Martin-Tyrrell-Washington
District Health Department
Tyrrell County Community Health Assessment
2010
Tyrrell County Health Department
408 Broad Street
Columbia, NC 27925
252.793.1751
www.mtwdistricthealth.org
Table of Contents
Purpose……………………………………………………………………………………….
Team Composition…………………………………………………………………………...
Process Overview……………………………………………………………………………
Outcomes……………………………………………………………………………………..
4
4
4
5
Community Health Assessment Acknowledgements………………………………………..
6
County Overview…………………………………………………………………………….
8
Demographics
Population Estimates……………………………………………………………………... 12
Age Distribution………………………………………………………………………….. 13
Race and Ethnicity……………………………………………………………………….. 13
Education…………………………………………………………………………………….. 14
Economic Characteristics
Poverty……………………………………………………………………………………
Employment………………………………………………………………………………
Agriculture………………………………………………………………………………..
Transportation…………………………………………………………………………….
15
15
16
16
Community Health Status
Community Health Ranking MATCH……………………………………………………
Peer Counties……………………………………………………………………………..
18
18
Leading Causes of Death
Heart Disease……………………………………………………………………………..
Cerebrovascular Disease (Stroke)………………………………………………………...
Cancer…………………………………………………………………………………….
Chronic Respiratory Diseases…………………………………………………………….
Alzheimer’s Disease……………………………………………………………………..
Unintentional Injuries…………………………………………………………………….
Motor Vehicle Injuries……………………………………………………………………
Diabetes…………………………………………………………………………………...
Kidney Disease……………………………………………………………………………
Pneumonia and Influenza…………………………………………………………………
Update on 2009 H1N1 and 2009-10 Seasonal Influenza Activity………………………..
Septicemia………………………………………………………………………………...
19
20
21
23
23
24
25
25
25
26
27
28
Maternal and Child Health
Infant Mortality…………………………………………………………………………...
Teen Pregnancy…………………………………………………………………………...
Child Abuse and Death…………………………………………………………………...
Child Overweight…………………………………………………………………………
29
29
30
31
Tyrrell County Community Health Assessment 2010
2
Other Health Statistics Data
Obesity and Physical Inactivity…………………………………………………………... 32
Smoking………………………………………………………………………………….. 32
Childhood Asthma……………………………………………………………………….. 32
Communicable Diseases
HIV………………………………………………………………………………………..
AIDS……………………………………………………………………………………...
Chlamydia………………………………………………………………………………...
Gonorrhea…………………………………………………………………………………
Syphilis……………………………………………………………………………………
Tuberculosis (TB)………………………………………………………………………...
Vaccine Preventable Diseases…………………………………………………………….
33
33
34
35
35
35
36
Environmental Health
Water Quality……………………………………………………………………………..
Air Quality………………………………………………………………………………..
37
37
Health Care Resources.............................................................................................................
38
Access to Care
Adults…………………………………………………………………………………….. 40
Children…………………………………………………………………………………... 41
Mental Health………………………………………………………………………………... 41
Emerging Issues……………………………………………………………………………...
42
Review of Primary Data
Listening Groups Summary………………………………………………………………
43
Summary and Next Steps…………………………………………………………………….
46
Acknowledgements…………………………………………………………………………..
48
Appendix……………………………………………………………………………………..
49
Tyrrell County Community Health Assessment 2010
3
Tyrrell County 2010 Community Health Assessment
Purpose
Every four years local health departments within North Carolina are required to conduct a
community health assessment. The purpose of the assessment is to examine the health status of
the community in order to determine the health priorities for the next four years. The community
health assessment process and findings should represent the concerns of the public and be
conducted in such as a way as to involve the various stakeholders including members of the
community.
Team Composition
Martin-Tyrrell-Washington District Health Department (MTW) and the Tyrrell County Health
Assessment Team have jointly conducted the community health assessment for the past several
years. For this assessment, a committee was formed in early 2010 with representatives from the
MTW District Health Department, Tyrrell County School System, Tyrrell County Clerk of
Court, Tyrrell County Cooperative Extension, Tyrrell County Faith Community, Tyrrell County
Commissioners, All Soul’s Catholic Church (Hispanic population), local business partners in
Tyrrell County, as well as members of the community. Leadership for the committee was
provided by the MTW Health District Health Department. Members of the committee were
recruited from MTW District Health Department. Several meetings were held for the primary
purpose of determining how best to solicit input from the community regarding health concerns.
The assessment team decided that this year listening groups would be the best avenue for
collecting health information for Tyrrell County. Once questions were developed for collecting
information, committee members met to develop a listening group tool and determine areas
within Tyrrell County to hold the listening groups. All Soul’s Catholic Church assisted with the
translation of the listening group tool and helped with translating to the Hispanic groups in
Tyrrell County. Paulo Giron from All Soul’s Catholic Church was the interpreter who assisted
MTW with translation.
Process Overview
One requirement for the community health assessment process is the collection of primary data
from members of the community. A community health survey was developed to ascertain
community members’ perception of health concerns and suggestions for improving the health
within the communities of Martin and Washington counties. The population of Tyrrell County is
small and that is why the health assessment team decided to take the best avenue of using
listening groups in Tyrrell County.
A review of secondary data was conducted by reviewing county level health data primarily
compiled by the NC State Center for Health Statistics. Other resources were also utilized such as
Cecil G. Sheps Center for Health Services Research at the University of North Carolina – Chapel
Hill.
Tyrrell County Community Health Assessment 2010
4
It is well recognized that other factors within a community affect the health of a community.
Demographic, educational, economic, and environmental data for the County were reviewed as
well to determine the potential for impact on health status within the county.
Additionally, where possible, Martin-Tyrrell-Washington District Health Department data was
compared to data from Eastern North Carolina, North Carolina, and the United States. A review
of data across several years was also conducted to determine trends in health status for Martin,
Tyrrell and Washington counties.
The data was then compiled and formal presentations were made to the Tyrrell County
Community Health Team at the November 2010 meeting. Each member was given the
opportunity to vote for the five (5) top health priorities. The health categories/priorities were
based on the 2010 Health Objectives. This meeting was announced through e-mails and through
the MTW call-down system.
Members of the Tyrrell County Community Health Assessment Team received the data by mail
prior to the November 2010 meeting. A review of the data was conducted at the November
MTW Board of Health meeting, as well as a review process undertaken to determine health
priorities. The Board voted to endorse the priorities identified by the Tyrrell County Community
Health Assessment Team.
Outcomes
The priority health objectives for 2010 – 2014 are as follows:
 Chronic Diseases (Diabetes, Cancer, Heart Disease)
 Obesity (Child & Adult)
 Dental Health
 Access to Health Care
 Communicable Disease (HIV/AIDS/STDs)
 Teen Pregnancy
Tyrrell County Community Health Assessment 2010
5
Community Health Assessment Acknowledgements
The Tyrrell County Community Health Assessment Team included representatives from all areas
of Tyrrell County. Members also included individuals that work to provide health, wellness, and
support resources to citizens in the Martin-Tyrrell-Washington Health District. The Community
Health Assessment Team met on the second Thursday of each month starting in March 2010 to
create a plan for conducting the health assessment and solving any problems encountered. The
following individuals have contributed to the preparation of this document.
Larry Hill
Tyrrell County Commissioner
Tyrrell County NC
Durwood Cooper, Jr.
Business Owner
Village Reality and Management Services Inc.
Dee Furlough
Cooperative Extension Agent
Tyrrell County Cooperative Extension
Terri Ward
Clerk
Martin-Tyrrell-Washington District Health Department
Linda Clough
Medical Office Assistant
Martin-Tyrrell-Washington District Health Department
Sam Brickhouse
Environmental Health Specialist
Martin-Tyrrell-Washington District Health Department
Patsy Swain
Special Education Teacher
Columbia High School
Sheila Cuminsky
Principal
Tyrrell County Elementary School
Cecelia Edge
Program Technician
Tyrrell County Farm Service Agency
USDA Service Center of Columbia
Melanie Armstrong
Register of Deeds
Tyrrell County Courthouse
Tyrrell County Community Health Assessment 2010
6
Faria White
Minister/Community Member
Salem Missionary Church
Samantha Combs
Alligator Chapel Church
Community Member
Laurie Spencer
Retired School Teacher
Tyrrell County Community Member
Paula Giron
Spanish Hispanic Interpreter
All Souls Catholic Church
Sarah Hill
Tyrrell County Community Member
Barbara S. Leary
Community Service Coordinator
Martin-Tyrrell-Washington District Health Department
Kim Hough, RN
Clinical Nurse Supervisor
Martin-Tyrrell-Washington District Health Department
Billie Patrick
Health Education Supervisor/Preparedness Coordinator & Safety Officer
Martin-Tyrrell-Washington District Health Department
Erica Payton
Public Health Educator II
Martin-Tyrrell-Washington District Health Department
Lynette Romero
Public Health Educator I
Martin-Tyrrell-Washington District Health Department
Tyrrell County Community Health Assessment 2010
7
County Overview
Tyrrell County…nature’s buffer zone, sprawled between the urban mainland
and the popular stretch of North Carolina’s Outer Banks.
Here is where the red wolf howls. Bald eagles and northern harriers soar
across the sunset. American alligators live at their northern limits near ancient
pocosin forests. Conservation gems like Palmetto-Peartree Preserve, Emily
and Richard Preyer Buckridge Coastal Preserve, Pocosin Lake National
Wildlife Refuge and the new bayside Eastern 4-H Environmental Education
Conference Center help highlight Tyrrell County’s remarkable natural wealth.
And Tyrrell County has even more to offer…history, art, unique festivals, lodging, dining and
shopping opportunities…all right here.
The county was formed in 1729 as Tyrrell Precinct of Albemarle
County from parts of Bertie Precinct, Chowan Precinct, Currituck
Precinct, and Pasquotank Precinct. It was named for Sir John
Tyrrell, one of the Lords Proprietors of Carolina.
With the abolition of Albemarle County in 1739, all of its
constituent precincts became counties. In 1774 the western part of
Tyrrell County was combined with part of Halifax County to form
Martin County. In 1799 the western third of what was left of
Tyrrell County became Washington County. In 1870 the half of Tyrrell County east of the
Alligator River was combined with parts of Currituck County and Hyde County to form Dare
County.
During the Civil War, Union forces occupied the Albemarle region beginning with the surrender
of Roanoke Island in 1862. Although Tyrrell County saw little serious military action, the town
of Columbia was bombarded. As throughout much of North Carolina, the social and economic
ramifications of the war were profound. The Pettigrew and Collins estates never recovered from
the war and deteriorated into underutilized, subdivided tenant farms. In 1930, the federal
government acquired most of these plantation tracts and launched the Scuppernong Farms
Project, a short-lived resettlement program for small farmers. This part of the county contains a
scattering of one-story, frame 1930s farmhouses that may represent this federally sponsored
project. In 1939, the State of North Carolina purchased the plantation house at Somerset and a
portion of Bonarva for Pettigrew State Park.
The county seat of Columbia was laid off on the east side of the Scuppernong River between
1793 and 1802. Primarily fishing and trading center before the Civil War, the town grew in the
late nineteenth century as a result of the expanding lumber industry. Between the 1880s and turn
of the century, the population of Columbia rose from 166 to 382, as lumber mills appeared on the
waterfront. The major employer was the Branning Manufacturing Company of Edenton, which
built a substantial planning mill at the south end of town and laid a railroad spur into the rich
Tyrrell County Community Health Assessment 2010
8
timberlands. In 1908, the Norfolk and Southern Railway extended its tracks to Columbia, but
withdrew to Creswell in Washington County in 1948 (Davis 1963:62; Pezzoni 1994).
The remainder of Tyrrell County developed slowly in the nineteenth and early twentieth
centuries, characterized by small, isolated farms and commercial fishing operations. Farm
tenantry led to a steady decline in the average size of farms, which dropped from 127 acres in
1890 to only 67 acres in 1940. Farmers raised corn, some cotton, livestock, and, increasingly,
Irish potatoes. By the late 1940s, Tyrrell County ranked as the number one potato producer in the
state (Davis 1963:62).
The success of agriculture as well as the lumber and fishing industries was made possible by
advancements in transportation. In addition to the Norfolk and Southern Railway, new, paved
roads and bridges slowly improved access to selected parts of the county. During the 1920s, U.S.
Highway 64 was paved through the county and, in 1926; a bridge was built over the
Scuppernong River at the west end of Columbia's main street. N.C. Highway 94 was constructed
across the heart of the county in 1933, linking Columbia with Hyde County to the south. The
discontinuation of rail service after World War II was partially compensated for by a renewed
road-building campaign, and, in 1962, the monumental three-mile-long Lindsay C. Warren
Bridge was erected across the Alligator River to Dare County.
