The Center for Women’s Health Research (CWHR) released our ninth-edition of the North Carolina Women’s Health Report Card May 9, 2016. This document is a progress report on the health and health care needs of North Carolina’s 5+ million women. Research efforts that require the most attention are identified through the collection and analysis of data for the report card. Current areas of research targeted by the Center include prevention, cancers affecting women, chronic disease (including cardiovascular health, diabetes and obesity), women’s mental health, and substance abuse. It is the only health report of its kind in North Carolina.

Previous editions have been released biennially and tracked the state’s female health statistics in two year increments. CWHR’s 2012 edition analyzed indicators over a nine-year time period which allowed for the inclusion of a trends analysis. The 2016 edition presents data primarily from 2014. Previous editions of the report card are also available for comparison. While each section below has key observations from the report card’s advisory board, there is also a summary of key findings available – the top three positive and adverse findings from this report card. Readers will also note that Healthy People 2020 is often cited as a benchmark to determine how North Carolina is hitting targets set by a consortium of agencies.

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Source: Carolina Demography analysis of American Community Survey Data (1-year samples from IPUMS-USA). Life expectancy at birth from NC SCHS. County projections from North Carolina Office of State Budget and Management (OSBM). Download 2008-2014 Data

Observations

  • The state’s female population is steadily growing and women are projected to outnumber men through 2020.
  • Overall, the median age is increasing, particularly among Caucasian women who have an average age of 42.6. Asian and Hispanic women in NC have an average age of 28.7 and 26.3 respectively, and represent the youngest segments of the population.
  • The average life expectancy, at birth, is 80.7 in NC, while the national average is 81.

The following data represents that reported by NC women in 2014:

Number of Women (all ages) 5,106,024
Life Expectancy at Birth 80.7
Age (Average all NC Women) 39.4 NCWHRC Average Age
Caucasian 42.6
African American 37.3
Asian 34.1
Average Age: Other 28.7
Hispanic 26.3
Age (% by Years of Age)
Under 18 22% NCWHRC Age by Years
18 to 29 16%
30 to 44 20%
45 to 59 20%
60 and older 22%
Race & Ethnicity %
Caucasian 64% NCWHRC Race Ethnicity
African American 22%
Asian 2%
Other 3%
Hispanic 8%
% Veteran (18+) 1.7%
Source: Carolina Demography analysis of American Community Survey Data (1-year samples from IPUMS-USA). Download 2008-2014 Data

Observations

  • The number of married women has slowly decreased, and been replaced with higher numbers of women who report their marital status as single, widowed or divorced/separated.

The following data represents that reported by NC women in 2014:

Average family size
All Women 2.66 NCWHRC Average Family Size
Caucasian (non-Hispanic) 2.52
African American (non-Hispanic) 2.77
Asian (non-Hispanic) 3.20
Other (non-Hispanic) 2.72
Hispanic 3.47
% with own children in home (regardless of child age)
All Women 37% NCWHRC Children in Home
Caucasian (non-Hispanic) 34%
African American (non-Hispanic) 40%
Asian (non-Hispanic) 52%
Other (non-Hispanic) 36%
Hispanic 53%
Among those with children in the home:
Number of children (average)
All Women 1.73 NCWHRC Average Number Children
Caucasian (non-Hispanic) 1.68
African American (non-Hispanic) 1.75
Asian (non-Hispanic) 1.67
Other (non-Hispanic) 1.70
Hispanic 2.09
Number of children <5 (average)
All Women 0.32 NCWHRC Less Than Children
Caucasian (non-Hispanic) 0.31
African American (non-Hispanic) 0.28
Asian (non-Hispanic) 0.35
Other (non-Hispanic) 0.39
Hispanic 0.45
% giving birth in past year (ages 15-50)
All Women 5% NCWHRC Number Given Birth
Caucasian (non-Hispanic) 5%
African American (non-Hispanic) 5%
Asian (non-Hispanic) 7%
Other (non-Hispanic) 7%
Hispanic 8%
Marital Status (15+)
Married 46% NCWHRC Marital Status
Divorced/Separated 16%
Widowed 9%
Never Married/Single 29%
Source: Homelessness counts from NC Coalition to End Homelessness Point-in-Time Coutn Data for 2014 (retrieved from www.ncceh.org/pitdata). All other data from Carolina Demography analysis of American Community Survey Data (1-year samples from IPUMS-USA). Download 2008-2014 Data

The following data represents that reported by NC women in 2014:

Among women 18+
% Living in Group Quarters (all types) 2% NCWHRC Living 18
% Living in Households 98%
If living in Households
% Living in Single-Female Headed Household NCWHRC Living Single
All NC Women 22%
All NC female children (age 0-17) 29%
All NC women age 18+ 21%
Share of ALL NC households that are Single-female households 14%
% of 65+ living alone 33.9%
Caucasian (non-Hispanic) 34% NCWHRC Elderly Living Alone
African American (non-Hispanic) 35%
% 18+ Living in HH receiving food stamps 16.9%
Caucasian (non-Hispanic) 11% NCWHRC Food Stamps
African American (non-Hispanic) 32%
Asian (non-Hispanic) 10%
Other (non-Hispanic) 30%
Hispanic 21%
Homelessness
Total Number of Homeless Women 4,520 NCWHRC Homeless
with adults and children 2,565
w/o any children 1,923
child-only homeless 32
% of NC Female Population 0.09%
Source: Carolina Demography analysis of American Community Survey Data (1-year samples from IPUMS-USA) and 2014 Behavioral Risk Factor Surveillance System (BRFSS). Download Data

