco Prevention and Con- were also used to help increase products and how to help people for toxic drugs as well as Nalox- trol, Centers for Disease Control awareness of the harms of to- who are addicted with 44 attend- one kits for the reversal of drug (CDC) Grant: Pitt County Health bacco usage. The following ac- ees; Placed a Truth Campaign overdoses. Testing is provided for Department continued to receive tivities were implemented: 5 A’s advertisement on WITN over the HIV, and Hepatitis C. Bus passes, funding from a CDC Core grant for tobacco cessation training summer to target youth; Placed gas, and food cards have been from the NC DHHS to help pre- was held for 23 health depart- a “Making Menthol Black” cam- provided to participants allowing vent smoking and other tobacco ment clinical staff and the Smile paign online to bring awareness them to follow-up with medical use; eliminate exposure to sec- Safari Mobile Dental Unit staff; to the historic precedent of to- appointments when transporta- ondhand smoke; help tobacco Promotion of tobacco cessa- bacco companies targeting mi- tion is an issue. This initiative is users quit and eliminate tobac- tion counseling on ECU campus norities. supported by funding ($275,000) co-related health disparities. This through health events, flyers, and from the NC DHHS Injury and Vio- funding provided support for a encouraging nurses to promote it lence Prevention Branch. Program Coordinator to serve 10 during their screenings reached eastern NC counties, including 455 people; Tobacco 101 and a Additional Community Pitt County as the lead County. behavioral workshop were con- Partner Progress: With e-cigarettes quickly gaining ducted for Pitt County Schools population among teens, there staff; Partnered with SAAD, the Pitt County Sheriff’s Heroin was high focus on Tobacco Free Pitt County School system and Addiction Recovery Program Schools. State and Tobacco Pre- Vidant who implemented an Es- Pitt County Health Department, (S.H.A.R.P.) and Women’s Em- vention and Control grant funds cape the Vape event for DH Con- ekiM Needle Exchange Pro- powerment and Recovery Pro- supplied Pitt County Schools with ley High School reaching over 500 gram: Pitt County Health Depart- gram (W.E.A.R.): The S.H.A.R.P. new signage to support the 100% students; Worked with the Health ment partnered with the ”ekiM for program offers comprehensive Tobacco Free Campus Law which Service Core at South Central Change” to support a community services to assist inmates strug- also includes e-cigarettes. E-ciga- High School on tobacco educa- syringe exchange program in an gling with addition to successful- rette and tobacco education was tion and prevention reaching 120 effort to reduce the transmission ly re-enter society upon release also presented to various schools students; Implemented E-ciga- of diseases such as HIV and Hep- from jail. Services begin upon in the Pitt County School system rette disposal education at the atitis C. “ekiM (Mike spelled back- incarceration and follow through and surrounding counties. The Pitt County Fair; Provided updat- wards) for Change” is a limited release. W.E.A.R. focuses on cog- Tobacco Prevention and Control ed 100% Tobacco Free Schools liability corporation created by nitive behavior and person-cen- Branch partnered with Eastern signs that include the e-cigarette Dianne Carden-Glenn in memory tered therapy helping partici- AHEC and Pitt County Schools to symbol for Pitt County Schools; of her son, Mike, who died tragi- pants become more self-aware. host a training for the counselors Implemented a Certified Tobac- cally from an overdose. The pro- This program teaches vital life from Pitt County Schools about co Treatment Specialist Train- gram provides free, clean syringes skills such as effective parenting, tobacco, the effects on youth, and ing at Eastern AHEC to improve as needed and accepts used ones healthy and rational thinking, the importance of intervention the clinical awareness and capa- for safe disposal. Wound care kits money management, and illicit for prevention and cessation. Web bilities of tobacco cessation; Host- and hygiene supplies are provid- substance prevention, to name a and Television based advertise- ed a training for professionals ed. Program participants also re- few. Both of these programs were ments from the Truth Campaign to learn more about tobacco ceive Fentanyl test strips to test founded by Sheriff Paula Dance. 7 Maternal and Child Health (Board of Health Priority) Progress and Interventions Goal: Reduce Pitt County’s infant mortality rate with special emphasis on reducing the rate among African American women.

