Anson County now leads the state in toddler obesity, single-parent households and newly-diagnosed gonorrhea cases.
The county has been one of the 20 least healthy counties in the state since 2011, according to the County Health Rankings Organization. Last year, it ranked 94 out of all 100 counties for overall healthiness.
Dr. Fred Thompson, head of the Anson County Health Department, presented the data to the county commissioners during their meeting on March 7. The health department and Carolinas HealthCare System-Anson worked together to complete the 2016 Community Health Assessment, which involves a community survey and interviews.
Through 546 surveys and 27 ‘key informant interviews,’ the county complied its primary data, Thompson explained. Secondary data was also gathered. The report included information from the County Heath Rankings Organization.
Survey participants were asked to rank the 22 health problems as “‘major problem,’ ‘somewhat of a problem,’ ‘not a problem’ or ‘don’t know,’” according to the executive summary of the report.
Illegal drug use topped the report with 92 percent of the responses. Tobacco use/smoking was second, obesity/overweight was third, alcoholism/alcohol abuse ranked fourth and teen pregnancy rated fifth. Inactivity/lack of physical activity was sixth, diabetes ranked seventh, heart disease was eighth, abuse of prescription drugs was ninth and cancer ranked tenth among the survey participants’ concerns.
Those same participants have actually been diagnosed with high blood pressure/hypertension (46 percent), obesity/overweight (40 percent), high cholesterol (35 percent), arthritis (29 percent), depression or anxiety disorder (20 percent) and diabetes (17 percent).
Key informants made a slightly different list of concerns, with diabetes as first, followed by obesity, heart disease, hypertension, misuse of prescription drugs, kidney disease, mental health, illegal drug use, stroke and smoking, respectively.
What actually kills Ansonians?
Heart diseases are the primary killer in the county, according to the 2017 County Health Data Book of the State Center of Health Statistics. Cancer (all types) is the next top killer of county residents, followed by cerebrovascular disease (stroke), chronic lower respiratory diseases, diabetes, atherosclerosis (hardening of the arteries) and kidney disease — a tie in their deadliness in the county — “other intentional injuries,” septicemia and motor vehicle injuries.
Obesity or being overweight — which 40 percent of the survey respondents have been diagnosed with — affects even the youngest residents, Thompson said. Anson County has the highest percentage of obese and overweight toddlers ages 2 to 4 among six similar peer counties and the state, affecting 37.5 percent of the county’s tots.
Sexually transmitted diseases also pose a problem, Thompson said.
“Anson currently has the highest rate of newly-diagnosed gonorrhea cases in the state,” he read from the executive report. “Anson also had a significant increase in the number of new syphilis cases.”
While teen pregnancy was fifth on the list of concerns among survey respondents, the county’s teen pregnancy rate actually decreased from 2008 to 2015, Thompson said. But the rate started to climb after that, jumping 18 percent from 2014 to 2015.
“Anson had the lowest percentage of improvement compared to all six of its peer counties and the state,” the report found. “Anson is a very traditional county and many of its citizens are uncomfortable with programs that might be perceived as ‘safe sex’ focused. However, the opinion expressed by the public through the survey and interviews is that there needs to be more resources to help prevent STDs and teen pregnancies.”
The county needs more health care providers to address all of the health issues that are killing Anson residents, Thompson said.
“In the survey, 44 percent of participants said that the care they need is not available in Anson County,” the executive summary said. “The percentage of county citizens that are not insured, coupled with the extremely high ratio of residents to primary care physicians (2,290:1) make it difficult for many people to get the care required to prevent or control the chronic diseases that are occurring in large numbers, specifically diabetes, obesity and hypertension and the resulting conditions (stroke, heart disease, kidney disease, etc.) Even people with insurance said that they are frequently prohibited from getting the care they need because of the high deductible/co-pay or their insurance does not cover the care.”
Thompson said that the increase in single-parent households is likely also a contributing factor. Anson has the highest percentage of children in a single-parent household compared to its peer counties and the state, according to the report. Thompson believes that families may have a harder time getting children the care they need if they are in a single-parent household.
Education and a low amount of healthy opportunities are also problems.
“Compounding this problem are three other factors: lack of access to health food; lack of access to safe, convenient physical activity opportunities; and people typically do not understand and/or believe the impact of poor diet on health (especially diabetes and hypertension),” the summary said.
Thompson’s summary provided a graphic showing the factors believed to most affect the county. The graphic showed that a lack of jobs likely “negatively impacts (the) ability to recruit primary care providers (spouses cannot find employment)”, and the “lack of providers makes it difficult to get appointments,” causing a problem with a “lack of monitoring of patients’ lifestyles and medication compliance, (resulting) in intensifying of chronic diseases, specifically diabetes, obesity, hypertension, heart disease and stroke.”
A separate graphic showed that a “high percentage of children in single-parent households and/or poverty households” leads to the “inability of parents to secure health care and provide healthy food for their children.” This likely leads to the “extremely high percentage of overweight and obese children in the county,” causing “early onset of diabetes, hypertension, heart disease and stroke.”
The list of problems afflicting county residents is a long one. To try and tackle it, Thompson said the County Health Assessment team carefully chose three priorities to focus on: decreasing childhood obesity, preventing STDs and teen pregnancy, and preventing and controlling hypertension. All three will be documented in the county’s mandatory action plan.
The health department normally bears the responsibility of the mandatory plan, which will be due to the state in September. The State of the County Health Report will be due next March.
This year, Carolinas HealthCare will take on childhood obesity and hypertension since it has the resources to do so, Thompson explained. The county health department will focus on lowering the rate of STDs and teen pregnancy.
There is one bright spot: Thompson said the county had a 100 percent immunization rate when the state audit was performed three weeks ago.
“Not everything is doom and gloom, and I don’t want you to think that it is,” he said.
Thompson did ask the county commissioners to contribute to the cause.
Anson has gone without a public health educator for too long, he said, adding that at one point, the county health department had three. With no one filling the role, getting the word out about preventing or controlling health issues is difficult, he said. Thompson said he researched other North Carolina counties’ data to see if he could find one county without a public health educator. He couldn’t find any.
“I’m well aware of budget restraints and I’m well aware that every department will ask for things you can’t provide,” Thompson said. “But I hope when you look at the budget, you will find a way to fit a public health educator in.”
Reach reporter Imari Scarbrough at 704-994-5471 and follow her on Twitter @ImariScarbrough.