Agenda - 02-01-1993 - III-B - Laserfiche WebLink

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4 NEEDS STATEMENT The adolescents of Orange County have significant problems with unintended pregnancy, poor pregnancy outcomes, sexually transmitted diseases, chronic disease, substance abuse, mental health problems, school dropout, poverty, poor access to health care, violence including homicide and suicide, injury, homelessness and delinquency. Orange County is an environment of contrasts. The county consists of seven townships with a total population of 93,851 persons. Three of the townships are urban with over two thirds of the county's population and the remaining five are rural. Eighty percent of the county residents are white, sixteen percent black, two and one half percent Hispanic, one percent American Indian and one half percent other. Throughout the proposal references to the county will be made as Southern Orange County which consists of Chapel Hill and Carrboro and Northern Orange County which consists of Hillsborough, Cheeks, Little River, Cedar Grove, Bingham and Eno. Orange County has 13,488 youth between the ages of 10 and 19. Of these, forty seven percent are males, fifty three percent females and twenty percent live in rural communities. There are two public school systems within the county, Orange County Schools (Northern Orange County) and the Chapel Hill/Carrboro City Schools (Southern Orange County) with a combined enrollment of approximately 9,145 students in grades six through twelve. Orange county is home to a state university and major medical center which is the largest employer in the county. The unemployment rate is slightly over two percent but there are nearly four thousand cases of public assistance per month and fourteen percent of residents live below the poverty level. Over sixty percent of mother's in Orange County work outside of the home. Despite the seemingly abundant availability of health care, the health needs of the urban and rural adolescent of Orange County are not being met. In a recent Orange County Health Department Community Diagnosis, five of the eight top health problems, high number of unwanted pregnancies, poor pregnancy outcomes, increasing numbers of communicable diseases, increased number of injuries due to motor vehicle accidents and increasing use of drugs and alcohol relate significantly to adolescent health care issues. Access to health care is a major problem for adolescents in both Northern and Southern Orange County. The primary barriers to services are unavailability of clinical sites and clinical hours, transportation to services, visibility of services in and outside of the school, quality confidential care that can be assured to any adolescent despite income or socioeconomic level, flexibility of services that considers the inherent differences in a culturally and racially diverse population and coordination of services with a means of intersecting services to enhance delivery and results rather than fragment. The primary sources of medical care for adolescents in Orange County are private physicians, Orange County Health Department (OCHD), University of North Carolina Hospital (UNCH) and UNCH-Emergency Room (UNCH-ER) and Orange-Chatham Health Services (OCCHS). At the present time there is no single numerical indicator as to who provides the bulk of medical care for Orange County adolescents. The OCHD is the only source of free medical care for adolescents in the county and in 1992 it provided unduplicated services to 887 adolescents ranging from the age of 11 to 21 with over 400 follow up visits. A crude estimate of how many adolescents do not have a known medical provider was found in a random survey of two middle schools' health information forms in Southern Orange County. Sixteen percent of health forms indicated that students did not have a known medical provider and nineteen percent indicated the use of the emergency room for primary medical care. Similar findings were found among fifth graders