Demographics
IncomeAnother important issue is health. Essential to life for Pittsboro teens, adolescent health and the goal of improving it are what initially brought us to the community. With the charges presented to us by Maria and the Chatham Coalition for Adolescent Health, we were given an adolescent focus within our assigned community and took that opportunity to discover all the factors that affect adolescents and their well-being. Thus, we see health demographic information as particularly important. The issues that we examined were drug use, leading causes of death, crime, and STDs and teen pregnancy. Like much of our secondary data, health information is measured at the county level. Thus, we apply this information to Pittsboro with caution. However, because a large number of students who live outside the city limits attend school and other functions in Pittsboro, or use its services and resources, we feel it is necessary to report the data.
According to the 2000 Chatham County Schools Alcohol and Other Drug Survey, drug use decreased in the county between 1999 and 2000. Although we cannot speculate that these data accurately reflect Pittsboro teens, we feel that they are worth examining since providers suggest that drugs impact teens across the county. While more specific results about drug use are outlined in Table 7, Appendix F, important conclusions will be discussed here.
The summary of findings from the survey reveals several points with regard to tobacco, alcohol, marijuana, inhalant, and other drug use among Chatham County teens. First, students tend to see tobacco as the most harmful of all the drugs, while they believe their friends and parents see marijuana as the most harmful. Second, the number of students who report they drink and drive dropped to its lowest level at 6%, while the number of students who report that they have ridden with someone intoxicated remained level, but at its lowest since 1990. Third, since 1998, early experimentation with alcohol, tobacco, marijuana, and inhalant use decreased among students who report drug use sixth grade or earlier. Except for experimentation with marijuana, which has remained level, this decrease among experimentation with drugs also holds true for this who report drug use eighth grade or earlier. A fourth finding is that lifetime and habitual use of all drugs decreased since 1998, with inhalant and tobacco use showing the most significant changes. Fifth, the use of drugs before and after school is down as is the number of students who believe that it is easy to get drugs at school. Finally, students are having a more difficult time buying cigarettes or alcohol at convenience stores.
Overall, it appears from these data that alcohol and drug use is declining in Chatham County. However, its presence still causes concern for community members and providers, leading us to assume that alcohol and drug use will continue to have a significant impact on Pittsboro adolescents.
Using the Health of Chatham 2000 provided by the Chatham County Health Improvement Project (CCHIP) we found that the Top 10 Causes of Premature Death in Chatham County from 1994-1998 were heart disease, cancer, stroke, motor vehicle and other unintended injuries, pneumonia and influenza, Chronic Obstructive Pulmonary Disease, diabetes, homicide, suicide, and Septicemia. A comparison of Chatham County to North Carolina shows that motor vehicle injury deaths are higher in Chatham County than in North Carolina. This could be explained by the fact that rural counties usually show higher motor vehicle deaths than urban counties. Chatham County did reach and surpass the goals of Healthy Carolinians 2000 to decrease mortality rates for heart disease, cancer, stroke, diabetes, and other injuries. Healthy Carolinians 2000 objectives were not met for chronic obstructive pulmonary disease and unintentional motor vehicle injuries. Accidents and injuries, especially motor vehicle injuries, are the highest risk for those under 20 years of age. This last fact is very important since there is such a reliance on motor vehicle transportation in the county, particularly among teens seeking entertainment and recreation outside of Pittsboro. Thus, the community's teens might be at particular risk, since they have to rely so much on car transport to get around.
Research at the Jordan Institute for Families in the School of Social Work at the University of North Carolina at Chapel Hill suggests that the earlier youths engage in crime, aggression/violence, drop out of school, or begin using drugs, the greater the likelihood that they will have chronic and increasing problems in the future (NC Office of Juvenile Justice, 2000). For instance, McCord and Ensminger (1995) found that teacher ratings of aggression at age 6 predicted arrests for violent crimes up to age 33. In another study, it was reported that two-thirds of boys with official arrests for violence by age 26 had high teacher ratings of aggressive behavior at ages 10 and 14 (Stattin & Magnuson, 1989). A close examination of crime statistics among teens in Pittsboro is therefore necessary to assess the health of adolescents now and in the future. Again, like most of our data, this information exists at the county level. However, we will report it in this case because the Pittsboro teen community encompasses more than just those teens who live within the city limits.
