Saturday, October 1, 2022

$1.5M over 3 years: Federal grant could fund new county division to fight health inequities

The county is hoping to be awarded a federal grant to create a health equity division within its health and human services department, to be located at 1507 Greenfield St., also the home of the Pandemic Operations Center. (Courtesy/New Hanover County)

NEW HANOVER COUNTY — “The pandemic shined a light on the inequities and disparities within historically marginalized populations here in New Hanover County,” county equity coordinator Fawn Rhodes told Port City Daily.

So much so, two years ago commissioners called it a public health crisis “to be treated with urgency” and signed a resolution to prioritize the reduction of racial inequities. On Monday, the board unanimously decided to commit grant funds, if allocated, for the creation of a new division in its public health department.

READ MORE: Resolution to declare racism a ‘public health crisis’ heads to New Hanover County Commissioners

“The Health Equity Division is a continuation of efforts that began during the pandemic,” Rhodes said. 

Hired at the beginning of 2022, Rhodes — who would also lead the division — submitted the grant July 15. If awarded, the county could receive up to $500,000 for three years, $1.5 million in total. $135,000 would go toward operating costs and $1.1 million for salaries and benefits of four positions. 

Nearing the third year, NHCHHS would reevaluate the effectiveness of the program and identify possible state funding sources for continued sustainability.

Rhodes told commissioners at the meeting that local underserved communities — those with low-income who are uninsured or under-insured — experience higher rates of “chronic illness, epigenetic trauma, morbidity, mortality and violence in their communities.” She explained the history of trauma is a “result of systemic and structural racism.”

According to the county’s grant application, historical events have played a role in the continued disparities. It noted that between 1860 and 1900, including the time period the Wilmington Massacre of 1898 occurred, Black Americans represented 55% of New Hanover County’s population of 81,366. Following the murder of between 60 and 300 Black Wilmingtonians in 1898, more than 2,000 Black individuals fled the county. By 1920, New Hanover County’s Black population had dropped to 10%.

As of 2020, the county’s population is 231,448, with 13% identifying as Black or African American. Of the local Black population, 34% live in poverty and 11.6% are uninsured.

The application also references a 2008 study conducted by The State Center for Health Statistics and Office of Minority Health and Health Disparities that found, “the largest health disparities, in which Black Americans death rate is at least twice that of whites, are in diabetes, kidney disease, HIV and homicide.”

The Hispanic population also face high levels of inequities due to “language barriers, illiteracy, and undocumented status,” Rhodes reported in the application. “Like Black Americans the Hispanic community has a high prevalence of chronic illness, poverty, food insecurity and affordable housing issues.”

Over the last several decades, research has indicated major inequities stem from unequal access to healthcare and lack of insurance, according to the New England Journal of Medicine. 

The goal of the county’s new division is to reduce health polarities by 10% in five years by implementing initiatives, programs and policies. To do so, New Hanover County will increase collaboration with community partners, including Food Bank of North Carolina, Nourish NC, Coastal Horizons, Leading into New Communities (LINC) and the Wilmington Housing Authority.

Rhodes outlined to commissioners the team aims to gain renewal of trust, while reducing barriers — such as access to transportation or childcare, associated finances and even “fear” about going to the doctor.

“Men at age 50 know they should start getting annual physicals but they put it off, put it off, put it off,” Wilmington Housing Authority executive director Tyrone Garrett said. 

The health equity division plans to send its team to visit individuals in their neighborhoods or homes, within specific zip codes — 28401 through 28412, 28428, 28429, 28449 and 28480 — identified by Cape Fear Healthnet and assess individuals’ needs. A nurse would perform basic medical assessments, educate on nutrition and refer clients to one of three providers: Cape Fear Health Clinic, Dawson Med and Med North.

The division would consist of three employees, in addition to Rhodes supervising; there would be two community health equity workers (one Spanish-speaking) and a nurse. The initiative would be housed at the New Hanover County Pandemic Operations Center, 1507 Greenfield St. 

Cape Fear Health Net would also send an enrollment specialist along with the new team to help eligible individuals sign up for health insurance and be aware of available resources.

“The outcomes we hope to receive are to ensure ease of access,” Rhodes explained. “And to hire more employees in public health that are representative of the communities we serve.” 

To do this, the new division staff will refer up to seven clients a week to services offered throughout the county’s health department — such as reproductive health, general nutrition and even employment services. 

Rhodes said, if the grant is greenlit, she will utilize funds to begin recruiting for the open positions in October, launch training through the end of the year and open offices in January 2023. She also plans to develop a “robust media and marketing campaign” and establish a presence at events, conferences and summits to disseminate information.

“Anything to allow families to get care they should have, and some don’t even know they should have, is great,” Garrett said. “I’m welcoming it; anything that can be done on our side to avail our residents of opportunities for care, we’ll partner with the county to do.”

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