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Wayne County 2012 Community Health Assessment Page 86
Wayne County
Community Health
Assessment
2012
WCCHA
2012

Acknowledgements
The development of the 2012 Wayne County Community Health Assessment is a
collaborative effort between Wayne Memorial Hospital, Wayne County Health Department,
Wayne Action Teams for Health (WATCH), Wayne County Board of Health and East
Carolina University. Please see below for members of the leadership collaborative.
Becky Craig Wayne Memorial Hospital
Carolyn King Wayne County Health Department
Davin Madden Wayne County Health Department
Kim Larson, RN, PhD Wayne County Board of Health
Sissy Lee-Elmore Wayne Action Teams for Community Health (WATCH)
Mandee Foushee Lancaster, MA ECU Center for Survey Research
Justin Raines ECU Center for Survey Research
Zach Love ECU Center for Survey Research
The collaborators wish to acknowledge the participation of individuals from a
number of groups throughout Wayne County who shared their understanding, skills and
innovative ideas for improving community health in Wayne County.
Lt. Col. Chris Hayes, MD, for SJAFB Seymour Johnson AFB
Chris Martin Mount Olive Pickle
Harold Brashear, CPA Nunn, Brashear CPAs
Cedric Bradford Century 21 - Dees & Tyndall
Sam Hunter TA Loving
Ken Jones, MPA EastPointe
Nadir Attiah, MD Local Psychiatrist
Gratiela Zbarcea, MD Local Psychiatrist
Randy Swackhammer, MD Internal Medicine Physician
Dave Tayloe, MD Pediatrician
Lloyd Smith, MD Emergency Department Physician
Phyllis Hill, RN Wayne Initiative for School Health (WISH)
Brian Smith WC Office of Emergency Services
Bill Broadaway, Chair, Board of Directors Wayne Memorial Hospital
Jana Blackman, RN Wayne Memorial Hospital
Donna Edmundson, RN Wayne Memorial Hospital
Pam Anderson, RN Wayne Memorial Hospital
Georgia Dees Wayne Memorial Hospital
Pamela Johnson Cherry Hospital
Dr. Steve Peters Cherry Hospital
Ellen Brubeck, MD O'Berry Center
Ta-Kisha Darden Wayne County Health Department
Stephanie Howard, RD Wayne County Health Department - WIC

Brooke Bitzenhofer, Intern Wayne County Health Department
J.D. Evans Wayne County Commissioner
Christine Smith Wayne County Extension
Bill Johnston Curtis Media
Phyllis Moore News Argus
Allison Pridgen Wayne County Schools
Sandra McCullen Wayne County Schools
Ina Rawlinson Wayne Community College
Dr. Joy Phillips, RN Mount Olive College
Eryn McAulliffe Wayne County Services on Aging
Charlie Ivey Wayne Partnership for Children
John Richards YMCA
Karen Schneider United Way
Rovonda Freeman Bradford March of Dimes
Doricia Benton Community Soup Kitchen
Dr. Marlee Ray WAGES
Chuck Waller American Red Cross
Glenda White St. Mark Church of Christ
Rev. Joe Jackson Best Grove Missionary Baptist
Cpl. Marissa Davis City of Goldsboro Police
Robert Chunn Wayne County Sheriff's Department
Tom Flores Wayne County Sheriff's Department
Trooper Larry McKeithan NC State Patrol
Jimmie Ford State Board of Community Colleges
Appreciation is also expressed to the people within Wayne County who participated
in the 2012 Community Health Assessment survey, focus groups and public presentation
providing vital information about their concerns and suggested action steps to make
Wayne County a healthier community.

Table of Contents
Purpose 7
Team Composition 7
Process Overview 7
Outcomes 8
County Overview 9
Population Demographics 9
Population Estimates 9
Age Distribution 10
Race Distribution 10
Sex Distribution 11
Economic Factors 11
Income and Poverty 11
Employment 14
Education 15
Educational Attainment 15
Dropout Rates 16
SAT Scores 17
Free and Reduced Lunch 18
Crime and Violence 18
Crime Index Rates 18
Detailed Crime Statistics 19
Health Indicators 20
Infant Mortality Rates 20
General Mortality Rates 20
Leading Causes of Death 21
Age-Specific Death Rates 22
Race/Sex-Specific Death Rates 23
Health Conditions 24
Cancer 24
Heart Disease 26
Diabetes 27

Asthma 29
Overweight/Obesity 30
High Blood Pressure 32
High Cholesterol 33
Communicable Diseases 34
HIV 34
AIDS 35
STDs 36
Tuberculosis (TB) 39
Maternal Health 40
Birth Rates 40
Pregnancy Rates 41
Abortion Rates 44
Maternal Health Indicators 44
Other Health Status Data 47
General Health Status 47
Mental Health 48
Smoking/Tobacco 50
Exercise 52
Screenings 52
Child Health 53
Access to Healthcare 55
Insured/Uninsured Population 55
Medicare/Medicaid 56
Hospital Utilization 56
Healthcare Providers 57
Environmental Health 58
Air Quality 58
Water Quality 59
Peer County Comparisons 59
Healthcare Resources 62
Parks and Recreation Facilities 63

Review of Primary Data 64
Stakeholders 64
Focus Groups 64
Community Survey 66
Summary and Next Steps 81
Appendix A – Community Survey 82
Appendix B – Focus Group Questions 109
Appendix C – Community Context 110
Access to Healthcare 110
Crime 112
Natural Recreation 113
Tobacco Use 114

Purpose
Local health departments within North Carolina are required to conduct a
community health assessment every four years. In March of 2010, legislation was passed
requiring not-for-profit hospitals to also conduct community health assessments. To meet
the requirements, Wayne Memorial Hospital and the Wayne County Health Department
partnered with the Wayne County Board of Health, Wayne Action Teams for Community
Health (WATCH) and East Carolina University (ECU) to identify the community health
needs in Wayne County.
The purpose of this community health assessment is to examine the health status of
the community to ascertain priority areas of focus for the next three to four years. The
health needs assessment process is inclusive and transparent. It involves various key
stakeholder groups, including members of the community. Action plans for addressing key
community health priorities will be formulated beginning Spring 2013.
Team Composition
Representatives from the Wayne County Health Department, Wayne Memorial
Hospital, Wayne County Board of Health, WATCH and ECU cooperatively conducted the
community health assessment. The collaboration identified the types and sources of data to
be collected, determined the methods for collecting input from the community and key
stakeholders concerning health related issues as well as communicating this information to
the various stakeholders in order to prioritize community health concerns.
Process Overview
The community health assessment has several requirements. One requirement is
the collection of primary data from community members. Wayne County elected to elicit
feedback from key stakeholder groups, conduct focus groups throughout the county, as
well as conduct a health opinion survey. The health opinion survey was adapted from the
Community Health Assessment Guidebook, NC Division of Public Health.
The stakeholder group of more than 50 members met quarterly throughout this
process to provide feedback. A specific meeting with Goshen clinic providers was held near
the end of data collection to assess their opinions of the needs. Ten focus groups were held
in specific geographic locations to discover community members’ perception of health
concerns and suggestions for improving health within the community. There were a total of
86 focus group participants. The survey was available online and in paper format in both
English and Spanish. A total of 1,369 surveys were completed.
A review of secondary data was conducted by examining county level health data
primarily compiled by the NC State Center for Health Statistics. Examples of such data

included leading causes of mortality, health care resource availability, and prevalence data
from the Behavioral Risk Factor Surveillance Survey (BRFSS). Factors such as
demographics, educational attainment, economic vitality and environmental issues within
a community also influence health. These data were reviewed to determine the potential
for impact on health status within the county. Moreover, a review of data across several
years was conducted to determine trends in health status for Wayne County.
Focus areas were selected based on the convergence of stakeholder input, focus
group and survey results as well as secondary data sources. Members of the Wayne County
Board of Health received the data presentation electronically prior to their January 2013
meeting. A review of the data was conducted at the January Board of Health meeting, as
well as a review of the process undertaken to determine the focus areas including the
recommendations from the leadership team.
Outcomes
The community health assessment identified the following focus areas for 2013 –
2016. Although this was a community health assessment, the social indicators below both
directly and indirectly influence community health. Without addressing both social and
health together, significant health improvements will not be accomplished.
Wayne
County
Focus
Areas
Social Indicators:
- Poverty
-Access to healthcare
- Crime
- Education
Health Indicators:
-Health literacy
- Mental health
- Health Conditions

County Overview: The Good Life. Grown Here.
Wayne County was established in 1779 and has a total area of 557 square miles.
Wayne County is located in the rural eastern portion of North Carolina, approximately 50
miles east of Raleigh and 90 miles west of Wilmington. Out of 100 North Carolina counties,
Wayne County is the fourth highest-producing county, in term of farm cash receipts, at
$353 million in 2011. 1 Agriculture has been a way of life here for many years, but the
mechanization of farming has had a profound impact on the lifestyles of county residents,
here and across the United States. Less active lifestyles at every age, and more time in front
of computer screens have impacted health statistics that are dependent on diet, exercise
and health habits, while communicable diseases (which were the cause of most hospital
admissions years ago) have been brought under control. The surface of the county is level
to gently rolling uplands with two primary waterways including the Neuse River and the
Little River. The elevations are predominantly 120 to 145 feet above sea level. The climate
is mild, with an average temperature of about 62 degrees and annual precipitation of about
50 inches of rainfall per year. 2
Goldsboro is the county seat and is situated geographically in the center of the
county. The municipalities located in Wayne County include the city of Goldsboro and the
towns of Eureka, Fremont, Mount Olive, Pikeville, Seven Springs, and the Village of Walnut
Creek. Wayne County has been named a metropolitan statistical area by the US
government. Additionally, Wayne County is home to the Seymour Johnson Air Force Base,
consisting of the 4th Fighter Wing and the 916th Air Refueling Wing. 3
Population Demographics
Population Estimates
As of July, 2011, the estimated population of Wayne County was up to 123,710 from
the April, 2010 population count of 122,623. This is a growth of 0.9% with a net migration
of 0.3%. Since April, 2000, the population of Wayne County has grown from 113,449,
representing an 8.3% increase. 4
1 Wayne County Agriculture Highlights. Available at:
http://wayne.ces.ncsu.edu/files/library/96/WAYNE%20COUNTY%20AGRICULTURE%20HIGHLIGHTS.pdf
2 Wayne County Government Website. Available at:
http://www.waynegov.com/Page/16
3 Wayne County Government Website. Available at:
http://www.waynegov.com/Page/16
4 NC Office of State Budget and Management. Available at:
http://www.osbm.state.nc.us/ncosbm/facts_and_figures/socioeconomic_data/population_estimates/county_
estimates.shtm

Age Distribution
The graph below represents population data for Wayne County as of 2010. The
median age in Wayne County is 36.7 years, whereas the median age in North Carolina was
36.7. The majority of the population in Wayne County is between the ages of 25 and 54 (39
percent). The school age (ages 5-19) population for Wayne County comprises 21 percent of
the total population. Furthermore, 14 percent of the population in Wayne County is senior
citizens (65 and older), which is slightly older than the North Carolina average, and older
than the major metropolitan areas where major universities are situated. 5
Race Distribution
The majority of Wayne County citizens are Caucasian (55.6 percent), whereas
African-Americans represent 31.1 percent of the population. Since 2000, the Hispanic
population in Wayne County has grown from 4.9 percent to 9.9 percent in 2010. American
Indian, Alaska Native, Asian, Pacific Islander or persons reporting two or more races
represent the remaining population. Overall, the race distribution is quite different from
that of North Carolina. In North Carolina, 65.5 percent of the population is Caucasian and
21.5 percent is African-American. North Carolina’s percent population of Hispanic origin is
8.4 percent compared to 16.3 percent of the US population. 6
5 US Census Bureau, American Fact Finder. Available at:
http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml
7 7 7 7 7
13
12
14
6 6
8
4
2
7 7 7 7 7
13
14 14
6 6
7
4
1
0
5
10
15
20
Percentage(%)
Agee
Wayne County and NC Population
Distribution by Age (2010)
Wayne
NC

Sex Distribution
The sex distribution in Wayne County as of 2010 is relatively equal with 51 percent
being female and 49 percent being male. These percentages are identical to that of North
Carolina in 2010. 7
Economic Factors
Income and Poverty
The graphs below depict Wayne County’s annual household income, median annual
household income, per capita income, and percent of population below the poverty
threshold. In 2011, 11.7 percent of Wayne County residents reported an annual household
income less than $10,000, compared to 8.8 percent in North Carolina. Additionally, only 9.1
percent of Wayne County residents reported an annual household income of $100,000 or
more, compared to 16.2 percent in North Carolina. 8 The average median annual household
7 US Census Bureau, State and County Quick Facts. Available at:
http://quickfacts.census.gov/qfd/states/37/37191.html
55.6
31.1
9.9
0.3 1.1 0.0 2.0
65.3
21.2
8.4
1.1 2.2 0.1 1.7
0
10
20
30
40
50
60
70
80
Percentage(%)
Race
Wayne County and NC Population
Distribution by Race (2010)
Wayne
NC

income in Wayne County in 2011 was $39,085, compared to $43,916 in North Carolina. 9
From 2007-2011, the average per capita income in Wayne County was $21,135, compared
to $25,256 and $27,915 in North Carolina and the US, respectively. 10 As of 2011, 23.5
percent of Wayne County residents reported living in poverty, whereas 17.9 percent
reported living in poverty in North Carolina. 11
These statistics are similar to previously reported statistics, and are typical of rural
counties compared to more urbanized counties in North Carolina. In general, North
Carolina is a more rural state than the average state, and income has always been lower
than national averages. The average of North Carolina per capita income in 2007-2011 per
the US census is 90.5% of the US average, compared to 82.8% in 1969.
10 US Census Bureau, State and County Quick Facts. Available at:
http://quickfacts.census.gov/qfd/states/37/37191.html
11.7
7.7
14.8
11.6
15.9
20.0
9.2 9.18.8
6.8
12.8 12.2
14.8
17.9
10.5
16.2
0
5
10
15
20
25
Percentage(%)
Income
Wayne County and NC Household Income (2011)
Wayne
NC

40,110
39,388
40,944 40,787
39,085
44,670
46,549
43,674
43,326
43,916
34,000
36,000
38,000
40,000
42,000
44,000
46,000
48,000
2007 2008 2009 2010 2011
IncomeinDollars
Year
Wayne County and NC Median Annual
Household Income
Wayne
NC
$21,135
$25,256
$27,915
0
5,000
10,000
15,000
20,000
25,000
30,000
Wayne NC US
IncomeinDollars
Per Capita Income (2007-2011)