In the 1970s, corporations such as First Colony Farms purchased
large sections of Tyrrell and adjacent counties for agricultural use
(Schoenbaum 1982: 112-115). The result was the systematic
transformation of the natural landscape on an unprecedented
scale. A vast network of drainage ditches was constructed and
thousands of acres of swamp forests were drained and cleared for
row crops. Consequently, Tyrrell County is today not only one of
the most remote and sparsely populated areas of the state but also one of the most recently
transformed. Small, isolated, turn-of-the-century farmsteads and agricultural communities, such
as Gum Neck near the south end of the county, stand in juxtaposition to enormous, flat tracts of
recently cleared farmland controlled by out-of-state interests.
Tyrrell County's wild and remote nature may have contributed to its sparse population and light
development in the past. Today, however, abundant water, forests and wildlife are recognized as
some of its most valuable assets and are helping to build a healthy, sustainable future for this
beautiful part of North Carolina.
As Cora Barksdale stated in the early 20th century, “Columbia…the town I’ve imagined in my
dreams but never believed existed.” Columbia’s quaint charm and Tyrrell County’s wild beauty
has captured the heart of more than a few. Cora Barksdale was one of them. She moved to
Columbia in the early part of the 20th century to become the editor of The Tyrrell Times
newspaper and her unabashed adoration of the place was obvious in her writing. Such
enthusiasm is understandable. In a world sometimes too anxious to attract tourists, Tyrrell
Tyrrell County Community Health Assessment 2010
9
County stands out as “the real thing”…genuine, down home, unpretentious. Visit Tyrrell County
today and see for yourself.1
Tyrrell County Government
Tyrrell County has an administrative form of government overseen by a five-person board of
commissioners. Commissioners are elected at large and each serves a four-year term. These
terms are staggered with two chosen in one election and three chosen in the next.
Tyrrell County Commissioners are as follows:
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Anthony (Tony) Sawyer
Gordon A. Deaver, Jr.
Thomas W. Spruill
Larry G. Hill
J. Fred Swain
o Penny Rhodes Jones, Clerk to the Board
For more information about Tyrrell County government, contact:
Tyrrell County Administrative Office
108 S. Water Street
Columbia, NC 27925
252.796.1371
Tyrrell County Courthouse
403 Main Street
Columbia, NC 27925
Register of Deeds – 252.796.2901
Clerk of Court – 252.796.6281
Tyrrell County Board of Education
106 S. Water Street
Columbia, NC 27925
252.796.1121
Columbia Town Government
Columbia is the county seat of Tyrrell County and has an alderman-manager form of
government. The following are the Town of Columbia Alderman, attorney and manager.



1
Mayor F. Michael Griffin
Alderman Ray Marner
Alderman Carl Willis
Tyrrell County Chamber of Commerce. Available at http://www.visittyrrellcounty.com
Tyrrell County Community Health Assessment 2010
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




Alderman Mildred Ogletree
Alderman Sandra Owens
Alderman Mike Crowder
Attorney Dwight Wheless
Manager, Clerk Rhett B. White
For more information about Columbia Town Government, contact:
Columbia Town Hall
103 Main Street
Columbia, NC 27925
252.796.2781
The Governing Board of MTW District Health Department
The Board of Health of Martin-Tyrrell-Washington District Health is established and maintained
as the governing body in accordance with the laws of the State of North Carolina of General
Statues 130A-34 through 130A-42.
The Board of Health serves as the global policy-making, rule-making, and adjudicatory body for
the district health department. The Board of Health has 15 members. The commissioners of each
county in the district appoint one of their members to the Board of Health. These appointed
commissioner members then appoint the other members of the Board including at least one
licensed physician licensed to practice in the State of North Carolina, one licensed dentist, one
licensed optometrist, one licensed veterinarian, one registered nurse, one licensed pharmacist,
and one professional engineer. If there is not a member of the district available for appointment
as designated above, additional representatives of the general public shall be appointed.
When a member of the general public is appointed due to the unavailability of one of the
licensed or professional level members, he/she shall serve only until a licensed or professional
member can be appointed.
The composition of the Board of Health shall reasonably reflect the population makeup of the
entire district and provide equitable district-wide representation. All members shall be residents
of the district.
Board of Health Members
Chairman: Thomas Spruill, Tyrrell County Commissioner
Martin County
Derek Price, Commissioner
Denise Edmondson, Registered Nurse
Robert M. Stalls, Public Member
Dr. Ben Shelton, Veterinarian
Ben Jones, Public Member
Tyrrell County Community Health Assessment 2010
11
Tyrrell County
Hannah Rogers, Public Member
Washington County
Jean Alexander, Commissioner
Dr. Carter Bennett, Dentist
Logan Womble, Pharmacist
Dr. Robert Venable, Physician
Judy Wright, Public Member, Vice Chairman
Eddie McNair, Public Member
Geography
According to the U.S. Census Bureau, the county has a total area of 600 square miles
(1,555 km²), of which, 390 square miles (1,010 km²) of it is land and 210 square miles (545 km²)
of it (35.05%) is water.
Tyrrell County, due to its close proximity to the Outer Banks, has been designated as part of the
IBX -Inner Banks. NCSU Tyrrell County Center gives the county's residents easy access to the
resources and expertise of NC State University and NC A&T State University. The county is
divided into five townships: Alligator, Columbia, Gum Neck, Scuppernong, and South Fork which are all part of the IBX - Inner Banks. Adjacent counties include:



Washington County, North Carolina - west
Dare County, North Carolina - east
Hyde County, North Carolina - south
As of 2000, Tyrrell County was the least populous county in North Carolina.
Demographics
Population Estimates
According to 2010 population estimates, Tyrrell County’s population is approximately 4,252.
The population increased 2.48% from April 2000 to July 2009. Estimates through 2014 indicate
that the County’s population will continue to grow at an annual growth rate of 0.3%. There is
only one incorporated town within Tyrrell County which is Columbia. Columbia is the largest
municipality with a 2009 estimated population of 855.2
As of 2009, there were 1,537 households, and 1,055 families residing in the county. The
population density was 11 people per square mile (4/km²). There were 2,032 housing units at an
average density of 5 per square mile (2/km²).
2
North Carolina State Demographics, July 2009 Municipal Estimates by County. Available at
http://www.demog.state.nc.us/.
Tyrrell County Community Health Assessment 2010
12
Age Distribution
Tyrrell County’s distribution of population by age is depicted in the graph below. 3 There were
1,537 households out of which 28.60% had children under the age of 18 living with them,
47.40% were married couples living together, 16.60% had a female householder with no husband
present, and 31.30% were non-families. 28.20% of all households were made up of individuals
and 14.40% had someone living alone who was 65 years of age or older. The average household
size was 2.42 and the average family size was 2.95.
In the county the population was spread out with 22.70% under the age of 18, 8.20% from 18 to
24, 30.30% from 25 to 44, 22.70% from 45 to 64, and 16.10% who were 65 years of age or
older. The median age was 39 years. For every 100 females there were 114.10 males. For every
100 females age 18 and over, there were 114.20 males.
Race and Ethnicity
The distribution of race in Tyrrell County is quite different when compared to North Carolina.
The racial makeup of the county was 56.9% White, 40.4% African American, 0.19% Native
American, 0.2% Asian, 1.7% from other races, and 0.9% from two or more races. Hispanic or
Latino of any race is 7.8% of the population. In North Carolina, 73.7% of the population is
white, 21.6% African American, 1.3% Native American, 2.0% Asian, and 7.7% of Hispanic or
Latino origin. In Tyrrell County we continue to see our Hispanic or Latino population continue
to increase.4
3
US Census Bureau, American Fact Finder, Tyrrell County, North Carolina, http://factfinder.census.gov/
U.S. Census Bureau, State and County QuickFacts; Population Estimates, Census of Population and Housing,
Small Area Income and Poverty Estimates, State and County Housing Unit Estimates, County Business Patterns,
Non employer Statistics, Economic Census. Available at http://quickfacts.gov
4
Tyrrell County Community Health Assessment 2010
13
Education
The following chart depicts the educational attainment of Tyrrell County’s population age 25
years and over. According to the 2000 U.S. Census Bureau 11.6.% of Tyrrell County’s
population had less than a 9th grade education, 22.1% had no diploma, 33.8% were high school
graduates, 17.4% had some college, but no degree, 4.6% had an Associate’s degree, 7.9% had a
Bachelors’ degree and 2.8% had a Graduate or professional degree.5
Education Attainment, Tyrrell County
3.16%
8.92%
24.94%
5.19%
< High School
High School
Some College
Associate's Degree
Bachelor's Degree
19.64%
Graduate or
Professional Degree
38.15%
The Tyrrell County Schools School District is located in Columbia, NC and includes 3 schools,
Tyrrell Elementary, Columbia Middle School, and Columbia High School. The school district
serves 624 students in grades PK through 12. The teacher ratio in the Tyrrell County School
District has 12 students for every full-time equivalent teacher, with the NC state average being
14 students per full-time equivalent teacher.
Regional Colleges and Universities that are utilized by Tyrrell County residents are:

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
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
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Beaufort Community College – Washington, NC
Chowan University – Murfreesboro, NC
College of the Albemarle – Elizabeth City, NC
East Carolina University – Greenville, NC
Elizabeth City State University – Elizabeth City, NC
Martin Community College – Williamston, NC
Mid-Atlantic Christian University – Elizabeth City, NC
Pitt Community College – Greenville, NC
Roanoke-Chowan Community College – Ahoskie, NC
5
U.S. Census Bureau, Tyrrell County, NC, Selected Social Characteristics in the United States: 2000. Available at
http://www.factfinder.census.gov
Tyrrell County Community Health Assessment 2010
14
Economic Characteristics
Poverty
Tyrrell County’s per capita money income in 1999 was $13,326 compared to the states per capita
money income of $20,307. Tyrrell County’s 2008 median household income was $31,732
compared to the state’s median household income of $46,574. Tyrrell County’s percent
population living in poverty is 26.9%, compared to 14.6% for North Carolina.6 In 2008, the
percentage of children living in poverty is 38.1%, compared to 19.9% of North Carolina
children.7 The chart below illustrates the poverty rates for Tyrrell County and Tyrrell County’s
peer counties.
Tyrrell County Residents Living in Poverty8
Individuals in Poverty
867 (number)
23.3% (percent)
Children in Poverty
291 (number)
31.5% (percent)
Poverty Census Data for Tyrrell County9
# in
Poverty
# of Children in
Poverty < 18 yrs
# of 65 + in
Poverty
# at 130%
Poverty Level
# of < 18 yrs
130% Poverty
# of 5-17 yrs
130% Poverty
248
63
49
392
78
63
510
189
96
637
237
205
Caucasian
African
American
Employment
Tyrrell County’s unemployment rate as of October 2010 was 8.5% compared to 9.1 % for the
State.10 Bordered by the Albemarle Sound on the north and the Alligator River and Atlantic
Intracoastal Waterway to the east, Tyrrell County offers unique opportunities for companies
dependent on water transportation. Located in the southeastern section of the region, Tyrrell
County is traversed by four-laned US Interstate 64.
With an abundance of large acreage tracts of land at low cost, Tyrrell County is primarily known
as the jumping off point to North Carolina's world famous Outer Banks. The fishing industry,
tourism and agriculture are the major economic engines in Tyrrell County.
6
US Census Bureau. State and County QuickFacts. Available at http://quickfacts.census.gov/
Kidscount.org. Available at http://datacenter,kidscount.org/data/bystate/stateprofile
8
NC Child Welfare, Work First, Food and Nutrition Services. Poverty Census Data. Available at
http://ssw.unc.edu.ma/.
9
NC Child Welfare, Work First, Food and Nutrition Services. Poverty Census Data. Available at
http://ssw.unc.edu.ma/
10
The Employment Security Commission of North Carolina. Labor Market Information. Available at
http://www.ncesc.com
7
Tyrrell County Community Health Assessment 2010
15
Tyrrell County welcomes the opportunity to share its unmatched quality of life and many
business amenities.11
Agriculture
Agriculture continues to play an important role in Tyrrell County’s economy. According to 2007
data, Tyrrell County has 68 farms, totaling 58,870 acres. The average size of the farms is 792
acres. The average age of the Tyrrell County farmer is 55.3. Among North Carolina counties,
2009 data shows that Tyrrell County is ranked 12th in the state for wheat crops and 14th for
soybean crops.
Transportation
In the past 10 years, North Carolina’s Northeast has seen
unprecedented improvements in our regional transportation
infrastructure. By land, sea or air, you can quickly and efficiently
transport your products anywhere in the world.
Access to the area is provided by an east-west interstate-quality US
Highway 64. There is also the two-lane Highway 94 that runs
across the heart of the county linking Tyrrell County to Hyde
County to the south. Multi-laned highways traverse North
Carolina’s Northeast Region to take you anywhere you need to go.
Interstate I-95 and US Highway 17, 264 and 158 place our region
within a day’s drive of 75% of the U.S. population. Over 60 motor
freight carriers serve the region. There are three modern deepwater ports – Wilmington, NC, Morehead City, NC as well as the
Virginia Ports in the Hampton Roads area of Virginia – the second
busiest port on the US East Coast.
A number of our
business/industrial sites are less than an hour’s drive from the Port
of Virginia via four-laned US Highway 17.
