Health is largely determined by social, economic, behavioral, and environmental factors, all of which affect health outcomes. These factors, known as social determinants of health, can serve as a barometer for regional wellness and quality of life.
21 social determinants of health were selected, as part of the Healthy NC 2030 initiative, to be a public health focus for the state's next decade. This overview radar chart explores how the Cape Fear Region is doing in comparison to the rest of the state for all indicators. Indicators closer to the circle's center are more of a challenge in this region, while indicators closer to the edge of the circle are regional strengths.
Healthy NC State Target (2030): 27%, of the population
Percentage of individuals with household incomes at or below 200% of the Federal Poverty Level.
In 2021, to be below the 200% FPL threshold, an individual living alone would need to make $25,760 a year or less. A household of four would need to make $53,000 or less total.
Highest rate of individuals below 200% FPL: 47.2%, Bladen
Lowest rate of individuals below 200% FPL: 26.7%, Brunswick
The map shows the percentage of individuals below 200% Federal Poverty Level (FPL) in the Cape Fear Region as well as the average yearly change in this metric.
In 2020, the percentage of individuals below 200% FPL in the Cape Fear Region was 36%. The county with the highest rate of individuals below 200% FPL was Bladen (47.2%), while the county with the lowest was Brunswick (26.7%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the ranking of counties in North Carolina by percentage of individuals below the poverty threshold.
By default, the ranking is shown for the 200% FPL threshold, but it is possible to change to other poverty thresholds with the Poverty Level dropdown selector above.
Using the Highest 25 and Lowest 25 buttons, it is possible to toggle between the 25 geographies with the highest and lowest values in the state.
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the percentage of individuals below the FPL in the Cape Fear Region by race and ethnicity from 2010 to 2020. By default, all races and ethnicities are shown. It is possible to hide a race or ethnicity by clicking it in the chart legend.
In 2020, the percent of individuals below 100% FPL in the Cape Fear Region was 36%. The population with the highest percentage of individuals below the FPL was Hawaiian Native or Pacific Islander (48.3%), while the population with the lowest was White (non-Hispanic) (11%).
*When the count of affected people is less than 10, the data is not displayed.
Highest Rate of Individuals Below 100% FPL 2020: 28%, Female, 18 - 24 years
Lowest Rate of Individuals Below 100% FPL 2020: 6.9%, Male, 65 - 74 years
The graph shows the percentage of individuals below the FPL in the Cape Fear Region by age and sex.
In 2020, the group with the highest percentage of individuals below 100% FPL by age and sex were female, 18 - 24 years (28%). The lowest percentage of individuals below 100% FPL by age and sex were male, 65 - 74 years (6.9%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the trend of the percentage of individuals living below the poverty threshold, as well as this metric's projection until 2030. By default, the trend is shown for the 200% FPL threshold, but it is possible to change to other poverty thresholds with the Poverty Level dropdown selector above.
In Bladen County, 47.2% of the population was living below 200% FPL in 2020. Between 2012 and 2020, Bladen County saw a 0.5% average annual decrease in this indicator.
*When the count of affected people is less than 10, the data is not displayed.
Cape Fear (2020): 6.41%, of the population
Healthy NC State Target (2030): 1.7, Disparity ratio between white and other populations
Percentage of individuals aged 16 and older who are in the labor force, but unemployed.
Individuals must be seeking work to be considered unemployed.
The map shows the unemployment rate in the Cape Fear Region as well as the average yearly change in this metric.
In 2020, the unemployment rate in the Cape Fear Region was 6.41%. The county with the highest unemployment rate was Onslow (8%), while the county with the lowest unemployment rate was Bladen (5%).
*When the count of affected people is less than 10, the data is not displayed.
Highest unemployment rate by race: 15.4%, 2+ races
Lowest unemployment rate by race: 5.38%, White (non-Hispanic)
The graph shows the unemployment rate in the Cape Fear Region by race and ethnicity, or age.
In 2020, the population with the highest unemployment rate by race and ethnicity in the Cape Fear Region was: 2+ races (15.4%), Asian (12.2%), and American Indian or Alaskan Native (11.3%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the unemployment rate in the Cape Fear Region by sex from 2010 to 2020, for the population between 20 and 64 years of age.
In 2020, female unemployment rate was 5.83%, while the male unemployment rate was 5.97%.
From 2010 to 2020, the female unemployment rate decreased 2.86% (from 8.69% to 5.83%), while the male unemployment rate decreased 1.5% (from 7.47% to 5.97%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the trend of the unemployment rate, as well as this metric's projection until 2030. It is possible to change the county and sex with the selectors above.