Employment
Wayne County’s unemployment rate for 2011 was estimated at 9.4 percent
compared to 10.5 percent for North Carolina. The unemployment rate in Wayne County has
risen 3 percent since 2002. The highest unemployment rates for Wayne County for the past
ten years were reported in 2010 with 9.5 percent of the population being unemployed. 12
Though unemployment in Wayne County is lower than North Carolina averages, the
average wage in Wayne County is more similar to other rural areas of North Carolina,
which is less than the average wage in urban areas, giving lower per capita income.
12 The Employment Security Commission of North Carolina, Labor Market Information. Available at:
http://www.ncesc1.com/LMI/workForceStats/workForceMain.asp
17.4
19.2
20.7
19.7
23.4
14.3 14.6
16.3
17.5 17.9
0
5
10
15
20
25
30
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Poverty Rates
Wayne
NC

Education
Educational Attainment
The following graph depicts the educational attainment of Wayne County’s
population age 25 and older. According to the 2010 estimates, 19.9 percent of the
population 25 and older have not completed high school or received an equivalency
diploma, compared to 15.2 percent of North Carolina adults. Wayne County has a lower
percentage of adults (14.4 percent) who report having a bachelor’s degree or higher
compared to North Carolina adults (27 percent). 13
Additionally, enrollment at Wayne Community College in the fall of 2012 was at
near-record levels, due to the commitment of the college to serve employer needs in Wayne
County, including agriculture. In addition, many Wayne County students are transferring to
4-year colleges after the first two years at Wayne Community College. 14
14 The Goldsboro News-Argus. Available at:
http://www.newsargus.com/news/archives/2012/11/28/colleges_enrollment_hits_new_high/
6.4 6.2
5.3 5.2
4.7 4.6
5.9
8.6
9.5 9.4
6.6 6.5
5.5 5.3
4.8 4.8
6.3
10.5 10.9 10.5
0
2
4
6
8
10
12
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Unemployment Rates
Wayne
NC

Dropout Rates
The graph below depicts the dropout rates for Wayne County and North Carolina
from 2006-2010. While the dropout rate in Wayne County has decreased from 5.7 per
thousand students to 4.8 per thousand students in this time period, the 2010 estimate
remains higher than North Carolina (3.7). 15
15 NC Public Schools Reports and Statistics. Available at:
http://www.ncpublicschools.org/data/reports/
19.9
30.7
26.2
8.9 10.1
4.3
15.2
27.3
21.8
8.7
17.8
9.2
0
5
10
15
20
25
30
35
Less than
high school
High school
/ GED
Some
college
Associate's
degree
Bachelor's
degree
Graduate /
Professional
degree
Percentage(%)
Education Level
Wayne County and NC Educational
Attainment (2010)
Wayne
NC

SAT Scores
The following graph reports the average SAT scores for Wayne County and North
Carolina, calculated by adding the verbal and quantitative scores from 2007 to 2011. In this
five year period, Wayne County has remained marginally lower than North Carolina, with
average scores in 2011 being 950 in Wayne County and 1001 in North Carolina. 16
16 NC Public Schools Reports and Statistics. Available at:
http://www.ncpublicschools.org/data/reports/
5.7
4.16
5.25 5.09
4.84
5.04
5.27
4.97
4.27 3.75
0
1
2
3
4
5
6
7
8
2005-2006 2006-2007 2007-2008 2008-2009 2009-2010
Rates
Year
Wayne County and NC Dropout Rates per
1,000 Population
Wayne
NC
961
979 972
954 950
1004 1007 1006 1005 1001
500
550
600
650
700
750
800
850
900
950
1000
1050
1100
2007 2008 2009 2010 2011
Score
Year
Average SAT Scores (Verbal + Quantitative)
Wayne
NC

Free and Reduced Lunch
According to Wayne County Schools, 66.3 percent of children enrolled in Wayne
County Schools for the 2010-2011 school years were enrolled for free or reduced price
meal benefits. This percentage increased from 59.8 percent in the 2006-2007 school years.
In contrast, 53.9 percent of children in North Carolina were enrolled in free and reduced
lunch benefits in the 2010-2011 school years. 17
Crime and Violence
Crime Index Rates
As illustrated in the chart below, the index crime rates for Wayne County have
decreased since 2006. However, when compared to neighboring counties such as Johnston
County, the index crime rates are relatively high. 18 The table below provides detailed crime
statistics for Wayne County from 2011. While the overall crime index rate has decreased
17 Data Center, Kids count. Available at:
http://datacenter.kidscount.org/data/bystate/Rankings.aspx?ind=2239&state=NC
18 NC Department of Justice, Crime. Available at:
http://www.ncdoj.gov/Crime/View-Crime-Statistics.aspx
59.8 59.2 61.1 63.5
66.3
48.5 48.4 49.9
66.3
53.9
0
10
20
30
40
50
60
70
80
2006-2007 2007-2008 2008-2009 2009-2010 2010-2011
Percentage(%)
School Year
Percentage of Students Enrolled in Free
and Reduced Lunch
Wayne
NC

since 2006, the table indicates increases in specific crimes since 2003 such as burglary and
larceny. Moreover, the violent crimes including murder, rape, robbery, and aggravated
assault have steadily decreased since 2003. 19 As of 2012, Wayne County and Goldsboro
reported 19 cases of murder, which is the most since 2007. 20
Detailed Crime Statistics
2011 Crime Detailed Crime Statistics for Wayne County
Offense 2003 2004 2005 2006 2007 2008 2009 2010 2011
Murder 10 12 13 7 20 11 14 8 10
Rape 9 11 8 8 10 5 11 6 5
Robbery 148 126 146 142 131 155 129 151 126
Aggravated
Assault
418 415 356 434 362 372 348 420 402
Burglary 1,476 1,585 1,329 1,532 1,653 1,658 1,658 1,878 1,625
Larceny 3,137 3,084 3,362 3,010 3,385 3,256 2,922 2,886 3,163
MV Theft 289 332 256 284 347 428 290 250 282
Total 5,487 5,565 5,470 5,417 5,908 5,885 5,372 5,599 5,613
19 NC Department of Justice, Crime. Available at:
http://www.ncdoj.gov/Crime/View-Crime-Statistics.aspx
20 The Goldsboro News-Argus. Available at:
http://www.newsargus.com/news/archives/2012/12/31/the_top_ten_stories_of_wayne_county_and_goldsb
oro_in_2012/
4711.4
5276.9 5271.3
4791.9 4957.3
4694.5
4654.4 4658.9 4581
4178.4
3919.8 3955.3
0
1000
2000
3000
4000
5000
6000
2006 2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Crime Index Rates per
100,000 Population
Wayne
NC

Health Indicators
Infant Mortality Rates
Infant mortality is the death of an infant prior to his/her first birthday. Wayne
County’s total infant mortality rate in 2011 was 11.6 per thousand live births compared to
North Carolina’s total infant mortality rate of 7.2 per thousand live births, respectively. The
infant mortality rate in Wayne County increased from 7.4 per thousand live births in 2010
to 11.6 per thousand births in 2011. Wayne County’s infant mortality rate declined
between the years of 2009 and 2010, but the rate has increased from 6.7 per thousand live
births in 2007. 21
General Mortality Rates
The chart below depicts the overall mortality rates for Wayne County and North
Carolina in five year averages from 2003 to 2011. Each of the five year averages for Wayne
County were more than 100 deaths higher per 100,000 population than North Carolina.
The 2007-2011 average death rate in Wayne County was 942.0 per 100,000 population
21 NC Division of Public Health, State Center for Health Statistics, County-Level Data. Available at:
http://www.schs.state.nc.us/schs/data/county.cfm
6.7
10.7
13.2
7.4
11.6
8.5
8.2 7.9
7.0 7.2
0
2
4
6
8
10
12
14
16
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Infant Mortality Rates
per 1,000 Live Births
Wayne
NC

compared to 808.4 per 100,000 population in North Carolina. Overall, the mortality rates
for both Wayne County and North Carolina have decreased steadily since 2003. 22
Leading Causes of Death
A comparison of the top five leading causes of death for all ages in Wayne County
and North Carolina are depicted in the graph below. Cancer and heart disease are the top
two leading causes of death in both Wayne County and North Carolina. The state exceeds
Wayne County in deaths caused by heart disease, respiratory diseases, and all other causes,
whereas Wayne County exceeds the state in deaths caused by cancer, cerebrovascular
disease, and diabetes. 23
992.4 973.8 972.0 960.7 942.0
875.3 861.4 845.5 819.0 808.4
0
200
400
600
800
1000
1200
2003-2007 2004-2008 2005-2009 2006-2010 2007-2011
Rates
Year
Wayne County and NC Mortality Rates
(All Causes)
Wayne
NC

Age-Specific Death Rates
The table below presents the top three leading causes of death categorized by age
group from 2007-2011. For the population age 0-19 in Wayne County, the death rates per
100,000 population for perinatal deaths (31.6) and motor vehicle deaths (12.8) are higher
than those for North Carolina. For the population age 20-39 in Wayne County, the death
rates for motor vehicle deaths (24.9) and homicide (21.7) are higher than those for North
Carolina. For the population age 40-64 in Wayne County, the death rates for cancer (215.5),
heart disease (157.2) and diabetes (38.9) are higher than those for North Carolina. For the
population age 65-84 in Wayne County, the death rates for cancer (1018.4), heart disease
(812.6) and cerebrovascular diseases (252.8) are higher than those for North Carolina. For
the population age 85 and older in Wayne County, the death rate for heart disease (3927.1)
is higher than those for North Carolina. 24
24 NC Division of Public Health, State Center for Health Statistics, County Health Data Book. Available at:
http://www.schs.state.nc.us/schs/data/databook/
25.2
18.5
6.6
4.6 4.2
40.8
22.8 21.3
5.4 2.9 5.9
41.7
0
5
10
15
20
25
30
35
40
45
50
Percentage(%)
Cause
Wayne County and NC Leading Causes of
Death (2011)
Wayne
NC

The Top Three Leading Causes of Death in Wayne County by Age (2007-2011)
Age Groups Cause of Death # of Deaths
(2007-2011)
2007-2011 Death Rate
Wayne NC
0-19 Perinatal Cond. 52 31.6 19.9
Motor Vehicle 21 12.8 7.9
Birth Defects 12 7.3 8.8
20-39 Motor Vehicle 39 24.9 21.1
Homicide 34 21.7 12.2
Injuries 31 19.8 21.0
40-64 Cancer 410 215.5 179.2
Heart Disease 299 157.2 120.5
Diabetes 74 38.9 20.5
65-84 Cancer 693 1018.4 898.0
Heart Disease 553 812.6 717.9
Cerebrovascular 172 252.8 187.7
85+ Heart Disease 308 3927.1 3871.4
Cancer 123 1568.3 1638.4
Cerebrovascular 89 1134.8 1146.8
Race/Sex-Specific Death Rates
The leading causes of death by age and sex from 2007-2011 can be found in the
following table. Cancer is the leading cause of death for all age and sex groupings, except for
African-American females. African-American males and females have diabetes as one of the
top five leading causes of death, whereas white males and females have respiratory
diseases as a top five leading cause of death. Overall, the death rates for cancer and heart
disease are substantially higher in males for both whites and African-Americans. 25

The Five Leading Causes of Death in Wayne County by Race and Gender (2007-
2011)
White Males African-American
Males
White Females African-American
Females
1 Cancer
(259.4)
Cancer
(263.6)
Cancer
(165.3)
Heart Disease
(183.3)
2 Heart Disease
(254.4)
Heart Disease
(257.5)
Heart Disease
(153.4)
Cancer
(159.6)
3 Cerebrovascular
Disease (63.0)
Cerebrovascular
Disease (84.6)
Cerebrovascular
Disease (46.3)
Diabetes
(61.5)
4 Respiratory
Diseases (43.9)
Diabetes
(76.0)
Respiratory
Diseases (40.3)
Cerebrovascular
Disease (47.0)
5 Injuries
(43.0)
Nephritis
(62.3)
Alzheimer’s
Disease (31.3)
Nephritis
(38.6)
Health Conditions
Cancer
The leading cause of death in Wayne County is cancer, and the following graph
depicts the cancer mortality rates for Wayne County and North Carolina from 2007 to 2011
per 100,000 population. From 2010 to 2011, Wayne County experienced an increase in
cancer mortality rates of almost 46 deaths per 100,000 population. As of 2011 the cancer
mortality rate in Wayne County is nearly 46 deaths per 100,000 population higher than the
state. 26

The following tables report the cancer incidence rates, cancer mortality rates, and
projected new cancer cases and deaths by type of cancer. From 2006 to 2010, the incidence
rates for prostate, lung, and colon cancers were higher than the state. From 2007 to 2011,
the mortality rates for all four major types of cancer were higher than the state. Wayne
County is projected to have 706 new cancer cases and 250 cancer deaths in 2013. Breast
cancer is projected to have the most new cases in 2013, whereas lung cancer is projected to
have the most deaths in 2013 for Wayne County. 27
Cancer Incidence Rates by Type per 100,000 Population (2006-2010)
Place Prostate Breast Lung Colon
Wayne 155.9 151.7 80.6 51.0
NC 153.7 155.9 74.8 43.4
Cancer Mortality Rates by Type per 100,000 Population (2007-2011)
Place Lung Prostate Breast Colon
Wayne 61.8 27.5 27.5 17.1
NC 54.1 24.3 22.6 15.2
27 NC Division of Public Health, State Center for Health Statistics, Cancer Data. Available at:
http://www.schs.state.nc.us/schs/data/cancer.cfm
214.4
188.6
231.7
188.9
235.3
192.1 188.4 186.3
181.0
188.5
0
50
100
150
200
250
300
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Cancer Mortality
Rates per 100,000 Population
Wayne
NC

Projected New Cancer Cases and Deaths - 2013
Projected New Cases Projected Deaths
Wayne NC Wayne NC
Total 706 56,164 250 19,855
Lung 108 8,559 77 6,126
Breast 117 9,339 18 1,393
Prostate 104 8,316 12 1,015
Colon 61 4,852 21 1,671
Heart Disease
The second leading cause of death in Wayne County is heart disease, and the
following graph depicts the heart disease mortality rates for Wayne County and North
Carolina from 2007 to 2011. Although heart disease rates in Wayne County are high, the
rates have decreased dramatically since 2007. As of 2011, the heart disease rate for Wayne
County was marginally higher than that of the state. 28

