NC Budget and Tax Center, public health

Latest data: NC will not come close to 2020 health objectives; legislature’s policy failures implicated

One of North Carolina’s goals is “to be one of the healthiest states in the nation.” However, the reality is that our state is not on track to reach this goal anytime soon.

Every 10 years since 1990, North Carolina has set decennial health objectives with the goal of making North Carolina a healthier state. In 2011, the state identified 13 major health focus areas and established 41 objectives and targets to be meet by the year 2020. According to our state’s health improvement plan, “Healthy NC 2020: A Better State of Health”:

“The case for improving the health of individuals throughout the state is strong…the improvement of population health is an important economic development strategy, because health is a form of human capital and as such is a significant “input” into our economic system.”

Unfortunately it appears our state will fall woefully short of achieving the goals outlined in its health improvement plan. Analysis of the latest state data and overall health rankings finds the following:

  • North Carolina is not on track to achieve major health objectives by 2020.

The state is not likely to meet targets for 32 out of 41 health objectives (78 percent) by 2020. At the current pace it would take the state 48 more years (or until the year 2065) to achieve all of its 2020 targets. As a result, 12 out of the 13 (92 percent) state’s major health focus areas are negatively affected and not likely to be successful in achieving the 2020 objectives related to them.

  • North Carolina is worse off in 18 key health objectives compared to nine years ago. In other words, instead of making progress, certain conditions have gotten worse.

Major health objectives in our state that are worse off today compared to nine years ago include: the unintentional poisoning mortality rate; the percentage of individuals aged 12 years and older reporting illicit drug use; the suicide rate; the rate of mental health-related visits to emergency rooms; the percentage of people spending more than 30 percent of their income on rental housing; the percentage of adults who have had permanent teeth removed due to tooth decay or gum disease; the number of critical violations per restaurant/food stand; and the percentage of adults with diabetes.

  • North Carolina has consistently trailed other states in overall health rankings for almost two decades, and currently ranks 32nd in the country.

Between 1990 and 2016, North Carolina’s average overall health ranking has been 36th. Considering the state currently ranks 32nd and that in 1990 the state ranked 36th, it can be said the state moves up four spots every 16 years. At this pace it would take another 88 years – until the year 2104 – for NC to make it into the top 10 list of best states for overall health.

Based on the evidence it is clear that the state has not done enough to promote the health of its people. The fact that over 600,000 people in the state fall in the health coverage gap, as a result of the General Assembly’s decision not to expand Medicaid, does not help. The fact that the General Assembly’s budget was $188.7 million short of the Governor’s proposal for promoting the health of North Carolinians, does not help either.

This is troublesome considering that health outcomes are directly tied to length and quality of life, economic development, employee engagement, productivity, and making North Carolina a thriving and competitive state. These findings are also troublesome given the fact that the U.S. Congressional Budget Office has reported recent GOP health plan proposals would have devastating impacts on the health and financial security of North Carolinians, from those with low and middle incomes to our most vulnerable citizens, such as medically-fragile children and seniors living in nursing homes. Furthermore, it is known that states that expanded Medicaid and closed health coverage gaps – in turn providing people with preventative care – has helped them achieve better health outcomes. Given the research that shows the important role of access to preventive care, health education and health insurance, current proposals at the federal level will likely push NC’s health objectives back even further.

Ensuring good health policies and supporting North Carolina in achieving established health objectives by 2020 now requires, more than ever, a concerted effort from health professionals, insurers, business and community leaders, advocacy organizations, consumer groups, the faith community and North Carolina’s residents.

Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.

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