The County has approximately 199.28 linear miles of public roads
and highways. Major expansion, improvement and maintenance of
primary and secondary highway thoroughfares fall under the
responsibilities of the State.
There are eleven general aviation airports located in North
Carolina’s Northeast Region. Tyrrell County travelers utilize the
services offered at nearby Pitt-Greenville Airport (90 miles away)
or Plymouth Municipal Airport (25 miles away). Municipal
airports, public heliports and hospital heliports are available, as
well.12
11
12
North Carolina Northeast Commission. Available at http://www.northeast.info
North Carolina’s Northeast Economic Development Region. Available at www.ncnortheast.com.
Tyrrell County Community Health Assessment 2010
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Regional Airports
 Raleigh, NC
 Norfolk, VA
 Newport News, VA
 Richmond, VA
County Airports
 Currituck County Airport (NX) Currituck, NC
 Dare County Regional Airport (MQI) Manteo NC
 First Flight Airport (FFA) Kill Devil Hills, NC
 Halifax County Airport (RZZ) Roanoke Rapids, NC
 Martin County Airport (MCZ) Williamston, NC
 Northeastern Regional Airport (EDE) Edenton, NC
 Ocracoke Island Airport (W95) Ocracoke, NC
 Pine Island Airport (7NC2) Corolla, NC
 Plymouth Municipal Airport (PMZ) Plymouth, NC
 Tri-County Airport (ASJ) Ahoskie, NC
 Warren Field Airport (OCW) Washington, NC
Public Heliports
 Outer Banks Heliport (NC88) Nags Head, NC
Hospital Heliports
 Albemarle Hospital (NC98) Elizabeth City, NC
 Bertie Memorial Hospital (8NC0) Windsor, NC
 Bethany South Heliport (72NC) Littleton, NC
 Halifax Regional Medical Center Heliport (NC51) Roanoke Rapids, NC
 Our Community Hospital Heliport (0NC6) Scotland Neck, NC
 Pungo District Hospital Heliport (NC89) Belhaven, NC
 Washington County Hospital Heliport (0NC3) Plymouth, NC
Tyrrell County Community Health Assessment 2010
17
Community Health Status
County Health Rankings – Mobilizing Action Towards Community Health (MATCH)
The Robert Wood Johnson Foundation and the University of Wisconsin Population Health
Institute have collaborated to develop the County Health Rankings. The County Health Rankings
is a component of the Mobilizing Action Towards Community Health (MATCH) project. The
County Health Rankings website provides access to the 50 state reports, ranking each county
within the 50 states according to its health outcomes and the multiple health factors that
determine a county’s health. Health Outcomes are the primary ranking used to rank the overall
health of counties. The county ranked number 1 is considered the healthiest county in the state.
Health outcomes in the County Health Rankings represent how healthy a county is. Health
outcomes are measured by two factors: how long people live (mortality) and how healthy people
feel (morbidity). In 2010, Tyrrell County received a Health Outcomes rank of 77 out of 100.
Health factors in the County Health Rankings represent what influences the health of the county.
The County Health Rankings measures for types of health factors (health behaviors, clinical care,
social and economic and physical environment factors) to determine an overall health factor
ranking. In 2010, Tyrrell County received a Health Factors ranking of 88 out of 100.13
Peer Counties
The North Carolina CATCH (Comprehensive Assessment for Tracking Community Health) is a
program that contains demographic and community data for all 100 counties in North Carolina.
The NC CATCH program also designates peer counties for each county. These counties can be
used to compare statistical data such as demographics and county data. The peer counties for
Tyrrell County are, Anson, Bladen, Hyde and Martin. Anson County has a Health Outcomes
rank of 87 and Health Factors rank of 92; Bladen County has a Health Outcome rank of 97
and a Health Factors rank of 81; Hyde County has a Health Outcomes rank of 34 and a Health
Factors rank of 84 and Martin County has a Health Outcomes rank of 95 and a Health Factors
rank of 87.14
13
County Health Rankings: Mobilizing Action Toward Community Health (MATCH). Available at
www.countyhealthrankings.org.
14
County Health Rankings: Mobilizing Action Toward Community Health (MATCH). Available at
www.countyhealthrankings.org.
Tyrrell County Community Health Assessment 2010
18
Leading Causes of Death
A comparison of the leading causes of death for all ages in Tyrrell County, and North Carolina
are illustrated in the graph below. Tyrrell County’s total mortality rates for heart disease, cancer,
diabetes, pneumonia and influenza, septicemia, and unintentional motor vehicle injuries exceed
the State’s rate for the diseases. The State exceeds the County’s rate of death for cerebrovascular
(stroke) disease, chronic lover respiratory diseases, chronic liver disease and cirrhosis, nephritis,
nephritic syndrome, and nephrosis (kidney disease), Alzheimer’s disease, unintentional injuries,
and motor vehicle injuries.15
2005 – 2009 Age Adjusted Death Rates for Leading Causes of Death – All Ages16
Standard = 2000 US Population Rates per 100,000 Population
Heart Disease
Tyrrell County’s heart disease mortality rate consistently exceeds the State’s rate; however, both
the County and the State have experienced similar declines in heart disease mortality. A
comparison of heart disease mortality using age-adjusted five year averages from the periods of
2003 - 2007 to 2005 – 2009 shows that total mortality rates for Tyrrell County have increased
over the years. White males have the highest rate of heart disease mortality for Tyrrell County.17
15
North Carolina Division of Public Health, State Center for Health Statistics. 2004-2008 NC Resident Race and
Sex-Specific Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook/.
16
North Carolina Division of Public Health, State Center for Health Statistics. 2004-2008 NC Resident Race and
Sex-Specific Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook/
17
North Carolina Division of Public Health, State Center for Health Statistics. 2004-2008 NC Resident Race and
Sex-Specific Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook/
Tyrrell County Community Health Assessment 2010
19
Heart Disease18
Race and Sex Specific Adjusted Death Rates – Tyrrell County
2003 – 2007
2004 – 2008
2005 - 2009
Source: NC State Center for Health Statistics
Hypertension (high blood pressure) and hyperlipidemia (high cholesterol) are risk factors for
heart disease and stroke. According to the 2009 Behavioral Risk Factor Surveillance Survey,
North Carolina and Eastern NC which includes Tyrrell County, have similar percent populations
reporting they have high blood pressure, 31.5% and 34.7% respectively compared to 28.7% of
US adults. The percent population reporting they have high cholesterol is the same for North
Carolina and Eastern NC, 39.6% and 39.6% respectively. US adults report a higher percentage,
80.6%.19
Cerebrovascular Disease (Stroke)
The total rate of deaths for Tyrrell County from cerebrovascular disease (stroke) has decreased
and maintained a steady rate for the same time period. White females have higher rates of
mortality than minorities and white males.
18
North Carolina Division of Public Health, State Center for Health Statistics. 2004-2008 NC Resident Race and
Sex-Specific Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook/
19
North Carolina Division of Public Health, State Center for Health Statistics. Behavioral Risk Factor Surveillance
System (BRFSS) Calendar Year 2009 Results. Available at http://www.schs.state.nc.us/SCHS/brfss/2009/.
Tyrrell County Community Health Assessment 2010
20
Cerebrovascular Disease (Stroke)20
Race and Sex Specific Age-Adjusted Death Rates – Tyrrell County
2003 – 2007
2004 – 2008
2005 – 2009
Source: NC State Center for Health Statistics
Cancer
As the leading cause of death for males for all populations and the second leading cause of death
for females of all populations, the age-adjusted mortality rate for cancer has increased from 2003
– 2009 for Tyrrell County and North Carolina.21 In 2007, the percent of cancer deaths was
21.2% for Tyrrell County compared to 23.0% for North Carolina. 22 As illustrated in the graph
below, Tyrrell County minority males have the highest mortality from all cancer types followed
by white males. White females have the lowest rate of mortality. All cancer mortality data
reported in this section of the report can be located at the reference described below.23
According the NC OSBM it is projected that in 2010 Tyrrell County will have a total of 28 new
cases of cancer from all types with 11 deaths occurring.24
20
North Carolina Division of Public Health, State Center for Health Statistics. 2004-2008 NC Resident Race and
Sex-Specific Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook/
21
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/Cancer.
22
North Carolina Central Cancer Registry (CCR). Cancer Profiles.
23
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race and Sex-Specific
Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook.
24
NC Population Estimates available at:
http://www.osbm.state.nc.us/ncosbm/facts_and_figures/socioeconomic_data/population_estimates_projections.shtm.
Tyrrell County Community Health Assessment 2010
21
Total Cancer Mortality25
Race and Sex Specific Age-Adjusted Death Numbers – Tyrrell County
2003-2007
2004-2008
2005-2009
Source Center for Health Statistics
Tyrrell County 2007 Cancer Deaths by Site26
NC Central Cancer Registry
25
NC Population Estimates available at:
http://www.osbm.state.nc.us/ncosbm/facts_and_figures/socioeconomic_data/population_estimates_projections.shtm
26
NC Population Estimates available at:
http://www.osbm.state.nc.us/ncosbm/facts_and_figures/socioeconomic_data/population_estimates_projections.shtm
Tyrrell County Community Health Assessment 2010
22
The chart below illustrates the number of new cancer cases and deaths projected for 2010 for
North Carolina and Tyrrell County.27
Projected New Cancer Cases and Deaths for Selected Sites – 201028
Total
NC
Cases
49,586
NC
Deaths
18,969
Tyrrell
Cases
28
Tyrrell
Deaths
11
Lung
7,772
5,914
4
4
Breast
8,213
1,360
4
1
Prostate
7,316
970
4
1
Colon/Rectum
4,812
1,6643
3
1
Chronic Respiratory Diseases
Chronic Respiratory Diseases are chronic diseases of the airways and other structures of the
lung. Some of the most common are asthma, chronic obstructive pulmonary disease (COPD),
respiratory allergies, occupational lung diseases and pulmonary hypertension.29 From 2005 –
2009, chronic lower respiratory disease was the 3rd leading cause of deaths for whites, the 10th
leading cause of deaths for minorities and the 4th leading cause of death for both males and
females. From 2004 – 2008, chronic respiratory disease was the 3rd leading cause of death for
whites, 9th leading cause of death for minorities, 4th leading cause of death for males and the 6th
leading cause of death for females. From 2003 – 2007, chronic respiratory disease was the 3rd
leading cause of death for whites, 8th leading cause of death for minorities, 4th leading cause of
death for males and 5th leading cause of death for females.
Alzheimer’s Disease
Alzheimer’s disease is one of the most common forms of dementia and is one of the top 10
causes of death for Tyrrell County. Compared to North Carolina, Tyrrell has a somewhat lower
rate of mortality however a consistent increasing trend is noted. In Tyrrell County, Alzheimer’s
disease is highest among minority females, followed by white females.30
27
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/
28
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/
29
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/
30
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race and Sex Specific
Age-Adjusted Death Rate. http://www,schs.state.nc.us/SCHS/data/databook/
Tyrrell County Community Health Assessment 2010
23
Alzheimer’s Disease
Race-Specific and Sex-Specific Age-Adjusted Death rates per 100,000
2003-2007
2004-2008
2005-2009
Unintentional Injuries
Tyrrell County’s fourth leading cause of death for the total population is unintentional injuries.
Both Tyrrell County and North Carolina have seen an increase in the rate of overall mortality
from this. White females have the highest mortality rates. From 2005-2009, unintentional
injuries were the leading cause of death in white males.31
Unintentional Injuries (excluding Motor Vehicle)
Race and Sex Specific Age Adjusted Death Rates – Tyrrell
Rates per 100,000 Populations
2003 – 2007
2004 – 2008
2005 - 2009
Source: NC Center for Health Statistics
31
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/
Tyrrell County Community Health Assessment 2010
24
Motor Vehicle Injuries
Tyrrell County’s tenth leading cause of death is motor vehicle injuries. According to the 2003 –
2007 five year span motor vehicle injuries was the leading cause of death for white males. For
the five year span of 2004 – 2008 it was the leading cause of death for white females. For the
years of 2005 – 2009 data was not available because there was not enough to report due to such a
small population. There was not enough data to create stable statistics.
Diabetes
Tyrrell County’s age-adjusted diabetes mortality rates are consistently somewhat higher than
North Carolina. From 2005-2009 diabetes was the fifth leading cause of death for African
American males following white males. According to the 2009 Behavioral Risk Factor
Surveillance Survey for Eastern North Carolina which includes Tyrrell County, 12.7% of adults
compared to 9.6% of North Carolina adults report they have diabetes.32
Diabetes
Race and Sex Specific Age-Adjusted Death Rates, Tyrrell County
Rates per 100,000 Populations
2003 – 2007
2004 – 2008
2005 – 2009
Source: NC Center for Health Statistics
Kidney Disease
Nephritis, Nephrotic Syndrome and Nephrosis (conditions involving the kidneys) are not one of
the leading causes of death in Tyrrell County however; there are many minority males and white
males that have kidney disease. It is likely that diabetes contributes to the development of these
health conditions.33
32
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/
33
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race Specific and Sex
Specific Age-Adjusted Death Rate. http://www.schs.state.nc.us/SCHS/data/databook/
Tyrrell County Community Health Assessment 2010
25
Nephritis, Nephrotic Syndrome, Nephrosis
Race and Sex Specific Age Adjusted Death Rates, Tyrrell County
Rates per 100,000 Populations
Pneumonia and Influenza
Pneumonia and Influenza is the sixth leading cause of death in Tyrrell County. The 2005 – 2009
time periods has the lowest number of deaths compared to the 2003–2007 and 2004–2008 time
periods. From 2005–2009, pneumonia and influenza was the ninth leading cause of death for
whites, eighth leading cause of death for males and seventh leading cause of death for females.