Pitt County Infant Mortality Racial Disparities Ratio (5-Year Averages) Source: Infant Mortality Racial Disparities Between White, Non-Hispanic and Infant Mortality African-American Non-Hispanics 2009-2018, NC State Center for Health Statistics Pitt County’s 2018 total infant death rate of 6.7 / 1,000 live births African exhibited considerable improvement when compared to past years (8.8 White Non- Disparity American Years Hispanic Ratio / 1,000 live births in 2017 and 12.9 / 1,000 live births in 2016). Although Non-Hispanic only slightly, Pitt County’s 2018 total infant death rate was also lower than North Carolina’s 2018 total infant death rate of 6.8/1,000 live births 2009-2013 5.9 17.1 2.90 for the first time in well over a decade. However, there continues to be a 2010-2014 6.6 16.9 2.56 significant disparity between White Non-Hispanic and African American Non-Hispanic infant deaths. Between 2014 – 2018, Pitt County’s 2011-2015 6.8 16.7 2.46 disparity ratio between White Non-Hispanic and African American Non- Hispanic infant deaths was 3.43 based upon 5-year averages. Premature 2012-2016 7.8 16.8 2.15 births, low weight births and birth defects continue to be the leading causes of infant mortality in Pitt County. Numerous evidence-based 2013-2017 6.9 15.8 2.40 programs designed to help improve birth outcomes and prevent infant mortality attempted to address the issue throughout 2019. 2014-2018 4.7 16.1 3.43

North Carolina Infant Mortality Racial Disparities Ratio (5-Year Averages) Source: Infant Mortality Racial Disparities Between White, Non-Hispanic and African-American Non-Hispanics 2009-2018, NC State Center for Health Statistics African White Non- Disparity American Years Hispanic Ratio Non-Hispanic 2009-2013 5.4 13.6 2.52 2010-2014 5.4 12.9 2.39 2011-2015 5.5 12.9 2.35 2012-2016 5.4 13.0 2.41 2013-2017 5.3 12.7 2.40 2014-2018 5.2 12.7 2.44 Pitt County Infant Mortality Rates 5-Year Averages White Non-Hispanic and African American Non-Hispanic Comparison 2009-2013, 2010-2014, 2011-2015, 2012-2016, 2013-2017, 2014-2018 INTERVENTIONS Source: NC State Center for Health Statistics Pitt County Health Department receive support for up to a year 18 Better Beginnings Breastfeeding after having a baby. Breast pumps 16 Peer Counselor Program: are available to assist women with th s 14 2009-2013 This program is led by trained maintaining their breastmilk sup- Bir 12 2010-2014 Peer Counselors with personal ply. The Peer Counselors provid- breastfeeding experience who 10 2011-2015 ed 128 home visits in 2019. The provide support and encour- 8 2012-2016 Breastfeeding Program is funded agement to women enrolled in by NC WIC and the Vidant Health er 1,000 Li ve 6 2013-2017 the Women, Infant and Children Foundation. (VH – in part) te P 4 2014-2018 (WIC) Program. Peer Counsel- Ra 2 ors establish a relationship with Pitt County Health Department 0 women during their pregnancy Breastfeeding Celebration: The Annual World Breastfeeding Pitt County White Pitt County African and provide intensive support in Non-Hispanic American Non-Hispanic the first month after the baby is Celebration, themed “Empower born. Women may continue to Parents, Enable Breastfeeding,” 8 was held in August 2019 reaching Pitt County Health Department unsafe sleeping environments. a total of 85 participants includ- Breast Pump Worksite Initia- Low-cost cribs, safe sleep survival ing women, children, support tive: Through funding from NC kits and education were provided partners, exhibitors and volun- DHHS, Pitt County Health Depart- to low-income parents. In 2019, teers. This free community event ment’s Health Promotion Team 45 safe sleep educational sessions was designed to connect families Pitt County Health Department entered into a partnership with were offered and 328 cribs were with resources that encourage Breastfeeding Mural: Special (ECU) distributed to families in need. and support breastfeeding and WIC grant funding was received to promote and support breast- Funding from NC DHHS support- also included a kid’s activity sta- in 2019 to add a breastfeed- feeding among ECU employees. ed paid television and website tion, photo booth, healthy WIC ing-friendly mural to the outside ECU completed the CDC Worksite advertisements to promote the recipe sampling, and free books walls of the breastfeeding office Health Scorecard and launched program to families. from the Dolly Parton’s Imagina- at the Health Department. One this employee breastfeeding Pitt County Health Department initiative in early April 2019. Lac- tion Library Program. wall of the mural depicts a wom- Healthy Beginnings: Pitt Coun- tation rooms and equipment an breastfeeding her child, sur- ty Health Department received Pitt County Health Department (breast pumps) are now available rounded by her support partners. funding from the NC DHHS and Breastfeeding Support Group upon a mother’s return to work The image represents the links from the County to provide sup- – Mothers of Milk Support at ECU. ECU now provides moth- between breastfeeding, nourish- port services to pregnant and (M.O.M.S.): A monthly breast- ers preparing for maternity leave ment, support and development. postpartum women who need