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2018 Public Health Dashboards May 13, 2018 Executive Summary 4 | Page As of February 2018, North Carolina has enrolled 2,055,472 individuals in Medicaid and CHIP — a net increase of 29% since the first Marketplace Open Enrollment Period and related Medicaid program changes in October 2013. However, NC falls five percentage points (5%) behind the US, and Orange County falls seven percentage points (7%) behind. In numbers, this represents a difference of nearly 187,000 low‐income individuals in NC and more than 10,000 low‐income individuals in Orange County that would be covered if the county’s uninsured rates matched those of the United States. In terms of resources, Orange County leads the state in physician density, and the supply of physicians grew from 2013 to 2016. 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. Trends in 2016 continue to show growth in both physician and dentist density. Sexually Transmitted Infections (STIs) The incidence of most STIs increased in 2016 for Orange County. Gonorrhea, Chlamydia and HIV Infection Rates in particular are higher for Orange County than our peers, and increasing at a significant rate. From 2012‐2016, Chlamydia increased at a faster rate than North Carolina (~13 case increase a year per 100,000 for NC vs ~ 35 case increase a year per 100,000 for Orange County. Disaggregated data from 2015 by township has shown that these higher rates of STIs are affecting both urban and rural areas of the county. Injury and Violence Alcohol related vehicle indicators showed improvement from 2015 to 2016, which was identified as an area of concern on previous dashboards. Both alcohol related crash rates and reported drinking and driving behaviors among youth saw a decrease. However, texting and driving is rising among youth (21% in 2017, compared to 17% in 2015). 2016 also saw an increase in several indicators related to violent crime. In particular, the indicator for rape crimes increased from 15 per 100,000 to 21 per 100,000. While sexual assault crimes are often under reported, national media trends have increasingly reported on a movement to hold public figures responsible for these crimes and may account for some of this increase in reporting at the local level. In any case, this is an indicator to be aware of for Orange County as it is on the rise and greater than or peers. Drug overdose is an additional area of concern, examined in greater depth as a part of the Substance Use and Mental Health dashboard and summary. Maternal and Infant Health Orange County performs well on most indicators of Maternal and Infant Health, however many disparities exist for these indicators by race and ethnicity. In 2016, Orange County also saw an increase in the teen pregnancy rate and % of teen pregnancies that are repeat. 1 in 4 teen pregnancies in 2016 was a repeat teen pregnancy. With small numbers, it is important to remember that fluctuations in indicators such as these is expected from year to year. Non‐Hispanic Black Babies in particular are at high risk for either a low or very low birth weight as compared to other race and ethnicity groups. Approximately 13% Non‐Hispanic black children are born low birth weight as compared to 6% Non‐Hispanic White children. Similarly 3.2% Black children have a very low birth weight, whereas only 1.2% Non‐Hispanic White births are very low birth weight. Therefore, Non‐Hispanic Black babies are more than two times as likely to be born with a low or very low birth weight as compared to their Non‐Hispanic White peers.