Community Health Findings Haywood County Community Health Findings Prepared for WNC Healthy Impact By Professional Research Consultants, Inc.

Western North Carolina Counties

Methodology Telephone survey methodology Allows for high participation and random selection These are critical to achieving a sample representative of county and regional populations by gender, age, race/ ethnicity, income Landline (94%) and cell phone (6%) English and Spanish Note – PRC did get adequate representation of younger ages, which is always the biggest concern and a major reason for including cell phones.

Methodology 3,300 telephone surveys throughout WNC Adults 18+ Gathered data for each of 16 counties Weights were added to enhance representativeness of data at county and regional levels Note: Random sampling produces highly representative sample. However, some population groups (e.g., men, younger adults) tend to be underrepresented. To address this, PRC “weights” the raw data to improve representativeness (i.e., adjusts results to produce sample to more closely match demographic characteristics of population). Final survey is highly representative of counties in terms of geographic distribution and demographic characteristics

Methodology Full WNC sample allows for drill-down by: County Age Gender Race/ ethnicity (White, Black, Hispanic, Native American) Income (3 levels based on poverty status) Other categories, based on question responses Individual county samples allow for drill-down by Income (2 levels based on poverty status

Survey Instrument Based largely on national survey models When possible, question wording from public surveys (e.g., CDC BRFSS) 75 questions asked of all counties Each county added three county-specific questions Approximately 15-minute interviews Questions determined by WNC stakeholder input

Minimizing bias Potential bias Noncoverage error - Underrepresentation of people without phones Sampling error - Estimates based on only a sample Measurement error - Responses to questions may not be completely accurate due to question wording, interviewer’s tone, etc. Strategies to minimize bias Random selection Strict adherence to administration protocols Use of a tested survey instrument Automated CATI system (lessens risk of human error in data entry)

Keep in mind Sampling levels allow for good local confidence intervals, but you should still keep in mind that error rates are larger at the county level than for WNC as a region Results for WNC regional data have maximum error rate of +1.7% at the 95% confidence level Results for individual counties have maximum error rate of +6.9% at the 95% confidence level PRC indicates in regional report when differences – between county and regional results, different demographic groups, and 2012 to 2015 – are statistically significant

Keep in mind For more detailed information on methods, see: PRC’s Primary Data Collection: Research Approach & Methods document (2015) County-specific CH(N)A Templates

Expected Error Ranges for a Sample of 200 Respondents at the 95 Percent Level of Confidence Note: ● The "response rate" (the percentage of a population giving a particular response) determines the error rate associated with that response. A "95 percent level of confidence" indicates that responses would fall within the expected error range on 95 out of 100 trials. Examples: ● If 10% of the sample of 200 respondents answered a certain question with a "yes," it can be asserted that between 5.8% and 14.2% (10% ± 4.2%) of the total population would offer this response. ● If 50% of respondents said "yes," one could be certain with a 95 percent level of confidence that between 43.1% and 56.9% (50% ± 6.9%) of the total population would respond "yes" if asked this question.

Population & Sample Characteristics (Haywood County, 2015) Sources: ● 2015 Census Estimates/Projections. Geolytics, Inc. ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. Notes: ● Hispanics can be of any race. Other race categories are non-Hispanic categorizations (e.g., “White” reflects non-Hispanic White respondents).

Sample of Seasonal (Part-Time) Residents (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 102]

QUALITY OF LIFE

County is a “Fair/Poor” Place to Live (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 5] Notes: ● Asked of all respondents.

Top Three County Issues Perceived as in Most Need of Improvement (Haywood County, 2015)   Haywood WNC Economy/Unemployment  Nothing Road Maintenance/Safety Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 6] Notes: ● Asked of all respondents.

SELF-REPORTED HEALTH STATUS

Overall Health

Experience “Fair” or “Poor” Overall Health (Haywood County) % "Fair/Poor" Physical Health Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 7] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Limited in Activities in Some Way Due to a Physical, Mental, or Emotional Problem (Haywood County) % Activity Limitations Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 86] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Type of Problem That Limits Activities (Among Those Reporting Activity Limitations; Haywood County, 2015) % Activity Limitations Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 87] Notes: ● Asked of those respondents reporting activity limitations.