feeding support group was held with a packet of information ex- The mural is an intentional way to extensive case management ser- at the Health Department provid- plaining this initiative. Pitt County vices. This program includes care ing a nurturing environment for positively promote and normalize Health Department also collabo- coordination and home visiting breastfeeding women to connect breastfeeding in the Health De- rated with Vidant Medical Center services in the following areas: with others. A total of 65 attend- partment lobby area. The other Lactation Services to create ma- healthy weight and physical ac- ees participated in the monthly side of the mural includes imag- terials ensuring employees are tivity, daily folic acid/multivitamin breastfeeding support group es of families and children being aware of this initiative and link- consumption, early and contin- meetings, some attending multi- active. The pictures encourage ing patients with proper supplies uous prenatal care, breastfeed- ple meetings. physical activity and movement. and training to utilize the pumps ing initiation and maintenance, placed at ECU and other partici- postpartum care, reproductive pating worksites. life planning, safe sleep practic- Pitt County Health Department es, tobacco use/ smoking cessa- Child Care Health Consultant tion and eliminating secondhand Program: Pitt County Health smoke exposure and well–child Department Child Care Health visits. Consultants provided technical Pitt County Health Department assistance and training to child NC Baby Love Plus: Pitt County care staff at centers and homes. Health Department continued to In 2019, 181 child care workers receive funding from the Health received ITS-SIDS (Infant/Toddler Resources and Services Admin- Safe Sleep and SIDS Risk Reduc- istration’s (HRSA) Maternal and tion) training; 70 received Keep it Child Health Bureau to support Clean-Handwashing and Diaper- the NC Baby Love Plus program. ing training; 15 received an Emer- The purpose is to improve birth gency Planning and Response outcomes and the health of wom- training; 20 received Medication en of childbearing age through Administration training; and 22 strengthening the perinatal received Be Active Kids training. systems of care, building family Program staffing and activities resilience, promoting quality ser- were funded by a Martin / Pitt vices, and increasing communi- Partnership for Children, Smart ty capacity to address perinatal Start grant. disparity. Outreach was provided Pitt County Health Department to 3,636 women of childbearing Child Fatality Prevention Team age and their families. Approxi- (CFPT): The Pitt County Child mately 257 women were linked Fatality Prevention Team is com- to health and social resources. prised of members from various Pitt County Health Department local agencies and disciplines Nurse-FamilyPartnership (NFP): who work collaboratively. This The NFP is an evidence-based team identifies and reduces pre- community health, nurse home ventable child fatalities in Pitt visiting program for low-income County through systematic re- first time mothers that empow- views. In 2019, a total of 18 child ers them to transform their lives deaths occurred in Pitt County. and create a better future for One (1) death was selected for themselves and their babies. The review. NFP program has three goals: 1. Pitt County Health Department Improve pregnancy outcomes by Cribs for Kids: The Pitt County helping women engage in good Health Department continued preventive health practices, in- the Cribs for Kids campaign de- cluding thorough prenatal care signed to decrease the rates of from their healthcare providers, accidental infant deaths due to improving their diets and reduc- 9 ing their use of cigarettes, alcohol In addition, WIC provided infor- and illegal substances; 2. Improve mational brochures throughout child health and development by the year upon request. The Nutri- helping parents provide respon- tion Division continued to have sible and competent care; and 3. strong partnerships with the West Improve the economic self-suf- Greenville Health Council, Pitt ficiency of the family by helping Partners for Health, the Pitt Coun- parents develop a vision for their ty Farm and Food Council and the own future, plan future pregnan- Healthy People, Healthy Carolin- cies, continue their education and ians grant initiative. find work. The NFP served 113 Pitt County Health Department families during 2019 and provid- Youth Development / Adoles- ed 1,395 home visits. Funding for cent Pregnancy Prevention the program was provided by the Program: Pitt County Health De- NC DHHS, Vidant Health Foun- inars to groups. Through invested ing, bean bag toss, crawl-through partment’s Youth Development dation, Martin-Pitt Partnership community partnerships and col- tunnel, fruit and veggie toss game and Pregnancy Prevention pro- for Children, Eddie and Jo Allison laboration, this evidence-based and an interactive dance video. gram served 73 middle and high Smith Family Foundation, and program continues to strengthen Pitt County Health Department school students during the school United Way of Pitt County. (VH – Pitt County