Western North Carolina is home to nearly one million people living in 18 counties. On average, our primarily rural region is poorer, older, and less resourced than other areas of the state, but our communities are close-knit, innovative, and resilient.
Some of our region's most pressing rural health challenges include:
Limited Health Workforce
- All 18 WNC counties are primary care health professional shortage areas (HPSA)
- Only 6 out of 10 adults in 16 WNC counties had a dental visit in the past year
- WNC Health Network. (2018). 2018 WNC Healthy Impact Community Health Survey: Data Workbook. [Data set]. Source
- 5 WNC counties have no practicing Psychiatrist
- NC Health Workforce. (2024). North Carolina Health Professional Supply Data. [Data system]. Source
- 7 WNC counties have no practicing Ob/Gyn
- NC Health Workforce. (2024). North Carolina Health Professional Supply Data. [Data system]. Source
Fewer Resources
- Geography creates transportation challenges
- 2 Rural Hospital closures since 2005
- The Cecil G. Sheps Center for Health Services Research. (2025). Rural Hospital Closures. [Data set]. Source
Ongoing Opioid Epidemic
- 12 out of 18 counties have higher rates of opioid-related deaths than the state average
- NC Overdose Epidemic Data. (2025). Interactive Overdose Data. [Data charts]. Source
- In WNC, from 2019-2023, it was more than twice as likely for a person to die from an opioid overdose than from a car crash
- NC State Center for Health Statistics (NC SCHS). (2025). Race-Specific and Sex-Specific Age-Adjusted Death Rates by County: County Health Data Book. [Data tables]. Source
- NC Overdose Epidemic Data. (2025). Interactive Overdose Data. [Data charts]. Source
Challenging Social Determinants of Health
- In WNC, from 2019-2023, 19.3% of children live in poverty, which is 1.2% greater than the state average
- U.S. Census Bureau. (2025). Poverty Status in the Past 12 Months: ACS 5-Year Estimates. [Data tables]. Source
- 23.6% of WNC is age 65 or older, which is 6.9% higher than the state average
- U.S. Census Bureau. (2025). ACS Demographic and Housing Estimates: 2023 ACS 5-Year Estimates. [Data tables]. Source
- 18.1% of WNC ages 18-65 is uninsured, compared to 12.7% of NC and 8.1% of the U.S.
- WNC Health Network. (2024). 2024 WNC Healthy Impact Community Health Survey: Data Workbook. [Data set]. Source
- Median WNC household income is $12,602 less than the state average
- U.S. Census Bureau. (2025). Selected Economic Characteristics: ACS 5-Year Estimates. [Data tables]. Source
Above-Average Rates of Disease
- Diseases of the heart
- Chronic liver disease and cirrhosis
- Chronic lower respiratory diseases
- Alzheimer’s disease
- NC State Center for Health Statistics (NC SCHS). (2024). Causes of Death. [Data tables]. Source