Caregiving

Provide Regular Care or Assistance to a Friend/Family Member Who Has a Health Problem or Disability (Haywood County) % Serve as a Caregiver to a Friend/Family Member Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 89] Notes: ● Asked of all respondents.

Mental Health & Mental Disorders

>7 Days of Poor Mental Health in the Past Month (Haywood County) % >7 Days of Poor Mental Health/Past Month Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 83] Notes: ● Asked of all respondents.

“Always” or “Usually” Get Needed Social/Emotional Support (“Always” and “Usually” Responses; Haywood County) % “Always/Usually” Get Needed Social/Emotional Support Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 82] Notes: ● Asked of all respondents.

Unable to Get Needed Mental Health Care or Counseling in the Past Year (Haywood County) % Unable to Obtain Needed Mental Health Svcs in Past Yr Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 84] Notes: ● Asked of all respondents.

Dissatisfied with Life (“Dissatisfied” and “Very Dissatisfied” Responses; Haywood County) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 81] Notes: ● Asked of all respondents.

CHRONIC CONDITIONS & INJURY

Cardiovascular Risk

Prevalence of Heart Disease (Haywood County, 2015) % Heart Disease (Heart Attack, Angina, Coronary Disease) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 24] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes diagnoses of heart attack, angina or coronary heart disease.

Prevalence of Stroke (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 25] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 North Carolina data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes diagnoses of heart attack, angina or coronary heart disease.

Have Had Blood Pressure Checked in the Past Two Years (Haywood County) Healthy People 2020 Target = 94.9% or Higher % Blood Pressure Checked in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 34] ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-4] Notes: ● Asked of all respondents.

Prevalence of High Blood Pressure (Haywood County) Healthy People 2020 Target = 26.9% or Lower % Blood Pressure Checked in Past 2 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 111] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-5.1] Notes: ● Asked of all respondents.

Taking Action to Control Hypertension (Among Adults with High Blood Pressure; Haywood County) % [HBP] Taking Action to Control High Blood Pressure Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 33] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of respondents who have been diagnosed with high blood pressure. ● In this case, the term “action” refers to medication, change in diet, and/or exercise.

Have Had Blood Cholesterol Levels Checked in the Past Five Years (Haywood County) Healthy People 2020 Target = 82.1% or Higher % Cholesterol Checked in Past 5 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 37] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-6] Notes: ● Asked of all respondents.

Prevalence of High Blood Cholesterol (Haywood County) Healthy People 2020 Target = 13.5% or Lower % Told Have High Cholesterol (Ever) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 112] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective HDS-7] Notes: ● Asked of all respondents.

Taking Action to Control High Blood Cholesterol (Among Adults with High Blood Cholesterol Levels; Haywood County) % [HBP] Taking Action to Control High Blood Cholesterol Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 36] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of respondents who have been diagnosed with high blood pressure. ● In this case, the term “action” refers to medication, change in diet, and/or exercise.

Falls

Have Fallen in the Past Year (Seniors Age 65+; Haywood County) % [Seniors 65+] Have Fallen in the Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 88] Notes: ● Asked of those respondents age 65+. ● Percentages outlined in red reflect sample sizes deemed unreliable (n<50).

Diabetes

Prevalence of Diabetes (Ever Diagnosed) (Haywood County) % Diabetes/High Blood Sugar % Borderline/Pre-Diabetes Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 28] ● PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. Notes: ● Asked of all respondents. ● Excludes gestational diabetes (occurring only during pregnancy).

Prevalence of Borderline or Pre-Diabetes (Haywood County) % Diabetes/High Blood Sugar % Borderline/Pre-Diabetes Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 28] ● PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Excludes gestational diabetes (occurring only during pregnancy).

Tested for Diabetes in the Past Three Years (Among Adults Not Diagnosed With Diabetes; Haywood County) % [Non-Diabetics] Tested for Diabetes in the Past 3 Years Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 29] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of respondents who have never been diagnosed with diabetes; also includes women who have only been diagnosed when pregnant.