families. WIC Holiday Open House: The year. Students participated in ac- in part) Pitt County Health Department Pitt County WIC Program had a tivities that focused on life skills Pitt County Health Department WIC Improvements and En- festive time at the WIC Holiday development, goal setting and PIMPAC: The Pitt Infant Mortal- hancements: The Pitt County WIC Open House held in December community service. Funding from ity Prevention Advisory Council Program received special funding 2019. Along with WIC staff and Vidant Medical Center Commu- (PIMPAC) continued to oversee in the amount of $27,085 from the volunteers, Dr. John Silvernail, nity Health Programs helped to programs and services aimed N.C. Department of Health and Health Director was also “all support the activities. No preg- at improving Pitt County’s birth Human Services to enhance the aboard” for the story time read- nancies were reported among outcomes by implementing strat- physical environment, improve ing of the Polar Express. Partic- participants. egies to combat Pitt County’s customer service and promote ipants or potential WIC partici- leading causes of infant death the WIC Program. Funding was pants sampled healthy recipes Additional Community (preterm birth, low weight births, used for murals in the health de- made from WIC approved foods. and birth defects). The 27th an- partment lobby, marketing on The community had the oppor- Partner Progress: nual “Making Pitt’s Babies Fit” the GREAT Bus and a non-invasive tunity to see the new murals “The Maternity Fair featured over 80 hemoglobin machine. In addi- Tree of Life” and “Under the Sea”, Vidant Medical Center (VMC) exhibits and served approximate- tion, staff “Caseload Challenges” painted by Tabatha Ferrell, local Eastern Carolina Injury Preven- ly 500 people, linking many with included promotional activities artist. The Tree of Life encourag- tion Child Passenger Safety: needed resources. The event was that helped to continuously in- es breastfeeding, is inclusive of VMC provided 278 child safe- sponsored by PIMPAC, Pitt County crease the number of individuals all family and support partners, ty seat checks and distributed Health Department, Vidant Med- enrolled in WIC. By November and encourages physical activity. 25 seats to indigent families. ical Center Community Health 2019, the WIC caseload increased Under the Sea is located in the Through the Child Passenger Programs, Target of Greenville, to 4,228. Health Department’s Height and Safety Diversion initiative, 105 Weight Measurement Area and Triple P – Positive Parenting Pro- Pitt County Health Department families received Child Passenger gram, and the Greenville Conven- offers a soothing environment to WIC Fun Days: During 2019, two Safety education and had their tion Center. children while they receive ser- traffic seat ticket reduced through WIC Fun Days were held and fea- vices. Other activities included the District Attorney’s office. Pitt County Health Department tured simple cooking demonstra- an ornament station for the kids, Triple P Positive Parenting Pro- tions using WIC foods, fun physi- promotion of reading through Through the Child Passenger Seat gram: Pitt County Health De- cal activities, and goody bags for the Dolly Parton Imagination Li- Distribution/Toyota Buckle Up For partment continued to receive families. Food tastings coincided brary and live seasonal music. Life Program, 112 adults and chil- funding from NC DHHS along with educational mini lessons dren received occupant protec- with the added partnership of or featured topics, and provided Pitt County Health Department tion education and 50 child safety The Impact Center at Frank Porter samples of WIC foods and recipes. WIC Outreach / Inreach: WIC seats were distributed to foster Staff displayed at a number of Graham and Prevent Child Abuse Both the March (National Nutri- parents in Pitt County. NC. In 2019, 833 caregivers and tion Month) and October Fun events during 2019 and distribut- 1,265 children were impacted. Days were each attended by more ed nutrition information and small Additionally, 10 Pitt County pro- than 50 participants who sam- incentive items. Events included viders from various agencies were pled healthy recipes, reaching displaying at Pitt County Human trained in Triple P Level 3 Primary more than 100 individuals. To get Services (5/19) and presenting at Care along with an additional four kids moving, the Fun Days incor- a Staff Meeting (2/19); Give Kids (4) trained to deliver Triple P Sem- porated activities such as bowl- a Smile Day (2/19); Making Pitt’s Babies Fit Maternity Fair (4/19); Lucille Gorham Educational Inter- generational Center community event (4/19); Family Academy at Carver Library (4/19) and (11/19); Little Willie Health Celebration (5/19); Juneteenth Celebration/ West Greenville Block Party (6/19); the AMEXCAN Health Fair (7/19); World Breastfeeding Celebration (8/19), Head Start Community Health Fair (7/19); Pitt County Fair (9/19); and Latino Festival (9/19). 10 Sexually Transmitted Diseases (Board of Health Priority) Progress and Interventions Goal: Reduce Pitt County’s rate of Sexually Transmitted Disease with emphasis on Chlamydia and HIV.

