The New Hanover Community Endowment recently published two community assessment results examining gaps in the county’s early childhood and behavioral health systems.

The findings, released in October and focused on childcare and behavioral health, have the potential to shape future strategic grants from the endowment and create lasting transformational change in New Hanover County, officials say.

The endowment, valued at more than $1.7 billion and created from the 2021 sale of the previously county-owned New Hanover Regional Medical Center, shared its plan to use data-based research to develop its grantmaking strategy.

Over the past year, endowment officials have worked with various third-party firms to conduct several studies on systemic gaps and development opportunities across New Hanover County, including recreational and youth needs; early childhood systems; behavioral health; and entrepreneurship.

Findings from the recreational assessment are expected later this year, with the entrepreneurial ecosystem study expected early next year, officials said.

“(The assessments) validate the lived experience, community voices, trusted voices,” said David Stegall, the endowment’s vice president of programs and grants. “But … if we can work alongside other communities, learn from other communities and/or have community partners here or funders outside the community who might be interested in this work … that could be powerful.

“This helps validate what the true need is and where the gaps and opportunities are,” he added.

Results from both the early childhood systems assessment and the behavioral health landscape assessment point to interlocking forces, such as low wages and high housing costs, that often compound in the same communities, limiting a household’s ability to overcome those barriers.

For example, NC Child’s early childhood systems assessment found that while New Hanover County performs about 10% better than the state average on early childhood education indicators, childcare is still unaffordable for many families. The study reported that married couples in the county spend over 10% of their median income on infant care, while single fathers spend around 26% and single mothers nearly 35%.

High turnover rates drive strain on the county’s childcare facilities; the study found that the county currently has a 38% turnover rate among its childcare workforce and that, since 2019, the county has experienced an 11.9% decline in childcare programs.

As the study notes, low compensation, such as the county’s average wage of $14.58 per hour for childcare workers, is strongly associated with higher turnover, which worsens financial strain on childcare facilities.

As a result, and based on community engagement focus groups, interviews and surveys, NC Child recommended recurring salary supplements and access to employer-sponsored health insurance as one possible strategy for improving the county’s childcare landscape.

Similarly, Mosaic’s behavioral health assessment emphasized workforce stabilization and early prevention to reduce crisis and provider strain.

Notably, the behavioral health study found that four ZIP codes in New Hanover County account for roughly 68% of crisis demand, and that post-pandemic demand has accelerated rather than stabilized.

Specifically, downtown Wilmington (28401), northeast Wilmington (28405), central/midtown Wilmington (28403) and south Wilmington, including Myrtle Grove and Monkey Junction (28412), are identified as high-need areas in the county, with some of the highest poverty rates concentrated in the midtown and downtown areas.

“If we are going to close those gaps, if we are going to improve outcomes overall, we have to be mindful of these ZIP codes and what is happening, or not happening, in these ZIP codes,” endowment President and CEO Sophie Dagenais said.

“Some of what is happening, or not happening, in these ZIP codes may trigger or invite a strategy that ultimately will impact the behavioral health in those ZIP codes, but that really actually go more to workforce preparedness, food access,” she said.

Beyond social determinants of health, such as housing stability and early childhood education, the behavioral health assessment also identified bottlenecks in the county’s healthcare system.

According to the study, only one acute inpatient psychiatric provider – Novant Health New Hanover Behavioral Health Hospital – serves the entire county, with emergency departments carrying a significant crisis burden and acting as “the system’s default crisis stabilizer.”

Additionally, while 69 unique service providers operate across 151 locations, only three serve non-English-speaking residents.

“A real gap here in New Hanover County is the post-acute care infrastructure,” Dagenais said. “We don’t have a crisis or post-care infrastructure for our New Hanover County residents.”

Dagenais added that, using data gathered from the assessments, the endowment will focus on building on “infrastructure architecture,” specifically for determinants of health that may overlap across various community needs.

“I think that what (these assessments) have reinforced is that we have the potential to have large-scale impact in communities with the greatest need,” Stegall said. “And part of that has to do with, what are the contributing factors that are leading to developmental delays, that may be leading to chronic behavioral or other health issues?”