Respiratory Conditions

Current Prevalence of Asthma (Haywood County, 2015) % Current Asthma Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 120] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 North Carolina data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes those who have ever been diagnosed with asthma and who report that they still have asthma.

Prevalence of Chronic Obstructive Pulmonary Disease (COPD) (Haywood County, 2015) % COPD (Lung Disease) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 23] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 North Carolina data. ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Includes those have ever suffered from or been diagnosed with COPD or chronic obstructive pulmonary disease, including bronchitis or emphysema.

MODIFIABLE HEALTH RISKS

Nutrition

Average Servings of Fruits in the Past Week (Haywood County) Average Servings of Vegetables in the Past Week Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 63] Notes: ● Asked of all respondents. ● For this issue, respondents were asked to recall their food intake during the previous week. Reflects 1-cup servings of fruits in the past week.

Average Servings of Vegetables in the Past Week (Haywood County) Average Servings of Fruits in the Past Week Average Servings of Vegetables in the Past Week Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 64] Notes: ● Asked of all respondents. ● For this issue, respondents were asked to recall their food intake during the previous week. Reflects 1-cup servings of vegetables in the past week, excluding lettuce salad and potatoes.

Level of Difficulty Accessing Fresh Produce at an Affordable Price (Haywood County) This is a REVISED version of an EXISTING slide Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 66] Notes: ● Asked of all respondents.

Physical Activity & Fitness

No Leisure-Time Physical Activity in the Past Month (Haywood County) Healthy People 2020 Target = 32.6% or Lower % No Leisure-Time Physical Activity Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 73] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective PA-1] Notes: ● Asked of all respondents.

Meets Physical Activity Recommendations (Haywood County) % Moderate Physical Activity % Vigorous Physical Activity % Meeting Physical Activity Guidelines % Strengthening Physical Activity Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 133] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● In this case the term “meets physical activity recommendations” refers to participation in moderate physical activity (exercise that produces only light sweating or a slight to moderate increase in breathing or heart rate ) at least 5 times a week for 30 minutes at a time, and/or vigorous physical activity (activities that cause heavy sweating or large increases in breathing or heart rate) at least 3 times a week for 20 minutes at a time.

Moderate Physical Activity (Haywood County) % Vigorous Physical Activity % Meeting Physical Activity Guidelines % Strengthening Physical Activity Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 134] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Moderate Physical Activity: Takes part in exercise that produces only light sweating or a slight to moderate increase in breathing or heart rate at least 5 times per week for at least 30 minutes per time.

Vigorous Physical Activity (Haywood County) % Moderate Physical Activity % Vigorous Physical Activity % Meeting Physical Activity Guidelines % Strengthening Physical Activity Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 135] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Vigorous Physical Activity: Takes part in activities that cause heavy sweating or large increases in breathing or heart rate at least 3 times per week for at least 20 minutes per time.

Strengthening Physical Activity (Haywood County) % Moderate Physical Activity % Vigorous Physical Activity % Meeting Physical Activity Guidelines % Strengthening Physical Activity Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 164] Notes: ● Asked of all respondents. ● Strengthening Physical Activity: Takes part in physical activities or exercises that strengthen muscles at least 2 times per week.

Believe It Is Important That Community Organizations Make Physical Activity Spaces Available for Public Use After Hours (“Very Important” and “Somewhat Important” Responses; Haywood County) % Feel Easier Access to Activity Spaces Is Important Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 77] Notes: ● Asked of all respondents.

Body Weight

Healthy Weight (Percent of Adults With a Body Mass Index Between 18 Healthy Weight (Percent of Adults With a Body Mass Index Between 18.5 and 24.9; Haywood County) Healthy People 2020 Target = 33.9% or Higher % Healthy Weight (BMI 18.5-24.9) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 137] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Based on reported heights and weights, asked of all respondents. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-8] ● The definition of healthy weight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), between 18.5 and 24.9.

