State of the County Health Report

1. 2 0 0 8 State of the County Health Report www.franklincohealth.org

2. About Franklin County Franklin County is conveniently located 21 miles northeast of the state capital, Raleigh, with easy access to three interstate highways (I-40, I-85, I-95). The county is comprised of 494 square miles and Louisburg is the county seat. Other municipalities in the county include Bunn, Franklinton, Centerville and Youngsville. We have an estimated population of 57,222 in 2007, gaining approximately 1,773 residents since 2006. Map provided by: Franklin County Graphic Information Systems (GIS) Office Centerville Franklinton Louisburg Youngsville Bunn

3. The Year In Review • In 2007, Franklin County Health Department provided 320 Maternal Health services, 74 Head Start dental screenings, served 1,826 children in the Child Health Clinic, an average of 600 clients per month through WIC (Women’s, Infants and Children) and 616 food inspections. In addition, our Dental Clinic provided 9,864 miles of free patient transportation in the 2007-2008 Fiscal Year. • Franklin County Volunteers In Medicine Clinic serves uninsured and underinsured residents of our county. In 2007, the facility served 330 patients, with a combined total of 1,033 visits. The overall cost of medications disbursed was over $48,842. • Franklin County Health Department, Board of Health, Animal Control, and the Animal Advisory Board initiated a certified Rabies Vaccination Program in an effort to decrease the instances of rabies and increase public education of the disease.

4. Leading Causes of Death According to the State Center for Health Statistics, these disease and ailments represent 75.1% of the 333 deaths in Franklin County in 2006. Endocrine & Nutritional Diseases 6.1% Respiratory Ailments 7.9% Heart & Circulatory Diseases 32.7% Cerebrovascular Disease 5.4% Cancer 23% • Diseases of the Circulatory System include heart attacks, congestive heart failure, atherosclerotic heart disease and hypertension. • Diseases of the Respiratory System include influenza, pneumonia, emphysema, asthma and COPD. • Cerebrovascular Diseases includes strokes. • Endocrine and nutritional diseases includes diabetes.

5. County Health Concerns • Overweight and Obesity... • Franklin County and surrounding counties rank #6 in the • state for percentage of overweight and obese adults. • Diet… • 22.2% of residents in Franklin County and surrounding counties reported eating the recommended five or more servings of fruits and vegetables per day. • Physical Activity… • 44.6% of residents in Franklin County and surrounding • counties reported meeting the daily physical activity • recommendations that include, moderate exercise for 30 • or more minutes per day, five or more days per week; or • 20 or more minutes of vigorous activity on three or more • days per week. All data gathered from the 2007 Behavioral Risk Factor Surveillance System (BRFSS). Franklin County data is compiled with Nash and Wilson counties.

6. 2007 Community Health Assessment Summary • 51% of the Franklin County residents rated adult obesity as a major problem. • 48% percent of respondents rated childhood obesity as a major problem. • 59% percent of residents stated that lack of transportation was a major barrier to health services. • 53% of respondents sited health insurance coverage as the top county concern relative to health and human services. • 23% of the Franklin County residents ranked child asthma as a major problem in the county.

7. Health Priorities Based on findings in the 2007 Franklin County Community Health Assessment and 2007 health data collected for this report, the following health priorities has been set for health promotion activities. • Overweight & Obesity • Physical Activity • Nutrition • Chronic Diseases • Diabetes • Cancer • Arthritis • Youth Health • Physical Activity • Nutrition • Asthma • Access to Care • Underinsured, Uninsured & Indigent Populations

8. Progress Made in the Last Year • Frankly Healthy, the Franklin County Healthy Carolinians Chapter, is currently publishing Ray of Hopenewsletters that are distributed to over 2000 people at a variety of locations, organizations, and agencies throughout the county including schools, businesses, and churches. It was designed to reach all church members aged 18 and older who want to learn more about making positive and healthy lifestyle choices. • The Susan G. Komen Breast Cancer Foundation awarded the Franklin County Health Department a grant for a program entitled“A Ray of Hope for Franklin County”. This initiativeprovided training to volunteers, workshops and in-services to educate women about breast health, in both churches and worksites. • Franklin County Volunteers In Medicine Clinic collaborated with Rex Mobile Mammography Unit in providing mammograms to county residents. The Unit’s mission is to take high-quality mammography services to areas where women have difficulty accessing healthcare.

9. Progress Made in the Last Year • The Restaurant Heart Health Survey (RHHS) is a statewide face-to-face survey used by local health departments and the NC Division of Public Health to assess the smoking and dining policies and practices of individual restaurants in each county. Franklin County obtained 51completed surveys, which resulted in one establishment becoming smoke free and another agreeing to a ban on Sundays. • Frankly Healthy received funding from the Project DIRECT Academy in 2006, to implement a diabetes education program in Louisburg. This program entitled the Main Street Diabetes Program (MSDP) involves African American churches on and near Main Street in Louisburg, which includes walking and nutrition components. The goals of the MSDP are to raise awareness of the seriousness of diabetes, educate people about the specifics of diabetes, increase physical activity, and improve overall diet. This initiative remains ongoing. • Louisburg Senior Center, Volunteers In Medicine Clinic and Franklin County Health Department partnered to facilitate a Diabetes Expo for our residents. The event was used to increase the awareness of diabetes prevention and management, physical activity and nutrition.