Chlamydia According to the 2018 NC HIV/STD/Hepatitis Surveillance Report, Newly Diagnosed Chlamydia Annual Rates Comparison of Pitt County and NC Chlamydia is the most frequently reported bacterial STD both Source: NCHIV/STD/Hepatitis Surveillance Unit, 2019. 2018 NC STD Surveillance Report nationally and in North Carolina. A higher number of cases are reported NC DHHS, DPH, Communicable Branch, Raleigh, NC among women and most often among women between the ages of 1200 20-24 years, followed by ages 15-19 years and ages 25-29 years. In 2018, Black / African women and men had the highest Chlamydia rates. 1000 If left untreated, it can cause damage to the female reproductive tract,

including infertility and Pelvic Inflammatory Disease. It can also result in pulation 800 problems during pregnancy. Po 600 Pitt County Although North Carolina experienced a 33.6% increase in the number NC of newly diagnosed Chlamydia cases between 2014 -2018 and a 27.8% 400 increase in annual Chlamydia rates during the same reporting period,

Pitt County’s Chlamydia rate was 77.2% higher than North Carolina’s tes per 100,000 200 rate in 2018. Pitt County experienced a 27.5% increase in the annual Ra number of newly diagnosed Chlamydia cases from 2014-2018 (1,608 0 2014 2015 2016 2017 2018 cases to 2,050 cases). Expressed in rates per 100,000 population, this represents a 24% increase in new case rates (918.9 / 100,000 in 2014 to Year 1139.4 / 100,000 in 2018). Source: NCHIV/STD/Hepatitis Surveillance Unit, 2019. 2018 NC STD Surveillance Report NC DHHS, DPH, Communicable Branch, Raleigh, NC

Newly Diagnosed HIV Annual Rates HIV Comparison of Pitt County and NC Source: NCHIV/STD/Hepatitis Surveillance Unit, 2019. 2018 NC HIV Surveillance Report HIV is caused by retrovirus and spread through certain body fluids. NC DHHS, DPH, Communicable Branch, Raleigh, NC It weakens a person’s immune system, making it difficult to fight off infections. Currently, there is no cure for HIV, although medical care, 30 including antiretroviral treatment, can help control HIV. According to the 25 2018 NC HIV/STD/Hepatitis Surveillance Report, North Carolina’s newly diagnosed HIV annual rates decreased from 15.9 / 100,000 population 20 to 13.9 respectively, between 2014-2018. During this same reporting opulation Pitt County 15 period, Pitt County’s newly diagnosed HIV annual rates decreased from NC 25.9 / 100,000 population to 21.0 respectively. In 2018, Pitt County’s 10 newly diagnosed HIV annual rate was 51% higher than North Carolina’s. 5

During this same year, Pitt County was ranked as having the 8th highest tes per 100,000 P Ra newly diagnosed HIV rate among all 100 NC counties. 0 2014 2015 2016 2017 2018 Source: NCHIV/STD/Hepatitis Surveillance Unit, 2019. 2018 NC HIV Surveillance Report NC DHHS, DPH, Communicable Branch, Raleigh, NC Year

INTERVENTIONS

Pitt County Health Department, promoted awareness at the West cable Disease / Sexually Transmit- necessary to help them change Communicable Disease Health Greenville Health Council’s June- ted Disease and Family Planning their behavior in ways that will Educator: A Public Health Educa- teenth Celebration; Head Start Clinics. Sister to Sister is a HIV/ reduce their risk for STDs, espe- tor was hired and began the im- Screening/Health Fair; Traveling STD prevention intervention that cially HIV. is implemented in the clinical set- plementation of evidence-based Adolescent Health Fair; STI Pre- Pitt County Health Department, interventions (Sister to Sister; vention Educational Session at ting with heterosexual, African VOICES (Video Opportunities Voices – Video Opportunities for the Juvenile Detention Center; American Women, ages 18-45, for Innovative Condom Educa- Innovative Condom Education and National Night Out. who are HIV negative, and are not tion and Safer Sex) Program: and Safer Sex; and Community pregnant. It is a one-time, one- Pitt County Health Department, VOICES is an evidence-based, Condom Distribution Sites), all on-one safer sex session delivered Sister to Sister Program: The single-session, video-based HIV/ designed to help prevent STD by a health educator. It provides Sister to Sister evidence-based STD prevention intervention that transmission. The Health Educa- program was implemented in the women with knowledge, beliefs, is delivered in a group setting and tor also provided education and Health Department’s Communi- motivation, skills, and confidence designed to increase condom ne- 11 gotiation skills and condom use fy those at most risk for HIV and among participants. During the link them to qualified providers