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 Sandhills 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: 52.8%, Robeson
Lowest rate of individuals below 200% FPL: 26.2%, Moore
The map shows the percentage of individuals below 200% Federal Poverty Level (FPL) in the Sandhills Region as well as the average yearly change in this metric.
In 2020, the percentage of individuals below 200% FPL in the Sandhills Region was 41%. The county with the highest rate of individuals below 200% FPL was Robeson (52.8%), while the county with the lowest was Moore (26.2%).
*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 Sandhills 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 Sandhills Region was 41%. The population with the highest percentage of individuals below the FPL was American Indian or Alaskan Native (26.9%), while the population with the lowest was Asian (11.9%).
*When the count of affected people is less than 10, the data is not displayed.
Highest Rate of Individuals Below 100% FPL 2020: 30.5%, Female, < 5 years
Lowest Rate of Individuals Below 100% FPL 2020: 10.9%, Male, 75+ years
The graph shows the percentage of individuals below the FPL in the Sandhills Region by age and sex.
In 2020, the group with the highest percentage of individuals below 100% FPL by age and sex were female, < 5 years (30.5%). The lowest percentage of individuals below 100% FPL by age and sex were male, 75+ years (10.9%).
*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 Cumberland County, 41.4% of the population was living below 200% FPL in 2020. Between 2012 and 2020, Cumberland County saw a 0.27% average annual increase in this indicator.
*When the count of affected people is less than 10, the data is not displayed.
Sandhills (2020): 7.12%, 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 Sandhills Region as well as the average yearly change in this metric.
In 2020, the unemployment rate in the Sandhills Region was 7.12%. The county with the highest unemployment rate was Scotland (11.7%), while the county with the lowest unemployment rate was Montgomery (3.5%).
*When the count of affected people is less than 10, the data is not displayed.
Highest unemployment rate by race: 10.4%, 2+ races
Lowest unemployment rate by race: 3.95%, Asian
The graph shows the unemployment rate in the Sandhills Region by race and ethnicity, or age.
In 2020, the population with the highest unemployment rate by race and ethnicity in the Sandhills Region was: 2+ races (10.4%), Black (9.47%), and American Indian or Alaskan Native (9.02%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the unemployment rate in the Sandhills Region by sex from 2010 to 2020, for the population between 20 and 64 years of age.
In 2020, female unemployment rate was 7.16%, while the male unemployment rate was 6.42%.
From 2010 to 2020, the female unemployment rate decreased 2.42% (from 9.58% to 7.16%), while the male unemployment rate decreased 3.01% (from 9.43% to 6.42%).
*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.
The graph shows the trend of the unemployment rate in the county, as well as this metric's projection and target until 2030. By default, the trend is shown for all the population, but it is possible to change the sex with the selector above.
In Cumberland County the unemployment rate reached 7.8% in 2020. Between 2010 and 2020, Cumberland County saw a 0.24% average annual decrease in this indicator.
*When the count of affected people is less than 10, the data is not displayed.
Sandhills (2019): 1.14, 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: 2.04, Robeson (2019)
Lowest Short-term Suspension per 10 Students: 0.52, Moore (2019)
The map shows the short-term suspension rate per 10 students in the Sandhills Region as well as the average yearly change in this metric.
In 2019, the short-term suspension rate in the Sandhills Region was 1.14 per 10 students. The county with the highest short-term suspension rate was Robeson (2.04), while the county with the lowest short-term suspension rate was Moore (0.52).
*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 Sandhills Region by race and ethnicity from 2014 to 2019.
In 2019, the population with the highest short-term suspension rate was African American (3.13), while the population with the lowest short-term suspension rate was Asian (0.4).
*When the count of affected people is less than 10, the data is not displayed.
Sandhills (2020): 151, 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: 208, Scotland (2020)
Lowest incarceration rate per 100,000 population: 91.9, Harnett (2020)
The map shows the incarceration rate per 100,000 population in the Sandhills Region as well as the average yearly change in this metric.
In 2020, the incarceration rate in the Sandhills Region was 151 per 100,000 population. The county with the highest incarceration rate was Scotland (208), while the county with the lowest incarceration rate was Harnett (91.9).