Prevalence of Total Overweight (Overweight or Obese) (Percent of Overweight or/Obese Adults; Body Mass Index of 25.0 or Higher Haywood County) % Overweight Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 137] ● PRC National Health Surveys, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. Notes: ● Based on reported heights and weights, asked of all respondents. ● The definition of overweight is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 25.0, regardless of gender. The definition for obesity is a BMI greater than or equal to 30.0.

Prevalence of Obesity (Percent of Obese Adults; Body Mass Index of 30 Prevalence of Obesity (Percent of Obese Adults; Body Mass Index of 30.0 or Higher; Haywood County) Healthy People 2020 Target = 30.6% or Lower % Obese Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 137] ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective NWS-9] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. Notes: ● Based on reported heights and weights, asked of all respondents. ● The definition of obesity is having a body mass index (BMI), a ratio of weight to height (kilograms divided by meters squared), greater than or equal to 30.0, regardless of gender.

Substance Abuse

Current Drinkers (Haywood County) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 146] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Current drinkers had at least one alcoholic drink in the past month.

Chronic Drinkers (Haywood County) Sources: ● PRC Community Health Survey, Professional Research Consultants, Inc. [Item 147] ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents. ● Chronic drinkers are defined as having 60+ alcoholic drinks in the past month.

Binge Drinkers (Haywood County) Healthy People 2020 Target = 24 Binge Drinkers (Haywood County) Healthy People 2020 Target = 24.3% or Lower % Binge Drinker (Single Occasion - 5+ Drinks Men, 4+ Women) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 148] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-14.3] Notes: ● Asked of all respondents. ● Binge drinkers are defined as those consuming 5+ alcoholic drinks on any one occasion in the past 30 days; * note that state and national data reflect different thresholds for men (5+ drinks) and women (4+ drinks).

Excessive Drinkers (Haywood County, 2015) Healthy People 2020 Target = 25.4% or Lower Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 150] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective SA-15] Notes: ● Asked of all respondents. ● Excessive drinking reflects the number of persons aged 18 years and over who drank more than two drinks per day on average (for men) or more than one drink per day on average (for women) OR who drank 5 or more drinks during a single occasion (for men) or 4 or more drinks during a single occasion (for women) during the past 30 days.

Have Taken a Prescription Drug in the Past Month That Was Not Prescribed (Haywood County, 2015) % Prescription Drug Misuse in the Past Month Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 58] Notes: ● Asked of all respondents. ● Includes reported use of a prescription drug not prescribed to the respondent.

Have Ever Shared a Prescription Medication With Someone Else (Haywood County, 2015) % Have Shared a Prescription Medication Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 59] Notes: ● Asked of all respondents.

Tobacco Use

Current Smokers (Haywood County) Healthy People 2020 Target = 12 Current Smokers (Haywood County) Healthy People 2020 Target = 12.0% or Lower % Current Smoker Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 45] ● PRC National Health Surveys, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-1.1] Notes: ● Asked of all respondents. ● Includes regular and occasional smokers (everyday and some days).

Currently Use Smokeless Tobacco Products (Haywood County) Healthy People 2020 Target = 0.3% or Lower Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 46] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 North Carolina data. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective TU-1.2] Notes: ● Asked of all respondents. ● Includes regular and occasional users (everyday and some days).

Currently Use E-Cigarettes (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 47] Notes: ● Asked of all respondents. ● Electronic cigarettes (or e-cigarettes) are battery-operated devices that simulate traditional cigarette smoking, but do not involve the burning of tobacco. The cartridge or liquid "e-juice" used in these devices produces vapor and comes in a variety of flavors. ● Includes regular and occasional use (everyday and some days).

Have Breathed Someone Else’s Cigarette Smoke at Work in the Past Week (Among Employed Respondents; Haywood County) % [Employed] Breathed Smoke at Work in Past Week Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 49] Notes: ● Asked of employed respondents.

Believe It Is Important That Public Walking/Biking Trails Are 100% Tobacco-Free (“Strongly Agree” and “Agree” Responses; Haywood County) % Agree Parks and Trails Should Be 100% Tobacco-Free Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 50] Notes: ● Asked of all respondents. ● Includes “very important” and “somewhat important” responses.