From 2004–2008, pneumonia and influenza was the 10th leading cause of death for whites, and
eighth leading cause of death for females. From 2003– 2007, pneumonia and influenza was the
eighth leading cause of death for whites, males and females.
Influenza is a vaccine preventable disease. Flu shots are recommended for several population
groups including children and adults with chronic conditions, as well as all persons 50 and over
and recommended for anyone older than six months of age in 2010. According to the 2009
North Carolina Behavioral Risk Factor Surveillance System, 37% of Eastern North Carolina
adults compared to 40.9% of North Carolina adults are receiving a flu shot each year. This
percentage can be improved in order to ensure that the most vulnerable populations which
include our young and older populations are protected from developing complications due to
influenza.
A new strain of influenza, 2009 H1N1, emerged in the United State and globally in late April
2009. Health Departments across the country were tasked with providing education and
facilitating access to vaccinations for healthcare providers and the public. At the same time,
seasonal influenza vaccinations were underway for the 2009-10 flu seasons.
CDC estimated that the 2009 H1N1 pandemic resulted in more than 12,000 flu-related deaths in
the US. In contract to seasonal flu, nearly 90% of the deaths occurred among people younger
than 65 years of age.
Tyrrell County Community Health Assessment 2010
26
Update on 2009 H1N1 Influenza and 2009-10 Seasonal Influenza Activity in Tyrrell County
2009-10 Vaccine Administration by Health Department
 Administered 399 H1N1 vaccines and 148 FluMist® Vaccines
 Administered 306 seasonal vaccines and 155 FluMist® Vaccines
 Health Department administered approximately 50% as many flu vaccines in 2009-10 as
compared to a normal season.
Community H1N1/Flu Vaccination Clinics

4 Businesses

2 After school programs

1 Community centers
 Numerous childcare centers
Distribution of H1N1 Vaccine
 Facilitated the distribution of thousands of vaccines to local healthcare providers
2009 Seasonal FluMist® Vaccination Program
 105 vaccines administered to children/teachers in 3 schools and 3 childcares
Community Education
 Hosted a community forum to provide accurate and timely information from key leaders
and to provide citizens and opportunity to ask questions about the flu.
 Developed and distributed thousands of copies of educational literature, individual hand
sanitizers and disposable tissues.
 Developed a local flu information website and hot-line.
 Developed and funded a flu vaccination billboard.
Partnership with African American Community
 Partnered with members of the African American faith and community at-large to plan an
outreach campaign to encourage participation in flu vaccination clinics.
 Developed radio and print advertisements to dispel myths and misinformation about flu
vaccine and to encourage flu vaccinations.
 Partnered with area churches and community centers to host vaccination clinics.
Campaign materials were developed to create awareness and promote vaccinations. MTW
placed ads in the local newspapers and distributed flyers throughout neighborhoods. Efforts to
encourage people to get vaccinated continued throughout the winter and spring of 2010.
Tyrrell County Community Health Assessment 2010
27
Septicemia
Tyrrell County’s tenth leading cause of death is septicemia. Septicemia is caused by the spread
of microorganisms and their toxins through the bloodstream. Years ago people referred to this
infection as “blood poisoning.” In Tyrrell County, white males have the highest rates of mortality
followed by minority females.34
Septicemia
Race and Sex Specific Age Adjusted Death Rates – Tyrrell County
Rates per 100,000 Populations
2003-2007
2004-2008
2005-2009
Source: NC State Center for Health Statistics
34
North Carolina Division of Public Health, State Center for Health Statistics. NC Resident Race and Sex-Specific
Age-Adjusted Death Rate. Available at http://www.schs.state.nc.us/SCHS/data/databook/
Tyrrell County Community Health Assessment 2010
28
Maternal and Child Health
Infant Mortality
Infant mortality is the death of an infant prior to his/her first birthday. From 2004-2008 the infant
mortality rate for Tyrrell County was 7.8 per 1,000 live compared to North Carolina rate of 8.4
per 1,000 live births. In 2009 and 2008 Tyrrell County has been ranked number one in the state
for teen pregnancies ages 15-19. While Tyrrell County has seen an increase in the percentage of
live births ages 15-19, the percentage of births classified as low birth weight (5lbs, or less) is
12.5 for Tyrrell County compared to the state rate of 9.1. The percentage of mothers who report
smoking during pregnancy is 16.0 for Tyrrell County compared to 11.5 for the state.35
Infant Mortality Rates – Tyrrell County
Total, White and Minority Rates per 1,000 Live Births
2003-2007
2004-2008
2005-2009
Teen Pregnancy
North Carolina’s teen pregnancy rate fell to a record low in 2009. Teenage girls ages 15-19 in
North Carolina had 1,256 fewer pregnancies in 2009 than in 2008. New data shows that 56 out
of every 1,000 teen girls ages 15 to 19 became pregnant in 2009. The new rate reflects a 4.4%
decrease from the 2008 rate of 58.6 per 1,000 girls. Despite the positive trends, Tyrrell County
saw higher rates of teen pregnancy than urban counties in 2009. Tyrrell County ranks #1 out of
100 in North Carolina counties. In 2009, 25.0% of Tyrrell County’s adolescent pregnancies
were repeat pregnancies compared to 28.6% for North Carolina.36
35
North Carolina Division of Public Health, State Center for Health Statistics, Infant Mortality Statistics. Available
at http://www.schs.state.nc.us/SCHS/data/vitalstats.cfm.
36
North Carolina Division of Public Health, State Center for Health Statistics, Infant Mortality Statistics. Available
at http://www.schs.state.nc.us/SCHS/data/vitalstats.cfm.
Tyrrell County Community Health Assessment 2010
29
Adolescent Pregnancy Rate37
Tyrrell County and NC by Year
Rates per 1000 15-19 year old girls
Child Abuse and Death
The following chart depicts a decrease in the number of cases reported to the Tyrrell County
Department of Social Services that were substantiated or found in need of services from FY
2005-2006 and 2006-2007. In FY 2007-2008 over half of the reports were substantiated or at
minimum, the child/families were not in need of service. In the largest percent of cases 43.6%,
the children were found to be in an injurious environment. An additional number of the
substantiated cases were due to an injurious environment related to domestic violence or
substance abuse.38
Tyrrell County
Child Protective Services Assessment Findings by Year
37
Adolescent Pregnancy Prevention Coalition of North Carolina. Available at http://www.appcnc.org/statistics
North Carolina Division of Social Services. Child Welfare Central Registry. Available at
http://www.ncdhhs.gov/dss/stats/cr.htm
38
Tyrrell County Community Health Assessment 2010
30
Child Overweight
Much attention has been focused on the impending health crisis of childhood overweight and
obesity. Tyrrell County has devoted a significant number of resources trying to battle this
problem. Partnerships exist among the health care provider, the local health department, faith
communities as well as the school system. The graph below illustrates no significant change for
the past three years among Tyrrell County children at risk for overweight or obesity and ranked
6th for overweight. According to 2009 data, Tyrrell County is ranked 95 out of 100 counties for
child obesity. Counties are ranked from 1 to 100 indicating the lowest (best) rate of overweight
or obesity and 100 indicating the worst (highest) rate. 39
Tyrrell County and North Carolina
Percent of Children Overweight and Obese
Source: North Carolina Nutrition and Physical Activity Surveillance System ((NC-NPASS), Division of Public
Health
39
Prevalence of Overweight, At-Risk for Overweight, and Underweight in Children 2 through 18 years of age by
County, NC-NPASS, 2006-2009, NC Nutrition and Physical Activity Surveillance System, Division of Public
Health, DHHS. Available at http://www.eatsmartmovemorenc.com/data/index.html
Tyrrell County Community Health Assessment 2010
31
Other Heath Status Data
Obesity and Physical Inactivity
Obesity and physical inactivity have been shown to contribute to the leading causes of mortality
including heart disease, some cancers, stroke, and diabetes. The graphs below show a
comparison of weight categories for adults in Eastern North Carolina, North Carolina and the
United States for 2005 and 2009.40 41
Percent of Adults at Recommended Weight, Overweight, and Obese.
ENC, NC, and US 2005 and 2009
2005
2009
Smoking
Smoking has long been associated with many of the leading causes of mortality including heart
disease, cancer, stroke, and chronic lower respiratory disease. Eastern North Carolina’s percent
of adults reporting they are current smokers is 20.3% in 2009. By way of comparison, North
Carolina adults, 20.3% and Northeastern Partnership 29.2% of adults reported being current
smokers in 2009.42
Childhood Asthma
Approximately 12.8% of Tyrrell County’s adult population report they currently have asthma
compared to 12.9% of North Carolina adults. A review of 2009 hospital discharges with the
40
North Carolina Division of Public Health, State Center for Health Statistics. Behavioral Risk Factor Surveillance
System (BRFSS) Calendar Year 2005 and 2009 Results. 2009 results available at
http://www.schs.state.nc.us/SCHS/brfss/2009/
41
Centers for Disease Control, National Center for Chronic Disease and Prevention and Health Promotion.
Behavioral Risk Factor Surveillance (BRFSS), Prevalence Data, Nationwide (States and DC) – 2005 and 2009.
2009 results available at http://apps.need.cdc.gov/brfss/page.asp?cat=HA&yr=2009&state=UB#HA.
42
North Carolina Division of Public Health, State Center for Health Statistics. Behavioral Risk Factor Surveillance
System (BRFSS) Calendar Year 2009 Results. Available at http://www.schs.state.nc.us/SCHS/brfss/2009.
Tyrrell County Community Health Assessment 2010
32
primary diagnosis of asthma showed that Tyrrell County had a discharge rate of 46.6 per 100,000
for children ages 0-14 compared to North Carolina’s discharge rate of 116.2 per 100,000
populations.43
Communicable Diseases
HIV
Based upon the average rate of HIV for 2007, 2008, and 2009, Tyrrell County is ranked as 64 for
HIV disease in the State. The County’s three-year average HIV rate is 8.0 per 100,000
population which in under the State’s three-year average rate of 19.3 per 100,000 population. As
of 12/31/09 a cumulative total of 5 cases of HIV have been reported in Tyrrell County. 44
HIV
Tyrrell County and NC by Year
Rates per 100,000 population
Source: NC 2009 HIV/STD Surveillance Report, NC Division of Public Health
AIDS
Tyrrell County is ranked 92 in the state for number of AIDS cases. The County’s three-year
average AIDS rate is 0.0 per 100,000 population compared to North Carolina’s AIDS rate of
10.0 per 100,000 population. As of 12/31/09, a cumulative total of 2 cases of AIDS have been
reported in Tyrrell County.45
43
North Carolina Division of Public Health, State Center for Health Statistics, Behavioral Risk Factor Surveillance
System (BRFSS) Calendar Year 2009 results. Available at http://schs.state.nc.us/SCHS/brfss/2009
44
NC Division of Public Health, Epidemiology and Special Studies Unit, HIV.STD Prevention and Care Branch.
2009 HIV/STD Surveillance Report. Available at http://www.epi.state.nc.us/epi/hiv/pdf/std09rpt/pdf
45
NC Division of Public Health, Epidemiology and Special Studies Unit, HIV.STD Prevention and Care Branch.
2009 HIV/STD Surveillance Report. Available at http://www.epi.state.nc.us/epi/hiv/pdf/std09rpt/pdf
Tyrrell County Community Health Assessment 2010
33
AIDS
Tyrrell County and NC by Year
Rates per 100,000 Population
Source: NC 2009 HIV/STD Surveillance Report, NC Division of Public Health
Chlamydia
Tyrrell County has Chlamydia case rates that are higher than North Carolina. In 2009 Tyrrell
County had 24 cases of Chlamydia or a rate of 587.2 per 100,000 population compared to North
Carolina’s rate of 474.2 per 100,000. The average annual number of cases is about 20.
Chlamydia is a sexually transmitted disease. Tyrrell County is experiencing an increase in the
rate of Chlamydia as well as North Carolina.46 It is believed that an increase in the number of
tests performed has led to an increased number of cases.
Chlamydia
Tyrrell County and NC by Year
Rates per 100,000 population
Source: NC 2009 HIV/STD Surveillance Report, NC Division of Public Health
46
NC Division of Public Health, Epidemiology and Special Studies Unit, HIV/STD Prevention and Care Branch.