*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 Sandhills Region by race and ethnicity, and sex.
In 2020, the population with the highest incarceration rate was Black (308), while the population with the lowest incarceration rate was White (71.2).
*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 Sandhills 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 Sandhills Region was 9.65%. The county with the highest percentage of the population ages 16 to 19 that was neither in school nor working was Montgomery (17.6%), while the county with the lowest was Richmond (3.08%).
*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 Sandhills 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 8.69%, and 10.5% 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 1.8% (from 10.5% to 8.69%) and among males it decresed 0.5% (from 11% to 10.5%).
*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 Cumberland County, 9.04% of the population ages 16 to 19 was neither in school nor working in 2020, with an annual percentage change of -0.11%.
*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 Sandhills 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 Sandhills Region by race and ethnicity.
In 2019, the population with the highest percentage of children who were proficient in reading (grade level proficient) in Cumberland County Schools was Asian (76.7%), while the population with the lowest percentage was African American (44.6%).
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 Sandhills 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 Cumberland County Schools were female, grade level proficient (59%). The lowest percentage of children who were proficient in reading at the end of third grade were male, level 5 (8.3%).
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: 79.9%, Lee (2019)
Lowest Access to Exercise Opportunities: 20.9%, Hoke (2019)
The map shows the percentage of people with access to exercise opportunities in the Sandhills 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 Sandhills Region was 63%. The county with the highest access to exercise opportunities rate was Lee (79.9%), while the county with the lowest rate was Hoke (20.9%).
*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.
Lowest Food Hardship Index, 2020: 0.01, Moore Tract 9506.01
The map shows the Food Hardship Index in the Sandhills Region as well as the average yearly change in this metric.
In 2020, the Food Hardship Index in Sandhills was 0.41.
The tract with the highest Food Hardship Index was Richmond Tract 9703 (0.99), while the tract with the lowest was Moore Tract 9506.01 (0.01).
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.
Sandhills (2019): 15.8%, 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: 19.9%, Scotland
Lowest percentage of people with severe housing problems: 12.1%, Moore
The map shows the percentage of people with severe housing problems in the Sandhills Region as well as the average yearly change in this metric.
In 2019, the percentage of people with severe housing problems in the Sandhills Region was 15.8%. The county with the highest the percentage of people with severe housing problems was Scotland (19.9%), while the county with the lowest was Moore (12.1%).
*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 Cumberland County, 17.1% of the population was living with severe housing problems in 2019. Between 2013 and 2020, Cumberland County saw a 0.1% average annual increase 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 2017-2019: 29.9, Lee
Lowest drug overdose rate in 2017-2019: 14.2, Scotland
The map shows the drug overdose death rate (average across years) per 100,000 population in the Sandhills Region as well as the average yearly change in this metric.
In the years of 2017-2019 the county with the highest drug overdose death average was Lee (29.9), while the county with the lowest drug overdose death average was Scotland (14.2).
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: 27.9%, Robeson
Lowest percentage of tobacco use in 2019: 16%, Moore
The map shows the percentage of current adult smokers in Sandhills Region.
In 2019, the percent of adults who were current smokers in the Sandhills Region was 20.9%. The county with the highest percentage of adults who were current smokers was Robeson (27.9%), while the county with the lowest was Moore (16%).
*When the count of affected people is less than 10, the data is not displayed.
Highest percentage of excessive drinking in 2019: 16.4%, Cumberland
Lowest percentage of excessive drinking in 2019: 13%, Robeson
The map shows the percentage of adults reporting binge or heavy drinking in the Sandhills Region.
In 2019, the percentage of adults reporting binge or heavy drinking in the Sandhills Region was 15%. The county with the highest percentage of adults reporting binge or heavy drinking was Cumberland (16.4%), while the county with the lowest was Robeson (13%).
*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: 18.4%, Robeson
Lowest percentage of adults with diabetes in 2019: 11.5%, Harnett
The map shows the percentage of adults with diabetes in the Sandhills Region.
