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March 13, 2017 Orange County has shown improvements in residents with a healthy weight according to national surveys. However, according to Community Health Assessment (CHA) results, 47% of survey respondents would be considered overweight or obese based on their BMI. In contrast, only 30% of survey respondents reported having been told by a doctor that they are overweight or obese. Sixty-five percent of CHA survey respondents reported meeting exercise recommendations. Social Determinants of Health and Access to Care Orange County has the highest Gini Coefficient of Income Inequality of all counties in NC with a population larger than 60,000 people (0.53). This means our county experiences high income dispersion, where fewer people hold a lot of wealth and many people hold little wealth. While the median income for households in Orange County is more than $59,000, 16% of residents are living in poverty, including 14% of children. Food insecurity and affordable housing are key areas of emphasis for mitigating the effects of poverty in Orange County. According to Feeding America, the percentage of the population that is food insecure (15%) stayed the same from 2013 to 2014. Orange County saw a decline in the percent of renters paying more than 30% or more of their income on rent, the definition of unaffordable housing. However, nearly half of Orange County renters still pay unaffordable rates for housing. North Carolina and Orange County each saw a decline in the percent of residents who are uninsured from 2013 to 2014 (age <65 years old). The percentage of low-income residents who were uninsured dropped the most drastically in North Carolina, from 33% to 25%. Orange County dropped at a slightly lower rate from 32% to 26%, putting us slightly behind the state and our peers. Orange County has seen a steady decline in uninsured rates across all indicators from 2011 to 2014. However, the percentage of low income children who were uninsured (12%) is still much higher than in our peer counties, the state, and the nation. In terms of resources, Orange County leads the state in physician density, and the supply of physicians grew from 2013 to 2014. In 2013 and 2014, Orange County ranked first in dentist density. Although there was a large decrease in the number of dentists in 2013, this trend reversed in 2014, with the dentist rate increasing by more than 6 dentists per 10,000 people. Sexually Transmitted Infections (STIs) The incidence of most STIs has increased in Orange County compared to previous years. Gonorrhea and HIV Infection Rates in particular are higher for Orange County than our peers, and increasing at a significant rate. Disaggregating this data by township has shown that these higher rates of STIs are affecting both urban and rural areas of the county. Maternal and Infant Health Orange County performs well on most indicators of Maternal and Infant Health, including having the lowest teen pregnancy rate in the state. However, many disparities exist for these indicators by race and ethnicity. For example, African American infants are more than three times as likely to die as Non-Hispanic white babies (disparity ratio of 3.2). Injury and Violence Injury and Violence statistics have remained generally stable in recent years. However, crime rates have decreased over the past decade. Alcohol related vehicle injuries are an area of concern for Orange County. Both alcohol related crash rates and reported drinking and driving behaviors among adults are more prevalent than our peers and the state.