intervention, participants explore for PrEP. The Program also works risks of STD infections, condom to provide capacity building and features, and condom use nego- technical assistance to increase tiation. At the end of the session, the ability of healthcare providers participants receive free condoms to provide high quality, accessi- of different varieties. In 2019, Pitt ble PrEP services, addressing the County Health Department be- national HIV prevention goals gan offering VOICES on a contin- of reducing new HIV infections, uous basis to community groups increasing access to care and re- upon request. Currently, VOICES ducing HIV-related disparities and is being implemented at PORT health inequities. Health Services, Pathways to Life (Mental Health and Substance Pitt County Health Department, Use Agency), and CHOICES (Men- Walk-In Services: To improve ac- tal Health and Substance Use cess to care and to help further Agency). prevent the spread of STDs in Pitt County, the Health Depart- Pitt County Health Department, ment offered Walk-In services for Community Condom Distribu- individuals in need of sexually tion Sites: Condom Distribution transmitted disease treatment, in Sites have been proven to in- addition to provision of clinical crease condom use and prevent appointments. Walk-In services HIV/STDs. In partnership with were also provided for pregnan- PiCASO (Pitt County AIDS Ser- cy testing; birth control pick up; vice Organization), additional Depo Provera Shots; Tuberculosis Condom Distribution sites were (TB) skin testing and reading; and established in the community. adult immunizations, including Supplies of condoms were reg- Influenza (Flu). ularly stocked and placed on display at community locations Pitt County Health Department, and offered free of charge to the Youth Development/ Adoles- public. In 2019, the following sites cent Pregnancy Prevention Pro- were established: Moyewood gram: The Program Coordinator Cultural and Recreation Center; provided pregnancy and STD pre- Kampus Kutz Barbershop; Unlim- vention education in the school ited Cuts Barbershop; Executive system for middle and high Cuts Barbershop; Pathways to school students and connected Life; CHOICES Behavioral Health students with other public health and Substance Abuse Agency; services as needed. RI International; and Harmony Hair Spa. Additional Community Pitt County Health Department, Partner Progress: PrEP (Pre-Exposure Prophylax- is for HIV) Program: NC DHHS PiCASO (Pitt County Aids Ser- Funding was awarded to Pitt vice Organization) HIV Testing: County Health Department in PiCASO provided educational ses- August 2019 to implement a PrEP sions to populations considered (Pre-Exposure Prophylaxis) Pro- high-risk for HIV and to organiza- gram for HIV prevention in the fol- tions that work with these groups. lowing counties: Beaufort, Carter- PiCASO also tested individuals for et, Craven Greene, Lenoir, Martin, HIV and referred individuals who Pitt (lead County), Pamlico, Wash- tested positive for the virus to the Pitt County Health Department ington, Wayne and Jones. The Brody School of Medicine’s Infec- primary purpose of this Program tious Disease Clinic for further 201 Government Circle is to improve access to Pre-expo- treatment. (VH) sure Prophylaxis (PrEP) services Greenville, NC 27834 for eligible persons at high risk for HIV with a primary focus on young, African American men 252-902-2300 who have sex with men (MSM). This Program enables local health departments to connect with Call for an appointment or for and develop relationships with the MSM communities to identi- information about Walk-In services. 12 Additional Community Partner Efforts The following updates reflect progress made towards addressing additional health priorities selected by community partners. In addition to the health priorities selected by the Board of Health, Pitt County Health Department worked collaboratively with the community to ensure that a broad range of priorities were addressed and without duplication of efforts. Access to Care / Social Determinants of Health (Community Partner Priority) Access East, Clinician for the NC MedAssist: This program dis- food; safe and affordable hous- James D. Bernstein Center: A pensed 3,307 prescription medi- ing; jobs, etc.) and provides feed- Physician Extender position was cations valued at $871,920 to 385 back to referral sources reporting supported at the James D. Ber- patients. (VH) if the individual connected with nstein clinic and served 491 un- the recommended service. Social Pitt County Care, Free Clinic insured new patients in need