In Bladen County the unemployment rate reached 5% in 2020. Between 2010 and 2020, Bladen County saw a 0.5% average annual decrease in this indicator.
*When the count of affected people is less than 10, the data is not displayed.
Cape Fear (2019): 0.66, suspensions per 10 students
Healthy NC State Target (2030): 0.8, suspensions per 10 students
Number of out-of-school short-term suspensions in educational facilities for all grades per 10 students.
A short-term suspension is 10 days or less. Data reflect total numbers of short-term suspensions that may include multiple suspensions per student.
Highest Short-term Suspension per 10 Students: 1.08, Sampson (2019)
Lowest Short-term Suspension per 10 Students: 0.5, Pender (2019)
The map shows the short-term suspension rate per 10 students in the Cape Fear Region as well as the average yearly change in this metric.
In 2019, the short-term suspension rate in the Cape Fear Region was 0.66 per 10 students. The county with the highest short-term suspension rate was Sampson (1.08), while the county with the lowest short-term suspension rate was Pender (0.5).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the short-term suspension rate per 10 students in the Cape Fear Region by race and ethnicity from 2014 to 2019.
In 2019, the population with the highest short-term suspension rate was African American (2.79), while the population with the lowest short-term suspension rate was Asian (0.39).
*When the count of affected people is less than 10, the data is not displayed.
Cape Fear (2020): 147, per 100,000 population
Healthy NC State Target (2030): 150, per 100,000 population
Incarceration in prisons per 100,000 population.
Incarcerated individuals are tallied in the county they resided in when they were first incarcerated, not where they are currently incarcerated.
Highest incarceration rate per 100,000 population: 199, Columbus (2020)
Lowest incarceration rate per 100,000 population: 114, Onslow (2020)
The map shows the incarceration rate per 100,000 population in the Cape Fear Region as well as the average yearly change in this metric.
In 2020, the incarceration rate in the Cape Fear Region was 147 per 100,000 population. The county with the highest incarceration rate was Columbus (199), while the county with the lowest incarceration rate was Onslow (114).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the incarceration rate per 100,000 population in the Cape Fear Region by race and ethnicity, and sex.
In 2020, the population with the highest incarceration rate was Black (439), while the population with the lowest incarceration rate was Asian (77.4).
*When the count of affected people is less than 10, the data is not displayed.
North Carolina (2016-17): 23.6%, of children
Healthy NC State Target (2030): 18.0%, of the population
Percentage of children who have experienced two or more of the following: hard to get by on money, parent/guardian divorced or separated, parent/guardian died, parent/guardian served time in jail, saw or heard violence in the home, victim/witness of neighborhood violence, lived with anyone mentally ill, suicidal or depressed, live with anyone with alcohol or drug problem, often treated or judged unfairly due to race/ethnicity.
This indicator, chosen by the Healthy NC 2030 taskforce, is not available at a geographic level less than regional.
In order to provide meaningful, localized insights into ACEs and ACEs-adjacent indicators, Cape Fear Collective convened a team of experts in ACEs and trauma to select a proxy metric for this indicator: percentage of disconnected youth, individuals aged 16 to 19 who are neither in school nor working.
The map shows the percentage of the population ages 16 to 19 that is neither in school nor working in the Cape Fear Region as well as the average yearly change in this metric.
In 2020, the percent of the population ages 16 to 19 that was neither in school nor working in the Cape Fear Region was 8.68%. The county with the highest percentage of the population ages 16 to 19 that was neither in school nor working was Columbus (20.1%), while the county with the lowest was Sampson (4.08%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the percentage of the population ages 16 to 19 that was neither in school nor working in the Cape Fear Region by sex from 2010 to 2020.
In 2020, the percentage of the population ages 16 to 19 that was neither in school nor working among females was 7.79%, and 9.38% among males.
From 2010 to 2020, the percentage of the population ages 16 to 19 that was neither in school nor working among females decresed 1.59% (from 9.39% to 7.79%) and among males it incresed 0.68% (from 8.7% to 9.38%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the trend of the percentage of the population ages 16 to 19 that is neither in school nor working as well as this metric's projection until 2030. It is possible to change to other counties and sex with the selector above.
In Bladen County, 10.4% of the population ages 16 to 19 was neither in school nor working in 2020, with an annual percentage change of 0.12%.
*When the count of affected people is less than 10, the data is not displayed.
Healthy NC State Target (2030): 80%, of the population
Percentage of children proficient or better at grade-level reading based on third grade End of Grade exams.
The graph shows the percentage of children who are proficient in reading at the end of the third grade in the Cape Fear Region by Local Education Agency (LEA) and achievement level in 2019.