Diabetes
The fourth leading cause of death in Wayne County is diabetes. The graph below
shows a comparison of the percentage of the population diagnosed with diabetes among
Wayne County and North Carolina. From 2006 to 2010, Wayne County has demonstrated a
consistently higher percentage of residents having diabetes than the state. Furthermore,
the percentage of the population of Wayne County diagnosed with diabetes has steadily
increased since 2007, with the 2010 percentage being 12%. 29
29 Centers for Disease Control and Prevention. Available at:
http://www.cdc.gov/
233.5
197.9 190.5 198.2
175.6
193.0 188.8 182.6
179.2 172.2
0
50
100
150
200
250
300
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Heart Disease
Mortality Rates per 100,000 Population
Wayne
NC

The following graph shows the diabetes mortality rates for Wayne County and
North Carolina from 2007 to 2011. The mortality rate for diabetes in Wayne County has
increased 7.4 per 100,000 population from 2008 (35.4) to 2011 (42.8). As of 2011, the
diabetes rate in Wayne County is 19.2 per 100,000 population higher than that of the state.
Furthermore, the 2007-2011 diabetes mortality rate per 100,000 population was higher
for African-American males (50.9) and females (40.4) than white males (21.7) and females
(14.2). 30
10.8
10.4
11.1 11.6
12.0
9.1 9.0 9.3 9.6 10.0
0
2
4
6
8
10
12
14
2006 2007 2008 2009 2010
Rates
Year
Wayne County and NC Percentage of
Population Diagnosed with Diabetes
Wayne
NC

Asthma
The following graph details the percentage of the population diagnosed with asthma
in Wayne County and North Carolina from 2007 to 2010. The percentage has decreased in
Wayne County from 2009 (18 percent) to 2010 (14.2), but remains higher than that of the
state as of 2010 (12.6 percent). 31 The table below the graph reports the 2011 hospital
discharge statistics for asthma in Wayne County and North Carolina. Both the total
discharge rate and the age-specific discharge rate (ages 0-14) were higher in Wayne
County than the state. 32
31 NC Division of Public Health, State Center for Health Statistics, Behavioral Risk Factor Surveillance System
(BRFSS). Available at: http://www.schs.state.nc.us/schs/brfss/
37.3 35.4 36.9 39.1
42.8
23.7 23.5 22.5 21.4
23.6
0
10
20
30
40
50
60
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Diabetes Mortality
Wayne
NC

2011 Hospital Discharges with Asthma
Residence Total Number Total Rate Ages 0-14 Rate Ages 0-14
Wayne 166 134.2 44 172.4
NC 9,880 102.3 3,004 157.3
Overweight/Obesity
Obesity has been shown to contribute to the leading causes of death including heart
disease, some cancers, and diabetes. The graph below depicts a comparison between
Wayne County and North Carolina from 2010 to 2012 on the percentage of adults reporting
obesity. The percentage of obese adults in Wayne County has increased from 31 percent to
33 percent, whereas the percentage of obese adults in North Carolina has remained
constant at 29 percent from 2010 to 2012. 33
33 NC State University Institute for Emerging Issues. Available at:
http://www.ncsu.edu/iei/wp-content/uploads/2012/03/Wayne.pdf
14.1 13.4
18.0
14.2
12.1 11.7
12.9 12.6
0
2
4
6
8
10
12
14
16
18
20
2007 2008 2009 2010
Percentage
Year
Population Diagnosed With Asthma
Wayne
NC

The following graph illustrates the number of people reporting normal weight,
overweight, and obesity across age groups. In 2010, the age groups of 35-44, 45-54, and 55-
64 reported higher numbers in the overweight and obese categories than the normal
weight category. Conversely, more than half of the population age 18-25 reported being at
a normal weight. 34
34 NC State University Institute for Emerging Issues. Available at:
http://www.ncsu.edu/iei/wp-content/uploads/2012/03/Wayne.pdf
31 32
33
29 29 29
0
5
10
15
20
25
30
35
40
45
50
2010 2011 2012
Percentage(%)
Year
Obese Adults
Wayne
NC

High Blood Pressure
High blood pressure, or hypertension, has been found to be correlated with the
leading causes of death including heart disease, some cancers, and diabetes. The following
graph depicts the percentage of Wayne County and North Carolina residents informed of
hypertension by a physician. The percentages in Wayne County have decreased from 2007
(34.1 percent) to 2011 (26.4 percent). In contrast, the percentages for North Carolina have
increased from 2007 (28.8 percent) to 2011 (32.4 percent). 35
0.0
2000.0
4000.0
6000.0
8000.0
10000.0
12000.0
14000.0
16000.0
18000.0
20000.0
18-25 25-34 35-44 45-54 55-64 65+
NumberofPeople
Age
Wayne County Overweight and Obese by Age
(2010)
Obese
Overweight
"Normal"

High Cholesterol
A third precipitating factor in relation to leading causes of death including heart
disease, some cancers, and diabetes is high cholesterol. The graph below shows the
comparison of Wayne County and North Carolina with regards to the percentage of the
population informed by a doctor of high cholesterol. The percentage of Wayne County
residents informed of high cholesterol increased from 2007 (32.9 percent) to 2009 (38.7
percent), but decreased from 2009 to 2011 (36.9 percent). In comparison, the percentages
for North Carolina have remained higher than Wayne County in 2007, 2009, and 2011. 36
34.1
29.2
26.4
28.8
31.5
32.4
0
5
10
15
20
25
30
35
40
45
50
2007 2009 2011
Percentage(%)
Year
Population Informed by Doctor of High
Blood Pressure
Wayne
NC

Communicable Diseases
HIV
While the number of HIV diagnoses, asthma and AIDS diagnoses rates are not large
compared to heart disease and cancer, these trends are reported as they have been in the
past, when mortality was very high. These are managed as chronic diseases in the US now.
The following graph depicts the HIV rates per 100,000 population for Wayne County and
North Carolina from 2007 to 2011. In the period between 2010 and 2011, the HIV rate
nearly doubled from 10.6 to 20.4 per 100,000 population in Wayne County. As of 2011,
Wayne County’s HIV rate has surpassed that of the state. 37
37 NC Department of Health and Human Services, Facts and Figures. Available at:
http://epi.publichealth.nc.gov/cd/stds/figures.html#annual
32.9
38.7
36.9
39.6 40.0 38.5
0
5
10
15
20
25
30
35
40
45
50
2007 2009 2011
Percentage(%)
Year
Population Informed by Doctor of High
Cholesterol
Wayne
NC

AIDS
The following graph depicts the AIDS rates per 100,000 population for Wayne
County and North Carolina from 2007 to 2011. In the period between 2010 and 2011, the
AIDS rate more than doubled from 7.3 to 14.7 per 100,000 population in Wayne County. As
of 2011, Wayne County’s AIDS rate has almost doubled that of the state. 38
15.0
13.2
14.9
10.6
20.419.9 19.6
17.4
15.4 16.4
0.0
5.0
10.0
15.0
20.0
25.0
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC HIV Rates per 100,000
Population
Wayne
NC

STDs
Syphilis:
Sexually transmitted diseases have increased in Wayne County compared to the
state of North Carolina, and the Health Department is working with various agencies to
bring these under control. The following graph depicts the syphilis rates per 100,000
population for Wayne County and North Carolina from 2006 to 2010. Wayne County has
experienced a dramatic increase in syphilis rates since 2006, with an increase of 27.3 per
100,000 population from 2006 to 2010. The highest syphilis rates were recorded in 2009
with a rate of 51.9 per 100,000 population. As of 2010, Wayne County has a syphilis rate
more than five times higher than that of North Carolina. 39
7.9
8.8
7.9
7.3
14.7
9.4
10.1 10.0
8.3 8.7
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC AIDS Rates per
100,000 Population
Wayne
NC

Gonorrhea:
The following graph reports the gonorrhea rates per 100,000 population for Wayne
County and North Carolina from 2006 to 2010. The gonorrhea rates in Wayne County have
increased dramatically since 2006, with an increase of more than 75 per 100,000
population as of 2010. Wayne County experienced the highest gonorrhea rates in 2009
(292.1). As of 2010, the gonorrhea rate in Wayne County is more than 100 per population
higher than the state. 40
13.1
14.9
24.6
51.9
40.4
7.0 6.4 5.5
10.2
7.7
0
10
20
30
40
50
60
2006 2007 2008 2009 2010
Rate
Year
Wayne County and North Carolina
Syphilis Rates per 100,000 Population
Wayne
NC

Chlamydia:
The most prevalent STD in Wayne County is chlamydia. The following graph depicts
the chlamydia rates in Wayne County and North Carolina from 2006 to 2010. The
chlamydia rate in Wayne County has doubled from 2006 to 2010. As of 2010, the chlamydia
rates in Wayne County were almost 330 per 100,000 population higher than the state. 41
180.9 159.0
227.9 292.1
257.4199.3 188.2
162.8 160.6 150.9
0
50
100
150
200
250
300
2006 2007 2008 2009 2010
Rate
Year
Gonorrhea Rates per 100,000 Population
Wayne
NC

Tuberculosis (TB)
The following graph shows the tuberculosis rates for Wayne County and North
Carolina from 2006 to 2010. In 2008, Wayne County experienced a dramatic decrease in
the tuberculosis rate, but the rate in 2010 is nearly two times higher than that of 2008. As
of 2010, the tuberculosis rate in Wayne County is more than twice that of the state. 42
42 NC Department of Health and Human Services, Disease and Topics. Available at:
http://epi.publichealth.nc.gov/cd/diseases/tb.html
397.6 371.6
631.6 626.4
779.4
387.0
346.0
411.0
474.0 450.0
0
100
200
300
400
500
600
700
800
2006 2007 2008 2009 2010
Rate
Year
Chlamydia Rates per 100,000 Population
Wayne
NC

Maternal Health
Birth Rates
The following graph reports the overall birth rates for Wayne County and North
Carolina from 2006 to 2010. The birth rate in Wayne County has steadily decreased since
2007. As of 2010, the birth rate in Wayne County (13.2) is marginally higher than that of
the state (12.8). 43
7.1
7.7
2.6
7.0 6.8
4.6
3.8
3.6
2.7
3.1
0
1
2
3
4
5
6
7
8
9
10
2006 2007 2008 2009 2010
Rate
Year
Tuberculosis Rates per 100,000 Population
Wayne
NC

Pregnancy Rates
The following graph depicts the pregnancy rates for females ages 15 to 44 in Wayne
County and North Carolina from 2007 to 2011. Over the five year period, Wayne County
has demonstrated consistently lower pregnancy rates than the state. As of 2011, the
pregnancy rate in North Carolina (84.4) is higher than that of Wayne County (73.3). 44
15.6
15.3
14.3
13.2
14.0
14.4
14.2
13.5
12.8
12.5
10
11
12
13
14
15
16
17
2007 2008 2009 2010 2011
Rate
Year
Wayne County and North Carolina Birth
Wayne
NC

The next two graphs depict overall teen pregnancy rates and teen pregnancy rates
by race from 2006 to 2010 for Wayne County and North Carolina. The overall teen
pregnancy rate in Wayne County has steadily declined from 2007 to 2010. However, the
teen pregnancy rates in Wayne County have remained higher than the state over the five
year period. As of 2010, Wayne County reported more than 17 teen pregnancies per 1,000
population than the state. 45 Teen pregnancy is an issue that differentially affects races, as
shown in the second graph. Non-white residents of Wayne County have reported at least 25
more teen pregnancies per 1,000 population than white residents each year over the five
year period. However, the teen pregnancy rates for both non-white and white residents of
Wayne County have decreased since 2007. 46
84.7
83.9
78.9
76.4
73.3
92.0
91.0
84.2
82.6
84.4
50
55
60
65
70
75
80
85
90
95
100
2007 2008 2009 2010 2011
Rate
Year
Pregnancy Rates for Females Ages 15-44 per
1,000 Population
Wayne
NC

79.9
73.5
68.2 67.4
57.3
63.0
58.6 56.0
49.7
43.8
0
10
20
30
40
50
60
70
80
90
100
2007 2008 2009 2010 2011
Rate
Year
Wayne County and North Carolina Teen
Pregnancy Rates per 1,000 Population
Wayne
NC
63.0 59.7
53.7
47.9
41.6
110.7
87.3 87.2 86.6
80.1
0
20
40
60
80
100
120
2007 2008 2009 2010 2011
Rate
Year
Wayne County Teen Pregnancy Rates by
Race per 1,000 Population
White
Non-
White

Abortion Rates
The following graph depicts the abortion rates for Wayne County and North
Carolina from 2007 to 2011. The abortion rates in Wayne County surpassed those of the
state in 2009 and remain marginally higher than the state as of 2011. Overall, the abortion
rates in Wayne County have decreased by 2.4 per 1,000 population since 2007. 47
Maternal Health Indicators
The following graph details the percentage of resident live births classified as low
birth weight in Wayne County and North Carolina in five year periods from 1994 to 2008.
The percentages of low birth weights have remained fairly constant across this time period
for both Wayne County and the state. Since the 1994 to 1998 time period, Wayne County’s
percentage of low birth weights has increased 1.1 percent, whereas the state has increased
0.3 percent. 48
48 NC Division of Public Health, State Center for Health Statistics, Trends in Key Health Indicators. Available
at: http://www.schs.state.nc.us/schs/data/trends/pdf/Wayne.pdf
14.8
12.9 12.7
14.7
12.7
15.1
14.4 13.4
13.2
11.4
0
5
10
15
20
2007 2008 2009 2010 2011
Rate
Year
Abortion Rates per 1,000 Population
Wayne
NC

The following graph portrays the percentage of resident live births where the
mother smoked during pregnancy for Wayne County and North Carolina in five year
periods beginning in 1994. The percentages of mothers who smoked during pregnancy
have steadily decreased for Wayne County and the state from 1994 to 2008. From 2004 to
2008, 12.4 percent of mothers in Wayne County smoked during pregnancy, whereas 11.5
percent of mothers in the state smoked during pregnancy. 49
8.1
8.9 9.2
8.8
8.9 9.1
0
5
10
15
1994-1998 1999-2003 2004-2008
Rate
Year
Percentage of Resident Live Births Classified
As Low Birthweight (2,500 grams/ 5 lbs 8
ozs or less)
Wayne
NC

