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New Health Ranking Shows Disparities Persist In NC

The green map shows the distribution of North Carolina’s  health outcomes, based on an equal weighting of length  and quality of life. The map is divided into four quartiles with less color intensity indicating better performance.
County Health Rankings & Roadmaps

The more money you make, the better your health outcomes. That's according to new data released Wednesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

In North Carolina, for instance, Wake County residents have the highest median income, according to Census figures. The county also ranks as the No. 1 county by health outcomes, according to the ninth annual County Health Rankings report.

On the other end of the spectrum, residents of Scotland County have the lowest median income, and rank No. 99 in health outcomes. Only Robeson County ranked lower in terms of health outcomes and its median income was only 2.2 percent higher than that of Scotland.

"Where we live makes a difference in how well and how long we live. And not everyone has the same opportunity to be healthy," said Ali Havrilla, a community coach with County Health Rankings & Roadmaps, which released the data. "A healthy community is a productive community that contributes to shared economic growth. But unfortunately, some communities have experienced generations of isolation from opportunity."

Analyzing all of North Carolina's 100 counties shows a clear correlation between median household income and health outcomes.

The interactive chart below plots every North Carolina County by median household income and health ranking. Counties toward the top of the chart have the highest incomes while counties to the left of the chart have the best health outcomes. Circle size indicates relative county population.

Of course, there are always a few outliers. Consider that Watauga County ranks No. 8 in health outcomes, but has a median income of less than $40,000, a figure more closely associated with counties that ranked in the bottom half of the RWJF list.

There was some correlation between population and health outcomes, in which counties with more residents tended to rank higher in terms of health outcomes. However, that correlation was looser. Guilford, Forsyth, and Cumberland counties are comparably sized by population, but vary widely in health outcomes. Guilford ranked 20, Forsyth ranked 39, and Cumberland ranked 75, according to the County Health Rankings.

This year, the rankings put a special focus on race. State health experts said they are in the process of developing strategies focused on investing in the health of all North Carolinians.

"We need to do more to address the true underlying drivers of health, if we want to see improvements and decrease health care costs," said Elizabeth Tilson, North Carolina's health director and chief medical officer. "Our vision is a North Carolina that optimizes health and well-being for all people by effectively stewarding resources that bridge our communities and our healthcare system."

Jason deBruyn is WUNC's Supervising Editor for Digital News, a position he took in 2024. He has been in the WUNC newsroom since 2016 as a reporter.
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