The graph shows the ranking of Local Education Agencies (LEAs) in North Carolina by the percentage of children who are grade-level proficient in reading at the end of third grade.
By default, the ranking is shown for grade-level proficiency, but it is possible to change the ranking to other achievement levels with the upper selector.
Using the Highest 25 and Lowest 25 buttons, it is possible to toggle between the 25 geographies with the highest and lowest values in the state.
Third Grade Reading Proficiency by Race and Ethnicity
The graph shows the percentage of children who were who were proficient in reading (grade level proficient) at the end of third grade in the Cape Fear Region by race and ethnicity.
In 2019, the population with the highest percentage of children who were proficient in reading (grade level proficient) in Bladen County Schools was White (52.8%), while the population with the lowest percentage was African American (37.6%).
Third Grade Reading Proficiency by Sex and Achievement Level
The graph shows the third grade reading proficiency in the Local Education Agencies (LEAs) in the Cape Fear Region by sex and achievement level.
In 2019, the highest percentage of children who were proficient in reading at the end of third grade in Bladen County Schools were male, grade level proficient (43.8%). The lowest percentage of children who were proficient in reading at the end of third grade were female, level 5 (4.9%).
Healthy NC State Target (2030): 92%, of the population
Percentage of the population living half a mile from a park in any area, one mile from a recreational center in a metropolitan area, or three miles from a recreational center in a rural area.
Exercise access is based on census tract proximity to public parklands or recreational facilities such as “gyms, community centers, dance studios, pools,” and other exercise facilities.
Highest Access to Exercise Opportunities: 89.3%, New Hanover (2019)
Lowest Access to Exercise Opportunities: 29.5%, Duplin (2019)
The map shows the percentage of people with access to exercise opportunities in the Cape Fear Region as well as the average yearly change in this metric.
In 2019, the percent of the population that had access to exercise opportunities in the Cape Fear Region was 63.4%. The county with the highest access to exercise opportunities rate was New Hanover (89.3%), while the county with the lowest rate was Duplin (29.5%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the ranking of counties in North Carolina by the population estimated as having access to exercise opportunities or the average yearly change.
Using the Highest 25 and Lowest 25 buttons, it is possible to toggle between the 25 geographies with the highest and lowest values in the state.
*When the count of affected people is less than 10, the data is not displayed.
Healthy NC State Target (2030): 5%, of the population
Percentage of people who are low-income that are not in close proximity to a grocery store.
This indicator, chosen by the Healthy NC 2030 taskforce, is based on USDA-designated food deserts. For metropolitan communities, living close to a grocery store is defined as being less than a mile from a store; in rural areas, the threshold proximity is 10 miles from a grocery store according to the USDA.
Because access to healthy food is a significant issue in the Cape Fear region, and because this indicator was only available at a county-level geography, Cape Fear Collective created a Food Hardship Index from a logistic regression model predicting USDA food desert status.
The Food Hardship Index indicates how close a neighborhood is to being a designated food desert, with 1 indicating very high levels of food hardship and 0 indicating very low.
The map shows the Food Hardship Index in the Cape Fear Region as well as the average yearly change in this metric.
In 2020, the Food Hardship Index in Cape Fear was 0.30.
The tract with the highest Food Hardship Index was Onslow Tract 8 (1.00), while the tract with the lowest was Brunswick Tract 203.07 (0.00).
The graph shows the ranking of counties in North Carolina by the Food Hardship Index.
Using the Highest 25 and Lowest 25 buttons, it is possible to toggle between the 25 geographies with the highest and lowest values in the state.
Cape Fear (2019): 15.7%, of the population
Healthy NC State Target (2030): 14%, of the population
Percentage of households with at least 1 of four HUD-designated housing problems.
The U.S. Department of Housing and Urban Development defines severe housing problems as occupied household units that have at least one of the following issues: overcrowding (>1 occupant per room), high housing costs (monthly housing costs >= 50% of monthly income), or lack of adequate kitchen or plumbing facilities.
HUD has not made post-2017 data publicly available, so CFC built a regression model to predict 2018 and 2019 severe housing problems based on the number of households with each individual HUD-designated housing problem.
Highest percentage of people with severe housing problems: 17.6%, Bladen
Lowest percentage of people with severe housing problems: 14.3%, Brunswick
The map shows the percentage of people with severe housing problems in the Cape Fear Region as well as the average yearly change in this metric.
In 2019, the percentage of people with severe housing problems in the Cape Fear Region was 15.7%. The county with the highest the percentage of people with severe housing problems was Bladen (17.6%), while the county with the lowest was Brunswick (14.3%).