The graph below portrays the percentage of mothers who received prenatal care in
the first trimester for Wayne County and North Carolina. Although the percentage of
mothers who received prenatal care in the first trimester in Wayne County has increased
since the 1994 to 1998 time period, the percentage in the 2004 to 2008 time period
remains 11.5 percent lower than the state. 50
15.9 15.4
12.4
15.7
13.6
11.5
0
5
10
15
20
25
30
1994-1998 1999-2003 2004-2008
Rate
Year
Percentage of Resident Live Births Where
Mother Smoked During Pregnancy
Wayne
NC

Other Health Status Data
General Health Status
The following graph depicts the results of the Center for Disease Control’s
Behavioral Risk Factor Surveillance System (BRFSS) survey question regarding general
health status for Wayne County and North Carolina residents. A higher percentage of
residents in Wayne County report having excellent health (21.8 percent) than the state (18
percent). Additionally, the majority of Wayne County residents report have good, very
good, or excellent health (81.8 percent). 51
65.2
69.3 70.6
83.1 84.0 82.1
0
10
20
30
40
50
60
70
80
90
100
1994-1998 1999-2003 2004-2008
Rate
Year
Percentage of Resident Live Births Where Mother
Received Prenatal Care in the 1st Trimester
Wayne
NC

Mental Health
Mental health has been identified as a top issue in Wayne County. However, the
ability to report mental health statistics is limited. The following graph depicts the mental
health emergency admission rate per 10,000 population for Wayne County and North
Carolina from 2008 to 2010. The rate has increased steadily from 2008 to 2010 and has
remained higher than the state’s rate. Moreover, the 2010 rate in Wayne County was 71 per
10,000 population higher than that of the state. 52
52 NC Department of Health and Human Services, Statistics and Publications. Available at:
http://www.ncdhhs.gov/mhddsas/statspublications/Reports/
21.8%
31.5%
28.5%
12.5%
5.7%
18.0%
31.5% 30.9%
14.0%
5.6%
0%
5%
10%
15%
20%
25%
30%
35%
Excellent Very Good Good Fair Poor
Percentage
Status
2011 General Health Status for Wayne
County and NC
Wayne
NC

The following tables report the number of Wayne County residents served in area
mental health programs and alcohol / drug treatment centers from 2006 to 2010. The
number of residents served in area mental health programs has increased by over 2,500
from 2006 to 2010. Additionally, the number of residents served in alcohol / drug
treatment centers has increased by 37 from 2006 to 2010. 53
Wayne County Residents Served in Area Mental Health Programs
2006 2007 2008 2009 2010
4,020 3,574 4,267 4,832 6,546
Wayne County Residents Served in Alcohol / Drug Treatment Centers
2006 2007 2008 2009 2010
65 88 95 85 102
Suicide:
Another conceptualization of the mental health issue can be determined by the
suicide rates in a particular location. The following graph portrays the suicide rates per
100,000 population in Wayne County and North Carolina from 2006 to 2011. The rates in
this time period for Wayne County have fluctuated but have steadily decreased from 2009
53 Log Into North Carolina (LINC). Available at:
http://data.osbm.state.nc.us/pls/linc/dyn_linc_main.show
196.6 199.9
215.0
128.4
153.6
144.0
0.0
50.0
100.0
150.0
200.0
250.0
2008 2009 2010
Rates
Year
Wayne County and NC Mental Health Local
Emergency Department Admission Rate per
10,000
Wayne
NC

to 2011. As of 2011, the suicide rate in Wayne County is lower than that of the state.
However, the 6-year average from 2006 to 2011 for Wayne County is very close to the
state. 54
Smoking /Tobacco
Smoking and tobacco use are notorious precipitating factors in cancer-related
deaths. Specifically, the smoking statistics presented below are indicative of the prevalence
and mortality rates associated with lung cancer in Wayne County and the state. The
following graph depicts the percentage of smokers in Wayne County and North Carolina
from 2007 to 2011 as reported by the BRFSS survey. According to the results of the survey,
the percentage of smokers in Wayne County has decreased by 6.4 percent from 2007 to
2011. As of 2011, the percentage of smokers in Wayne County and North Carolina are
identical at 21.8 percent. 55
13.1
17.4
7.8
18.0
11.4
8.9
12.3 11.8
12.6
12.4
12.2 12.4
0
2
4
6
8
10
12
14
16
18
20
2006 2007 2008 2009 2010 2011
Rates
Year
Wayne County and NC Suicide Rates per
100,000 Population
Wayne
NC

The following tables report additional information concerning tobacco and tobacco
use as reported by the BRFSS survey. As of 2011, half of the residents in Wayne County
never smoked and 27.9 percent indicated that they were a former smoker. Furthermore,
16.3 percent of respondents reported that they smoke every day, whereas 5.4 percent
smoke some days. The next table indicates that 8.8 percent of residents in Wayne County
chew tobacco, whereas 5.2 percent of residents in the state chew tobacco. The third table
shows that 16 percent of Wayne County residents report being exposed to secondhand
smoke in their homes, whereas only 5 percent report exposure in the workplace. 56
2011 Smoking Status
Residence Smoke Everyday Smoke Some Days Former Smoker Never Smoked
Wayne 16.3% 5.4% 27.9% 50.3%
NC 15.6% 6.1% 24.8% 53.4%
2011 Chewing Tobacco Use
Residence Yes No
Wayne 8.8% 91.2%
NC 5.2% 94.8%
28.2 28.6
22.4 24.3
21.8
22.9
20.9 20.3 19.8
21.8
0
5
10
15
20
25
30
35
2007 2008 2009 2010 2011
Percentage(%)
Year
Smokers
Wayne
NC

Percentage of People Exposed to Secondhand Smoke in the Past Seven Days (2011)
Residence Home Work
Wayne 16% 5%
NC 14% 8%
Exercise
The following graph depicts the percentage of residents who exercised in the past
month from according to the BRFSS survey. From 2010 to 2011, the percentage of Wayne
County residents who exercised in the past month increased 10.8 percent and surpassed
the 73.3 percent of North Carolina residents who exercised in the past month in 2011. 57
Screenings
The following graph portrays the percentage of residents in Wayne County and
North Carolina who got a flu shot in the past year from 2007 to 2011 according to the
BRFSS survey. From 2010 to 2011, the percentage of Wayne County residents who got flu
shots increased 8.6 percent. As of 2011, the percentage of residents who got flu shots in
68.6 68.7 65.3 64.9
75.775.7 75.4 73.6 74.3 73.3
0
10
20
30
40
50
60
70
80
90
100
2007 2008 2009 2010 2011
Percentage(%)
Year
Residents who Exercised in the Past Month
Wayne
NC

Wayne County was 7.2 percent higher than the state. The combined efforts of Wayne
Memorial Hospital and the Wayne County Health Department have been important with
regard to the increases in flu shots amongst residents in Wayne County. 58
Child Health
The following graph depicts the leading causes of child deaths ages 0 to 19 in Wayne
County and North Carolina in the 2007 to 2011 time period. Prenatal conditions are the
highest percentage of child deaths (42.6 percent), followed by illness (18 percent) and
birth defects (9.8 percent) in Wayne County. Alternatively, the highest percentage of child
deaths in North Carolina is birth defects (42.6 percent), followed by prenatal conditions
(34.5 percent) and illness (19.8 percent). 59 The table below the graph reports the total
number of child deaths in Wayne County and North Carolina by cause of death and age. The
majority of child deaths are the result of prenatal conditions and occur before the age of
one. 60
39.2 36.2
34.1
39.8
48.4
38.5
40.4 40.9
42.2 41.2
0
10
20
30
40
50
60
2007 2008 2009 2010 2011
Percentage(%)
Year
Residents Who Got a Flu Shot in the Past
Year
Wayne
NC

Location
(2007-
2011)
Total Cause of Death Age
Birth
Defects
Perinatal
Conditions
SIDS
Illness
Motor
Vehicle
Homicide
Suicide
Other
Under1
1-4
5-9
10-14
15-17
Wayne 122 12 52 11 22 9 3 3 10 85 12 8 7 10
NC 7,331 1,082 2,527 435 1,449 577 240 129 892 4,899 713 428 472 819
Childhood Obesity:
The following graph portrays the percentage of children ages 2-18 identified as
overweight or obese in Wayne County and North Carolina from 2005 to 2009. This
percentage for Wayne County has steadily declined from 2005 to 2009. As of 2009, the
percentage of obese children in Wayne County was 5.7 percent less than the state. 61 One
important program in place has been the partnership between the Goldsboro YMCA and
Goldsboro Pediatrics, to educate at-risk children through the CHANGE For CHILDREN
program, a 10-week physical activity and nutrition program for overweight children ages
6-15 years old. CHANGE runs Monday through Thursday afternoons “to help children raise
their self-esteem and confidence, and improve their health through fun physical activity
61 Eat Smart Move More NC. Available at:
http://www.eatsmartmovemorenc.com/Data/Texts/
9.8
42.6
9.0
18.0
7.4
2.5 2.5
8.2
42.6
34.5
5.9
19.8
7.9
3.3
1.8
12.2
0
5
10
15
20
25
30
35
40
45
50
Birth
Defects
Perinatal
Condition
SIDS Illness Motor
Vehicle
Homicide Suicide Other
Percentage(%)
Cause
Leading Causes of Child Deaths (Ages 0-19)
in Wayne County and NC (2007-2011)
Wayne
NC

and exercise”, with the goal of bringing about life-changing behaviors that lead to a
healthier child.
Access to Health Care
Insured/Uninsured Population
Access to health care has been identified as a top issue in Wayne County. The
following graph depicts the percent of uninsured residents in Wayne County and North
Carolina from 2006 to 2010. The percentage of uninsured residents in Wayne County
increased 4 percent from 2009 to 2010. As of 2010, the percentage of uninsured residents
in Wayne County (20.4 percent) surpassed that of the state (19.1 percent). 62
62 US Census Bureau, Small Area Health Insurance Estimates. Available at:
http://www.census.gov/did/www/sahie/
34.0
37.3
33.0
30.9
28.5
32.4
33.3 33.3 33.9 34.2
0
5
10
15
20
25
30
35
40
2005 2006 2007 2008 2009
Percentage(%)
Year
Percentage of Children Ages 2-18 Identified
as Overweight or Obese
Wayne
NC

Medicare/Medicaid
The following table reports the Medicaid eligible statistics for Wayne County and
North Carolina as of July 2009. The majority of Wayne County and North Carolina Medicaid
eligible are between the ages of 0 and 5. In Wayne County, 20 percent of the total
population was Medicaid eligible, whereas 17 percent of North Carolina residents were
Medicaid eligible. 63
Medicaid Eligibles by Age or Group for Wayne County and NC for June 2009
Health
Choice
0-5 6-11 12-20 21+
Non
ABD
21+
ABD
Family
Planning
Total
Medicaid
Population
Total
Population
July 2009
% of
Pop.
WC 2,261 6,376 3,976 4,323 4,429 5,690 912 24,794 122,623 20%
NC 143,022 408,023 253,855 274,805 300,954 339,484 57,966 1,577,121 9,543,537 17%
Hospital Utilization
The following table reports the hospital utilization statistics for Wayne County and
North Carolina in 2011. The discharge rate in Wayne County was 12.8 per 1,000 population
higher than the discharge rate of North Carolina. Additionally, the days stay rate for Wayne
63 NC Department of Health and Human Services, Statistics and Reports. Available at:
http://www.ncdhhs.gov/dma/pub/index.htm
18.1 17.7 17.5 17.4
20.4
18.6 18.2 17.4 18.0
19.1
0
5
10
15
20
25
2006 2007 2008 2009 2010
Percentage(%)
Year
Percentage of Population Uninsured
(Ages <65)
Wayne
NC

County was nearly 100 per 1,000 population higher than North Carolina. However, the
average charge per day and the average charge per case were lower in Wayne County than
the state. 64
Location Total
Cases
Discharge
Case Rate
(Per 1,000)
Avg.
Days
Stay
Days Stay
Rate (Per
1,000)
Total Charges Avg.
Charge
per day
Avg.
Charge
per Case
Wayne 13,988 113.1 5.2 583.7 $358,701,607 $4,968 $25,645
NC 968,063 100.3 4.9 489.8 $26,779,613,000 $5,663 $27,683
Healthcare Providers
One critical statistic in examining health care access is the number of providers
within a given county. The following tables report the primary care provider as a ratio of
the population and the health professional per 10,000 population in Wayne County and
North Carolina. The table below indicates that there are almost 300 more people per
primary care provider in Wayne County than the state. Furthermore, there are greater than
500 more people per primary care provider in Wayne County than the national benchmark.
65 In the second table, Wayne County has a lower rate of every type of health professional
per 10,000 population than the state. The most notable difference in rates between Wayne
County and the state are for total physicians and registered nurses (RN’s). 66
Primary Care Provider as a Ratio of the Population (2012)
Wayne 1,554:1
NC 1,135:1
National Benchmark 631:1
2010 Health Professionals per 10,000 Population
Location Total
Physicians
Total
Primary
Care
Dentists Pharmacists RN’s Nurse
Practitioners
Certified
Nurse
Midwives
Physician
Assistants
Wayne 14.4 6.3 3.7 7.2 90.2 2.8 0.0 3.2
NC 21.7 9.4 4.4 9.1 97.3 3.8 1.2 3.8
65 County Health Rankings and Roadmaps. Available at:
http://www.countyhealthrankings.org/app/north-carolina/2012/measures/factors/4/map
66 Cecil G. Sheps Center for Health Services Research, NC Health Professions Data System. Available at:
http://www.shepscenter.unc.edu/hp/prof2010.htm

Environmental Health
Air Quality
The NC Division of Air Quality utilizes the Air Quality Color Code Guide (see table
below) to alert the public of air quality issues related to ozone and fine particles. Air
pollution levels within the range of orange, red, purple or maroon are considered
exceeding the Environmental Protection Agency (EPA) standard. Furthermore, the
American Lung Association provides county-level grades for air quality based on EPA
standards. In 2010, Wayne County received a letter grade of “B” for daily particle pollution,
having only one “orange” particle day. Additionally annual average levels of air pollution
are calculated by the EPA based on air pollution levels. The chart below depicts the 3-year
averages from 2004 to 2010 in annual average air quality for Wayne County. 67
67 American Lung Association, State of the Air. Available at:
http://www.stateoftheair.org/2012/states/north-carolina/wayne-37191.html
Air Quality Index
Levels of Health Concern
Numerical
Value
Meaning
Green/Good 0-50 Air quality is considered satisfactory, and
air pollution poses little or no risk.
Yellow/Moderate 51-100 Air quality is acceptable; however, for
some pollutants there may be a
moderate health concern for a very small
number of people who are unusually
sensitive to air pollution.
Orange/Unhealthy for
Sensitive Groups
101-150 Members of sensitive groups may
experience health effects. The general
public is not likely to be affected.
Red/Unhealthy 151-200 Everyone may begin to experience health
effects; members of sensitive groups may
experience more serious health effects.
Purple/Very Unhealthy 201-300 Health alert: everyone may experience
more serious health effects.
Maroon/Hazardous >300 Health warnings of emergency
conditions. The entire population is more
likely to be affected.