2009 HIV/STD Surveillance Report. Available at http://www.epi.state.nc.us/epi/hiv/pdf/std09rpt.pdf.
Tyrrell County Community Health Assessment 2010
34
Gonorrhea
Tyrrell County’s rate of gonorrhea exceeds the State’s rate as well. The County averages are
about 9 cases per year. From 2005 – 2009 Tyrrell County’s rates increased and dramatically
then held steady. When reviewing the gender of cases, there appears to be no significant
differences among males and females. Once again the highest rates of gonorrhea in the State are
in Eastern North Carolina which includes Tyrrell County.47
Gonorrhea
Tyrrell County and NC by Year
Rates per 100,000 population
Source: NC 2009 HIV/STD Surveillance Report. NC Division of Public Health
Syphilis
Syphilis rates in North Carolina have fallen significantly. Tyrrell County experienced its largest
percent decrease from 2005 – 2009. There have been no reported cases of syphilis in Tyrrell
County in the last five years. Much of the improvement is credited to active surveillance and
disease investigation within the Eastern Counties in North Carolina. Again, increased disease
control efforts have been focused in counties with high syphilis rates which have been in Eastern
North Carolina.48
Tuberculosis (TB)
Tuberculosis is thought by many to be a disease of the past. However, the prevention and
control of this communicable disease continues to be a public health priority. Through
aggressive control measures, including direct oral therapy, Tyrrell County and North Carolina
have experienced decreases in the number of cases reported annually. From 2005 – 2099 Tyrrell
County has no reported cased of tuberculosis. Tyrrell County’s rate is definitely lower than the
47
NC Division of Public Health, Epidemiology and Special Studies Unit, HIV/STD Prevention and Care Branch.
2009 HIV/STD Surveillance Report. Available at http://www.epi.state.nc.us/epi/hiv/pdf/std09rpt.pdf
48
NC Division of Public Health, Epidemiology and Special Studies Unit, HIV/STD Prevention and Care Branch.
2009 HIV/STD Surveillance Report. Available at http://www.epi.state.nc.us/epi/hiv/pdf/std09rpt.pdf
Tyrrell County Community Health Assessment 2010
35
State’s. North Carolina is ranked as the 26th highest state for case rates in the United States in
2009. This can be viewed as significant progress -- in 1980, North Carolina was ranked as the 3rd
highest state for case rate. The number of NC TB cases in 2009 was 250. Since 1980, TB cases
in North Carolina have decreased by almost five percent per year. The number of AfricanAmericans with TB decreased by 32.7 percent from 2005 to 2009. The rate for AfricanAmericans decreased from 9.0 to 5.3 per 100,000 population.49
Vaccine Preventable Diseases
Children are required to receive vaccinations for ten communicable diseases during their
childhood. These include measles, mumps, rubella, Hepatitis B, diphtheria, tetanus, Pertussis
(whooping cough), Hemophilus influenza B, polio, and varicella (chickenpox). From 2005-2009
Tyrrell County has no report of any of these communicable diseases.
49
NC Division of Public Health, Division of Epidemiology, Tuberculosis Control. NC Tuberculosis Data, Annual
NC Tuberculosis Statistical Summary. Available at http://www.epi.state.nc.us/epi/tb/data/html
Tyrrell County Community Health Assessment 2010
36
Environmental Health
Water Quality
Tyrrell County has 2 community water systems and is a part of the Pasquotank Watershed. The
primary water source type is groundwater. Public water systems in North Carolina are monitored
and regulated by the Public Water Supply System within the Division of Environmental Health,
NC Department of Environment and Natural Resources. The Environmental Protection Agency
(EPA) provides water quality standards and requires that water systems are periodically
monitored for bacteria and other compounds. If any of these tests exceed the EPA action level,
the water system must correct the problem, return to compliance with EPA water quality
standards or provide alternative water supply to its customers.50
There was no data found to indicate that any particular water system in Tyrrell County has an ongoing water quality issue. Residents can review the results of water quality monitoring for their
water system by visiting https://www.pwss.enr.state.nc.us/NCDWW/.
Air Quality
The North Carolina Division of Air Quality within the North Carolina Department of
Environment and Natural Resources monitors outdoor air quality throughout North Carolina.
According to Tyrrell County’s 2008 Air Quality report, Tyrrell County has an average of 226
days good air quality, 69 days of moderate air quality, 3 days of unhealthy air quality for
sensitive groups and 1 day of unhealthy air quality.51 Below is the NC Division of Air Quality
Color Code Guide. This guide is used to alert the public of air quality issues related to the ozone
levels.52
Air Quality Index Levels of Health
Concern
Green/Good
0-50
Yellow/Moderate
51-100
Orange/Unhealthy for Sensitive
groups
101-150
Red/Unhealthy
151-200
Purple/Very Unhealthy
201-300
Maroon/Hazardous
>300
50
51
Numerical Value
Meaning
Air quality is considered satisfactory, and air pollution
poses little to no risk.
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.
Members of sensitive groups who may experience
health effects. The general public is not likely to be
affected.
Everyone may begin to experience health effects;
members of the sensitive groups may experience more
serious health effect
Health alert: everyone may experience more serious
health effects
Health warnings of emergency conditions. The entire
population is more likely to be affected
U.S. Environmental Protection Agency. My Environment. http://www.epa.gov/
U.S. Environmental Protection Agency. My Environment. http://www.epa.gov/
Tyrrell County Community Health Assessment 2010
37
Health Care Resources
Tyrrell County has very limited resources when it comes to health care availability. The county
has two ambulatory health care clinics: Columbia Medical Center and Martin-TyrrellWashington District Health Department. Tyrrell County does not have any private practice
physicians or dentists.
Columbia Medical Center is a rural health clinic with one family nurse practitioner and one
registered nurse. The clinic is located in Columbia and takes all major medical insurances,
Medicare, Medicaid and serves self payers on a sliding fee scale. Columbia Medical Center
serves the citizens of Tyrrell County and neighboring counties. The clinic is open Monday –
Friday 8:00 am – 5:00 pm.
Columbia Medical Center does have specialists that visit the clinic on certain days such as a
podiatrist, oncologist, and cardiologist. Services include CDL, sports, school, and employment
physicals. They offer immunizations, pharmacy assistance program and the medical access
program.53
Martin-Tyrrell-Washington District Health Department (MTW) is one of 85 health departments
in North Carolina. The mission of the District Health Department is to strive to promote healthier
lifestyles, reduce risks, disabilities, and years-of-life lost by providing personal and
environmental health services. The Health Department is responsible for assessing the health of
the community and health hazards in the community; assuring that needed health services are
available in the community; enforcing laws and regulations that protect health and ensure safety;
and advocating for policies that support the health of the public. The Health Department
operates a variety of preventive health services in the area of women’s and children’s health and
communicable disease control and including primary care. The Health Department also manages
a dental clinic in Plymouth to ensure that the dental needs of the uninsured or underinsured
children are met. The Health Department has competent health professionals. We have a
Medical Physician, Physician’s Assistant, Family Nurse Practitioner, Registered Nurses, Health
Educators, Social Workers, Environment Health Specialists, and other Community Services
Staff.
Roanoke Home Care and Hospice (RHCH) is the home care agency of Martin-TyrrellWashington District Health Department and is composed of a home health division, hospice
division, and home care division. RHCH is licensed by North Carolina and accredited by the
Accreditation Commission for Health Care, Inc. for delivery of skilled nursing, physical and
occupational therapy in-home aide services, medical social services, and infusion nursing.
RHCH maintains offices in Williamston, Plymouth, and Columbia, NC, to provide services in
the district to the residents of our community.
The Tyrrell County Department of Social Services administers the following Public Assistance
of Income Maintenance programs: Medicaid, Work First Cash Assistance, and Special
53
http://columbiamed.net/services
Tyrrell County Community Health Assessment 2010
38
Assistance to Adults, Food Stamps, and Energy Assistance. In addition to the public assistance
programs, the Department of Social Services operated the child support enforcement program.
The Department also provides protective services for abused and neglected children and adults,
foster care for children and adults, adoption services, day care services for children, family
planning, employment counseling services, and individual and family adjustment services. It
also assists person in securing health care consumer education and other informational services.54
Health Care Providers
The tables provided below indicate the types and numbers of health care professionals available
in Tyrrell County. The information is based on 2009 data. Tyrrell County’s number of health
care professionals per person is not favorable compared to North Carolina’s average number of
health care professionals per person.55
North Carolina Health Professions Data System
2009 Total and Primary Care Physician
County
Total
Physicians
Tyrrell
0
Total
Primary
Care
0
Family
Practice
General
Practice
Internal
Medicine
OB/GYN
Pediatrics
Other
Specialty
0
0
0
0
0
0
2009 Other Health Professionals
County
Chiropractors
Dentists
Dental
Hygienists
Occupational
Therapists
Tyrrell
0
0
0
0
County
Tyrrell
Registered
Nurses
11
Occupational
Therapy
Assists
0
Optometrists
Pharmacists
Podiatrists
Psychologists
Physical
Therapists
0
2
0
0
0
2009 Nurses
Certified Nurse
Midwives
0
Nurse
Practitioners
1
Licensed
Practical Nurses
1
Tyrrell County is very needy when it comes to health care and health care providers. Most of the
residents in Tyrrell County have to travel a far distance to meet their health care needs or go to a
hospital. The following hospitals are utilized by Tyrrell County residents.
Chowan County Hospital, located in Edenton, NC 30 miles northeast of Columbia, offers a wide
range of services and healthcare specialties to Tyrrell County residents. The hospital has 71
acute-care and 40 skilled care beds. The hospital provides intensive care service, a surgical
center, an emergency department, a specialty care clinic, and a dedicated outpatient surgery area
with endoscopy capabilities. Chowan Hospital is affiliated with the University Health Systems
54
Tyrrell County Department of Social Services. Available at: http://www.ncvan.org/directory/tyrrell/TyrrellCountyDeptofSocialServices /
55
Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, North Carolina
Health Professions Data System. Annual Profiles: 2009, 2009 Health Care Professionals – State and County Totals.
Available at http://www.shepscenter.unc.edu/hp/prof09.htm.
Tyrrell County Community Health Assessment 2010
39
of Eastern North Carolina. This partnership provides access to state-of-the-art services offered
by top notch academic center. Following are some of the services provided at the facility,
Maternity Care Home Care Radiology, including CT nuclear screening, ultrasound,
mammography, mobile MRI and bone density screening Telemedicine, providing consultation
with specialists at other locations Rehabilitation, inpatient and outpatient Cardiopulmonary
rehabilitation Wellness screenings and education and skilled nursing unit.
Washington County Hospital, located in Plymouth, NC, 35 miles west of Columbia, is a 49-bed
JCAHO-accredited critical access facility. The hospital offers a full range of inpatient and
outpatient services, a 24-hour emergency department, and hospital based and operated
ambulance department, family practice, laboratory, radiology department, pharmacy,
cardiopulmonary services, complete surgery facilities, telemedicine, and physical therapy.
Other emergency medical services are also provided to Tyrrell County residents at both the Dare
County Hospital and the Pitt County Memorial Hospital, located in Greenville, NC. Both of
these hospitals are more than 60 miles away from Columbia.
Access to Care
Adults
The following graphs compare the percentage of adults in Eastern North Carolina, North
Carolina, and the United States who are insured versus uninsured. The tables below depict
insurance status among all adults compared to adults age 18-64. Eastern North Carolina’s
percent of all adults insured is 73.4% compared to 22.2% for Eastern North Carolina’s adults age
18-64. Among the groups compared Eastern North Carolina has the highest percent adults
uninsured and the United States has the lowest percent of adults uninsured. 56 About 71% of
individuals in NC and Eastern North Carolina reported they could not see a doctor in the past 12
months due to cost.57
Health Care Access
Eastern North Carolina (ENC), North Carolina (NC), United States
2009
All Adults
Adults 18-64
56
North Carolina Division of Public Health, State Center for Health Statistics. Behavioral Risk Factor Surveillance
System (BRFSS) Calendar Year 2009 Results. Available at http://www.schs.state.nc.us/SCHS/brfss/2009/.
57
Centers for Disease Control, National Center for Chronic Disease and Prevention and Health Promotion.
Behavioral Risk Factor Surveillance System (BRFSS), Prevalence Data, Nationwide (States and DC) – 2009.
Available at http://apps.nccd.cdc.gov/brfss/page.asp?cat=HA&yr=2009&state=UB#HA.
Tyrrell County Community Health Assessment 2010
40
Regarding access to dental care, the majority of Tyrrell County adults reported it had been
greater than 12 months since they had their teeth cleaned by a dental hygienist. Nearly 50%
reported they had one or more teeth removed because of tooth decay or gum disease.58 There are
no dentists practicing in Tyrrell County. Only the MTW pediatric dental facility in Plymouth
accepts patients with Medicaid in the 30 mile radius around Columbia.
Access to Care
Children
In Tyrrell County, there are approximately 823 children ages less than 21 enrolled in Medicaid
according to the Division of Medical Assistance. Approximately half of Tyrrell County children
ages birth – 21 are enrolled in Medicaid.59
North Carolina Health Choice for Children extends health care coverage to children whose
family income exceeds Medicaid eligibility criteria. There is an income eligibility that must be
met, but it is less stringent that Medicaid eligibility requirements. In Tyrrell County, 83 children
under age 19 are enrolled in Health Choice as of November 2009.