While more detailed crime data for Chatham County is presented in Appendix F, Table 8, a brief summary follows. The rate of juveniles' first appearance in court in 1995 was 52 per 1,000 youth, while the rate of juvenile arrests in Chatham County in subsequent years up to 1998 for youth ages 6 to 14 remained steady at zero. The rate of school violence and safety violations for the county remained steady at 5.5 per 1,000 teens between 1997 and 1999, which fell from 13.9 per 1,000 in 1996. In comparison, the average rate for North Carolina between 1997 and 1999 was 6.1 per 1,000 teens and 6.6 in 1996. Fortunately, there were no reported cases of firearm possession at school in Chatham County between 1995 and 1999, and juvenile arrests for weapon law violations have steadily decreased since 1994, from five per 1,000 teens to one per 1,000 teens in 1998. On average, the overall rate of crimes and arrests for teens in Chatham County have been well below that of the state in the last several years.
Although we do not have documented reports of this information, interviews with school nurses at Horton Middle School reveal that obesity is a growing problem among Pittsboro youth and teens. In fact, most of the visits to the school clinic are for weight problems. Factors contributing to this are the lack of access to information about healthy eating, lack of access to healthy food options, and the lack of access to recreation. A vicious cycle develops when teens have no nearby recreational center to access, (as is the case in Pittsboro), and look to other options instead, such as eating. And when little to no healthy food options are present, they eat whatever they can.
Our final health topic examined STDs and teen pregnancy. Chatham County Health Department statistics indicate that for teens younger than age 14, the rate of sexually transmitted disease diagnosis in 1997 was 14.1 per 1,000 teens; a statistic which is only 4.8 points below that of North Carolina. By comparison, health department data show a much more alarming rate for teen pregnancy. In fact, while teen pregnancy rates for the state have decreased over the last decade, those for the county have increased. In 1994, the teen pregnancy rate was 90.4 per 1,000 teens between the ages of 15 and 19, while the rate for North Carolina was 95.4 per 1,000 teens between the ages of 15 and 19. In contrast, the county rate in 1998 hovered around 96.8 per 1,000 teens, whereas the state rate had dropped to 85.5 per 1,000 teens. Even more appalling were the six pregnancies among 10-14 year olds in 1998, a rate of 4.5 per 1000 teens between the ages of 10 and 14. Although STDs among adolescents are critical to consider, teen pregnancy has drawn more attention to the county over the past few years because of its noticeably high rates. Chatham's startling teen pregnancy rates prompted graduate students from the Maternal and Child Health Department at the University of North Carolina at Chapel Hill School of Public Health to conduct a survey to investigate Chatham teens' knowledge about sexual health and pregnancy and STD prevention. Results of the survey revealed that "adolescents in the County need more information about reproductive health services. Many teens do not know basic facts about their own reproductive health and are not prepared to prevent pregnancy and sexually transmitted disease." (See Table 9, Appendix F, for detailed survey results)
Certainly, STDs and teen pregnancy have an impact on both teens and others in the community due to the issues' myriad of social and economic consequences. But what is even more contentious than the problems that ensue is the discussion sparked from legislation related to the issues, specifically the debate over North Carolina's Abstinence Until Marriage Legislation for school health curriculum. And, since the county health department is located in Pittsboro, these concerns may have a much greater influence on the local community. The effects could be felt further if rates continue to rise and people respond by assessing adolescents more frequently and to a greater extent. It will be interesting to not only follow the research and reactions of the community to the information, but to also monitor the impact that the issues will have on teens as data continue to surface.
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