Behavioral and Mental Health Analysis

 Data Source: NC Alcohol Data Dashboard, NC Injury and Violence Prevention Branch 

Understanding alcohol use within service counties provides community health members the knowledge of where programs and preventative measures need to be placed.

Alcohol use impacts numerous aspects of an individual's life; from health, relationships, employment, and income, excessive alcohol use can cause detrimental effects. Understanding patterns of alcohol use within the Western Youth Network's service counties provide greater awareness of what counties need services to aid those negatively affected by alcohol use. While the current situations during this global COVID-19 pandemic are changing numerous daily life aspects, understanding previous alcohol use patterns can aid in knowing where possible greater use can occur.

The Alcohol Use data provided by the North Carolina Injury and Prevention Violence Branch consists of 2017 data that includes alcohol use related data variables that are illustrated in the maps below.

To view and explore the map, select the map to view the map larger. A legend will appear in the bottom left corner of the map. Select any county to view additional data information.

From the latest data available, there is a count of the number of alcohol-related deaths for each service county.

Based on the data source, if the count is less than 10 it is to be interpreted with caution.

The map below indicates the number of alcohol-related deaths. Understanding patterns of alcohol-use can prevent further increases in death numbers. The North Carolina Injury and Prevention Branch (NCIPB) of the North Carolina Department of Health and Human Services indicates alcohol-use is a concern for the whole community as much as it affects the individual. The NCIPB explains "alcohol-related deaths have been trending upwards", indicating that it is a concern across the state. Evaluating alcohol use is pertinent in providing support for a healthy community.

The rates provided in the map below are per 100,000 people.

As a note, the map below also provides the total population value within the information pop-up when selecting a county. Use this to compare the rate and population values.

Although there are more counties with lower alcohol-related death counts, with alcohol-related death rates, Avery and Alleghany counties have higher death rates although the death counts are lower than some of the surrounding counties. This should be noted as well as knowing rates show a different spatial or geographic pattern as it is calculated based on 100,000 people. Between the two maps, Wilkes County has a high alcohol-related death count and rate that should be noted.

Understanding patterns in alcohol-use is important as it shows where communities are needing help in moderating and controlling use. By illustrating and understanding alcohol intoxication by emergency room visits, it shows where communities are experiencing detrimental effects of alcohol-use that is risking an individual's life.

The map provided indicates the number of emergency room visits (of all ages) within each service county.

By looking at data for those under the ages of 21, it shows where youth use of alcohol is prevalent. This map shows where communities are experiencing increasing youth alcohol use.

From NC Injury and Prevention Branch, data has been collected from the North Carolina Department of Transportation on vehicle crashes. As alcohol use increases, there is a greater risk for injury, especially when operating a vehicle.

As the infographics above from NCIPB inform, there are more fatal vehicle crashes involving alcohol than the total number of vehicle crashes. With that, it is necessary to understand the geographic pattern of fatal crashes involving alcohol in the service counties. The map provided shows the data related to this.

Note that the count of alcohol-related crashes is a 5-year rate.

Rates are calculated per 100,000 people

As alcohol-related crashes have a higher chance of being a fatal vehicle crash, it is necessary to know the rate and pattern of these crashes across the service counties.

Note that the rate of alcohol-related crashes are a 5-year rate.

This map illustrates the spatial pattern of fatal crashes, not necessarily involving alcohol, to show as a comparison and illustration to other maps provided above.

Note that the count of fatal crashes are a 5-year rate.

As important as it is to know the spatial patterns of alcohol use within the service counties, it just as necessary to know where individuals are accessing alcohol. Outlets indicate locations where alcohol is available for purchase and consumption.

The Maximum Outlet Rate, from NCIPB, is the highest density rate of any Census tract in a county. For the service counties of WYN, the Maximum Outlet Rate is then looking at the highest density rate of the counties' Census tract at a county level. The map below shows the geographic pattern of the Maximum Outlet Rate.

Off-Premise outlets are those locations where individuals purchase alcohol to consume elsewhere. These can include grocery stores, liquor stores, gas stations, and big-box stores. (NCIPB)

The map provided shows the spatial distribution of Off-Premise Outlets by the count of these types of locations for each county.

On-Premise outlets include locations where individuals purchase alcohol and consume on-site. These locations include restaurants, bars, and cafes. (NCIPBThe map provided shows the spatial distribution of On-Premise Outlets by the count of these types of locations for each county.

This map shows the count of total outlets, on- and off-premise outlets.

It is important to note the total number of outlets that provide communities with alcohol access.

