Rowan County officials present 2025 community health needs assessment to Spencer aldermen

Courtney Meese, Community Health Manager for Rowan County Public Health and executive director of the Healthy Rowan coalition, presented key findings from the county's 2025 Community Health Needs Assessment (CHNA) during the Spencer Board of Aldermen pre-agenda meeting.

Meese said the CHNA combined 1,303 resident surveys collected between Feb. 19 and April 11 with focus groups and secondary data. "We collected 1,303 surveys from county residents," she said, adding that the sample is a convenience sample and has limits for subpopulation estimates. The steering committee used magnitude, seriousness and feasibility to rank priorities.

The assessment identified three top priority areas: behavioral health (combining mental-health and substance-use concerns), housing (affordable, accessible and safe housing) and healthy lifestyles (chronic-disease prevention, increased physical activity and access to affordable healthy food). Meese emphasized gaps in preventive care and workforce shortages: she cited about 35 primary-care providers per 100,000 residents and only 36 dentists per 100,000, with a small share accepting Medicaid.

Meese highlighted specific local challenges: a third-grade reading proficiency well under the Healthy North Carolina 2030 target (she cited a local rate near 30 percent versus an 80 percent target); food insecurity at roughly 16 percent countywide and 21.2 percent among children (2018'123); and higher-than-state-average rates of chronic disease and lower life expectancy in several communities. On substance use, she said Rowan had high overdose mortality in recent years but that local opioid-settlement work and the county HOPE team have reduced the county's ranking among worst-affected counties.

Board members asked about links between early-reading proficiency and later outcomes and how federal Medicaid changes might affect the county. Meese said national correlations exist between early reading and later outcomes but that local impacts are harder to quantify. On Medicaid changes, she said county public-health leadership is monitoring developments and that measurable effects are likely to appear over years rather than immediately.

Next steps, Meese said, include publishing an executive summary and full CHNA report (the report is due in March), public presentations to municipalities and stakeholders, setting up task forces, developing measurable action plans tied to the priorities and monitoring program implementation and outcomes. She encouraged board members to serve as "trusted messengers" when sharing findings with residents.