Mental Health
Albemarle Gap Analysis – Mental Health60
East Carolina Behavioral Health (ECBH) is a local Management Entity designated by the NC
Division of Mental Health, Development Disabilities and Substance Abuse Services to oversee
the appropriate provision of state and federally funded services and supports. ECBH manages a
local benefit to assist with the multiple challenges of managing services while containing cost.
East Carolina Behavioral Health does not provide direct services. The mission is to work in
partnership with people who face significant challenges related to substance abuse, mental
illness, and/or developmental disability. Their commitment is to provide consistently excellent,
person-centered, family-oriented services within a recovery based system that is flexible,
accessible, and respects the individual’s freedom of choice. A person can access services by
contacting the Access to Care Line at 1-877-685-2415. The Access to Care line is staffed by
clinical professionals who provide triage, screening and referrals to providers throughout the
ECBH area. Emergency assistance is provided 24-hours daily, 365 days a year.
East Carolina Behavioral Health Serves the following counties: •Beaufort •Bertie •Camden
•Chowan •Craven •Currituck •Dare •Gates •Hertford •Hyde •Jones •Martin •Northampton
•Pamlico •Pasquotank •Perquimans •Pitt •Tyrrell and •Washington. It coordinates mental health,
58
North Carolina Division of Public Health, State Center for Health Statistics. Behavioral Risk Factor Surveillance
System (BRFSS) Calendar Year 2009 Results. Available at http://www.schs.staate.nc.us/SCHS/brfss/2009/.
59
North Carolina Department of Health and Human Services, Division of Medical Assistance. Authorized Title
XIX Eligible Less Than Age 21.
60
East Carolina Behavioral Health, Albemarle Gap Analysis. Available at:
http://www.ecbhlme.org/UserFiles/Files/Needs%20Assessment/AlbemarleGapAnalysisFinal10.
Tyrrell County Community Health Assessment 2010
41
developmental disability and substance abuse services for children and adults of four counties in
the Roanoke-Chowan region, including mental health counseling, emergency services including
a 24-hour crisis hotline, a day program for adults with mental illness, community and schoolbased education and prevention programs, a child development center, early childhood
intervention, a program for developmentally disabled adults, a program for mentally retarded or
disabled adults, a detoxification and residential treatment center and outpatient counseling and
treatment for DWI offenders. (Information from Roanoke-Chowan Human Services. Accessible
at:
http://www.dhhs.state.nc.us/mhddsas/lmedirectory.htm and accessed July 2010).
http://www.ecbhlme.org/UserFiles/Files/Needs%20Assessment/AlbemarleGapAnalysisFinal10.
http://dexknows.com/business_profiles/east_carolina_behavioral_health/
Emerging Issues
Tyrrell County Teen Pregnancy
More the 19,000 North Carolinians between the ages of 10 and 19 get pregnant each year –
giving the 9th highest teen pregnancy rate in the nation. And while our rates have improved over
the past two decades, we cannot deny the profound effect that pregnancy has on communities,
future generations and the teens themselves.
The answer to “Why do teens get pregnant?” can seem so simple – after all, we all know how
babies are made. But both significant research and common sense tell us that the answer to that
question is much more complicated. Education, socio-economic status, future opportunities,
how a teen relates to parents or peers, and self-esteem only scratches the surface of the risk
factors for teen pregnancy.
Preventing teen pregnancy requires a multi-pronged approach. Schools, community groups,
parents, doctors, educators, legislators, and teens themselves must all be involved to give teens a
chance for a healthier future.61
North Carolina’s teen pregnancy rate fell to a record low in 2009. Teenage girls ages 15-19 in
North Carolina had fewer pregnancies in 2009 than in 2008. The new data, compiled by the NC
Department of Health and Human Services (NC DHHS), shows that 56 out of every 1,000 teen
girls ages 15 to 19 became pregnant in 2009. The new rate reflects a 4.4% decrease from the
2008 rate of 58.6 per 1,000 girls.
Although we are seeing a drop in the teen pregnancy rate in North Carolina, Tyrrell County
ranks number one in the state for teen pregnancies ages 15-19 for 2008 and 2009. Tyrrell county
had 12 pregnancies in 2009 with a rate of 116.7 per 1,000 population compared to the States rate
of 56.0 per 1,000 population. White teen pregnancies numbers ages 15-19 are 8 with a rate of
210.5 compared to North Carolina’s rate of 46.4. African American teen pregnancies ages 15-19
are 4 with an non-reportable rate. (Rates based on fewer than 20 cases are statistically unreliable
61
Adolescent Pregnancy Prevention Coalition of North Carolina. Available at http://appcnc.org/teen-health-in-nc
Tyrrell County Community Health Assessment 2010
42
and are not presented here).
population of 6 teens.62
Hispanic teen pregnancies cases ages 15-19 are 3 out of a
When asked what the community could do to solve this health problem the interviewees
suggested increasing preventive care programs and efforts to educate the community as well as
teens and parents about teen pregnancy and other risk factors associated with having unprotected
sex. They also recommended improving access to health services and doing a better job about
getting health information out to the community. Increased funding was also a need.
The listening group’s members expressed concern that there are few employment opportunities
and recreation facilities for the youth in Tyrrell County. They think the youth are bored and not
under watchful supervision and this leads to teens having unprotected sex.
The listening groups were informed that North Carolina public school students will benefit from
the new Healthy Youth Act that started this year. The law requires schools to provide 7th, 8th and
9th graders with medically accurate information on STD prevention, pregnancy prevention and
health relationships. The listening groups suggested that maybe we could follow other counties
such as Lee and Davidson Counties where they have started coalitions that teach pregnancy
prevention strategies to high risk teens or peer education programs. These coalitions would be
established within different communities and not the schools.
Review of Primary Data
In the summer and fall of 2010, Tyrrell County Health Department and the Tyrrell County
Community Health Assessment Team conducted a Listening Group Questionnaire for the
purpose of soliciting the community’s input to identify the major health concerns for Tyrrell
County, as well as suggestions for actions the community can take to improve these areas of
concern. The questionnaire was available in both English and Spanish. (See Appendix for a
copy). It was not the intent of this questionnaire to collect prevalence data for Tyrrell County.
The data available from the Behavior Risk Factor Surveillance System was used to analyze the
prevalence of many health conditions and health behaviors in Tyrrell County. Mortality and
prevalence data were reviewed in an earlier section of this report.
The questionnaires were made available to listening group members from different communities
within Tyrrell County. Health Department Staff, with assistance from some volunteers,
administered the questionnaire to different listening groups, recorded the listening group’s
responses and also documented their responses. Health Department staff coordinated 10 listening
groups that included key leaders in the County including elected officials within all of the
municipalities, the School Principles, the Chamber of Commerce, the director of Tyrrell County
Cooperative Extension, local business leaders, faith community and citizens of Tyrrell County
from all socio-economic groups.
62
Adolescent Pregnancy Prevention Coalition of North Carolina. Available at http://appcnc.org/teen-health-in-nc
Tyrrell County Community Health Assessment 2010
43
Listening Group Summary – English and Hispanic Groups63
The listening group’s demographics consisted of 48 Caucasian American Women, 31 African
American Women, 12 Hispanic/Latino American Women, 6 Hispanic/Latino American Men, 5
Caucasian Males, and 10 African American Men totaling 112 participants.
A summary of the findings can be found below. The top five issues listed as a serious problem
are provided for each section. A summary of the demographics and additional information is
also provided. The entire results of the listening groups can be found in the appendix.
Key Findings
Top responses per questions:
1.
What do you like best about living in Tyrrell County?
 Close knit/family oriented
 Quiet/helpful/friendly
 Great place to raise children and water access
 Wildlife/hunting, rural/farming/small/quaint/needs are met
 Picturesque
2.
What do you like least about living in Tyrrell County?
 Limited health care/distance/isolated community
 No jobs
 No recreation
 Limited shopping
 Water and sewage need
 Lack of privacy/gossip
 No entertainment/activities for adults
3.
Do many in your organization/church have health insurance?
 50% responded yes
 40% responded no
 10% responded yes with limited coverage
 Overall consensus was that most children have Medicaid and most seniors have
Medicare.
4.
What percentage of people in Tyrrell County do you think have health insurance?
 Each listening group gave a different percentage.
 Majority responded that 65 and up of the population have Medicare, children 18
and under have Medicaid.
63
Tyrrell County Health Department and Tyrrell County Community Health Assessment Team 2010. Result
compiled and analyzed by Health Education Team of Martin-Tyrrell-Washington District Health Department.
Tyrrell County Community Health Assessment 2010
44

Majority responded that people ages 25-55 were least likely to have insurance and
if they worked they did not have insurance due to type of work such as seasonal
work or employment that does not offer insurance coverage.
5.
What are the health problems in Tyrrell County?
 Chronic Diseases (Cancer, Heart Disease, Stroke, Diabetes, High Blood Pressure)
 Obesity
 Asthma
 Dementia
 Sexually Transmitted Diseases (STDs)
 Teen Pregnancy
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Education
 Recreational Facility
 Exercise
 Elected officials providing needed resources instead of what they think needs to
be provided or offered
 Water and environmental improvements
 Support groups/increase of resources
7.
Would you use a fitness center if there was one in Tyrrell County?
 9 out 10 listening group sessions had an unanimous yes but fitness center would
have to be affordable, in a good location and with extended business hours
 1 out of 10 listening group sessions felt that some would use it but not all because
some people did not like change
8.
What keeps people from being healthy in Tyrrell County?
 Poor choice of food/cost/quality
 Attitudes/traditions
 Lack of health care facilities
 Education
 Low esteem/depression/drugs
9.
What do you think would remove these barriers?
 Education
 Transportation Assistance
 Better health care facilities
 More shopping options
 More affordable health food options
Tyrrell County Community Health Assessment 2010
45
In addition to inquiring about what people considered to be the major health problems for Tyrrell
County, participants were asked to identify the three behaviors (among adults and among
children) that concerned them the most. The results are as follows:
Top concerns: Adult Behaviors
Top Concerns: Youth Behaviors
Not enough physical activity
Alcohol abuse
Drinking and Driving
Tobacco Use
Illegal Drug Use
Unprotected sex/teen pregnancy
Illegal drug use
Alcohol Use
Not enough physical activity/no resources
Tobacco use
Finally, listening group participants were asked to identify other issues they felt affected health.
More than 50% of the respondents identified the following: Crime, Gangs, Youth Violence and
Illegal Drug Use (possession and selling).
Summary and Next Steps
The priorities for 2010 – 2014 were selected based upon a review of the data and input from the
community. The priorities are as follows:






Chronic Diseases (Cancer, Heart Disease, Diabetes, Stroke)
Obesity (Child & Adult)
Dental Health
Access to Health Care
Communicable Diseases(HIV/AIDS/STDs)
Teen Pregnancy
Subcommittees formed by the Tyrrell County Community Health Assessment Team and the
Tyrrell County Health Department around each of the priority areas are in the process of
reviewing the information from the assessment to guide them in the development of action plans.
It is apparent from the review of the data that disparities either by sex and/or race exist for many
of the health priorities identified. This information should be used by the committees to
determine priority for the interventions that are proposed.
Though not reviewed in this report, another portion of the community assessment asked people
for their suggestions of actions that can be taken to address the priority areas they had identified.
These action plans will be shared with the subcommittee chairs for the purpose of developing
action plans consistent with the assessment findings. Additionally, results from the Hispanic
listening group will be shared with the Hispanic/Latino Health Coalition which currently is not a
part of the Tyrrell County Community Assessment Group. The input from the Coalition will be
sought to ensure that action plan strategies targeting the Hispanic/Latino population are
culturally appropriate. Opportunities to strengthen partnerships will certainly be explored
through this process.
Tyrrell County Community Health Assessment 2010
46
Action plans, using the template provided by the Office of Health Carolinians, will be due to the
Tyrrell County Community Health Assessment Team and Tyrrell County Health Department by
June 2011.
This report will be available to the public on the Health Department’s website at
www.mtwdistricthealth.org. Additionally, presentations and a summary of the document will be
prepared and printed for dissemination to the Tyrrell County Board of Commissioners and other
elected officials within the county, as well as the community as large. A press release will be
provided to the media announcing the findings of the assessment and availability of this
document. Simultaneous with all dissemination efforts will be recruitment of new members to
the Tyrrell County Community Health Assessment Team.
Tyrrell County Community Health Assessment 2010
47
Acknowledgements
The development of the 2010 Tyrrell County Community Health Assessment document is a
shared responsibility between Martin-Tyrrell-Washington District Health Department and the
Tyrrell County Community Health Assessment Team. Both organizations would like to
acknowledge the contributions made by many individuals and organizations throughout the
County, as well as assistance from regional and state partners. Most of all, Martin-TyrrellWashington District Health Department and the Tyrrell County Community Health Assessment
Team is extremely grateful to the people within the County who participated in the Community
Health Assessment listening groups providing invaluable information regarding what concerned
them the most and proposed action steps to make Tyrrell County a healthier community.