Water Quality (EPA measures watershed quality using 15 indicators)
Based on EPA measures of watershed quality using 15 different indicators,
Sperling’s Best Places has created a rating system on a 100 point scale, with 100 being the
highest possible water quality. According to this 2010 report, Wayne County scored 70 out
of 100, compared to 74 out of 100 for the state, and 55 out of 100 for the US. 68
Peer County Comparisons
According to the CHA Guidelines, comparisons must be made between the county of
interest and peer counties regarding secondary data. Peer counties are determined by
their similarity in population size, density, age/race distributions, and poverty levels. The
following counties have been identified as peer counties for Wayne County: (1) Alamance,
(2) Gaston, (3) Pitt, (4) Robeson, and (5) Rowan.
68 Sperling’s Best Places. Available at:
http://www.bestplaces.net/health/county/north_carolina/wayne
13.1 12.6 12.3
11.1 10.8
15.0 15.0 15.0 15.0 15.0
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
2004-2006 2005-2007 2006-2008 2007-2009 2008-2010
Value
Year
Wayne County Average Annual
Concentration Compared to the EPA
Standard
Wayne
EPA

Please find below a listing of common priority areas for Wayne County’s peer counties.
Alamance:
 Access to healthcare
 Obesity
 Mental health
 Substance abuse
 Education
 Poverty
Gaston:
 Obesity
 Cardiovascular disease/high blood pressure
 Cancer
 HIV/STDs
 Mental health
 Substance abuse
Pitt:
 Chronic disease
 STD
 Healthy weight
 Violence
Robeson:
 Obesity
 Substance abuse
Rowan:
 Obesity
The following table reports whether Wayne County is below average, average, or
above average with regards to peer counties in four data domains including: (1) education,
(2) economy, (3) social, and (4) health. Wayne County needs most improvement in the
health domain, followed by economy and education. Regarding the social domain, Wayne
County is doing better that its peer counties.

Indicator Wayne Peer County Comparison
Below Avg. Average Above Avg.
Education
Percent with High School
Diploma or Higher
80.1%
Percent with Associate’s
Degree
8.9%
Percent with Bachelor’s
Degrees or Higher
14.4%
Drop-Out Rate 4.84
SAT Scores 950
Economy
Median Annual Household
Income
$39,085
Per Capita Income $20,141
Poverty Rates 23.4
Unemployment 9.4
Percent of Students on Free
and Reduced Lunch
66.3%
Social
Violent Crime Rate 454.1
Property Crime Rate 4,240.4
Percent Population
Uninsured
20.4%
Primary Care Provider Ratio 1,554:1
Health
Infant Mortality Rate 11.6
Teen Pregnancy Rate 57.3
Cancer Mortality Rate 235.3
Heart Disease Mortality Rate 172.2
Diabetes Mortality Rate 42.8
STD Rates 1077.2
HIV / AIDS Rates 35.1

Health Care Resources
 Cliffs of the Neuse State Park
 Edgewood Community Development School
o Services for autistic and moderate to profoundly mentally handicapped children
between the ages of 3 and 21 years of age
 Eastern Associates Speech and Language Services, Inc.
o Speech language and communicative disorder therapy for adults and children
 Eastpointe
o Information, referral, crisis intervention telephone services provided by Wayne
County Mental Health Association
 Goldsboro Pediatrics
o Provides quality pediatric care and referrals as needed
 Goshen Medical Center
o Provides income-based health care services
 Habitat for Humanity of Greater Goldsboro
o Provides home ownership opportunities for low-income families
 Mount Olive Family Medicine
 Mount Olive Pediatrics
 Salvation Army
o Provides food, clothing, medicine, and other necessities to low income families
 The Shelter of Wayne County
o Emergency shelter for abused women and children
 Soup Kitchen
o Provides meals Monday through Saturday to needy people in downtown Goldsboro
 United Church Ministries
o Interdenominational organization providing emergency assistance
 WAGES
o Community action agency dedicated to helping Wayne County mobilize its resources
to combat poverty
 WATCH Healthcare Program
o Provides a medical home to the uninsured of Wayne County. A mobile medical unit
and a stationary clinic at the Goldsboro Family YMCA provide free acute and
primary health care with indicated labs and free prescription medications for those
who qualify.
 Wayne Community College
o Provides adult high school, GED, post-secondary, and continuing educational
opportunities to Wayne County citizens
 Wayne County Communities in Schools

o Community based organization that works to prevent students from dropping out of
school
 Wayne County Department of Social Services
o Comprehensive financial and family preservation services provided to income
eligible and at risk residents
 Wayne County Health Department
 Wayne County Mental Health Center
o Treatment for mental illness and substance abuse
 Wayne Memorial Hospital
 Wayne Uplift Resource Center
o Provides comprehensive family development services to residents of low-income
housing communities in Goldsboro
 Wayne Initiative for School Health (WISH)
o School-based program that provides services for minor illness, injuries,
immunizations, nutrition services, lab services, comprehensive physicals, health
education, chronic illness management, and dental screenings
o Brogden Middle, Dillard Middle, Goldsboro High, Wayne School of Engineering,
Mount Olive Middle, Southern Wayne High
Parks and Recreation Facilities
 Goldsboro Family YMCA
 Parks
o Berkley Park
o Fairview Park
o Henry C. Mitchell Park
o Herman Park
o H.V. Brown Park
o Mina Weil Park
o North End Park
o Peacock Park
o Quail Park
o South End Park
o Stoney Creek Park
 Recreation:
o Boys and Girls Club
o Herman Park Center
o Senior Citizens Building
o W.A. Foster Recreation Center

Review of Primary Data
The review that follows summarizes data collected from stakeholders, focus groups
and the community survey. The leadership team compared the primary data to secondary
data as well as contextual information, not included in this section, about Wayne County to
determine the focus areas of this Community Health Assessment. These data are meant to
portray a snapshot of community perceptions during the assessment period.
Stakeholders
The leadership team compiled a list of key stakeholders representing multiple
sectors including municipal, health, education, philanthropy, and faith-based organizations.
A community meeting with 43 stakeholders convened to gain support for the community
health assessment and to gather opinions about community health best practices. A group
of up to 10 stakeholders sat at each of seven tables. Each table was assigned one of the
following categories: church, family, government/health department, hospital/physicians,
neighborhood, schools and other. Stakeholders were asked to answer the question, “What
would a health County look like?” Responses were recorded and organized according to the
categories.
Themes included access to care, healthy eating, physical activity, community safety,
and mental health. In relation to access to care, stakeholders discussed strategies such as
screening, health education and outreach. Barriers to access included the high cost of
health care and lack of health insurance as well as cultural and language differences. In
relation to healthy eating and physical activity, most participants expressed an
understanding of the link between unhealthy food choices and lack of physical activity on
particular health outcomes, such as obesity and diabetes. In relation to community safety,
stakeholders wanted the “ability to walk everywhere safely.” Mental health was discussed
it in terms of prevention. Stakeholders approached health care from a proactive
perspective, with emphasis on prevention, such as access to lighted sidewalks, walking
trails and bicycle lanes. For multiple stakeholders, prevention also included more school
nurses, primary care and mental health services.
A meeting was conducted with providers in a local clinic that targets uninsured and
low income residents. This group noted that some patients with poor family health history
were resigned to having high blood pressure, or diabetes, as per: “It runs in my family;
that’s just the way it is”. This group suggested that increasing the understanding of how
changes in diet and exercise and/or treatment with medications could often help delay or
correct health conditions would be a good strategy to consider.
Focus Groups
Focus groups (N = 86) with community members were conducted to solicit feedback
regarding the health needs in the community. Three focus groups were comprised of

primarily under-represented populations. The other seven met in strategic geographic
locations throughout the county. A number of first responders, due to location, were asked
to participate in the seven focus groups along with the general public that lived in or in
close proximity to the area or region. Although efforts were made to have under-
represented populations present at the seven focus groups, the participants were
predominantly White. There was an equal gender representation in the ten focus groups.
Two team members conducted each session by asking a series of questions. Results were
transcribed and analyzed for themes.
Focus Group Summary Table (34 females, 32 males)
Location Date Attendance
Community Soup Kitchen 2/8/12 1 female, 6 males
WATCH free clinic 2/15/12 3 females, 3 males
Latino Market 2/15/12 3 females, 4 males
Grantham Fire Department 5/21/12 9 females, 3 males
Wayne County Public Library 5/22/12 4 females, 5 males
Pinewood Fire Department 5/31/12 4 females, 3 males
Fremont Fire Department 6/4/12 3 females, 5 males
Seymour Johnson Air Force Base 6/14/12 7 females, 8 males
Dudley Fire Department 6/19/12 4 females, 5 males
Seven Springs Fire Department 6/21/12 3 females, 3 males
When asked about the best thing about living in their community, the majority of
participants agreed on characteristics such as community support, friendliness, a feeling of
connectedness and both size and location. People primarily walk, ride bikes, participate in
youth sports and go to the YMCA to stay healthy. Participants also discussed involvement
in personal gardening as well as community gardens as a way to stay healthy.
Health information was received actively from doctors, the WATCH van and health
fairs. Multiple dissemination sources were also discussed, such as newspaper articles, the
hospital newsletter, churches, schools, the health department and word of mouth.
Participants cited obesity, cancer, mental health issues, diabetes, high blood
pressure, heart disease and drugs/alcohol as serious community health problems. The
common causes were listed as poor diet, lack of exercise, smoking, and a busy lifestyle.
Moreover, participants frequently discussed the inability to pay for healthcare, lack of
insurance and lack of access to and ability to afford healthy foods as causes for the
aforementioned health problems.
Common barriers to healthy community members were lack of information,
education and time, costs associated with eating healthy, transportation issues, and lack of
access to healthy foods. Other barriers included lack of exercise for children due to
technology and decreased time spent outdoors. Additionally, poverty, culture and a
shortage of doctors were discussed.

Participants were asked to suggest solutions to the community problems.
Answers included more satellite healthcare centers and clinics, more doctors with longer
available hours, having the WATCH van run more frequently and more advertising about
available transportation services. Additional resources such as farmer’s markets and
community gardens were also cited. Participants thought more education and information
regarding healthy eating and exercise would be beneficial as well as increased access to
healthy foods and exercise programs. Incentivizing healthy eating and exercise was a
common idea as was utilizing churches, workplaces, schools and other organizations to
disseminate information, offer exercise programs and provide healthy foods to community
members.
When requested to think about any group not receiving enough healthcare, the
elderly, migrant workers, the Hispanic population, and new college graduates and
teenagers were discussed. Additionally, both the uninsured and the population that is
slightly above the poverty threshold, therefore receive no assistance, but barely makes
enough money to pay for health insurance were common responses.
Community Survey
A community survey was developed and implemented to compliment and reinforce
secondary data collected from a variety of sources. The purpose of the survey was to collect
the varying opinions of community members regarding a variety of community health
topics.
The community survey (N = 1369) was administered in both online and paper
format, in order to capture the opinions of individuals with and without Internet access.
Research team members made community members aware of the survey at the focus group
sessions. Focus group attendants were also given information cards, which included an
Internet link to the online survey, to distribute to additional community members. Paper-
format surveys were strategically placed at select locations around the county. The survey
took approximately 30 minutes to complete and consisted of fixed-answer and open-
answer question types. As an incentive for participation, a free two-week membership to
the local YMCA was offered.
The majority of survey respondents were women (83.2 percent) and approximately
half (49.4 percent) were between the ages of 35 and 54. The racial distribution of
respondents primarily consisted of 66.8 percent White, 27.2 percent Black, and 3.4 percent
Hispanic/Latino. Educational attainment was high among respondents with 65 percent
reporting that they had an Associate’s degree or higher. Half of survey respondents (50.1
percent) had an annual household income of at least $50,000.
Population calibration or “data weighting” was conducted to compensate for
discrepancies between the survey population demographic profile and that of the county.

Weighting procedures were conducted on demographic variables age, sex, race, income,
and education. The weighting process allows underrepresented demographic groups to
have equivalent opinions as those who are overrepresented. All data presented below has
been weighted to the demographics of Wayne County.
Respondents were asked to rate the quality of life in Wayne County. The majority of
respondents agreed or strongly agreed that Wayne County has clean air and water (79
percent), is a good place to grow old (69 percent) and raise children (67 percent), has good
healthcare (65 percent), and that they are able to receive help from other community
members in time of need (60 percent). In contrast, more than half of respondents (66
percent) did not agree that there was plenty of economic opportunity in Wayne County.
Quality of Life Survey Results
Indicators Percent who agree or strongly agree
Clean air and water 79
Good place to grow old 69
Good place to raise children 67
Good healthcare 65
Help for people in time of need 60
Safe place to live 57
Plenty of economic opportunity 34
From a list of 18 possible choices, respondents identified the health condition(s)
that they had been diagnosed with by a doctor or health care professional. The most
frequently reported diseases are listed below. At 38 percent, the top health condition
selected was overweight/obesity. Closely related, high blood pressure (31 percent) and
high cholesterol (25 percent) trailed overweight/obesity as the second and third health
conditions selected, respectively.
Self-Reported Chronic Disease
Disease Percent reporting diagnosis
Overweight/obesity 38
High blood pressure 31
High cholesterol 25
Depression/anxiety 24
Asthma 17
Diabetes 11

Respondents selected five top issues for Wayne County out of 54 options. The table
below includes the most frequently reported social issues. The top three social issues
selected include job availability (45 percent), poverty/low income (36 percent) and drug
abuse (36 percent).
Social issues
Social Issues (selected 5) Percent respondents (sums to >100%)
Job availability 45
Poverty/low income 36
Drug abuse 36
Violent crime 24
Gang activity 24
Recreation opportunities 18
Discrimination/racism 16
The table below includes the most frequently reported health issues, out of the 54
options for top issues in Wayne County. The top three health issues selected included
alcohol use (21 percent), overweight children (19 percent) and overweight adults (19
percent).
Health issues
Health Issues (selected 5) Percent respondents (sums to <100%)
Alcohol use 21
Overweight children 19
Overweight adults 19
Cancer 13
Allergies 9
Heart disease 4
Chronic diseases 4
Survey respondents indicated if they participated, during a normal week, in any
physical activity or exercise that lasts at least a half an hour. More than two-thirds of
respondents (69 percent) indicated that they did engage in exercise.
Exercise behaviors of community members
Engage in Exercise Percent respondents
Yes 69
No 31