*The 2018 and 2019 values were built from a CFC model.
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the trend of the percentage of the population living with severe housing problems, as well as this metric's projection until 2030.
In Bladen County, 17.6% of the population was living with severe housing problems in 2019. Between 2013 and 2020, Bladen County saw a 0.23% average annual decrease in this indicator.
*The 2018 and 2019 values were built from a CFC model.
*When the count of affected people is less than 10, the data is not displayed.
Highest drug overdose rate rate in 2018-2019: 34.3, New Hanover
Lowest drug overdose rate in 2018-2019: 12.7, Duplin
The map shows the drug overdose death rate (average across years) per 100,000 population in the Cape Fear Region as well as the average yearly change in this metric.
In the years of 2018-2019 the county with the highest drug overdose death average was New Hanover (34.3), while the county with the lowest drug overdose death average was Duplin (12.7).
In order to provide meaningful, localized insights into this indicator, we substituted data from the CDC PLACES project that measures the percent of the current population aged ≥18 years who report having smoked ≥100 cigarettes in their lifetime and currently smoke every day or some days.
Highest percentage of tobacco use in 2019: 23.3%, Columbus
Lowest percentage of tobacco use in 2019: 16%, New Hanover
The map shows the percentage of current adult smokers in Cape Fear Region.
In 2019, the percent of adults who were current smokers in the Cape Fear Region was 18.4%. The county with the highest percentage of adults who were current smokers was Columbus (23.3%), while the county with the lowest was New Hanover (16%).
*When the count of affected people is less than 10, the data is not displayed.
Highest percentage of excessive drinking in 2019: 20.6%, Onslow
Lowest percentage of excessive drinking in 2019: 12.1%, Bladen
The map shows the percentage of adults reporting binge or heavy drinking in the Cape Fear Region.
In 2019, the percentage of adults reporting binge or heavy drinking in the Cape Fear Region was 16%. The county with the highest percentage of adults reporting binge or heavy drinking was Onslow (20.6%), while the county with the lowest was Bladen (12.1%).
*When the count of affected people is less than 10, the data is not displayed.
In order to provide meaningful, localized insights into this indicator, we substituted data from the CDC PLACES project that measures the percent of the current population aged ≥18 years who report having been diagnosed with diabetes in their lifetime, excluding pregnancy-related diabetes.
Highest percentage of adults with diabetes in 2019: 17.4%, Bladen
Lowest percentage of adults with diabetes in 2019: 8.2%, Onslow
The map shows the percentage of adults with diabetes in the Cape Fear Region.
In 2019, the percentage of adults with diabetes in Cape Fear was 12.2%. The county with the highest percentage of adults with diabetes was Bladen (17.4%), while the county with the lowest was Onslow (8.2%).
*When the count of affected people is less than 10, the data is not displayed.
Race with highest percentage of diabetes patients under the age of 45: 42%, Biracial
Race with lowest percentage of diabetes patients under the age of 45: 5.25%, White
The graph shows the percentage of diabetes patients under the age of 45 in Cape Fear by race.
In 2021, the percentage of diabetes patients under the age of 45 in Cape Fear by race was Biracial (42%), Other (23%), American Indian or Alaskan Native (15.9%), Asian (12%), Black (10.7%), Unknown (8.58%), and White (5.25%).
*When the count of affected people is less than 10, the data is not displayed.
Cape Fear 2020: 9.39, per 100,000 population
Healthy NC State Target (2030): 6, per 100,000 population
Number of new HIV diagnoses per 100,000 population.
Highest HIV diagnosis rate in 2010-2020: 20.1, Bladen
Lowest HIV diagnosis rate in 2010-2020: 6.5, Brunswick
The map shows the HIV diagnosis rate (average across years) in the Cape Fear Region as well as the average yearly change in this metric.
In the years of 2010-2020, the county with the highest average HIV diagnosis rate was Bladen (20.1 per 100,000 population), while the county with the lowest average HIV diagnosis rate was Brunswick (6.5 per 100,000 population).
In order to provide meaningful, localized insights into this indicator, we substituted data from NC Live Birth Statistics that measures the number of births to girls under 18 per 1,000 population.
Highest teen births rate in 2018-2019: 3.03, Duplin
Lowest teen births rate in 2018-2019: 0.73, Onslow
The map shows the teen birth rate (average across years) per 1,000 females under 18 in the Cape Fear Region as well as the average yearly change in this metric.
Between 2018-2019, the county with the highest average teen birth rate was Duplin (3.03), while the county with the lowest was Onslow (0.73).
The graph shows the ranking of counties in North Carolina by the teen birth rate (average across years) per 1,000 females under 18 or the average annual change.