Tyrrell County
Tyrrell County Commissioners
Tyrrell County Register of Deeds
Tyrrell County Emergency Management
Tyrrell County Department of Social Services
Tyrrell County Senior Center
Tyrrell and Washington County Smart Start
Tyrrell County Schools
Tyrrell County Chamber of Commerce
Roanoke Home Care & Hospice
Martin-Tyrrell-Washington District Health Department Staff
Tyrrell County Cooperative Extension
Tyrrell County Library
Tyrrell County USDA
All Souls Catholic Church Interpreter
Tyrrell County Health Department Interpreter Staff
North Carolina State Center for Health Statistics
Tyrrell County Faith Communities
Tyrrell County Local Businesses
Tyrrell County Civic Groups
Tyrrell County Community Members
The Scuppernong Reminder
Tyrrell County Community Health Assessment 2010
48
Appendix
Tyrrell County Community Health Assessment 2010
49
Tyrrell County 2010 Listening Group Dialogue Tool
Introduction: Good morning/afternoon/evening. My name is ________________________ and
I work for Martin-Tyrrell-Washington District Health Department (MTW) as a Health Educator.
I am collecting data for our state mandated Community Health Assessment that is required every
four years. The assessment determines the health status of Tyrrell county’s communities,
identifies resources needed to address health and social problems, and provides a plan to improve
the health status of Tyrrell County.
You are being asked to participate because you are a valued citizen of Tyrrell County and I need
your knowledge and input about Tyrrell County’s health status.
This interview should take approximately one and a half hours. You are free to refuse to answer
any of these questions. Your name will not be written on this questionnaire, and we will keep
the data we collect confidential. We will not release any identifying information in connection
with these results.
Thank you for your participation in this project.
Questions
1.
What do you like best about living in Tyrrell County?
2.
What do you like least about living in Tyrrell County?
3.
How many people in your organization/church have health insurance?
4.
What percent of people in Tyrrell County do you think have health insurance?
5.
What are the health problems in Tyrrell County?
6.
What are some things you think could be done to prevent the health problems mentioned?
7.
Would you use a fitness center if there was one in Tyrrell County?
8.
What keeps people from being healthy?
9.
What do you think would remove these barriers?
Tyrrell County Community Health Assessment 2010
50
2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: June 20, 2010
Interviewer: Laurie Spencer
Church/Organization: Cedar Grove Methodist Church
Community: Gum Neck
Demographics: 6 Caucasian Women, 2 Caucasian Males, 1 African American Male
1.
What do you like best about living in Tyrrell County?
 Close knit family environment
 Total family atmosphere – each helping others
 Rich soil – how it provides employment opportunities and resources
 Quiet neighborhood
 Great place to raise children
 Tyrrell County has a good drug store
 God’s country
 Hunting – not wasting the animals, use the meat for food instead of just killing the
animal for the sport
2.
What do you like least about living in Tyrrell County?
 Wal-Mart not close to us however it would change our environment
 Not many opportunities for the youth to return to their home town after their
educational experiences are complete
 Not any physicians – must travel out of town
 Takes 20 minutes just to get to town (Columbia)
 Getting medicines refilled – would be great to have a courier service from the drug
store.
 Trying to get meds refilled at one time due to insurance time frames and when/how
the doctor writes the prescriptions.
 Get job for a youth or retired individual to courier the meds to people
 Educate the community to ask their physicians so people can tell their physician
about these issues
 Tyrrell County does not provide transportation for some such as Senior Citizens in
Gum Neck
 Educate the people about the services available in Tyrrell County
 Maybe we need to our contact emergency manager about sending out messages to
citizens of Tyrrell County which is a way to educate, inform everyone about issues.
Monthly phone messages with updated information about the Tyrrell County services
that are available on health would be absolutely wonderful
 Cell tower service is weak in Gum Neck. Maybe US Cellular could put a tower up at
Cherry Farms which is closer to Gum Neck
 Internet service for Gum Neck (Hughes Net) outlines a region that does not have
access to these services. Need the internet services so individuals can educate
themselves, research important health concerns
Tyrrell County Community Health Assessment 2010
51
3.
Do many in your organization/church have health insurance?
 Fortunately 100% in this church have insurance
 Gum Neck community approximately 25% of people are insured
4.
What % of people in Tyrrell County do you think have health insurance?
 Probably about 25%
 Discussed how those with no insurance do not have to pay the full amount, they cut
the bill by 50%. Those with insurance make of the difference
 Insurance eats you alive, but you need to have it in order to see a physician or go to
the hospital
 Discussed the new health care plans
5.
What are the health problems in Tyrrell County?
 Diabetes – root to a lot of diseases
 Obesity
 Heart Disease
 Cancer – can it be prevented? Yes, but due to other complications. Other stated NO
HIV
 Asthma and allergies – may be caused by the environment, the moisture in our
climate
 Nurse in the community stated there are more diabetes, heart disease and asthma in
Tyrrell County
6.
What are some things you think could be done to prevent the health problems
mentioned?
 EDUCATION, EDUCATION, EDUCATION
 We have to reach out to others. Gum Neck community feels that they are left out of
some important issues and concerns in the county
 Homebound people need to reached
 Depends on what type of people and their environment they live in regarding the kind
of answers you get. Need to reach other people
 These other people we are talking about have additions. Drug abuse is a disease. It is
because the children see it and the cycle continues. These people do not appreciate
health insurance. They need to step out this environment. The children see what
their parents are doing so they say and think it is okay for them if their parents do it.
 I asked “how do you reach out to these people?”
o Many stated their lives are unmanageable. Sometimes it is not to get to the
drug addicts but to get to the people who can stop this cycle, such as the
sellers. The younger generation needs to be educated in schools, churches,
everywhere. Then they need to have the courage and strength to talk, reach
out to their parents. The church can help. School educators can help – give
advice on the way these dress etc. Most important it takes the parent – the
parent needs to have themselves healthy and together in order to set an
example. It must start at home.
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7.
Would you use a fitness center it there was one in Tyrrell County?
 Yes
 Great for the children
 Create Jobs
 Would help some with their health issues for improvement
 It would need to be open 24 hours
 Once had a farmer who donated land for recreation department, however, the town
managers/planners in Tyrrell County refused this opportunity. Other issues such as
insurance coverage etc. to this. Probably needed grant monies but did not give the
residents a chance to work of this wonderful ideas.
8.
What keeps people from being healthy in Tyrrell County?
 Lack of education
 Lack of information
 Lack of willpower
 Lack of facility
 Need more physicians/nurses to educate us
 Education
 Addictions to drugs, alcohol – but these people need to hit rock bottom before they
will seek help usually.
9.
What do you think it would take to remove these barriers?
 EDUCATION, EDUCATION, EDUCATION
 Getting more health educators out in the community to help our people!!!!
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: June 29, 2010
Interviewer: Laurie Spencer, Erica Payton
Church/Organization: Tyrrell County Health Department Staff
Community: Columbia
Demographics: 7 Caucasian Females, 1 Hispanic Female, 1 African American Female,
1 Caucasian Male
1.
What do you like best about living in Tyrrell County?
 Natural resources available – water all around for job opportunities and entertainment
 Quiet
 ½ mile from your neighbor
 Interesting road names as conversation piece
 Each community is a different place, but comes together in unity – interlinking
communities
 Large acreage but small population
 Close family environment even if they are not blood related
 Drug store
 Quaint little places to visit
 Food Lion
 Great schools with great technology
 Great library
 Multiple churches
 Public Health Department and Medical Center
2.
What do you like least about living in Tyrrell County?
 Distance to travel to shop and go to doctors/comparative shopping
 Transportation for all
 No hospital
 No Nursing Home
 Access to specialty care
 Only one day care
 Gossip
 High speed internet is an issue
 Water supply access – county water is not available for all areas, must use well
 Sewage issues – canals, drainage, wetness especially in the Alligator community
 Property value is affected by sewage issues
 Drainage issues for property owners
3.
How many people in your organization/church do think has health insurance?
 100%
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4.
What percent of people in Tyrrell Count do you think have health insurance?
 10%
 About 40% with Medicaid
 Overall with Medicare and Medicaid about 80%
 The big job opportunities have health insurance
 Many have access to it but they cannot afford it
5.
What are the health problems in Tyrrell County?
 Diabetes – root to a lot of diseases
 Cancer
 STDs
 High Blood Pressure
 Drug abuse
o Why: Access to all ages
o Fitness classes
o Lifestyles
o Heredity
o Needs a nutrition program
o No recreational facilities
o Water – drinking water safety issues
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Gym
 Recreational facilities
 Something to get up and get moving
 Someone/something to encourage people
 An incentive program – EDUCATION
 Need something for working people
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes – depends on cost, where it will be located, and how it will be managed
 Needs to have nutrition program or nutritionist
 Great for the children and all ages
 Create jobs
 Health create a healthier county
 Needs to open 24 hours
 A spa feature would be good
 Needs to have massage therapy offered
 Would draw other people into our communities such as Creswell
 Need to find some grants to address this issue
8.
What keeps people from being healthy in Tyrrell County?
 Laziness
 Overworked
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

9.
Depression
Stress
Choices in what they spend on foods
What do you think would remove these barriers?
 EDUCATION, EDUCATION
 Teamwork
 Social marketing – make it fun
 Relaxing
 Keep it simple
 Location of health educated facilities
 Transportation
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: July 13, 2010
Interviewer: Laurie Spencer, Billie Patrick
Church/Organization: Soundside Missionary Baptist Church
Community: Soundside
Demographics: 13 Caucasian Females, 1 African American Female
1.
What do you like best about living in Tyrrell County?
 Small Community
 Family Feeling
 Water and openness of area
 Water provides jobs
 Environment – have green space
 Not much traffic
 One-on-one community. Know most people
 Culture diversity – favorite time is Christmas
 Culture opportunities
 Lots to do in Tyrrell County
 Drive down the road and people wave
 Feel safer in Tyrrell County than in a bigger city
 Love the wildlife – woodpeckers, humming birds, red wolves, deer, cows, horses
 Can see stars at night
 Everyone know everyone – can get help from others
2.
What do you like least about living in Tyrrell County?
 Do not like that our young have to leave the county because of few jobs
 Don’t have hospital due to older people not near for them. Grown children are have
concerns for their parents health and welfare
 Lack of internet services
 Lack of cell phone towers
 One negative – we have to convince people to get stuff in Tyrrell County. For
instance, the new Food Lion, we had to jump through hoops to get a larger grocery
store in our area
 Sewer system – big issue
 Lack of good restaurants
 Rent is too high on buildings in town to start business and sustain that business
3.
Do many people in your organization/church have health insurance?
 Yes – majority of the people in our church have insurance of some kind
4.
What percent of people in Tyrrell County do you think have health insurance?
 50% of people in county are insured
5.
What are the health problems in Tyrrell County?
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



Cancer
Heart Disease
High Blood Pressure
Diabetes
Obesity – especially in the children
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Increase in exercise habits
 Elected officials need to offer more resources for county other than money makers
 Need more resources such as a place to go for physical activity, basketball, volleyball,
etc. Something like a YMCA
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes most definitely but need to be conscious of the cost
 Silo effect
8.
What keeps people from being healthy?
 Technology
 Convenience
 Cost
 Don’t want to change our way of living
9.
What do you think would remove these barriers?
 Communication is a big problem
 Transportation
 Jobs
 Money
 Education
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: September 18, 2010
Interviewer: Laurie Spencer, Billie Patrick
Church/Organization: All Soul’s Catholic Church
Community: Columbia
Demographics: 11 Hispanic/Latino Females, 5 Hispanic/Latino Males
1.
What do you like best about living in Tyrrell County?
 Nice town and friendly people
 Surrounded by water
 Like the housing in the county
 Quiet, peaceful
 Health Department services
 Good schools
 Good place for children to live
2.
What do you like least about living in Tyrrell County?
 No recreation, activities for kids
 Limited resources
 No transportation
 No hospital, doctors
 No place to go dancing
 Have to travel to other counties to get supplies
 Gossip
 Don’t like the way law enforcement look at Hispanic, Think we commit the
crimes
 High crime rate
3.
Do many people in your church/organization have health insurance?
 No. Limited insurance coverage – those covered would be those with children
who get Medicaid. Most of our people work seasonal work and have no
insurance
4.
What percent of people in Tyrrell County do you think has health insurance?
 30%
 The Hispanics in Tyrrell County do not have insurance. If we get sick and cannot
go to the doctor because we do not have the money to go.
5.
What are the health problems in Tyrrell County?
 Diabetes
 Asthma
 High Blood Pressure
 Obesity (Adults and Children)
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



Heart Problems
Cancer
Allergies
Substance Abuse
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Have a place to for exercising and dancing
 Diet
 Stop Smoking
 Affordable healthy foods likes vegetables and fruits
 Have doctors in the county
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes – would like place to go dancing more. Our cultural loves to dance and that
is how we keep moving and exercise
 Somewhere to that does not cost money
8.