of Determinants of Health Screening for the Uninsured Population: primary care services. Follow-up Tool: A medical/legal partnership Medical Students from the Brody services were also provided to exists between Vidant’s Pediatric School of Medicine volunteered 177 patients who had previously Asthma Program and Legal Aid of their time on Sundays to oper- visited the hospital’s emergency NC. There is a direct link between ate this clinic held at Pitt County department. (VH) the two entities and referrals are Health Department. Primary care easily and consistently coordi- Conditions in the Access East, Colon Cancer services including low-cost med- nated. Health Screenings: VMC Screening Project: Cancer ications and laboratory services Community Health began work- places where screenings were provided for un- were provided to 554 patients ing with the Greenville Housing insured residents. Thirteen (13) in- which includes 163 new patients. Authority Community Centers people live, learn, dividuals received services. (VH) (VH) to provide health screenings at Access East, Prescription Medi- Pitt County Council on Aging, its various locations. The group work, and play affect cation Assistance: A Medication Medicare Options Counselor: is now working to provide blood Assistant helped Health Assist A Medicare Options Counselor pressure monitors at these com- a wide range of health and Bernstein Center patients provided 1,707 counseling ses- munity centers. obtain 2,217 prescription medica- sions for Medicare beneficiaries risks and outcomes. tions valued at $789,608. (VH) to help them access cost saving Vidant Medical Center (VMC) / programs and make informed Pitt County Emergency Man- These conditions Access East for Project MEND: decisions about healthcare cover- agement Community Paramed- A social worker connected pa- age resulting in a savings of $1.3 ic Program: Pitt County Emer- such as housing, tients from various free clinics million. (VH) gency Management operated (Greenville Community Shelter, a Community Paramedic (CP) safe neighborhoods, Oakmont and Pitt County Care) to Real Crisis, Pitt Resource Con- Program in unison with VMC and Health Assist and/or primary care nection (PRC): PRC promoted with support from Vidant Health. income, education and providers and to other communi- access to care through their 350 Healthcare was provided to com- ty resources to establish a contin- member network representing munity members and decreased healthy food access uum of care. (VH) 124 agencies and through com- the number of unnecessary emer- CareNet Counseling East, Client munity events and a weekly TV gency department visits. In ad- are known as Social Aid for Mental Health Counsel- show on GPAT. Community mem- dition, counseling services were ing: A total of 992 Faith integrat- bers’ needs including assistance provided to seniors to assist them Determinants of ed mental health counseling ses- with medical services/supplies, with Medicare Part D enrollment. sions were provided regardless of prescription medications, rent, Seniors were also assisted with Health (SDOH). ability to pay. (VH) utilities and furniture were iden- applications to the Department ECU Physicians, Prescription tified and individuals were linked of Social Services for the Low-In- Medication Assistance Pro- with resources. (VH) come Energy Assistance Program. gram: Medications were provided The CP Program linked commu- to help patients manage chronic Vidant Medical Center (VMC) / nity members to services such as diseases. Patients obtained 1,430 Pitt Partners for Health (PPH) home health, Meals on Wheels, prescription medications valued Access to Care Initiative: In 2019, free clinics, food stamps and Source: Centers for Disease at $2.1 million. (VH) PPH members began working more. (VH) Control and Prevention to promote NCCARE360 among https://www.cdc.gov/ Jarvis United Methodist agencies within Pitt County. Vidant Medical Center (VMC) socialdeterminants/index.htm Church, Shepherd’s Helpers: NCCARE 360 is an initiative sup- School Nurse Program: The Reusable, portable aluminum ported by a partnership between School Nurse Program improved ramps were provided to 50 peo- the NC DHHS; and the Founda- access to care including chronic ple with physical challenges. (VH) tion for Health Leadership and disease and medication manage- Oakmont Baptist Church: The Innovation; and implementation ment for students enrolled in Pitt Oakmont Ramp Builders con- partners, United Way of NC/211, County Schools. Case Management structed wooden ramps for 46 Expound Decision Systems, and services were provided for 357 stu- disabled individuals enabling Unite Us. NCCARE 360 electroni- dents. There were 7,263 student them to attend medical appoint- cally connects individuals to health encounters and 208 health ments. (VH) community resources (healthy education sessions held. 13 Mental Health (Community Partner Priority) Mental“

