Community health cannot be fully understood without considering the health of the individuals that make up that community and social and environmental health indicators. The Moncure/Haywood community in rural Southeastern Chatham County was examined through Community Diagnosis, a process that integrates quantitative and qualitative data to create a picture of the social, political, psychological, environmental and physical health of communities. Our findings create this document that may provide a tool to help the community in future organizing and developing endeavors. Four students from the Department of Health Behavior and Health Education at the University of North Carolina's School of Public Health were assigned the task of exploring the community health of Moncure/Haywood as a learning experience. The four students, Shelly Harris, Kevin Harrell, Katie McIntire, and Dawn Rogers, worked within the community from September 1998 until May 1999, compiling data and interacting with Moncure/Haywood community members with the assistance of a preceptor, Margaret Pollard, the Chatham County Commissioner. The community diagnosis process attempts to understand the community from an insider's perspective. In order to attain this perspective, the methodology acknowledges that health status cannot be determined by statistics alone. Community Diagnosis examines the strengths and resources available to a community while examining the needs and weaknesses. A simultaneous examination may result in matching needs with already available assets and preventing overlap and duplication of services. This document provides a starting point for community members to address needs and use available resources. The project began in the Fall of 1998 with the secondary data collection regarding the general and social health of the community. Statistics gathered include morbidity and mortality, economic and demographic information, and historical and cultural information. Due to the lack of specific data on Moncure/Haywood, information was collected from the 1990 United States Census for the block group that includes Moncure/Haywood. Chatham County statistics were used when block group level data was not available. These data were compared to county and state statistics as well as to government health goals. Sources for secondary data include Log Into North Carolina (LINC), United States Census of 1990, Chatham Community Health Improvement Project (CCHIP), various state and county web sites, and agents within the local community. The qualitative data collection process began simultaneously. Community windshield tours and informal interviews at local gathering spots provided a glimpse into the community life of Moncure/Haywood. One aspect of exploring and introducing ourselves to the community included attending church services and community events. Moncure/Haywood is rich in cultural and community resources, which aided our endeavor. The Moncure/Haywood community sits in the southeast corner of Chatham County bordered by the Deep and Haw Rivers and U.S. Highway One, which are vital resources for the community. Many towns are located within a fifteen-mile radius of the community including Pittsboro, Sanford and Apex. The Research Triangle Park, a major technical and research center, and Raleigh, the state capital, are within 30 miles. The residents of Moncure/Haywood enjoy a community with a long, rich history. Originally attracting farming settlers, Moncure/Haywood lured developers of railroad and industry due to the plentiful natural resources. Religion also played a major role in the development of the community and continues to be of great importance to community members. Moncure/Haywood is a small community with less than 1000 residents. The population is almost equally balanced between African-Americans and White, providing a more integrated feel to the community than other rural towns. The majority of community members own their homes and the unemployment rate is very low. Once a booming town, Moncure/Haywood is now a bedroom community that relies on local industries and larger towns for employment. Residents generally travel to neighboring towns for shopping and recreation. Elementary and middle school children attend Moncure Elementary, and the community’s high school age teens are bussed to Northwood High School in Pittsboro. Moncure/Haywood is unincorporated and has no formal governing body. As a result, all community decisions are made at the county level by elected county commissioners. The community has grappled with the issue of incorporation for many years. Although not all agree, most community members feel that incorporation would be good for the community because of increased access to services and the potential for further growth. Community members obtain health services from the Moncure Community Health Center as well as from providers in Pittsboro, Sanford, Chapel Hill and other neighboring towns. The community health center provides many services and many of the older community members utilize its services. Other services for the community include a mobile health unit, social services, and community organizations. Data collection also involved collecting qualitative data through interviews with community members and service providers. An interview guide was established providing a framework of questions and issues to be addressed with interviewees. Institutional Review Board approval was obtained, and interviews began in January 1999. Interviewees were recruited through the preceptor as well as through informal interviews at church services. Community members suggested other persons to interview that would help create a picture of Moncure/Haywood life. Twenty people were interviewed and emerging issues became apparent as to the assets and needs of Moncure/Haywood. Data from the interviews were and then coded and organized into chapters to demonstrate the concerns of the community. A synopsis of the data was presented to community members in a community meeting on March 20, 1999 in order to reflect our findings and to obtain feedback. The forum provided an avenue for new issues to emerge and to reach residents who had not been heard. The drug problem that has emerged within the past five years in Moncure/Haywood concerned almost every community member. The drug problem has led to increased crime in the community. Many felt that the drug problem is a direct result from the lack of recreation and youth activities for the community's children. With an increase in the number of juvenile arrests within the past five years, the secondary data support the problem among the community's youth. Some community members also felt that lack of police protection may contribute to this problem as well, but action has been taken to place a Chatham County Deputy within a satellite office in the community. Most residents see growth in Moncure/Haywood positively. Growth would increase the tax base and attract businesses to the area. Sanford has begun the construction of a regional airport within two miles of the community which may further development. Residents felt that more opportunities and an increase in services would benefit Moncure/Haywood. The need for the development of a sewer system in Moncure/Haywood would be exacerbated by growth in the community. Many residents expressed that a sewage system needed to be developed in the community in order to attract more businesses and developers. Many residents also felt that this may only be accomplished if the community was incorporated. The strong sense of community and community ties in Moncure/Haywood was heard throughout the interviews. Community members felt that in times of need the community would pull together and assist one another. Churches and relationships between neighbors provide a stable foundation for the community and often catalyze community organizing. These fundamental foundations make the community competent to approach the issues that concern the community and to derive solutions. There are several limitations to the community diagnosis process in Moncure/Haywood. A large portion of secondary data was collected from the 1990 census that may not represent the current population. Lack of data specific to Moncure/Haywood also limited the accuracy of secondary data. The referral process limited the accuracy of the qualitative data. Interviewees referred community members to us. Therefore, data collected may represent one side of community issues. Data may also have been limited by a lack of trust among community members. This community diagnosis process only allowed a limited amount of time to engage and get to know residents. This may have influenced the type of information they were willing to share with us. This Community Diagnosis identified the strengths and weaknesses of Moncure/Haywood. This process can provide community members with a starting place to address their needs and to aid in getting support or funding for potential services. By highlighting the resources already available to the community, community members can also examine what creative solutions may already exist and prioritize the issues at hand.Master of Public Healt
