The Rowan County Health Department’s Community Health Needs Assessment (CHNA) Steering Committee met again on Monday at St. John’s Lutheran Church to discuss the impacts of substance abuse, substandard housing and transportation on area residents’ health.

During the meeting, Community Health Manager and Health Rowan Executive Director Courtney Meece informed the committee that Rowan County was outpacing its statewide counterparts in collecting survey data. As of Monday, the health department had collected 360 surveys, representing 22.5 percent of the 1,600 goals. 

A link to the survey can be found in the online version of this article. 

Savanna Johnston, the Rowan County Public Health harm reduction coordinator was the first presenter and she delved into how substance use disorder can drastically alter lives.

“It impacts family members, neighbors and all the people they touch in their general circle,” Johnston said, adding that it “disproportionately impacts underserved populations.”

With the steering committee’s mission of addressing public health concerns, Johnston circled back to how substance use disorder, particularly prolonged substance use disorder can have negative health impacts. 

“(Drugs are) contributing factors to a lot of chronic diseases, mental health issues and our health and safety with law enforcement and community crime rates,” she said.

Diving into some numbers, Johnston said that there were 36 fentanyl positive deaths in Rowan County in year to date data for 2024. On the positive side, that number was down from 68 in the same time frame from the year before. 

“Most people don’t want fentanyl,” Johnston said. “But, dealers are pumping it in because it makes it stronger.”

Johnston said they are not just seeing fentanyl though. “Tranq” or xylazine, a veterinarian tranquilizer, has been observed as well. 

“We are cleaning out those wounds all the time,” she said. 

Helping people with substance use disorder get clean can positively impact their lives but it can also spare others who are often caught in the crossfire of drugs.

“If someone in your office is using drugs it not only affects them, it can affect the entire workplace,” Johnston said, adding, “Drug use is a big reason why families are separated. If we can cut down on it we can improve lives.”

Housing

Kyle Harris is the community development planner for Salisbury Community Development Corporation. 

“Housing is a deeply woven issue related to health,” he said, describing it as “a profound nexus between health and housing.”

Impacts to health from substandard housing conditions can be multi-pronged. For those with limited incomes, deferred maintenance projects can pile up, resulting in increased exposure to elemental and hazardous conditions. 

As an example, Harris pointed to old carpeting’s possible effects on respiratory issues. 

“We know health outcomes of the household are impacted,” Harris said. “If we ask them to put resources towards housing security something else has to give.”

That something else can often be medically related. As housing costs have increased, affordable housing has become less accessible. 

“Wages are rising in Rowan County but not fast enough to keep up with increase in housing costs,” he said, adding, “Buying power of potential new homeowners is decreasing.”

According to Harris, most of the increase has happened in the last five years. 

“I’m a renter,” he said. “I am dealing with this myself. I am considering getting a roommate.”

That’s what it boils down to for a lot of people. 

“You have to be creative or accept substandard housing conditions,” he said.

Oftentimes, the end result is moving away from centralized resources. Harris called it driving until you qualify. However, the farther you get away from population centers, the farther you get away from resources available, leading to living in food deserts and less accessible medical clinics.

 

Homelessness

A lot of what Harris talked about overlapped with Rowan Helping Ministries Executive Director Kyna Grubb’s presentation.

“Fourteen thousand households in Rowan County are cost-burdened,” she said. What that means is that the household spends more than 30 percent of its income on housing. That number is greater when factored for renters, with 46 percent of Rowan County renters being cost burdened. 

Last year in Rowan County, there were 1,830 eviction filings. Meanwhile, 164 households faced foreclosure. Those two components greatly increase homelessness rates. 

Breaking down what housing costs look like, Grubb explained that someone needs to make $51,000 a year to not be cost burdened by $1,285 rent. Many jobs, like teachers, childcare workers and firefighters, don’t make enough to get over that hump. Therefore, many of the people that Rowan County relies on to take care of and teach its children as well as manage emergency situations, don’t make enough to afford to live here. 

Rowan Helping Ministries does help a lot of people. Grubb said they served 714 individuals last year and engaged 218 unsheltered individuals through street outreach, connecting them to housing and services. Through the crisis assistance network, they also provided 973 households with rent and utility assistance to prevent homelessness in 2024.

Transportation

Salisbury Transit Director Rodney Harrison discussed how residents can get around with a personal vehicle. 

“Our mission is to provide a safe, efficient and affordable mobility alternative to the general public in Spencer, East Spencer and Salisbury, thus permitting greater accessibility to employment, social, recreational, educational and medical facilities,” Harrison said.

Salisbury Transit’s three fixed routes all connect at a central transfer point in downtown Salisbury on Depot Street and operate from 6 a.m. to 7:10 p.m. on weekdays. The base fare is $1 and half fare for senior citizens, persons with disabilities, Medicare card holders and students.

As an example of the routes, Route 1 travels from Food Lion on Mooresville Road to the YMCA, Employment Security Commission, Salisbury High School, Rowan-Cabarrus Community College, Kohl’s/Belk and the Salisbury Customer Service Center. 

Salisbury Transit also provides an American with Disabilities Act paratransit service for individuals with disabilities within Salisbury, Spencer and East Spencer for $2 per one-way trip. Riders must be certified through application processes and those rides must be scheduled in advance. 

Harrison pointed out multiple benefits to the transit system:

• Managing chronic conditions: With chronic illnesses increasingly being treated on an outpatient basis transit is key to good health care outcomes and far more economical than emergency ambulance trips. 
• Making dialysis possible: For many Americans on dialysis, transit is a life-sustaining service.
• Serving those who serve the nation: Transit is a vital connection for veterans and their families to VA clinics and facilities.

The affordability of Salisbury Transit puts those benefits within reach of even economically constrained families. It also puts them in a position with expanded employment opportunities.

As with the previous CHNA meetings, Monday’s showed how various complex social matters are interwoven and impact health related outcomes.

 

To take the survey, click https://survey.alchemer.com/s3/8162936/CCCC-Survey