The graph below indicates the type of exercise activities in which survey
respondents engaged. Three-fourths (74.7 percent) indicated they engaged in walking as
an exercise. Less than half of respondents indicated weight training (42.3 percent), running
(31.7 percent), bicycling (30.6 percent) and sports team participation (18.7 percent) as a
form of physical activity in which they engaged.
Exercise Activities
The table below indicates the locations in Wayne County where survey respondents
participated in physical activity. Half of respondents (49 percent) indicated that they
exercised at home. Following, a quarter of respondents (26 percent) indicated that they
used the sidewalks and roads in their neighborhoods to exercise.
Exercise locations
Location Percent respondents (sums to >100%)
Home 49
Neighborhood sidewalks/roads 26
YMCA 9
Private gym 7
Herman Park 6
Stoney Creek Park 5
Public recreation center 3
Cliffs of the Neuse State Park 3
Waynesborough Park Trails 1
74.7
42.3
31.7 30.6
18.7
0
10
20
30
40
50
60
70
80
Walk Weights Run Bicycling Sports team
Percentage(%)
Rating
Exercise Activities

Respondents identified the services within the community that they believed
needed the most improvement. Services indicated as needing the most improvement by at
least 10 percent of survey respondents included recreational facilities (18 percent), higher
paying employment (14 percent), positive teen activities (11 percent) and availability of
employment (10 percent).
Services needing most improvement
Service (selected 1) Percent respondents (sums to <100%)
Recreational facilities 18
Higher paying employment 14
Positive teen activities 11
Availability of employment 10
Affordable health services 6
Healthier food choices 5
Road maintenance 4
Respondents identified health behavior topics for which they believed people
needed the most information about in Wayne County. Health topics that at least 10 percent
of survey respondents indicated their community needed more information about included
eating well/nutrition (13 percent), crime prevention (11 percent), stress management (10
percent) and preventing pregnancy and STDs (10 percent).
Top information needed
Topic (selected 1) Percent respondents (sums to <100%)
Eating well/nutrition 13
Crime prevention 11
Stress Management 10
Preventing pregnancy and STDs 10
Managing weight 8
Substance abuse prevention 8
Exercising/fitness 6

Similarly, respondents identified health behavior topics for which they believed the
children needed more information about in Wayne County. The top three health topics
selected were nutrition (13 percent), drug abuse (10 percent) and sexually transmitted
diseases (9 percent).
Top information needed for children
Topic Percent respondents (sums to <100%)
Nutrition 13
Drug abuse 10
Sexually transmitted diseases 9
Sexual intercourse 8
Reckless driving/speeding 8
Alcohol 7
Tobacco 4
When respondents were asked about their personal tobacco use, a large portion (88
percent) indicated that they did not smoke. Furthermore, nearly the entire survey
population (99 percent) indicated that they did not chew tobacco products.
Drug use
Drug Use Percent respondents
Do not smoke 88
Do not chew tobacco 99
Respondents who indicated that they currently used tobacco products were asked
about their intentions to cease their usage. A large portion of tobacco users (72 percent)
indicated that they had intentions to quit using tobacco products and nearly half (46
percent) had attempted to quit using.
Intentions to quit using tobacco products
Intention Percent respondents
Want to stop using tobacco 72
Tried to stop using 46

Over half (58 percent) of the survey population indicated that they did not consume
alcohol. The majority of remaining respondents indicated that they consumed less than or
equal to 1-2 drinks per week at 21 and 12 percent, respectively.
Alcohol consumption
Frequency Percent respondents
I do not consume alcohol 58
Less than 1-2 drinks per week 21
Consume 1-2 drinks per week 12
Consume 1-2 drinks per day 5
Consume 3 or more drinks per sitting 4
Self-reported drug use was extremely low among survey respondents. A combined 8
percent indicated that they were either confused about their prescription drug use or
believed that they may abuse their prescription drugs. Additionally, only 2 percent of the
survey population self-reported illegal drug use.
Self-reported drug abuse
Drug Use Percent respondents
I am confused about my prescription drug use 1
I think I may abuse prescription drugs 7
I use illegal drugs 2
Over half of survey respondents (54 percent) indicated that they had been exposed
to secondhand smoke within the last year. The most frequently selected locations in which
they were exposed to secondhand smoke included the home (31 percent) and workplace
(25 percent). Furthermore, a portion of respondents (34 percent) indicated that they were
exposed in other locations than were provided to them as choices on the survey. The other
locations provided by participants were primarily outdoors.
Secondhand smoke exposure within the last year
Exposure in the past year Percent respondents
Yes 54
No 46

Location of secondhand smoke exposure
Location Percent respondents
Home 31
Workplace 25
Restaurants 8
School 1
Hospitals 1
Other (primarily outdoors) 34
Survey respondents were asked the extent to which they agreed with a set of
potential solutions to health problems. All presented solutions received strong support.
Notably, health education (74 percent), parenting education (73 percent) and providing
alternatives for teens (71 percent) received large amounts of respondents who agreed or
strongly agreed with them as solutions.
Solutions to health problems
Solution Percent who agree or strongly agree
Health education 74
Parenting education 73
Providing alternatives for teens 71
Dealing with stress 68
Education about eating right 65
Classes to stop smoking 58
Reminders to exercise 53
Respondents were asked the where they receive most of their health-related
information. The top two sources of health information included a doctor/nurse and the
Internet, each with 32 percent.
Source of health information
Source of health information Percent respondents (sums to <100%)
Doctor/nurse 32
Internet 32
Health department 9
Hospital 8
Friends and family 8
Books/magazines 5
In addition to indicating agreement with possible solutions to health problems,
respondents were asked about the importance of additional solutions. The majority of

survey respondents rated all possible solutions as very or extremely important. The two
solutions that were selected as most important included that individuals take personal
responsibility of their health (93 percent) and that schools provide more health education
(88 percent).
Importance of possible solutions
Solution Percent very or extremely
important
Individuals take personal responsibility of their
health
93
Schools provide more health education 88
Hospitals recruit more health providers 78
Employers take an active role in health promotion 75
Restaurants provide healthier choices 71
Government provide more exercise facilities 60
Churches take an active role in health promotion 59
The graph below demonstrates the breakdown of type of health insurance among
survey respondents. Top insurance options included Blue Cross Blue Shield NC (26
percent), other private insurance (19 percent) and state employee coverage (10 percent).
Additionally, 20 percent of survey respondents indicated that they did not have any
insurance coverage. The final portion of respondents indicated that they had Medicare (10
percent), Medicaid (7 percent) or Military/Tricare (8 percent) coverage.

Type of Health Insurance Coverage
When asked where survey respondents went to receive healthcare, 59 percent
indicated that they went to a private physician’s office. Furthermore, a combined 42
percent of respondents received their care at either urgent care or the hospital/emergency
department.
Location where community members receive healthcare
Location Percent respondents (sums to >100%)
Private physician 59
Urgent care 24
Hospital/emergency department 18
Private dentist 18
GOSHEN Medical Center 6
Health department 6
Seymour Johnson AFB 5
State Employee
10%
BCBS NC
26%
Other Private
19%
Medicare
10%
Medicaid
7%
Military / Tricare
8%
None
20%
Type of Health Insurance Coverage

Survey respondents were asked when they had last visited a health care
professional. The majority of respondents (81 percent) had seen a health care professional
within the last year.
Last visit to a doctor
Last visit Percent respondents
Less than 1 year ago 81
1-2 years ago 9
2-3 years ago 2
3 or more years ago 8
If survey respondents indicated that they were unable to receive access to the
healthcare they needed, they were asked to cite the barrier to care. The top barrier to
healthcare was a lack of health insurance (9 percent), followed by limited coverage (5
percent) and costly deductible (4 percent).
Barriers to healthcare
Barrier Percent respondents (sums
to <100%)
No health insurance 9
Limited coverage 5
Costly deductible 4
Too long of a wait 2
Could not get an appointment 1
Doctor wouldn’t accept form of insurance 1
Dentist wouldn’t accept form of insurance 1
Respondents were asked to rate, in general, their personal health. The largest
percentage of respondents rated their health as very good (34.6 percent), followed closely
by good (31.7 percent). Nearly equal portions believed their health was either excellent (15
percent) or fair (17 percent). A small percentage rated their health as poor (1.7 percent).

General health rating
Respondents indicated whether they had undergone a preventative screening for a
variety of health conditions within the last 3 years. Over half of all respondents (57
percent) indicated that they had been screened for high blood pressure. A similar
percentage of females (53 percent) reported that they had been screened for breast cancer.
Fewer respondents reported undergoing screenings for diabetes (46 percent) and less than
a quarter of respondents indicated undergoing screenings for color cancer (24 percent)
and HIV/AIDS (21 percent).
Health screening behavior
Screening Yes No
High blood pressure 57% 43%
Breast cancer (F) 53% 47%
Diabetes 46% 54%
Prostate cancer (M) 34% 66%
Uterine cancer (F) 27% 73%
Colon cancer 24% 76%
HIV/AIDS 21% 79%
Respondents were asked if they participated in an assortment of health promoting
behaviors. The top three healthy behaviors included practicing safe sex (80 percent),
relaxing daily (74 percent) and getting adequate sleep (61 percent). The remaining
15
34.6
31.7
17
1.7
0
5
10
15
20
25
30
35
40
Excellent Very Good Good Fair Poor
Percentage(%)
Rating
General Health Rating

behaviors also received high levels of participation, ranging from eating fast food less than
twice a week (57 percent) to getting an annual flu shot (31 percent).
Health promoting behaviors
Health Behavior Yes No
Safe sex 80% 20%
Relax daily 74% 26%
7+ hours of sleep 61% 39%
Fast food (<2/week) 57% 43%
Take vitamins daily 57% 43%
Worry about needs 40% 60%
Flu Shot 31% 69%
Emergency Preparedness
The emergency preparedness of survey respondents was assessed with multiple
questions. Basic preparedness was questioned by asking respondents if they had working
smoke and carbon monoxide detectors and a basic emergency kit in their home. 58 percent
of respondents indicated that their home was equipped with only smoke detectors,
whereas 29 percent indicating having both smoke and carbon monoxide detectors. Half of
respondents reported having an emergency supply kit in their home. Regarding disaster
response, 51 percent of respondents reported using the television as their main source of
information during a large-scale disaster. 83 percent reported that they would leave their
home if they were instructed to do so by public authorities during an evacuation. If
participants were unwilling to evacuate if instructed to do so, the top reasons they would
not leave included concerns about family safety (22 percent), leaving property (20
percent), leaving pets (14 percent) and personal safety (13 percent). Finally, 54 percent of
households had at least one family member who was trained in CPR, 85 percent of
households consisted of members who were all trained in turning off household utilities
and 64 percent of adults were aware of their workplaces’ disaster plan.

Working smoke and carbon monoxide detectors
in the home
Percent respondents (sums
to <100%)
Yes, smoke detectors only 58
Yes, carbon monoxide detectors only 1
Yes, both 29
No 8
Basic emergency supply kit in the
home
Percent respondents
Yes 49
No 51
Main source of information during a large-scale
disaster
Percent respondents
Television 51
Radio 21
Text message (emergency alert system) 11
Internet 9
Social networking site 4
Neighbors 3
Newspaper 1
Would you leave your home if public authorities announced
a mandatory evacuation?
Percent
respondents
Yes 83
No 3
Don’t know/not sure 14

Main reason you would not
evacuate
Percent respondents (sums to <100%)
Concern about family safety 22
Concern about leaving property 20
Concern about leaving pets 14
Concern about personal safety 13
Lack of trust in public officials 7
Concern about traffic jams 3
Lack of transportation 3
Member in your household trained in CPR Percent respondents
Yes 54
No 46
All family members trained to turn off all household
utilities
Percent respondents
Yes 85
No 15
Do you know the disaster plan for the following areas? Percent respondents
Yes No N/A
Your workplace 64 18 18
Your child’s school 22 21 57
Your child’s daycare center 10 14 76

Summary and Next Steps
As mentioned previously, this comprehensive community health needs assessment
identified the following focus areas for 2013 – 2016. Moreover, without addressing both
social and health together, significant health improvements will not be accomplished.
As seen in the table below, there was significant overlap between the current health
findings and those from 2008. Teen pregnancy and infant mortality did not arise as focus
areas in the current assessment and the rates for these indicators are improving. However,
these areas continue to need attention as Wayne County’s infant mortality and teen
pregnancy rates are worse than those of North Carolina. In 2012, health literacy and mental
health were cited as key areas needing attention.
2008 Health Focus Areas 2012 Health Focus Areas
Obesity Obesity
Chronic Disease (Cancer, Heart Disease, Diabetes) Chronic Disease (Cancer, Heart Disease, Diabetes)
STDs (Sexually Transmitted Diseases) STDs (Sexually Transmitted Diseases)
Teen Pregnancy Health Literacy
Infant Mortality Mental Health
From January – May 2013 committees will be formed around the focus areas for the
purpose of developing action plans. These action plans will be used to guide initiatives for
the next four years and serve as a basis for reporting status annually toward addressing the
areas identified in this community health assessment process.
Wayne
County
Focus
Areas
Social Indicators:
- Poverty
-Access to healthcare
- Crime
- Education
Health Indicators:
-Health literacy
- Mental health
- Health Conditions

Appendix A – Community Survey
This community survey was available online and in paper format in both English and
Spanish.

Wayne County Community Health Needs Assessment
We are conducting a survey of our county to learn about the health and quality of life in Wayne
County. The results of the survey will be used to help address the major health and community issues
in our county.
If you are at least 18 years old and live in Wayne County, please complete the following survey (limit
one per household). All survey responses will remain anonymous.
To thank you for your participation, the Goldsboro Family YMCA is granting a free two-week
membership to all who complete the survey (limit one per household). You will receive more
information on how to claim this upon completion of the survey.
Part 1: Quality of Life Statements
Please indicate your level of agreement with the following statements.
Strongly
Agree
Agree Neutral Disagree
Strongly
Disagree
There is good healthcare in Wayne County. (Consider the cost
and quality, number of options and availability of healthcare in
the county.)
    
Wayne County is a good place to raise children. (Consider the
quality and safety of schools and child care programs, after school
programs and places to play in this county.)
    
