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2018 Public Health Dashboards May 13, 2018
<br />Executive Summary
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<br />As part of an effort to reduce overdose deaths, all four Orange County branches of law enforcement carry naloxone, an
<br />overdose reversal drug, and have been trained on how to use it in the field. From the start of the Good Samaritan/
<br />Naloxone Access law in 2013 through the end of 2017, Orange County has seen (a reported) 34 Community reversals, and
<br />11 law enforcement reversals.
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<br />Youth Mental Health and Self Harm
<br />Results from the 2017 Chapel Hill Carrboro City Schools and 2016 Orange County Schools Youth Risk Behavior Surveillance
<br />Survey show a generation of youth with many health needs. Middle school students in particular appear to be at risk for many
<br />mental health conditions. Only 8% of middle school questions from CHCCS showed movement in a positive direction, while
<br />37% show movement in a negative direction as compared to 2017. YRBS data show students face stressors in their day to day
<br />lives, are dealing with mental health conditions, and are at risk for physical self‐harm.
<br /> 1 in 5 high school students and 1 in 10 middle school students has been prescribed medication for mental health;
<br />and similarly, 1 in 5 high school students, and 1 in 10 middle school students report they would use mental health
<br />services provided at school if they were free and confidential.
<br /> 1 in 10 middle school students has made a suicide plan,
<br /> 13% middle school students reported purposely hurting themselves.
<br /> 1 in 25 middle school students has attempted suicide.
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<br />There were more than 40,000 NC ED Visits due to self‐inflicted injuries during the period January 1, 2012 – September 30,
<br />2015 (111.8 per 100,000 person‐years). Females were more likely to visit a NC ED for treatment of self‐inflicted injuries than
<br />males (126.8 versus 96.0 ED visits per 100,000 person‐years, respectively). Teenagers 15‐19 years of age had the highest rate
<br />of NC ED visits due to self‐inflicted injuries (291.9 per 100,000 person‐years), followed by individuals aged: 20‐24 (221.5), 25‐
<br />34 (177.6), 35‐44 (143.8) and 45‐54 years of age (118.7). These data support patterns seen in YRBS data in Orange County
<br />that show youth, and particularly young women are at an increased risk for mental health issues and self‐harm.
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<br />Chronic Disease and Obesity
<br />Overall, Orange County performs well compared to peers and NC when it comes to chronic disease and obesity. The
<br />exception that continually appears is in Female breast cancer, where Orange County often shows higher rates of both
<br />incidence and mortality. However for the first time in many years, Orange County saw a decrease in breast cancer
<br />mortality. However, prostate cancer and diabetes mortality saw a slight increase in 2016.
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<br />While Orange County performs well compared to peers and NC when it comes to chronic disease, the county has vast
<br />health disparities, particularly regarding chronic diseases. Black (Non‐Hispanic) residents in Orange County die from
<br />avoidable chronic diseases such as Heart Disease and Stroke at more than two times the rate of their White (Non‐Hispanic)
<br />peers (77.1 vs 31.5 deaths per 100,000). They are also more likely than white residents to be hospitalized for chronic
<br />conditions such as cardiovascular disease (64.9 per 100,000 vs 44.8 per 100,000, respectively).
<br />Social Determinants of Health and Access to Care
<br />Orange County consistently falls short of the nation, state, and/or peers when it comes to Social Determinants of Health. In
<br />particular, affordable housing, food insecurity, and income inequality are key and pressing issues for our County. 14% of
<br />children in Orange County live in poverty, and 36% of students are eligible for free or reduced lunch. In addition, 1 in 5
<br />residents are experiencing serious housing problems such as overcrowding or a need for repairs. Half of Orange County
<br />renters pay unaffordable rates for housing at 30% or more of their income. And of those facing food insecurity, 40% are
<br />ineligible for SNAP benefits. These stressors affect students, as evidenced by a drop in the graduation rate for economically
<br />disadvantaged students in 2017 (76% from 80%).
<br />North Carolina and Orange County each saw a decline in the percent of residents who are uninsured from 2014 to 2016 (age
<br /><65 years old). Orange County low‐income uninsured also continues to drop, from 32% in 2014, to now 23%. Orange County
<br />has seen a steady decline in uninsured rates across all indicators from 2011 to 2014. However, the percentage of low income
<br />children who were uninsured (12%) is still much higher than in our peer counties, the state, and the nation. Orange County
<br />and NC lag behind the US in nearly all insurance indicators, likely in part due to the exclusion of a Medicaid expansion for low‐
<br />income individuals and a changing insurance environment.
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