Martin-Tyrrell-Washington District Health Department

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

Table of Contents

Purpose………………………………………………………………………………………. / 4
Team Composition…………………………………………………………………………... / 4
Process Overview…………………………………………………………………………… / 4
Outcomes…………………………………………………………………………………….. / 5
Community Health Assessment Acknowledgements……………………………………….. / 6
CountyOverview……………………………………………………………………………. / 8
Demographics
Population Estimates……………………………………………………………………... / 12
Age Distribution………………………………………………………………………….. / 13
Race and Ethnicity……………………………………………………………………….. / 13
Education…………………………………………………………………………………….. / 14
Economic Characteristics
Poverty…………………………………………………………………………………… / 15
Employment……………………………………………………………………………… / 15
Agriculture……………………………………………………………………………….. / 16
Transportation……………………………………………………………………………. / 16
Community Health Status
Community Health Ranking MATCH…………………………………………………… / 18
Peer Counties…………………………………………………………………………….. / 18
Leading Causes of Death
Heart Disease…………………………………………………………………………….. / 19
Cerebrovascular Disease (Stroke)………………………………………………………... / 20
Cancer……………………………………………………………………………………. / 21
Chronic Respiratory Diseases……………………………………………………………. / 23
Alzheimer’s Disease…………………………………………………………………….. / 23
Unintentional Injuries……………………………………………………………………. / 24
Motor Vehicle Injuries…………………………………………………………………… / 25
Diabetes…………………………………………………………………………………... / 25
Kidney Disease…………………………………………………………………………… / 25
Pneumonia and Influenza………………………………………………………………… / 26
Update on 2009 H1N1 and 2009-10 Seasonal Influenza Activity……………………….. / 27
Septicemia………………………………………………………………………………... / 28
Maternal and Child Health
Infant Mortality…………………………………………………………………………... / 29
Teen Pregnancy…………………………………………………………………………... / 29
Child Abuse and Death…………………………………………………………………... / 30
Child Overweight………………………………………………………………………… / 31
Other Health Statistics Data
Obesity and Physical Inactivity…………………………………………………………... / 32
Smoking………………………………………………………………………………….. / 32
Childhood Asthma……………………………………………………………………….. / 32
Communicable Diseases
HIV……………………………………………………………………………………….. / 33
AIDS……………………………………………………………………………………... / 33
Chlamydia………………………………………………………………………………... / 34
Gonorrhea………………………………………………………………………………… / 35
Syphilis…………………………………………………………………………………… / 35
Tuberculosis (TB)………………………………………………………………………... / 35
Vaccine Preventable Diseases……………………………………………………………. / 36
Environmental Health
Water Quality…………………………………………………………………………….. / 37
Air Quality……………………………………………………………………………….. / 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 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 TyrrellCounty. Once questions were developed for collecting information, committee members met to develop a listening group tool and determine areas within TyrrellCounty to hold the listening groups. All Soul’s Catholic Church assisted with the translation of the listening group tool and helped with translatingto the Hispanic groups in TyrrellCounty. 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 TyrrellCounty is small and that is why the health assessment team decided to take the best avenue of using listening groups in TyrrellCounty.

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 CecilG.ShepsCenter for Health Services Research at the University of North Carolina – Chapel Hill.

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 AssessmentTeam 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

Community Health Assessment Acknowledgements

The Tyrrell County Community Health Assessment Team included representatives from all areas of TyrrellCounty. 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

TyrrellCounty Commissioner

TyrrellCountyNC

Durwood Cooper, Jr.

Business Owner

Village Reality and Management Services Inc.

Dee Furlough

Cooperative Extension Agent

TyrrellCounty 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

ColumbiaHigh School

Sheila Cuminsky

Principal

TyrrellCountyElementary School

Cecelia Edge

Program Technician

Tyrrell County Farm Service Agency

USDA Service Center of Columbia

Melanie Armstrong

TyrrellCounty Courthouse

Faria White

Minister/Community Member

SalemMissionaryChurch

Samantha Combs

AlligatorChapelChurch

Community Member

Laurie Spencer

Retired School Teacher

TyrrellCounty 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

County Overview

TyrrellCounty…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 TyrrellCounty’s remarkable natural wealth.

And TyrrellCounty 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 AlbemarleCounty in 1739, all of its constituent precincts became counties. In 1774 the western part of TyrrellCounty was combined with part of Halifax County to form Martin County. In 1799 the western third of what was left of TyrrellCounty became Washington County. In 1870 the half of TyrrellCounty east of the Alligator River was combined with parts of CurrituckCounty 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 TyrrellCounty 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 PettigrewState Park.

The county seat of Columbia was laid off on the east side of the ScuppernongRiver 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 timberlands. In 1908, the Norfolk and Southern Railway extended its tracks to Columbia, but withdrew to Creswell in WashingtonCounty in 1948 (Davis 1963:62; Pezzoni 1994).

The remainder of TyrrellCounty 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, TyrrellCounty 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 ScuppernongRiver 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 HydeCounty 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, TyrrellCounty 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.

TyrrellCounty'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 TyrrellCounty’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, TyrrellCounty stands out as “the real thing”…genuine, down home, unpretentious. Visit Tyrrell County today and see for yourself.[1]

TyrrellCounty Government

TyrrellCounty 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:

Anthony (Tony) Sawyer
Gordon A. Deaver, Jr.
Thomas W. Spruill
Larry G. Hill
J. Fred Swain
Penny Rhodes Jones, Clerk to the Board

For more information about TyrrellCounty government, contact:

TyrrellCounty Administrative Office

108 S. Water Street

Columbia, NC27925

252.796.1371

TyrrellCounty Courthouse

403 Main Street

Columbia, NC27925

Clerk of Court – 252.796.6281

TyrrellCounty Board of Education

106 S. Water Street

Columbia, NC27925

252.796.1121

ColumbiaTown Government

Columbia is the county seat of TyrrellCounty and has an alderman-manager form of government. The following are the Town of Columbia Alderman, attorney and manager.

Mayor F. Michael Griffin
Alderman Ray Marner
Alderman Carl Willis
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:

ColumbiaTown Hall

103 Main Street

Columbia, NC27925

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, TyrrellCounty Commissioner

MartinCounty

Derek Price, Commissioner

Denise Edmondson, Registered Nurse

Robert M. Stalls, Public Member

Dr. Ben Shelton, Veterinarian

Ben Jones, Public Member

TyrrellCounty

Hannah Rogers, Public Member

WashingtonCounty

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 600square miles (1,555km²), of which, 390square miles (1,010km²) of it is land and 210square miles (545km²) 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. NCSUTyrrellCountyCenter 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, TyrrellCounty’s population is approximately 4,252. The population increased 2.48% from April 2000 to July 2009. Estimates through 2014indicate that the County’s population will continue to grow at an annual growth rate of 0.3%. There is only one incorporated town within TyrrellCounty which is Columbia. Columbia is the largest municipality with a 2009 estimated population of 855.[2]