10. The Plan • Overweight and Obesity • Working On Wellness (W.O.W.) is a comprehensive exercise and nutrition program available to Franklin County employees. Various wellness initiatives are offered throughout the year designed to help discover, educate, and create awareness pertaining to health risks and behaviors. • Franklin County Cooperative Extension is offering Eat Smart, Move More, Weigh Less, a 12 week weight management program that uses a variety of strategies to help people achieve and maintain a healthy weight. The agency will also provide nutrition education to all 3rd grade students at Edward Best and Laurel Mill Elementary Schools beginning January 2009. Students will have 45 minute, weekly lessons on various topics such as portion sizes, increasing fruit and vegetable consumption, reading nutrition labels and becoming more physically active. • Franklin County Public School System continues to implement their annual 2nd Grade Nutrition Fair to build the knowledge of youth as it pertains to healthy nutrition and physical activity behaviors. In addition, the organization has been working diligently to establish a Employee Wellness Program to encourage healthy lifestyles among staff, enabling them to act as role models for the children they serve.

11. The Plan Chronic Disease Walk With Ease is a exercise program developed to address the benefits of increased physical activity, increased walking distance and speed, decreased pain and decreased depression among individuals inflicted with arthritis. Franklin County Health Department in collaboration with Louisburg and Franklinton Senior Centers have implemented this initiative for citizens of the county. • The Walk With Ease program: • Helps you develop a beneficial walking plan that meets your needs. • Helps you adhere to motivation and • manage pain. • Teaches you to exercise safely.

12. The Plan Youth Health Franklin County Health Department in conjunction with Community Care Network and various county agencies, have formed a coalition which has developed a comprehensive Youth Asthma program designed to educate parents and kids about the illness. The goals of the program are to decrease the amount of hospital discharges with a primary diagnosis of asthma rates among youth in Franklin County, and increase the underserved population's knowledge as to how this disease relates to self management and environmental factors. This will be accomplished by providing participants with the necessary educational and self-management resources.

13. The Plan Access to Care The percent of NC residents that lack health insurance for a full year has risen from 15.3 percent in 2000 to 18.1 percent in 2005. During that same year, 11.6 percent of youth ages 0 to 17 in Franklin County were estimated to be uninsured. Those ages 18 to 64 that were uninsured, comprised 20.6% of the population. As such, many community organizations have formed the Franklin County Healthcare Collaborative to address access to care. These agencies include: Franklin County Health Department, Franklin County Volunteers In Medicine Clinic, Franklin County Department of Social Services, Franklin Regional Medical Center, Franklin Community Health Center (Wake Health Services), Community Care Partners of Northern Piedmont, and Franklin Granville Vance Partnership for Children.

14. New & Emerging Issues • In October 2007 after seven years of operation, Flextronics ceased its Franklin County plant production, leaving 750 residents unemployed and resulted in the termination of their health care coverage. Governor Easley appointed a team to help employees of the layoff. A current primary focus for our county government is to replace the private employer, which had been the largest in county. • Novozymes is a Denmark based company which manufactures enzymes used to produce alternative fuels. They have approved an $26 million expansion that will add 50 additional employment positions in their Franklin County site. • Franklin Regional Medical Center (FRMC) is an eighty-five bed facility located in Louisburg, built in 1956. FRMC has proposed a new $90 million medical center in Youngsville that will cover 200,000 square feet, and 70 private hospital rooms.

15. Frankly Healthy • Our Healthy Carolinians Partnership, Frankly Healthy, is a partnership between community organizations and individuals. The mission of our collaborative is to improve health status and prevent premature death and injury for residents of the county regardless of age, race, income or educational level through a collaborative community effort. • Partners Include: • Franklin County Health Department • Franklin County Public Schools • Franklin County Cooperative Extension • Adolescent Parenting Program • Franklin County Volunteers in Medicine Clinic • Louisburg Senior Center • South Main Street Baptist Church • Franklin Regional Medical Center • Franklin County Parks and Recreation • Safe Space, Inc.

16. State of the County Health Report The purpose of this report is to communicate current Franklin County health information. Documents will be disseminated to the Public Library, Chambers of Commerce, County Commissioners, Board of Health, Franklin Regional Medical Center, Louisburg College, Franklin County Public Schools and other community venues. The Frankly Healthy partnership produces this report each year for three years, and a Community Health Assessment (CHA) in the fourth year. The next SOTCH will be completed in December 2009. For copies or for more information, contact: Franklin County Health Department at (919)496-2533 Or download at: www.franklincohealth.org This State of the County Health Report is a brief of the tremendous amount of work being done and to be done in Franklin County. As with most communities, Franklin County faces significant healthcare challenges, challenges that must be addressed by the entire community not just one organization or entity. Together we can continue building community partnerships and relationships that will enhance the health of all of our citizens.  I invite you to join us in this endeavor and share in the "wealth that is health."  A Note from the Health Director