Wayne County is a good place to grow old. (Consider the
county’s elder-friendly housing, transportation to medical
services, recreation and services for the elderly.)
    
There is plenty of economic opportunity in Wayne County.
(Consider the number and quality of jobs, job training/higher
education opportunities and availability of affordable housing in
the county.)
    
Wayne County is a safe place to live. (Consider how safe you feel
at home, in the workplace, in schools, at playgrounds, parks and
shopping centers in the county.)
    
There is plenty of help for people during times of need in Wayne
County. (Consider social support in this county: neighbors,
support groups, faith community outreach, community
organizations and emergency monetary assistance.)
    
There is good air and water quality in Wayne County.     
Part 2: Community Improvement
Please look at the following list of community issues on the next page. In your opinion, which are the
TOP FIVE issues that most affect the quality of life in Wayne County?

 Alcohol use
 Allergies
 Asbestos Exposure
 Asthma and other respiratory disorders
 Bio-terrorism
 Bulimia or Anorexia
 Cancer
 Child care (safe, affordable, available)
 Child abuse
 Chronic diseases
 Discrimination/racism
 Domestic violence
 Drug abuse
 Education (K-12) - Dropout rate
 Elder abuse
 Elder care (safe, affordable, available)
 Farming safety
 Firearms
 Fire protection
 Gambling
 Gang activity
 Health care availability
 Health care affordability
 Heart disease
 Homelessness
 Hopelessness
 Infant health
 Infectious diseases (hepatitis, meningitis, TB)
 Job availability
 Job security
 Lack of parenting skills
 Lack of/inadequate health insurance
 Land use/development
 Law enforcement
 Lead paint
 Loneliness
 Mental illness
 Mosquitoes
 Nursing home care (safe, affordable, available)
 Overweight adults
 Overweight children
 Pollution (air, water, land)
 Poverty/low income
 Prenatal health
 Radioactive materials (contamination)
 Rape/sexual assault
 Recreation opportunities
 Recycling availability
 Roads
 Secondhand smoke
 School violence
 Services for the disabled
 Theft
 Violent crime (murder, assault)

Please indicate your level of agreement with the following statements as good solutions to many of
the problems in the previous question.
Strongly
Disagree
Disagree Neutral Agree
Strongly
Agree
Education about eating right     
Classes to stop smoking     
Reminders to exercise     
Dealing with stress     
Providing alternatives for teens     
Parenting education     
Health education     
Please indicate any other possible solutions you believe can address the problems in Wayne County.
(Please indicate which problem(s) you are addressing)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

In your opinion, which ONE of the following services needs the most improvement in your
neighborhood or community? If there is a service that you think needs improvement that is not on
this list, please write it in.
 Animal control
 Child care options
 Elder care options
 Services for disabled people
 More affordable health services
 Better/more healthy food choices
 More affordable/better housing
 Number of health care providers (specify type of provider): ____________________
 Culturally appropriate health services
 Counseling/mental health/support groups
 Better/more recreational facilities (parks, trails, community centers)
 Healthy family activities
 Positive teen activities
 Transportation options
 Availability of employment
 Higher paying employment
 Road maintenance
 Road safety
 Parent education
 Other: ____________________
 None

Part 3: Health Information
In your opinion, which ONE health behavior do people in your own community need more
information about?
 Eating well/nutrition
 Exercising/fitness
 Managing weight
 Going to a dentist for check-ups/preventive care
 Going to the doctor for yearly check-ups and screenings
 Getting prenatal care during pregnancy
 Getting flu shots and other vaccines
 Preparing for an emergency/disaster
 Using child safety seats
 Using seat belts
 Driving safely
 Quitting smoking/tobacco use prevention
 Child care/parenting
 Elder care
 Caring for family members with special needs/disabilities
 Preventing pregnancy and sexually transmitted disease (safe sex)
 Substance abuse prevention (ex: drugs and alcohol)
 Suicide prevention
 Stress management
 Anger management
 Domestic violence prevention
 Crime prevention
 Rape/sexual abuse prevention
 Other: ____________________
 None

Where do you get most of your health-related information?
 Friends and family
 Doctor/nurse
 Pharmacist
 Church
 Internet
 My child's school
 Hospital
 Health department
 Help lines
 Books/magazines
 Other: ____________________
What health topic(s)/disease(s) would you like to learn more about?
_____________________________________________________________________________________
_____________________________________________________________________________________
Do you have children between the ages of 9 and 19 for which you are the caretaker? (Includes step-
children, grandchildren or other relatives)
 Yes
 No
ONLY ANSWER the next question IF you do have children between the ages of 9 and 19 for which you
are the caretaker:
Which of the following health topics do you think your child/children need(s) more information
about? Please check all that apply.
 Dental hygiene
 Nutrition
 Eating disorders
 Asthma management
 Diabetes management
 Tobacco
 Sexually transmitted diseases (STDs)
 Sexual intercourse
 Alcohol
 Drug abuse
 Reckless driving/speeding
 Mental health issues
 Suicide prevention
 Other: ____________________

Part 4: Personal Health
Would you say that, in general, your health is...
 Excellent
 Very good
 Good
 Fair
 Poor
Have you ever been told by a doctor, nurse or other health professional that you have any of the
following health conditions?
Yes No Not Sure
Asthma   
Depression or anxiety   
High blood pressure   
High cholesterol   
Diabetes (not during pregnancy)   
Osteoporosis   
Overweight/obesity   
Angina/heart disease   
Breast cancer   
Colon cancer   
Prostate cancer   
Skin cancer   
Uterine cancer   
HIV   
Sickle cell anemia   
COPD or emphysema   
Tuberculosis   
Chronic back pain   

Diabetes affects 1 in 10 Wayne County adults. Please indicate your status or awareness of the
following items.
Yes No Not Sure
Have you ever been tested for diabetes?   
Are you pre-diabetic (screening test)?   
Do you have knowledge of the symptoms of diabetes?   
Do you have knowledge of the health consequences of diabetes?   
Are healthy foods available to you?   
Do you have knowledge of the impact exercise can have on diabetes?   
ANSWER the next table ONLY IF you have ever been told by a doctor, nurse or other health care
professional that you have diabetes (not during pregnancy).
Please indicate your status on the following items.
Yes No Not Sure
Do you currently receive routine care for diabetes?   
Are you a part of a diabetes support group?   
Have you had success in healing wounds, which may be hindered by
diabetes?
  
Have you undergone any treatment for your eyes due to a diabetes
induced condition?
  
Are your diabetic needs met?   
Have you been to WADEC (Wayne Area Diabetes Education Center) on
Williams Street?
  

Have you undergone any preventive screenings for the following conditions (in the last 3 years)?
Yes No Not Sure
High Blood Pressure   
Breast cancer   
Colon cancer   
Prostate cancer   
Uterine cancer   
HIV   
Diabetes - blood sugar   
Sickle cell anemia   
COPD or emphysema   
Tuberculosis- skin test   
Dental exam   
Asthma   
Depression or anxiety   
Skin cancer   

Please indicate if you participate in any of the following.
Yes No Not Sure
Get the one-time pneumonia vaccination   
Take vitamins daily   
Wash your hands before eating   
Eat fast food less than 2 times per week   
Get 7+ hours of sleep each night   
Practice safe sex (condoms, other barriers)   
Use sunscreen outside   
Routinely wear a seat belt   
Find time to relax daily   
Talk to friends daily   
Feel safe in your neighborhood   
Worry about basic necessities   
Spend money on gambling more than once a month   
Attend religious services routinely   
Volunteer in your community   
In the past 30 days, have there been any days when feeling sad or worried kept you from going about
your normal business?
 Yes
 No
In the past 30 days, have you had any physical pain or health problems that made it hard for you to
do your usual activities such as driving, working around the house or going to work?
 Yes
 No
During a normal week, other than in your regular job, do you engage in any physical activity or
exercise that lasts at least a half an hour?
 Yes
 No
If you said YES about exercising, how many times do you exercise or engage in physical activity during
a normal week?
Please write in a number: _____________

If you said YES about exercising, where do you go to exercise or engage in physical activity? Please
choose all that apply.
 Home
 Private gym
 YMCA
 Sidewalks/roads in your own neighborhood
 Stoney Creek Park
 Public recreation center
 Herman Park
 Cliffs of the Neuse State Park
 Waynesborough Park (trails)
 Seymour Johnson AFB facilities
 Other: ____________________
If you said YES about exercising, please indicate your participation in any of the following activities as
part of your exercise routine (at least 3 times per week).
Yes No
Neighborhood walk  
Neighborhood run  
Weights  
Sports team participation  
Bicycling  

If you said NO about exercising, what are the reasons you do not exercise for at least a half hour
during a normal week? Please choose all that apply.
 My job is physical or hard labor.
 Exercise is not important to me.
 I don't have access to a facility that has the things I need, like a pool, golf course or a track.
 I don't have enough time to exercise.
 I would need child care and I don't have it.
 I don't know how to find exercise partners.
 I don't like to exercise.
 It costs too much to exercise.
 There is no safe place to exercise.
 Not enough bike trails
 I'm too tired to exercise.
 I'm physically disabled.
 I don't know.
 Other: ____________________
Not counting lettuce salad or potato products, think about how often you eat fruits and vegetables in
an average week. How many cups PER WEEK of fruits and vegetables would you say you eat? One
apple or 12 baby carrots equal one cup. Lettuce salad is the typical "house salad" with iceberg lettuce
or the salad mixes you get at the store or fast food restaurants, even if they have meat on top. Potato
products are French Fries, baked potatoes, hash browns, mashed potatoes - anything made from
white potatoes. For the purposes of this study, ketchup is NOT considered a vegetable.
Number of cups of fruit per week ____________
Number of cups of vegetables per week ___________
Number of cups 100% fruit juice per week ___________

Please indicate how frequently you consume alcohol.
 I do not consume alcohol
 Less than 1 - 2 drinks per week
 Consume 1 - 2 alcoholic drinks per week
 Consume 1 - 2 alcoholic drinks per day
 Consume 3 or some drinks in one sitting
Have you been exposed to secondhand smoke in the past year?
 Yes
 No
If you said YES about secondhand smoke, where do you think you are exposed to secondhand smoke
most often?
 Home
 Workplace
 Hospitals
 Restaurants
 School
 Other: ____________________
 I am not exposed to secondhand smoke.
Yes No
Do you smoke?  
Do you chew tobacco?  
If you said YES to either of the previous items, please indicate your status on the following items.
Yes No
Do you want to stop using tobacco products?  
Have you tried to stop in the last year?  
Have you tried medication to stop?  
Would you attend smoking cessation classes?  

Where would you go for help if you wanted to quit?
 Quit Line NC
 Doctor
 Church
 Pharmacy
 Private counselor/therapist
 Health Department
 I don't know
 Other: ____________________
 Not applicable; I don't want to quit.
Yes No Not Sure
I use less than 3 prescriptions currently   
I use more than 3 prescriptions currently   
I am confused about my prescription drugs   
I think I may abuse prescription drugs   
Do you use illegal drugs?
 Never
 Occasionally
 Routinely
An influenza/flu vaccine can be a "flu shot" injected into your arm or spray like "FluMist" which is
sprayed into your nose. During the past 12 months, have you had a seasonal flu vaccine?
 Yes, flu shot
 Yes, flu spray
 Yes, both
 No

Part 5: Access to Care/Family Health
Where do you go when you are sick? (Please select all that apply)
 Health Department
 SJAFB
 Private physician office
 Private dentist office
 WATCH van
 WATCH clinic at YMCA
 Hospital Emergency Dept.
 Goshen Medical Clinic
 Urgent Care Center
 Provider outside Wayne County
 Other, please specify: ____________________
Is your primary health care provider outside of Wayne County?
 Yes
 No
If you said YES above, please indicate the reasons why your primary health provider is located outside
of Wayne County. (Please select all that apply)
 Specialty not available in Wayne County
 History with provider
 Cannot get appointment in Wayne County
 Reputation of provider
If your provider is outside of Wayne County, in which county is your primary health care provider
located?
 Pitt County
 Wake County
 Other, please specify: ____________________

When was your last visit to a doctor?
 Less than 1 year ago
 1 - 2 years ago
 2 - 3 years ago
 3 or more years ago
What is your primary health insurance plan? This is the plan which pays the medical bills first or pays
most of the medical bills.
 State Employee Health Plan
 Blue Cross and Blue Shield of North Carolina
 Other private health insurance plan purchased from employer or workplace
 Other private health insurance plan purchased directly from an insurance company
 Medicare
 Medicaid or Carolina ACCESS or Health Choice 55
 The military, Tricare, CHAMPUS or the VA
 The Indian Health Service
 Other (government plan)
 No health plan of any kind
In your opinion, is your employer provided medical health insurance affordable?
 Yes
 No
 N/A

In the past 12 months, did you have a problem getting the health care you needed for you personally
or for a family member from any type of health care provider, dentist, pharmacy or other facility?
 Yes
 No
If you had trouble getting the care you needed, what type of provider or facility did you or your family
member have trouble getting health care from? Please choose all that apply and write in any that are
not listed here.
 Dentist
 General practitioner
 Eye care/optometrist/ophthalmologist
 Pharmacy/prescriptions
 Pediatrician
 OB/GYN
 Health department
 Hospital
 Urgent Care Center
 Medical Clinic
 Specialist: ____________________
 Specialist: ____________________
If you had a problem, which of these problems prevented you or your family member from getting the
necessary health care? Please choose all that apply and write in any that are not listed here.
 No health insurance.
 Insurance didn't cover what I/we needed.
 My/our share of the cost (deductible/co-pay) was too high.
 Doctor would not take my/our insurance or Medicaid.
 Hospital would not take my/our insurance.
 Pharmacy would not take my/our insurance or Medicaid.
 Dentist would not take my/our insurance or Medicaid.
 No way to get there.
 Didn't know where to go.
 Couldn't get an appointment.
 The wait was too long.
 Other: ____________________

If a friend or family member needed counseling for a mental health or a drug/alcohol abuse problem,
who is the first person you would tell them to talk to?
 Private counselor or therapist
 Support group (e.g., AA, Al-Anon)
 School counselor
 Doctor
 Minister/religious official
 Other: ____________________
 Don't Know
Please indicate which of the following dental care facilities that you routinely visit. (Please select all
that apply)
 Private dentist
What is your dental health insurance status?
 TRICARE (Military)
 Medicaid
 Other insurance, please specify: ____________________
 No insurance
Is dental health insurance available by your employer?
 Yes
 No
If it is available, in your opinion, is your employer provided dental health insurance affordable?
 Yes
 No
Was there a teenage pregnancy in your home in 2011?
 Yes
 No