 Data Source: Centers for Disease Control (CDC), National Center for Health Statistics (NCHS) 

To ensure a healthy community, it is important to evaluate substance use or substance misuse. As a component of substance use, the maps above evaluate alcohol use, and the maps below present opioid use within the service counties. Opioid use is another component of substance use that is relevant and prevalent, and for evaluating the service counties' health, it involves exploring the spatial patterns of opioid use.

From the CDC, the National Center for Health Statistics provides (NCHS) of Opioid Use by looking at Drug Poisoning. The model-based death rates, as explained on the  CDC, NCHS page , are 1) evaluating deaths per 100,000 people, and 2) using Bayesian statistical methods (CDC). Bayesian statistics is a theory of statistics that explores probability.

"[H]ierarchical Bayesian models with spatial and temporal random effects were used to generate estimates of county-level crude death rates due to drug poisoning for each year. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size" (CDC).

The rates calculated by the CDC to provide a balanced estimated death rate to benefit when data is sparse due to smaller population values.

For comparison, the map provided uses the same statistical measures by the CDC as it is a continuation of the opioid data from the NCHS for the year 2016.

The map provided uses the same statistical measures by the CDC as it is a continuation of the opioid data from the NCHS for the year 2015.

Continuation of the opioid data for the year 2014.

Continuation of the opioid data for the year 2013.

The death rates from drug poisoning, thus opioid use, vary from the years 2013 to 2017. In 2013, the highest death rates were in Wilkes, Ashe, and Avery Counties. 2014 showed lower death rates in Avery County and Ashe County, but increasing rates in Alleghany County; Wilkes County death rates continued to increase. Avery, Ashe, Alleghany, and Watauga Counties had increasing death rates in 2015, whereas there was a slight decrease in Wilkes County. All counties experienced increased death rates in 2016. In 2017, there was an improvement in Avery, Watauga, and Wilkes Counties as the death rates decreased. Ashe and Alleghany experienced slight increases in death rates in 2017. By knowing and being able to compare the visually the death rates, it provides a picture of the impact of opioid use in the service counties. By being able to know how opioid use is affecting the community health of these counties, measures and initiatives can begin and continue use.

Data Source:  NC Alcohol Data Dashboard, NC Injury and Violence Prevention Branch 

The NCIPB indicates that alcohol use increases the risk of suicide. The map below provides a count of suicides that, when tested, involved alcohol. Data provided consists of 10-year rates from 2007 to 2016. Each county contains a count that shows a geographic pattern of how alcohol is involved with the mental health of each community. Understanding the mental health of each county, decreasing the risk of suicide in individuals, is just as important as knowing alcohol use. As the maps below illustrate, there is a correlation between alcohol use and suicide. The maps above illustrate alcohol use within the service counties, and by knowing that it can help in knowing where to allocate resources to help those with substance use and mental health conditions.

As with the other rates provided, this rate is based on population, per 100,000 people. As with the map above, this data set is a 10-year rate.

Data Source: North Carolina VDRS

Mental health is a crucial aspect to consider for any community. For the service counties of WYN, mental health is a vital initiative that is used to evaluate other health aspects. Negative mental health can increase the risk of suicide. The maps below provide a spatial aspect of the cases of suicide for the service counties of WYN.

As the map provides a visual of, Wilkes and Ashe counties, these counties experienced more cases of suicide than the surrounding neighboring counties.

Comparing 2016 cases to 2015, Ashe County experienced an increased number of cases in 2016. 2016 presented a fewer number of cases than 2015 for service counties, except Ashe County.

Avery, Ashe, Watauga, and Wilkes Counties experienced fewer cases of suicide in 2015 than in 2014. Alleghany County had fewer cases in 2014 than in 2015.

In 2013, there were fewer cases of suicide in Avery, Alleghany, Watauga, and Wilkes Counties. Ashe County experienced more cases of suicide than in 2014.

In 2012, there were fewer cases of suicide in Watauga, Ashe, Alleghany, and Wilkes Counties. Avery County experience more cases of suicide in 2012 than in 2013.

a picture of the mental health status of the service counties. Wilkes County in nearly every year experienced a high number of cases every year; the highest of all counties each year. While Wilkes may have had some years where the number of cases decreased, Wilkes still experienced the highest number of cases from 2012 to 2016. Ashe and Watauga Counties also had increased suicide cases throughout these five years. There were a few years where the case count increased for Avery and Alleghany Counties, but the number of cases was lower for these counties than the other service counties.

The table below provides the data in another format.