Adverse Childhood Experienc- Vidant Medical Center (VMC) es (ACEs): Pitt County Health Eastern Carolina Injury Pre- Health Department staff and numer- vention Program: Education ous community partners have was provided on the following “ received ACEs training. ACEs, destructive decision topic areas: Matters! are potentially traumatic events suicide, bullying, substance abuse (experiencing or witnessing vio- and alcohol, sports safety, human lence, death of family member, trafficking, tobacco/vaping, parental instability, parental sub- teen pregnancy/STDS and safe stance abuse, etc.) that occur in relationships. childhood. ACEs are linked to Vidant Medical Center (VMC) / chronic health problems, mental Health Initiative. Group members community education. The group illness, and substance misuse in Pitt Partners for Health (PPH) represent approximately 15 differ- has submitted a proposal for the adulthood and can negatively Mental Health Initiative: A work- ent stakeholders in the commu- funding of community education impact education and job oppor- group meets monthly to focus on nity and have been working col- with a focus on Mental Health tunities. the Mental Health / Behavorial laboratively to develop a plan for First Aid.

New and Emerging Issues A Message from Pitt County’s Health Director

Greetings Fellow Pitt County Residents,

First, let me thank you for the opportunity to serve as your Health Director. I would also like to bring attention to the following new and emerging health issues that are occurring globally: Coronavirus 19 (COVID 19): Many human diseases begin as animal diseases. Sometimes we become inadvertently infected with an animal infection, for example Rabies. At other times, an animal infection makes the jump to humans; an example of this is Avian Influenza. This year, we are seeing this scenario on a large scale with Coronavirus, now known as COVID 19. This infection has made the jump from animals to humans and is now being spread by person to person contact in China and on a limited basis in other locations. There has also been person to person transmission in the United States. Infections such as COVID 19 are called “Emerging Infections” because they erupt unexpectedly in a community. The newness or novelty of emerging infections creates several challenges for public health and our healthcare system. First, there is little or no experience among healthcare providers with these infections. Second, it is usually difficult to test for the infection due to the lack of a test or limited availability of the test. Third, there may not be a specific treatment for the infection; in this case there is no approved antiviral medication for Coronavirus. Fourth, there may not be a vaccine available to help prevent the infection. Currently, there is no vaccine available for Coronavirus. In spite of these and potentially other challenges, we can defend ourselves from these infections. In the case of COVID 19, rapid isolation of known or suspected cases can help stop the spread of the infection. We are also placing exposed, but not clearly infected persons, under quarantine to help lessen the chance that they may develop and spread the infection before it is recognized. Public Health Funding: The other challenge we face that not only affects our ability to respond to emerging infections, but also our ability to operate on a day to day basis, is public health funding. Public health funding is at best poorly distributed. By that, I mean it exists in silos. Money in one silo cannot usually be moved to a different silo. Real world problems do not generally exist in a typical government funding silo. These problems span two or more silos or may involve issues without a source of funding to combat that issue. In order to effectively combat the public health problems of the twenty-first century, we must have a flexible and scalable source of funding to support our operations. Please do not just hear “we need more funding.” More funding would be nice and we could always use more funding to help the people of Pitt County; however, please hear, “we need to be more flexible in how we spend public health funds to better meet the unique challenges of our wonderful community.” - John L. Silvernail, MD, MPH Pitt County Health Director