SALISBURY — Rowan County ranks 59 out of 100 North Carolina counties for health outcomes, according to a report released Tuesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

But that number is one that has been improving of late, local health experts say. The most recent rating is compared to 62 in 2011 and 2018 and a high of 73 in 2017. And, within the report is a mixed bag of individual improvements and declines.

The rankings, released each year since 2011, are a snapshot that compares counties and shows that where a person lives influences how well and how long he or she lives. Health outcomes in the report include individual factors such as length of life and quality of life. The years of data for the latest rankings are 2015 to 2017.

According to the 2019 rankings, Wake County is the healthiest and Robeson is least healthy in North Carolina.

Mixed bag

“We are not the healthiest county, but it takes everyone working together,” said Steve Joslin, community health manager with Rowan County Public Health.

One part of the report focuses on health behaviors such as physical inactivity and access to exercise opportunities. And Rowan has made small strides in a measure of physical activity. In the 2012 report, 30 percent of adults 20 and older reported no leisure-time physical activity. In the latest report, that number was 27 percent. 

Community health education involves things such as encouraging people to walk more often, Joslin said.

In a couple of weeks, the health department will observe National Public Health Week with a range of activities, including a community walk at Granite Lake Park, resources on how to manage stress and a dental health day.

“We are trying to get people to move again by encouraging people to walk more often,” Joslin said.

He said the county is fighting against issues such as the popularity of fast-food restaurants in trying to improve local health.

“We promote the Salisbury-Rowan Farmers Market, but it’s hard for people to get to those places. We still have food deserts that stretch down U.S. 29,” Joslin said.

According to the data, lacking consistent access to food is related to negative health outcomes such as weight gain and premature mortality.

The 2019 rankings show Rowan County is getting worse in adult obesity, with 33 percent of the population currently considerably overweight. In previous years, a slightly smaller percentage of people in Rowan County were obese, with 30 percent in 2011 and 32 percent in 2012.

There’s also been a decrease in sexually transmitted infections in the rankings from 2018 to 2019 — from 637.7 to 526.8 chlamydia cases per 100,000 people.

The report says 13 percent of the population is uninsured in 2019 versus 14 percent in the year before.

Joslin said the uninsured may have been helped by the Affordable Care Act.

There’s a slight increase in mental health providers, and that helps fight the opioid crisis, Joslin said.

The Public Health Department along with a partner, the Rowan Youth Substance Use Prevention Taskforce (Rowan YSUP!), worked to educate the public about medication take-back boxes throughout the county. Currently, there are now 13 of those.

“I don’t think it’s a unique struggle for us. My thing is where do we stand with the counties surrounding us,” Joslin said.

The county hasn’t improved at all in tobacco use, as it’s remained at 19 percent of the population for years, Joslin said

He said the latest focus is reducing the prevalence of vaping. Public Health education specialist Amy Smith, in particular, has been talking with middle-schoolers about vaping, he said.

“We are seeing real problems at the schools. A year ago they were saying, ‘What is vaping?’ and now they are saying, ‘How do we get rid of it?'” Joslin said.

Healthy Rowan

There are advantages to having a healthier community, said Healthy Rowan Executive Director Alyssa Smith. A healthier community has an impact on poverty and education, Smith said.

Smith also had her own highlights from the report.

“There’s a really drastic decrease in the percent of children living in poverty. We went from 26 to 22 percent. That’s good news for us. That’s going to give them better outcomes in the long run,” Smith said.

Rowan has improved in clinical care, which includes those who are under 65 without health insurance; the ratio of population to primary care physicians/mental health provider; those who received flu vaccinations; and access to mammography screenings.

There was an increase in overdoses and metrics related to alcohol and substance use, but Rowan should see continued improvement in those areas, Smith said.

“For a long time, we had been hard on ourselves that this isn’t a good place to live. But so many people are working to improve every aspect of life in Rowan County,” Smith said.

She cautions people that the data used is slightly behind the current year.

Some things fluctuate such as violent crime or drug overdoses, “but it doesn’t mean we are going down a bad path,” she said.

Novant’s work

The rankings are relevant for Salisbury’s hospital, Novant Health Rowan Medical Center President Dari Caldwell said, because of its mission.

“Our mission is to improve the health of the community one person at a time. We are a health care system, and part of health is the health of the community,” Caldwell said.

Caldwell mentioned a number of hospital initiatives and programs, including making the mobile mammography unit accessible to those who may not normally have access. The hospital has also worked to increase the number of primary care providers across the county.

Caldwell said hospital officials don’t want everything to be “Salisbury-centric” and, instead, want to provide access to care to be where people live. There are primary health providers in China Grove and Rockwell.

Another goal is to make health care affordable. Caldwell said Novant Health has a robust financial assistance program.

“To qualify, you can be at 300 percent poverty or worse. It’s much more generous than the typical sliding scale. There’s no reason for anybody to be denied care in Rowan County,” she said.

Caldwell said Novant works in collaboration with other health care providers in the county, including the Cabarrus-Rowan Community Health Center in China Grove and Community Care Clinic in Salisbury.

Another initiative to improve health outcomes is offering the flu vaccine each year at Rowan Helping Ministries shelter for guests and staff.

Caldwell noted that mental health has been an area of focus for the health care system and it has worked on the medication take-back program and providing first responders with Narcan, the drug overdose reversal medication.

Caldwell said those looking at the rankings should watch how Rowan compares to all counties and whether the county has improved or worsened.

Rowan fared worse in the rankings than a majority of its neighbors and topped only Davidson County, which ranked 62nd for health outcomes. At 42nd-best in the state, Stanly was next closest.

Contact reporter Shavonne Walker at 704-797-4253.