Using the Highest 25 and Lowest 25 buttons, it is possible to toggle between the 25 geographies with the highest and lowest values in the state.
In order to provide meaningful, localized insights into this indicator, we substituted data from U.S. Census Bureau that measures the population without health insurance at all ages.
The map shows the uninsured rate in Cape Fear Region and how it has changed over time.
In 2020, the uninsured rate in Cape Fear Region was 11.1%. The county with the highest uninsured rate was Duplin (16.7%), while the county with the lowest uninsured rate was Pender (9%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the uninsured rate in Cape Fear by race and ethnicity from 2012 to 2020.
In 2020, the population with the highest uninsured rate was Other (35.6%), while the population with the lowest uninsured rate was Hawaiian Native or Pacific Islander (2.76%).
*When the count of affected people is less than 10, the data is not displayed.
The visualization shows the trend of the uninsured rate, its projection until 2030 and the target value for the county and race selected with the upper buttons.
In Bladen County, the uninsured rate for the all races (White, Black, Hispanic) population reached 11.5% in 2020. Between 2012 and 2020, Bladen County saw a 1.06% average annual decrease in this indicator.
*When the count of affected people is less than 10, the data is not displayed.
Healthy NC State Target (2030): 1:1,500
Primary care workforce as a ratio of the number of full-time equivalent primary care clinicians to county population.
Includes physicians, nurse practitioners, physician assistants, and certified nurse midwives.
Provider location defined by primary practice location on licensure information.
Certified nurse midwife counts were not available for 2019.
Highest primary care workforce rate 2019: 1 : 176, New Hanover
Lowest primary care workforce rate 2019: 1 : 1441, Pender
The map shows the ratio of primary care provider to total population in the Cape Fear Region as well as the average yearly change in this metric.
In 2019, the ratio of primary care provider to total population in Cape Fear Region was 1 : 368. The county with the highest ratio of primary care provider to total population in was New Hanover (1 : 176), while the county with the lowest was Pender (1 : 1441).
*When the count of affected people is less than 10, the data is not displayed.
Highest early prenatal care rate 2019: 66.2%, Sampson
Lowest early prenatal care rate 2019: 56.2%, Columbus
The map shows the early prenatal care rate in the Cape Fear Region as well as the average yearly change in this metric.
In 2019, the early prenatal care rate in the Cape Fear Region was 63.9%. The county with the highest early prenatal care rate was Sampson (66.2%), while the county with the lowest was Columbus (56.2%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the early prenatal care rate in the Cape Fear Region by race and ethnicity from 2011 to 2019.
In 2019, the population with the highest early prenatal care rate was White (non-Hispanic) (67.3%), while the population with the lowest was African American (non-Hispanic) (57.1%).
*When the count of affected people is less than 10, the data is not displayed.
Cape Fear (2019): 17.7, per 100,000 people
Healthy NC State Target (2030): 11.1, per 100,000 people
Age-adjusted number of deaths attributable to self-harm per 100,000 population.
This HNC 2030 indicator's data is drawn from NC Vital Statistics, which provides publicly-available data at the statewide level.
In order to provide meaningful, localized insights into this indicator, we substituted data from NC Detailed Mortality Statistics that is not age-adjusted.
Highest suicides rate in 2016-2019 per 100,000 population: 24.4, Pender
Lowest suicides rate in 2016-2019: 6.68, Sampson
The map shows the suicide rate (average across years) per 100,000 population in Cape Fear Region and how it has changed over time.
Between 2016-2019, the county with the highest average suicide rate per 100,000 population was Pender (24.4), while the county with the lowest was Sampson (6.68).
Highest infant mortality rate in 2016-2019 per 1,000 births: 9.57, Columbus
Lowest infant mortality rate in 2016-2019 per 1,000 births: 5.52, Onslow
The map shows the infant mortality rate (average across years) per 1,000 births in the Cape Fear Region as well as the average yearly change in this metric.
In the years of 2016-2019, the county with the highest average infant mortality rate was Columbus (9.57), while the county with the lowest was Onslow (5.52).
The map shows the average life expectancy in the Cape Fear Region as well as the average yearly change in this metric.
The highest average life expectancy was registered in Brunswick (79.2 years), while the lowest average life expectancy was registered in Columbus (73.5 years).
The graph shows the average life expectancy in the Cape Fear Region by race and ethnicity.
In 2020, the population with the highest average life expectancy in the Cape Fear Region was Hispanic (90.6), while the population with the lowest was Black (74.2).
* Data interpretation should consider the Hispanic Epidemiological Paradox.