Becky Carter: Social Factors Play Important Role in Determining Community’s Health

By Becky Carter
President and CNO, Blue Ridge Regional Hospital

All hospitals and health systems, Blue Ridge Regional Hospital included, periodically review the state of health of the communities they serve. Most are aware that our health is affected by germs that are shared and risks we inherit from our families. It is common knowledge that smoking or not wearing a seatbelt are choices that put our health at risk. Less familiar are other factors that greatly impact our health called Social Determinants of Health (SDOH). They include where and how we live, whether we have access to quality education, affordable, healthy and fresh food, if we feel safe in our communities, if we have health insurance, whether we’re connected to a strong support network of family and friends, and many other factors.

When any of these factors are not favorable, the health of people in the community suffers. The challenges of poverty, for example, pose many significant barriers to good health. Without adequate financial resources a family may have to live in housing without reliable heat; a parent may choose to forgo needed prescription medicine and use limited funds for food; an elderly person may not have reliable transportation to see a doctor for a persistent cough and more.

Because BRRH is invested in alleviating and removing barriers to improving the health of our community, we partnered with Toe River Health District to produce a sweeping assessment of our community’s healthcare needs and potential barriers to care. We not only surveyed the community, but also performed an exhaustive review of a wide range of public health data that’s compiled for Mitchell and Yancey counties. Information analyzed includes air and water quality, determining whether our neighbors have access to healthy food, population changes, causes of death, and more.

In the next few months, we’ll receive and share the study’s results, which will provide us with vital information on the healthcare challenges and realities our neighbors face. Then together, we can strategize about how to lessen and eliminate these barriers.

I’ve understandably heard concerns from community members about Mission Health’s possible acquisition by HCA Healthcare (HCA). Notably among them has been that BRRH’s “risk for closure will increase.” This isn’t the case; in fact, just the opposite is true. Provisions in the Mission’s contemplated agreement with HCA agreement leave the hospital much more secure against the threat of our closing, or offering fewer services.

Since it’s a nonprofit health system, Mission Health’s current “owners” are the communities that each of our member hospitals serve. Should the HCA agreement be completed, an independent, non-profit foundation will be created from the sale’s proceeds. The primary roles of the new foundation will be to fund initiatives that will improve our community’s health and wellbeing and decreasing future risks, including the social determinants that place residents at risk.

We’re excited about the promise that the Mission Health-HCA Healthcare partnership holds. The anticipated additional resources from the transaction – perhaps the largest foundation per capita in America – will allow us to do much more to aid community members in solving challenges that come between them and improved health.


Rebecca W. Carter, MSN, RN, FACHE is President and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine. Carter has served in senior hospital management for over 20 years and previously served as Chief Operating Officer and Chief Nursing Officer of Transylvania Regional Hospital in Brevard, also a part of the Mission Health system.

Ms. Carter is board certified in healthcare management and is a Fellow of the American College of Healthcare Executives (FACHE). A native of North Carolina, she holds undergraduate and graduate degrees in nursing from the University of North Carolina at Chapel Hill. Ms. Carter is currently a resident of Burnsville.

For more information on Blue Ridge Regional Hospital, visit missionhealth.org/blueridge [1].