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Annual Snapshot of Buncombe's Health

The County Health Rankings offer a snapshot of how healthy we are today and how healthy we will be in the future by giving us an idea of where we compare to other counties, the State, and the top-performing areas of the nation. The County Health Rankings, a collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Population Health Institute (UWPHI), offers a glimpse into factors that shape critical areas of health and safety that influence our quality of life in North Carolina and in Buncombe County. The Rankings consider factors such as high school graduation rates, access to healthy foods, rates of smoking, obesity, and teen births all of which have been shown to contribute to health outcomes. We can use The Rankings as a tool to direct our investments and measure our progress as we continue to find practical, innovative ways to raise the quality of life for our residents.

Buncombe’s Rankings in North Carolina:

Buncombe County ranks 25th out of 100 NC counties for overall Health Outcomes. Health Outcomes are an indicator of how healthy we are today and include factors such as how long people live (length of life) and how healthy people feel while they are alive (quality of life). While we are in the top 25% in the State, an area of concern continues to be a high rate of infant mortality.

Overall, Buncombe County ranks 5th out of 100 NC counties for Health Factors, which are indicators of how healthy we will be in the future. Health factors include measures such as access to medical care, high school graduation rates, violent crime, drug and alcohol abuse, and healthy living information.  This factor indicates that we are moving as a county in a direction that will lead to healthier outcomes.

Buncombe County is improving over time in areas such as preventable hospital stays, violent crime, diabetic monitoring, teen births and adult smoking rate, which are the health factors that show us we are on the right road for the future. Our rates of adult obesity, physical inactivity, health insurance status, and mammography screenings are trending stable. However, our County has seen an increase in: the number of injury related deaths, premature deaths, and higher rates of children living in poverty. Recent investments by the county (outlined below) will directly address these areas of concern.

Buncombe ranked 44th for Physical Environment, which measures air and water quality, severe housing problems, and number of commuters driving alone to work. All WNC counties appear in the list of worst air-quality counties in the state due to quality of air moving into our region from other parts of the US and improves in the eastern counties.

Buncombe County Strategies for Continued Improvement:

Buncombe County continues to partner with our community to support initiatives that are practical and evidence-based. Each of these efforts is focused on addressing the varied components that contribute to good health, working to offload negative factors and stack up our community’s positive factors.  Some examples of these efforts are:

  • Community Health Improvement Program (CHIP):  Health and Human Services continues to work with our CHIP partners, MAHEC and Mission Hospital to monitor and take action to improve our County’s key health priorities as identified in the Community Health Assessment (CHA).  The work to-date has focused on the agency-level response.  Starting this year, CHIP will work closely with the newly formed Community Engagement Team.  An example of a community-based effort coordinated through our CHIP partners and the HHS Community Engagement Team includes:
  • Community-Based Childbirth Experts: We are in the process of supporting community residents trained as licensed doulas and lactation consultants. These trusted health champions can improve health literacy, self-care, and health advocacy and help to improve health outcomes for our youngest residents.
  • Investment in our communities through Tipping Point Grants and the Isaac Coleman Community Investment Initiative. These investments focus on the homegrown efforts of communities to improve their health and resiliency and address social determinants of health, such as access to fresh fruits and vegetables, access to higher education, developing job skills, improving community connections, and neighborhood clean-up.
  • Buncombe County Family Justice Center launched in 2016 is a best practice, evidence-based response to domestic violence and sexual assault providing a pathway of safety, hope and healing for victims and their families.
  • BCHHS Mobilizing and Integrating Agency Priorities: Focusing agency efforts to have greater impact with the following populations: women and men of reproductive age at preconception, inter-conception, and perinatal stages. Actions for better outcomes include an embedded social work presence at Mission Hospital to assist mothers who are struggling with addiction to substances. BCHHS continues to double down on messaging to improve maternal and infant health through campaigns designed to improve preconception health and safe sleep practices. To improve infant mortality, BCHHS is providing safe sleep baby boxes to at-risk families.
  • ACE Collaborative and MARC Grant (Mobilizing Action for Resilient Communities): To date, the focus of the ACE Collaborative has been to coordinate and implement efforts to create trauma- informed practices in the clinical setting. Through the two-year MARC Grant, we are expanding this work out into the community, aligning the efforts of our neighborhoods and families to increase our capacity for more resilient behaviors and safer choices.

“What this data shows is that good health and wellbeing are complex and rely on many factors like housing, stability of relationships, access to greenways, and employment for the best outcomes to occur,” says BCHHS Health Division Director, Jan Shepard. “Our County’s investment in coordinated approaches to preconception health, domestic violence, opioid addiction and increased economic opportunities will continue to move us forward as a community toward greater resiliency and improved health.”

For more information on The Rankings, visit