What keeps people from being healthy?
 Lack of education
 Drugs, alcohol
 Attitude
 Need more doctors, health care facilities like an urgent care
 Tradition/culture
9.
What do you think would remove these barriers?
 Education
 Work with Health Educators in the community
 Transportation for doctors’ appointments, shopping, etc.
 Keep it simple and not be expensive (FREE)
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: 10-14-2010
Interviewer: Erica Payton
Church/Organization: Tyrrell County Community Health Team
Community: Columbia
Demographics: 6 Caucasian Females, 4 African American Females, 2 Caucasian Males,
2 African American Males
1. What do you like best about living in Tyrrell County?
 Near water
 Rural farm land
 Familiarity/home
 Safe, peace and quiet
 Wide open spaces
 Close knit, strong support system
 Picturesque
 Good communication
2. What do you like least about living in Tyrrell County?
 Not a lot of health facilities,
 Not a lot of places for elderly care
 Not a lot of job opportunities
 Lack of privacy
 No gym or fitness center
 Not a lot f recreation
 Too far to travel to reach resources
 Elderly and shut in population isolated
 Not enough shopping opportunities
 Sewage problems
3. Do many in your organization/church have health insurance?
 Most do – covered through Medicare or Medicaid – (MAP- Office of Rural
Health) Segment without insurance includes the 20 – 30 working age groups
4. What percentage of people in Tyrrell County do you think have health insurance?
 ¾ or 75%
5. What are the health problems in Tyrrell County?
 Cancer – all kinds
 Obesity
 Alzheimer’s/dementia
 Diabetes
 Asthma
 Heart problems
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6. What are some things you think could be done to prevent the health problems
mentioned?
 Improve water quality – farmland and failing septic
 Low socioeconomic status +
 Lack of transportation = low rate of regular doctor visits
 Healthier food choices – poor food choices/quality related to low socioeconomic
status
 Mold reduction to prevent asthma
 Increased opportunities for physical activities
7. Would you use a fitness center if there was one in Tyrrell County?
 Yes- fitness center needs to be affordable with extended business hours
8. What keeps us from being healthy?
 Cost
 Family tradition, food culture
 Laziness
 Education
 Depression and loneliness
 Lack of community participation (community engagement)
 Fast food/microwavable
9. What do you think would remove these barriers?
 Jobs and money
 Support groups
 Education, parental education (teen parents)
 Affordable and healthy food options
 More shopping/store options
 Develop healthy habits
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: October 18, 2010
Interviewer: Erica Payton, Lynette Romero
Church/Organization: Zion Grove Church
Community: Columbia
Demographics: 14 African-American Women, 3 African American Males
1.
What do you like best about living in Tyrrell County?
 Helpful and supporting people
 Small community
 Good School System
 Peace and Quiet
 Shared concerns within the community
 Close-knit, loving people
 Pretty and near water
 Friendly people
2.
What do you like least about living in Tyrrell County?
 No recreation, activities for kids
 Limited resources
 Increase poverty
 No sewage/poor infrastructure
 Increased flooding
 Substance abuse
 Inadequate housing
 Healthcare Needs
 Increased substance abuse
 Increased Crime
 Too far to travel to stores, restaurants, doctors
 High unemployment
 Increased teen pregnancy
3.
Do many in your organization/church have health insurance?
 Limited insurance coverage – those covered would be those with Medicare and
Medicaid. Most people work seasonal work and have no insurance.
4.
What percent of people in Tyrrell County do you think have health insurance?
 Would say 50% covered but decrease in adult population such as ages 25 – 55.
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5.
What are the health problems in Tyrrell County?
 Diabetes
 Asthma
 Depression
 High Blood Pressure
 Obesity (Adults and Children)
 Heart Problems
 Cancer
 Allergies
 Arthritis
 Dementia
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Education
 Diet
 Exercise
 Vitamin Supplements
 Better Air Quality/Environmental Health
 Better drainage (below sea level)
 Better land usage (priority on the people instead of wildlife)
 Stop Smoking
 Affordable healthy foods (vegetables, fruits)
 Stronger health care system
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes – need fitness center like YMCA. Something affordable that people of Tyrrell
County could use.
8.
What keeps people from being healthy?
 Poor food choices and quality. Less expensive/Fast food
 Nowhere to exercise. Decreased options (have to worry about animals, road, cars)
 Attitude – Apathy
 Increased usage of electronic such as TV, Games, etc.
 Tradition/Culture
 Decreased Health Education and Services. Need a Dietician.
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9.
What do you think would remove these barriers?
 Better shopping options
 Parental education
 Transportation (Doctor appointment/shopping)
 Elected officials – to know and act upon
 Self-motivation
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: October 21, 2010
Interviewer: Erica Payton, Lynette Romero
Church/Organization: Salem Missionary Baptist Church
Community: Columbia
Demographics: 15 African-American Women, 6 African American Males
1.
What do you like best about living in Tyrrell County?
 Helpful and supporting people
 Small community
 Good School System
 Peace and Quiet
 Shared concerns within the community
 Close-knit, loving people
 Pretty and near water
 Friendly people
2.
What do you like least about living in Tyrrell County?
 No recreation, activities for kids
 Limited resources
 Increase poverty
 No sewage/poor infrastructure
 Increased flooding
 Substance abuse
 Inadequate housing
 Healthcare Needs
 Increased substance abuse
 Increased Crime
 Too far to travel to stores, restaurants, doctors
 High unemployment
 Increased teen pregnancy
3.
Do many in your organization/church have health insurance?
 Limited insurance coverage – those covered would be those with Medicare and
Medicaid. Most people work seasonal work and have no insurance.
4.
What percent of people in Tyrrell County do you think have health insurance?
 Would say 50% covered but decrease in adult population such as ages 25 – 55.
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5.
What are the health problems in Tyrrell County?
 Diabetes
 Asthma
 Depression
 High Blood Pressure
 Obesity (Adults and Children)
 Heart Problems
 Cancer
 Allergies
 Arthritis
 Dementia
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Education
 Diet
 Exercise
 Vitamin Supplements
 Better Air Quality/Environmental Health
 Better drainage (below sea level)
 Better land usage (priority on the people instead of wildlife)
 Stop Smoking
 Affordable healthy foods (vegetables, fruits)
 Stronger health care system
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes – need fitness center like YMCA. Something affordable that people of Tyrrell
County could use.
8.
What keeps people from being healthy?
 Poor food choices and quality. Less expensive/Fast food
 Nowhere to exercise. Decreased options (have to worry about animals, road, cars)
 Attitude – Apathy
 Increased usage of electronic such as TV, Games, etc.
 Tradition/Culture
 Decreased Health Education and Services. Need a Dietician.
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9.
What do you think would remove these barriers?
 Better shopping options
 Parental education
 Transportation (Doctor appointment/shopping)
 Elected officials – to know and act upon
 Self-motivation
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: October 25, 2010
Interviewer: Erica Payton
Organization/Church: Tyrrell County Senior Center
Community: Columbia
Demographics: 8 Caucasian Females, 9 African American Females, 6 African
American Males
1. What do you like best about living in Tyrrell County?
 People
 Transportation through senior center
 Born and raised in Tyrrell County
 Hunting, fishing, farming, gardening
 Nice and quiet, peaceful
 Home
 Family
2. What do you like least about living in Tyrrell County?
 No Wal-Mart
 No shopping or places to eat
 No jobs
 Prices continue to go up because there is no competition
 40 miles to get to the nearest hospital
 Poor emergency care
3. Do many in your organization/church have health insurance?
 Most do within the senior population – 65 and up have medicare
4. What percentage of people in Tyrrell County do you think have health insurance?
 90% of the senior population
5. What are the health problems in Tyrrell County?
 Cancer
 Diabetes
 Heart Disease
 Mental Health
 Depression
6. What are some things you think could be done to prevent the health problems
mentioned?
 Better medical care
 Take care of your body while you are young
 Eating healthy
 Exercising
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7. Would you use a fitness center if there was one in Tyrrell County?
 No, nobody uses the equipment at the Senior Center
 People don’t like change
 Kids (younger population) may use it
8. What keeps us from being healthy?
 Ditches, canals, sewage, septic, outskirts of Tyrrell County left out
 Nothing for you to do
 The way we live – eating habits
 Smoking
 Wild women, alcohol, chewing tobacco
9. What do you think would remove these barriers?
 Better medical care
 Money/funds
 Jobs
 Less expensive food
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2010 Listening Group Question and Responses
1.
2.
3.
4.
5.
Date: October 26, 2010
Interviewer: Lynette Romero
Organization/Church: Tyrrell County Health Advisory Committee and School Staff
Community: Columbia, Tyrrell County
Demographics: 7 Caucasian Females, 8 African American Females
1.
What do you like best about living in Tyrrell County?
 Water Recreation
 Quiet, Peaceful
 Safe and Supportive
 Nice People
 Picturesque, helpful people
 Low crime
 Clean air
 Low traffic
 Great place to raise kids
 Grow foods/farming/gardening
 Safe neighborhoods
 SECU/banking
2.
What do you like the least about living in Tyrrell County?
 Limited shopping
 Lack of privacy
 Limited entertainment
 Little culture or arts
 No organized recreation
 No Wal-Mart
 No hospital
 Limited restaurants
 No health care
 Few jobs
 Kids leave the county due to limited opportunities
 Water Quality
 No higher education
3.
Do many in your organization/church have health insurance?
 No not everyone in the school system has health insurance
 Estimate about 60% have insurance
4.
What percent of people in Tyrrell County do you think have health insurance?
 About 40%
 Children and older people have insurance; covered by Medicare or Medicaid
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5.
What are the health problems in Tyrrell County?
 Diabetes
 Heart Disease
 Cancer
 High Blood Pressure
 ADHD
 Asthma
 Obesity
 Alcohol/Substance Abuse
 Arthritis
 Stress
 Stroke
 Renal Failure
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Education
 Organized recreation
 Support Groups
 Change habits – portion control, healthy eating
 Sedentary lifestyle
 Lack of awareness
 Stop smoking
 Activities to reduce stress
 Laugh more
 Drink more water instead of beverages
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes, but needs to be affordable and friendly to full-figure people
8.
What keeps people from being healthy?
 Too busy to eat healthy food – convenient to eat fast food
 Life stressors
 Lack of money
 Laziness
 Low self-esteem
 Time
 Lack of healthy food choices/shopping
 Healthier ways to cook
 Depression
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9.
What do you think would remove these barriers?
 Better jobs/pay
 Be educated on opportunities
 Parent education
 Learning to budget
 Nutritional assistance and better food choices
 Change cultural habits
 Combat drugs/alcohol
 Accountability
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2010 Listening Group Questions and Responses
1.
2.
3.
4.
5.
Date: November 2, 2010
Interviewer: Erica Payton, Billie Patrick
Organization/Church: Alligator Chapel Church
Community: Alligator
Demographics: 12 African American Females, 5 African American Males
1.
What do you like best about living in Tyrrell County?
 Peaceful
 Nice and caring people
 Good school system
 Friendly people
 People will help each other out when needed
 Good place to raise children
 Safe neighborhoods
 Water
 Wildlife, hunting
2.
What do you like the least about living Tyrrell County?
 Sewage/poor infrastructure, drainage, water standing everywhere
 Mosquitoes, smells awful
 No recreation, activities for kids
 No hospital
 No doctors – have to travel so far to see a doctor or specialist
 Healthcare needs
 Too far to travel to stores, limited shopping in Columbia
 Few jobs/no health insurance
 Increased teen pregnancy
 Inadequate housing
3.
Do many people in your organization/church have health insurance?
 Limited numbers do – mainly the children have Medicaid and the seniors have
Medicare. If you are between the ages of 24 – 60, most do not have health insurance
or limited insurance. A lot of people work seasonally and have jobs that do not health
insurance.
4.
What percent of people in Tyrrell County do you think have health insurance?
 About 50%
5.
What are the health problems in Tyrrell County?
 Heart Disease
 Cancer
 Diabetes
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








Stroke
Arthritis
Allergies
Dementia
High Blood Pressure
Prostate Cancer
Obesity (Children and Adults)
Depression
Asthma
6.
What are some things you think could be done to prevent the health problems
mentioned?
 Education
 Diet
 More Exercise
 Better Environment in Alligator. Too much mold, mildew. Need sewage system here
 Affordable healthy foods
 Stop smoking, drinking, using drugs
 Better health care system
 Need a doctor in this county
7.
Would you use a fitness center if there was one in Tyrrell County?
 Yes but it would need to be in this area because most people do not have any
transportation
 No probably would cost too much
8.
What keeps people from being healthy?
 Poor food choices and quality
 Culture and tradition
 Attitude
 No money
 Uneducated about healthy foods
 Cost too much
9.
What do you think would remove these barriers?
 Better health care – doctors, nurses, hospital
 Education
 Transportation
 Motivation
 Get moving more
 Eat better
 Support groups
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