ACCESS TO HEALTHCARE SERVICES

Health Insurance Coverage

Lack of Healthcare Insurance Coverage (Among Adults Age 18-64; Haywood County) Healthy People 2020 Target = 0.0% (Universal Coverage) % [Age 18-64] Lack Health Insurance Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 165] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-1] Notes: ● Reflects adults under the age of 65. ● Includes any type of insurance, such as traditional health insurance, prepaid plans such as HMOs, or government-sponsored coverage (e.g., Medicare, Medicaid, Indian Health Services, etc.).

Difficulties Accessing Healthcare Services

Was Unable to Get Needed Medical Care at Some Point in the Past Year (Haywood County) % Was Unable to Get Needed Medical Care in the Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 8] Notes: ● Asked of all respondents.

Healthcare Provider Has Helped to Connect With a Community Resource (Classes, Coaching) to Educate About Condition (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 39] Notes: ● Asked of those respondents who have been diagnosed with COPD, heart disease, stroke, asthma, diabetes/pre-diabetes, hypertension, and/or high blood cholesterol.

Primary Care Services

Have a Specific Source of Ongoing Medical Care (Haywood County, 2015) Healthy People 2020 Target = 95.0% or Higher Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 152] ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective AHS-5.1] Notes: ● Asked of all respondents.

Have Visited a Physician for a Checkup in the Past Year (Haywood County) % Have Had Routine Checkup in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 19] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. ● PRC National Health Surveys, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Preventive Screenings

Have Had a Mammogram in the Past Two Years (Among Women Age 50-74; Haywood County, 2015) Healthy People 2020 Target = 81.1% or Higher [All Ages] % [Women 50-74] Mammogram in Past 2 Years Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 115] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): 2013 North Carolina data. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective C-17] Notes: ● Reflects female respondents 50-74. ● *Note that state data reflects all women 50 and older (vs. women 50-74 in local, US, and Healthy People data).

Oral Health

Have Visited a Dentist or Dental Clinic Within the Past Year (Haywood County) Healthy People 2020 Target = 49.0% or Higher % [Age 18+] Dental Visit in Past Year Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 21] ● PRC National Health Surveys, Professional Research Consultants, Inc. ● US Department of Health and Human Services.  Healthy People 2020. December 2010. http://www.healthypeople.gov [Objective OH-7] ● Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC): North Carolina data. Notes: ● Asked of all respondents.

Vision Care

Had an Eye Exam in the Past Two Years During Which the Pupils Were Dilated (Haywood County, 2015) % Eye Exam in Past 2 Years Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 20] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Health Education & Outreach

Rely on Physicians for Most Healthcare Information (Haywood County, 2015) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 90] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Rely on the Internet for Most Healthcare Information (Haywood County, 2015) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 90] ● 2013 PRC National Health Survey, Professional Research Consultants, Inc. Notes: ● Asked of all respondents.

Advanced Directives

Have Completed Advance Directive Documents (Haywood County, 2015) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 104] Notes: ● Asked of all respondents.

Have Communicated Healthcare Decisions to Family or Doctor (Among Respondents With Advance Directive Documents; Haywood County) % Have Completed Advance Directive Documents Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 105] Notes: ● Asked of respondents with completed advance directive documents.

COUNTY-SPECIFIC QUESTIONS

“Considering cost, quality, number of options and availability, there is good access to healthcare in my county.” (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 14] Notes: ● Asked of all respondents.

“I believe my county provides the facilities and programs needed for children and youth to be physically active throughout the year.” (Haywood County) Sources: ● PRC Community Health Surveys, Professional Research Consultants, Inc. [Item 79] Notes: ● Asked of all respondents.

“I am usually able to get an appointment for the healthcare services I need when I need them.” (Haywood County, 2015) Sources: ● 2015 PRC Community Health Survey, Professional Research Consultants, Inc. [Item 15] Notes: ● Asked of all respondents.