In 2019, the percentage of adults with diabetes in Sandhills was 13.5%. The county with the highest percentage of adults with diabetes was Robeson (18.4%), while the county with the lowest was Harnett (11.5%).
*When the count of affected people is less than 10, the data is not displayed.
Highest HIV diagnosis rate in 2010-2020: 25.6, Scotland
Lowest HIV diagnosis rate in 2010-2020: 8.43, Moore
The map shows the HIV diagnosis rate (average across years) in the Sandhills 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 Scotland (25.6 per 100,000 population), while the county with the lowest average HIV diagnosis rate was Moore (8.43 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 2016-2019: 3.15, Robeson
Lowest teen births rate in 2016-2019: 1.04, Moore
The map shows the teen birth rate (average across years) per 1,000 females under 18 in the Sandhills Region as well as the average yearly change in this metric.
Between 2016-2019, the county with the highest average teen birth rate was Robeson (3.15), while the county with the lowest was Moore (1.04).
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 Sandhills Region and how it has changed over time.
In 2020, the uninsured rate in Sandhills Region was 11.3%. The county with the highest uninsured rate was Robeson (14.2%), while the county with the lowest uninsured rate was Moore (8.5%).
*When the count of affected people is less than 10, the data is not displayed.
The graph shows the uninsured rate in Sandhills by race and ethnicity from 2012 to 2020.
In 2020, the population with the highest uninsured rate was Other (25.8%), while the population with the lowest uninsured rate was White (non-Hispanic) (8.7%).
*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 Cumberland County, the uninsured rate for the all races (White, Black, Hispanic) population reached 10.4% in 2020. Between 2012 and 2020, Cumberland County saw a 0.61% 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 : 171, Moore
Lowest primary care workforce rate 2019: 1 : 1203, Montgomery
The map shows the ratio of primary care provider to total population in the Sandhills Region as well as the average yearly change in this metric.
In 2019, the ratio of primary care provider to total population in Sandhills Region was 1 : 339. The county with the highest ratio of primary care provider to total population in was Moore (1 : 171), while the county with the lowest was Montgomery (1 : 1203).
*When the count of affected people is less than 10, the data is not displayed.
Highest early prenatal care rate 2019: 72.5%, Cumberland
Lowest early prenatal care rate 2019: 53.4%, Robeson
The map shows the early prenatal care rate in the Sandhills Region as well as the average yearly change in this metric.
In 2019, the early prenatal care rate in the Sandhills Region was 65.8%. The county with the highest early prenatal care rate was Cumberland (72.5%), while the county with the lowest was Robeson (53.4%).
*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 Sandhills Region by race and ethnicity from 2011 to 2019.
In 2019, the population with the highest early prenatal care rate was White (non-Hispanic) (72%), while the population with the lowest was Hispanic (60.5%).
*When the count of affected people is less than 10, the data is not displayed.
Sandhills (2019): 12.7, 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 2017-2019 per 100,000 population: 18.9, Moore
Lowest suicides rate in 2017-2019: 10.4, Scotland
The map shows the suicide rate (average across years) per 100,000 population in Sandhills Region and how it has changed over time.
Between 2017-2019, the county with the highest average suicide rate per 100,000 population was Moore (18.9), while the county with the lowest was Scotland (10.4).
Highest infant mortality rate in 2016-2019 per 1,000 births: 11.4, Robeson
Lowest infant mortality rate in 2016-2019 per 1,000 births: 6.15, Moore
The map shows the infant mortality rate (average across years) per 1,000 births in the Sandhills 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 Robeson (11.4), while the county with the lowest was Moore (6.15).
The map shows the average life expectancy in the Sandhills Region as well as the average yearly change in this metric.
The highest average life expectancy was registered in Moore (79.1 years), while the lowest average life expectancy was registered in Robeson (71.7 years).
The graph shows the average life expectancy in the Sandhills Region by race and ethnicity.
In 2020, the population with the highest average life expectancy in the Sandhills Region was Hispanic (88.2), while the population with the lowest was Black (72.2).
* Data interpretation should consider the Hispanic Epidemiological Paradox.