If there was a teenage pregnancy in your home in 2011, please indicate the status of the pregnant
teenager in your home regarding the following items. Did she...
Yes No
Receive sufficient education about prevention?  
Receive prenatal care in the 1st trimester?  
Take parenting classes?  
Complete high school?  
If there was a teenage pregnancy, where did she receive your prenatal care in the 1st trimester?
(Please choose all that apply)
 Private obstetrician
Do you provide care for an elderly person?
 Yes
 No
If YES, please indicate your level of agreement with the following statements.
Strongly
Disagree
Disagree Neutral Agree
Strongly
Agree
I have sufficient access to physicians     
My adult day care needs are met     
There are sufficient resources for caregivers     
There are sufficient options for dementia     

Please indicate the importance of the following items.
Not at all
Important
Very
Unimportant
Neither
Important nor
Unimportant
Very Important
Extremely
Important
Individuals take more
personal responsibility for
their health
    
Hospitals recruit more
health providers
    
Government provide more
exercise facilities
    
Restaurants provide more
healthy choices
    
Schools provide more
health education
    
Churches take active role in
promoting health
    
Employers take active role
in promoting health
    

Part 6: Emergency Preparedness
Does your household have working smoke and carbon monoxide detectors?
 Yes, smoke detectors only
 Yes, carbon monoxide detectors only
 Yes, both
 No
 Don't know/not sure
Does your family have a basic emergency supply kit? (This kit includes water, non-perishable food,
any necessary prescriptions, first aid supplies, flashlight and batteries, non-electric can opener,
blanket, etc.)
 Yes
 No
If YES, how many days do you have supplies for?
Write in the number of days _____________

What would be your main way of getting information from authorities in a large-scale disaster or
emergency?
 Television
 Radio
 Internet
 Print media (ex: newspaper)
 Social networking site
 Neighbors
 Text message (emergency alert system)
 Other, please describe: ____________________
If public authorities announced a mandatory evacuation from your neighborhood or community due
to a large-scale disaster or emergency, would you evacuate?
 Yes
 No
 Don't know/not sure
If NO or NOT SURE, what would be the main reason you might not evacuate if asked to do so?
 Lack of transportation
 Lack of trust in public officials
 Concern about leaving property behind
 Concern about personal safety
 Concern about family safety
 Concern about leaving pets
 Concern about traffic jams and inability to get out
 Health problems (could not be moved)
 Other, please describe: ____________________
Are you or anyone in your household current in CPR?
 Yes
 No
Do all responsible family members know when and how to turn off all utilities to the house?
 Yes
 No

Do you know what the disaster plan is for the following areas? your workplace? For your children’s
school and/or daycare center?
Yes No Not Sure
Your workplace   
Your child's school   
Your child's daycare center   
Part 7: Demographic Questions
The next questions are general questions about you, which will only be reported as a summary of all
answers given by survey participants. Your answers will remain anonymous.
How old are you?
 15 - 19
 20 - 24
 25 - 29
 30 - 34
 35 - 39
 40 - 44
 45 - 49
 50 - 54
 55 - 59
 60 - 64
 65 - 69
 70 - 74
 75 - 79
 80 - 84
 85 or older
Are you Male or Female?
 Male
 Female
Are you of Hispanic, Latino or Spanish origin?
 Yes
 No

If you are of Hispanic, Latino or Spanish origin, are you:
 Mexican, Mexican American or Chicano
 Puerto Rican
 Cuban
 Other Hispanic or Latino (please specify): ____________________
What is your race? Please check all that apply.
 White
 Black or African American
 American Indian or Alaska Native
 Asian Indian
 Other Asian including Japanese, Chinese, Korean, Vietnamese and Filipino/a: ___________________
 Pacific Islander including Native Hawaiian, Samoan, Guamanian/Chamorro: ____________________
 Other race not listed here: ____________________
Do you speak a language other than English at home?
 Yes
 No
If YES, what language do you speak at home? ___________________________________________
What is your marital status?
 Never married/single
 Married
 Unmarried partner
 Divorced
 Widowed
 Separated
 Other
What is the highest level of school, college or vocational training that you have finished?
 Less than 9th grade
 9 - 12th grade, no diploma
 High school graduate (or GED/equivalent)
 Associate's degree or vocational training
 Some college (no degree)
 Bachelor's degree
 Graduate or professional degree
 Other: ____________________

What is your combined annual household income?
 Less than $10,000
 $10,000 to $14,999
 $15,000 to $24,999
 $25,000 to $34,999
 $35,000 to $49,999
 $50,000 to $74,999
 $75,000 to $99,999
 $100,000 or more
How many people does this income support? (If you are paying child support but your child is not
living with you, this still counts as someone living on your income.)
________________________ people
What is your employment status? Please check all that apply.
 Employed full-time
 Employed part-time
 Retired
 Armed Forces
 Disabled
 Student
 Homemaker
 Self-employed
 Unemployed for 1 year or less
 Unemployed for more than 1 year
If you chose ARMED FORCES, what is your current Military status?
 Active
 Retired
Do you have access to the Internet?
 Yes
 No
Please enter your zip code:
Your 5 digit zip code (home) _____________
Your 5 digit zip code (work) _____________

What are the best ways to communicate upcoming Wayne County events related to health to you?
(Please select all that apply)
 Newspaper
 Radio
 Church bulletin
 E-mail
 Twitter
 Facebook
 TV cable channel 10
Thank you for your participation!

Appendix B – Focus Group Questions
1. What is the best thing about living in this community?
2. What do people in this community do to stay healthy?
3. How do people get information about health?
4. What are the serious health problems in your community? What are the causes of
these problems?
5. What keeps people in your community from being healthy?
6. What could be done to solve these problems?
7. Is there anyone you know not receiving enough health care? If so, why?

Appendix C – Community Context
Access to Healthcare
Hospital emergency visits are an extremely expensive alternative to a visit
compared to a doctor’s office, or even an urgent care center, due to the expensive
equipment and services required to support true emergencies (such as MRI, CT, pharmacy
and 24-hour coverage). The incentive for some patients to use Emergency Departments
(without an emergency) is the obligation of the hospital, under federal law, to triage a
patient, without regard to payment status. At Wayne Memorial, about 25 percent of all
charges in the Emergency department are incurred without any payment source. The
WATCH mobile van and office at the Goldsboro YMCA provide a low-cost (no charge) venue
for some uninsured patients to visit, which keeps even higher numbers of ED visits from
occurring, and provides continuity of care to patients. Ideally, more doctors’ offices would
have late hours, and provide a lower-cost alternative to ED visits, similar to the extended
evening and weekend hours provided by Goldsboro Pediatrics at their offices around the
county.
The WATCH Healthcare Program provides a medical home to the uninsured
population of Wayne County. The WATCH mobile unit travels to predetermined locations
throughout the county on a monthly basis to provide continuity of care. A second clinic,
which is stationary, is located at the Goldsboro Family YMCA. WATCH is open one Saturday
each month because 50 percent of their patient population is employed and this offers
these patients an alternative to missing work hours for healthcare provision. WATCH
provides free acute and primary healthcare to the uninsured. Free labs are provided by
Quest Diagnostics and they value +$445,000 each year. Qualified patients with chronic
diseases are enrolled in the prescription assistance program which provides in excess of $2
million in free medications annually. Health education and an obesity program are offered
to patients as indicated. The WATCH Healthcare Program keeps even higher numbers of ED
visits from occurring, and provides continuity of care to patients. Ideally, more doctors'
offices would have late hours, and provide a lower-cost alternative to ED visits, similar to
the extended evening and weekend hours provided by Goldsboro Pediatrics at their offices
around the county. WATCH employs a professional clinical team at each site which
includes a family nurse practitioner, medical assistant and medical office assistant. WATCH
also utilizes volunteer physicians from the community for specialty clinics. Referrals are
made for patients with advanced disease states (i.e. cancer). In 2012, Wayne Memorial's
Emergency Department provided more than 60,000 visits, and WATCH provided 10,000
visits. While it is difficult to measure the impact of WATCH on disease rates, the downward
direction of smoking and heart disease in Wayne County (through increased access to
providers and health education) may be partly attributable to efforts in this arena since
2000.
Another location where patients under 18 (not included in the survey) receive care
is through a partnership between the State of North Carolina, the Wayne County school

system, Goldsboro Pediatrics (which provides access to their electronic medical records)
and Wayne Memorial Hospital. Wayne County Public Schools employs school nurses
through Wayne Memorial Hospital, which provides employee benefits, including continuing
education and supervision. There are a total of 19 full time school nurses. Two of these
school nurses serve Edgewood Developmental School full time and the others cover several
schools. Ten school nurses are funded by the State of North Carolina, five of which are
through the School Nurse Funding Initiative. Five are Child and Family Support Team
(CFST) Nurses. The CFST Nurses are teamed with Social Workers to identify students at
risk of academic failure and out of home placement. Each team serves one school. The
remaining schools have a school nurse available to provide services to students up to three
days per week. All school nurses must become nationally certified within three years of
employment. The school nurses will assess any student for any reason free of charge and
without an appointment. The program’s main purpose is to ensure that students with
health problems are able to attend school and that staff members are able to safely manage
their care. In addition to student assessment, school nurses provide a variety of trainings
for employees including medication, blood borne pathogen, CPR/First Aid and diabetes
trainings. Asthma is the most frequent health problem of students; however, the number of
students with diabetes and other chronic health conditions requiring invasive procedures
(ex. EpiPens, tube feedings, catheterizations, injections) increases each school year.
WISH is a more intensive school-based health clinic started in 1997 to address five
specific health problems; asthma, mental health, lack of well care/ dental care, teen
pregnancy and attention deficit disorders. WISH, with parental permission, provides easy
access for children to a medical provider who is a physician extender (can prescribe
medications, etc). WISH centers are based in four middle schools: Goldsboro Intermediate,
Mt. Olive Middle, Brogden Middle, Dillard Middle, and two high schools: Goldsboro High
School and Southern Wayne High School. The rate of emergency room visits and the
number of school suspensions have declined in the schools housing WISH centers. Each
center has a part time mid-level provider (PA or FNP) and a full time RN. The Health
Department contributes registered dieticians and health educators. Mental health services
are provided as needed. The goal of the WISH Health Centers is to help students succeed in
school by promoting healthy lifestyles and providing comprehensive health care services.
Despite the statistical shortage of physicians in Wayne County solid, innovative
programs like WATCH, WISH and school nursing have provided access to many citizens
who otherwise may have fallen through the cracks. There are appointments available for
adults who need a primary care physician, and for children who need to be seen by a
doctor. In addition, an endocrinologist (a specialist in diabetes treatment) is accepting new
patients. The hospital has also opened an outpatient wound care center, staffed by a full-
time doctor, to help with healing of diabetic sores, preventing amputations. Routine care is
the key to healing diabetic wounds.

Crime
City, police, community target crime
By John Joyce
Published in News Argus on December 9, 2012 1:50 AM (direct excerpts)
The Goldsboro Police Department and the city of Goldsboro are uniting with the
community in a program they hope will significantly reduce violent crime in and around
the city.
Police hope those who attended an organizational meeting Thursday will choose to become
part of Goldsboro Partners Against Crime -- an initiative designed to engage the citizenry in
not only catching criminals, but encouraging them to change their lives.
GPAC will work with police, members of the judicial system and the city administration to
target violent offenders in the city and engage them in efforts to deter them from
continuing in a life of crime.
Their methods will include individually targeted investigations, pressure from within their
own neighborhoods and stiffer prison sentences -- all moves that law enforcement officers
hope will compel offenders to either cut out their illicit activities, to take them elsewhere or
to suffer the consequences.
The number of murders in the city this year, 12, exceeds those in any year so far this
millennium. Of those 12, only three remain unsolved.
Assaults and armed robberies, sexual assaults and breaking and entering reports have
escalated as well.

Natural Recreation
Herman Park, the city’s oldest park (but without any specific exercise trails or
equipment) was most often cited as a place respondents exercised (6%), followed by
Stoney Creek Park (5%), Cliffs of the Neuse State Park (3%), and Waynesborough Park
Trails (1%). Stoney Creek Park was developed over the last several years, as a result of a
joint venture between WATCH and the City of Goldsboro with funds from the North
Carolina Trails Program. The 32-acre park includes improvements to Stoney Creek itself, a
disk golf course which is attracting state-wide attention, and a dogpark to encourage
outside play. A trail along Stoney Creek is in progress to encourage more walking, running,
and biking. The city and volunteers have built a three-mile single-track bicycle trail across
Ash Street from Stoney Creek Park, along the greenway, and signage has just been added to
increase its visibility; it’s open. More trails are planned in the woods owned by the City in
that area, adjacent to the greenway.
In May, 2012, the City of Goldsboro reclassified all city-owned sanitary sewer
easements (to protect in case of hurricane/floods) as greenways. The City and Wayne
County governments have applied for funds from the North Carolina Trails Program, to
complete a paved trail along Stoney Creek through the heart of Goldsboro, eventually
linking the Neuse River with Wayne Community College. In addition, the State has included
Wayne County in its plan for the North Carolina Mountains-to-Sea Trail, which will connect
the western border of North Carolina at Clingman’s Dome to Jockey’s Ridge on the Outer
Banks. Both a paddling trail (which exists in the Neuse River) and pedestrian and biking
trails are being considered along the Neuse River which would connect the Cliffs of the
Neuse State Park, 892 acres, featuring a unique geological cliff in an otherwise fairly flat
part of eastern NC, with Goldsboro, Smithfield and Kinston.

Tobacco Use
Survey respondents said they do not smoke (88 percent) or chew tobacco (99
percent) which is likely not representative of Wayne County’s greater population. Smoking
by Wayne County residents has, according to the BRFSS in 2011, declined from 28 percent
in 2007 to about 22 percent. It is encouraging that more people in Wayne County have quit
smoking (28 percent) than are currently smoking (22 percent) and that half never started.
Smoking trends in Wayne County are closer to the average for North Carolina than
ever before, which is surprising, given Wayne County’s historical association with growing
tobacco. In 2010, Wayne County was still the fourth largest producer of tobacco with $31
million in receipts (after Sampson, Johnston and Wilson), but was also the 8th largest
producer of vegetables and fruits, with $16 million in receipts. In the future, it is possible
that vegetables (including sweet potatoes and corn) will overtake tobacco and even more
of these locally grown vegetables will become available to local consumers. This may
inspire more farm to table opportunities.

Substance Abuse Wayne, Michigan

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