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Social Determinants of Health is one thing that they will need in order to survive if they left the shelter tomorrow. Many factors can create or limit opportunities for good health. Some communities are rich in resources while Karen speaking participants shared that "money/ others lack the social, economic and environmental income is an issue that keeps us from having the investments that are needed to support good health. best quality of life. We don't make enough money to One's socioeconomic status including education, support our families because when income is calcu- employment, income and housing are all factors that lated, they only take into account the rent. Nothing influence health. else is factored". Employment and Income • Karen speaking participants shared that "there is not enough money to support health issues due to all Orange County's unemployment rate (5.2%), among the co-pays. My husband works but I don't". individuals 16 and over, is lower than NC (7.2%), Bruns- wick County (7.8%) and New Hanover County (7.0%)58. Karen speaking participants shared that "no one can When we look at race, in NC, the highest unemployment support a family by working in housekeeping or in rates are experienced by African Americans, American the cafeteria". Indians and Hispanic/Latinx populations59. Karen speaking participants shared that "money According to income inequality measures, wealth in is enough but not enough to obtain food stamps Orange County is not evenly distributed across resident and Medicaid because they say our spouse makes populations. Orange County has an income inequality too much. So it looks like we have too much Gini coefficient of 0.51 and is the second highest in NC. money when we don't because we are living pay- This coefficient is also higher among Buncombe County check-to-paycheck, day-by-day, with 5-6 kids". (0.429), Brunswick County (0.478), and New Hanover County (0.475), Orange County's peer counties. The Poverty Gini coefficient ranges between zero and one, where The U.S. measures poverty by the federal poverty zero represents perfect wealth equality and everyone level (FPL). The FPL uses food costs to estimate ba- has the same level or share of wealth and one rep- sic income levels for families. Research suggests that resents total inequality and only one person has all the most families need an approximate income of twice the wealth and everyone else has nothing60. FPL to meet their basic needs. Children living in fami- The county's median household income ($65,522) is lies with incomes below the FPL are referred to as low above both NC ($50,320) and the U.S. ($57,652), but income. In 2018, twice the FPL was $50,200 for a family hides various pockets of poverty. The chart below of four with two children. More than 1 million children in shows household income among survey respondents NC live in poor or low-income households61. compared to Orange County residents, with the highest 14% of Orange County residents live in poverty. Poverty percentage of individuals making $100,000 - $249,999. is experienced the highest among individuals 18 to 64 Among Focus Group participants: years of age (17.3%), followed by those 18 and younger (9.3%) and then those 65 years and older(5.3%). The • Homeless participants shared that sufficient income most common racial or ethnic group living below the Figure 13: Household Income 25.00% 20.00% 15.00% OC Residents 10.00% (2018) 5.00% Survey 0.00% Respondents Less than $10,000- $15,000- $25,000- $35,000- $50,000- $75,000- $100,000 $250,000 (2019 CHA) $10,000 $14,999 $24,999 $34,999 $49,999 $74,999 $99,999 - or more $249,999 2019 COMMUNITY HEALTH ASSESSMENT 25