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How healthy, wealthy is Alamance County? Here are the numbers.

The 2018 Alamance County Community Assessment paints a picture of a growing county with economic challenges and disparities among racial groups contributing to health problems and a need to focus on education, access to healthcare, exercise, good food and poverty.

The Alamance County Health Department, Impact Alamance, Healthy Alamance, Alamance Regional Medical Center and Cone Health and the United Way of Alamance County collected data for the report, which is done every four years. It’s available at

The county’s population is older than the state as a whole. Statewide and locally, 45- to 54-year-olds make up the largest age group, but the county’s percentage of the middle-aged, at 13.5 percent, is nearly a third of a percentage point higher than the state’s, according to the CHA. While statewide 25- to 44-year-olds — at more than 25 percent of the population — make up a larger proportion of the population than in Alamance County, which is less than 24 percent.

Other demographics:

    • 57 percent of the county is occupied by single-family homes on five acres or less with heavy growth in the Southeast.
    • 39 percent is agriculture.
    • Population: 162,000, a nearly 7-percent increase since 2010.
    • 68 percent white.
    • 19 percent black.
    • 13 percent Latino.
    • 2 percent Asian.
    • Less than 1 percent American Indian.
    • 43,554 families, a 9-percent increase over 2010.
    • 64,205 households.



Largest employment sectors as of 2016:

    • 21 percent of Alamance County workers are in education, government or non-profits;
    • 20 percent manufacturing;
    • 17 percent retail and services;
    • 17 percent medical and healthcare; and
    • 13 percent leisure and hospitality.

More about our incomes:

    • $42,463 median income, more than $9,000 less than the state median.
    • $57,308 — the “self-sufficiency standard,” which is the minimum estimated income to realistically support a family of four in Alamance County without public assistance.
    • 118 families per average week get help at Allied Churches of Alamance County.
    • 28 percent of children lived in poverty from 2012 to 2016, about 4 percent more than the state’s child poverty rate.
    • 53 percent of students eligible for free-or-reduced school lunches.
    • 59 percent of households with children receive food stamps, compared to the state rate of 54 percent.

Poverty is concentrated in the northeast part of the county where 17 to 29 percent of families with children live below the poverty line, though the area along the Orange County line is much better off with 3 percent or less living below the poverty level. Southeast Alamance also has a high poverty rate, at 12 to 17 percent, while northeast Alamance near the Guilford County line is fairly affluent.

    • 13.8 percent of families living below the poverty level in 2016 was a lot higher than the 11.7 percent in 2011, but also a decline from the 2011 to 2015 peak of 14.4 percent. It’s also higher than the state’s 12.4 percent rate.
    • 27.8 percent of local children live below the poverty level, putting it among the higher rates in the state compared to the state level of 23.9 percent.
    • 12,007 families, or 25,055 individuals, got assistance through SNAP (food stamps) in 2017.
    • 24 percent of recipients were working.


The 2017 infant mortality rate was 5.2 deaths per 1,000 live births younger than 1 year old — a big drop from 8.7 in 2003. The statewide infant mortality rate was 7.1 deaths per 1,000 births.

Though minority infant mortality rates have fallen by 50 percent since 1999, it was still high, at 13.4 deaths per 1,000 births among black women.

Sixteen out of 1,000 births in 2012 to 2016 were to 15-to-17-year-old girls, though it was closer to 24 per 1,000 among African American and Hispanic girls, while white girls were closer to 12. Those numbers are higher than the state and national averages.

Causes of death:

    • 1,609 people died locally in 2017.
    • 20 percent died from heart disease, also the leading reason for hospitalization.
    • 19 percent from cancer.
    • 40 percent of cancers diagnosed were related to obesity.
    • 28 percent were forms of lung cancer.
    • Diabetes became the seventh leading cause of death in Alamance and statewide in 2007.

Sexually transmitted infections reported in 2017:

    • 905 chlamydia cases;
    • 273 gonorrhea cases;
    • 22 HIV cases; and
    • 22 syphilis cases.

Free screenings are available:

    • Alamance Cares – 3025 S. Church St., Burlington
    • Open Door Clinic of Alamance County – 319 N. Graham-Hopedale Road, Burlington

Opioid crisis

    • 49 opioid deaths were reported in Alamance County between 2013 and 2016
    • 19 were reported in 2017
    • 369 doses of naloxone countering opioid overdose were administered by Alamance County EMS in 2017.

Quality of life

    • 3.8 – days per month the average Alamance County resident experiences poor health, which is higher than the state rate of 3.6 days and an indication of worsening quality of life in Alamance County with the county’s rank going from 47th out of 100 counties for poor health affecting quality of life in 2015 to 63rd last year.
    • 44 percent of adults had permanent teeth removed due to gum infection as of 2016. Dental problems have a huge impact on general health, while dental care is expensive and often neglected.

Exercise makes a big difference in obesity and heart health.

Eighty-six percent of people lived near a park with things like trails and other ways to exercise last year compared to a little more than 77 percent in 2014, which is better than the state average.

About $4 million has been spent on those facilities since 2015. Much of that came from Impact Alamance grants, and the school system made its tracks and fields available for the public, municipalities built more sidewalks and bike lanes, and the county opened about 20 miles of hiking trails with more planned.


Seven percent of Alamance County residents in 2018 didn’t have easy access to nutritious, fresh food either because they lived too far from a grocery store and didn’t have reliable transportation, or simply didn’t have enough steady income. That percentage is higher than the state’s and has grown from a little more than 6 percent in 2015.

Fifty-seven percent of respondents to the Elon Poll said they lived more than a mile from a place to get fresh produce.

Food swamps — areas with four or more unhealthy options, like fast food and snacks rather than healthy options in grocery stores, is a local problem. One option the report suggests is limiting the number of fast-food restaurants allowed in a particular area with zoning ordinances.


    • 48 medical care providers per 100,000 people in Alamance County last year is considered a low ratio, according to the report, though a significant increase from 22 in 2015.
    • 18 percent of adults didn’t have health insurance as of 2017. That’s a steady drop from about 26 percent in 2011, but still nowhere near the best rates in North Carolina.
    • 12 percent of 18- to 64-year-olds — most likely to be ineligible for Medicaid or Medicare — had no insurance in 2016, a 2-percent decrease just from the year before, thanks at least in part to efforts to enroll people in the Affordable Care Act, according to the report.
    • 95 percent of children in Alamance County were insured in 2016, which is in the top half of North Carolina counties.
    • Distrust of the healthcare system keeps people, especially minorities, from seeking healthcare. Those who do find they have to work harder than they should to get care, according to a focus group cited in the assessment.
    • More people in Alamance County used the emergency department to diagnose diabetes and stroke than in neighboring counties, indicating that people aren’t getting regular care from general practitioners.


Education correlates to health with those who go farther in school living longer and suffering fewer serious illnesses, though there are still dramatic differences in the health among educated minorities and whites, according to the report.

82 percent high school graduation rate is lower than the state average of nearly 87 percent, but an improvement over 81 percent in 2016.

Graduation rates still vary widely by race and ethnicity:

    • 85 percent white;
    • 82 percent black; and
    • 75 percent Hispanic.

Reporter Isaac Groves can be reached at or 336-506-3045. Follow him on Twitter at @tnigroves.