The following data represents that reported by NC women in 2014:

% with ANY health insurance (18-64) 83%
Caucasian (non-Hispanic) 87%
African American (non-Hispanic) 82%
Asian (non-Hispanic) 88%
Other (non-Hispanic) 81%
Hispanic 51%
% Women 18-64 with Private Health Insurance 71%
If receiving private health insurance
% with insurance from employer/union 80%
% who purchased insurance directly 19%
% with insurance through TRICARE 6%
% Women 18-64 with Public health insurance coverage 15%
If receiving public health insurance:
% with insurance through Medicaid 79%
% with insurance through Medicare 30%
% with insurance through VA 5%
% with insurance through Indian Health Services 0.3%
Note: Individuals can receive health insurance coverage from multiple sources
All NC Females Caucasian Females African American Females Other Minority Females
Women with any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare 84.1% 86.6% 86.8% 55.1%
Eastern NC 84.6%
Piedmont 83.3%
Western 85.3%
Women who have Medicare (if have some form of health insurance) 33.4% 35.8% 29.8% 19.3%
Health insurance coverage (under age 65) 79.8% 82.3% 84.4% 52.1%
Health insurance coverage (under age 65) if employed for wages 85.7% 87.4% 87.2% ***
Among those without health insurance (~15%), how long since they have had any health insurance coverage
Less than a year 22.5% 26.9% 25.5% ***
1 – 3 years 14.4% 14.9% 22.3% ***
3+ years 34.0% 38.3% *** 14.6%
Have never had health insurance 29.1% 19.9% *** 69.3%
Women who had NO health insurance coverage at any point in past 12 months 8.4% 6.8% 12.4% 12.4%
Women who have one person they think of as personal doctor/health care provider
Yes, only one 66.1% 68.2% 66.6% 46.2%
Yes, more than one 15.8% 16.9% 15.4% 9.0%
Women who did not see a doctor when needed within past 12 months due to cost 19.0% 16.7% 20.7% 32.5%
Women who have delayed getting needed medical care within the past 12 months because:
Appointment not soon enough 5.6% 5.3% 6.1% 7.3%
Wait was too long 2.6% 2.1% 3.8% 4.4%
No transportation 3.2% 2.2% 4.8% 6.7%
Other 9.3% 8.9% 9.2% 12.8%
Did not delay/no medical care needed 79.2% 81.5% 76.1% 68.8%
Number of times women have been to a doctor, nurse, or other health professional in the past 12 months
1 visit 15.7% 14.9% 16.0% 21.4%
2 visits 19.1% 18.0% 20.3% 22.9%
3 visits 13.4% 13.5% 14.4% 10.4%
4 or more visits 42.5% 45.6% 39.8% 27.3%
Never 9.3% 8.0% 9.5% 18.0%
Women who did not take a medication as prescribed due to cost at some point in the past 12 months 13.1% 12.4% 15.5% 14.6%
Women who currently have medical bills that are being paid off over time 29.6% 26.0% 39.7% 30.6%
Source: Carolina Demography analysis of American Community Survey Data (1-year samples from IPUMS-USA). Download

Observations

  • On the whole, the economy is improving in North Carolina, which brings health benefits. However, the state is still far from pre-recession levels.
  • There is an overall improvement in insurance status that doesn’t seem to be attributed to employer sponsored insurance or Medicare/Medicaid. However, minority women are 1.82 times as likely to have lacked health insurance at some point in the past year compared to Caucasian women.
  • African American women were 1.24 times as likely to have not seen a doctor due to cost in the past year as Caucasian women. Despite this, African American women also report higher rates of medical debt than any other group. Other minority women citied not seeing a doctor in the past year due to cost 1.95 times more than Caucasian women

The following data represents that reported by NC women in 2014:

% in the labor force (among women 18-64) 70%
% unemployed (among women 18-64 and in the civilian labor force) 8.0%
Poverty Status among women 18+
% In Poverty 18%
% Extreme Poverty (<50% FPL) 9%
% Near Poverty (100-150% FPL) 11%
% Poverty by Race/Ethnicity
Caucasian (non-Hispanic) 14%
African American (non-Hispanic) 27%
Asian (non-Hispanic) 13%
Other (non-Hispanic) 28%
Hispanic 32%
Earned Income
% with any earned income (18+) 60%
Median earned income (if have earned income) $24,700
% with earned income (18-64) 72%
Median earned income (18-64) (if have earnings) $25,000
Any Disability (Ages 18+) 17.2%
Disability by Age (18+)
18 to 29 6%
30 to 44 7%
45 to 59 17%
60 and older 34%
Disability by Race/Ethnicity (18+)
Caucasian (non-Hispanic) 18%
African American (non-Hispanic) 20%
Asian (non-Hispanic) 6%
Other (non-Hispanic) 22%
Hispanic 7%
Speak English Less than “Very Well” (18+) 5%
Caucasian (non-Hispanic) 1%
African American (non-Hispanic) 1%
Asian (non-Hispanic) 38%
Other (non-Hispanic) 3%
Hispanic 48%
Source: Carolina Demography analysis of American Community Survey Data (1-year samples from IPUMS-USA). Download 2008-2014 Data

Observations

  • Educational attainment has slightly increased with more women attending college and completing higher degrees.

The following data represents that reported by NC women in 2014:

Educational Attainment (25+)
Less than HS 12%
HS/GED 25%
Some College 33%
BA+ 29%
Caucasian (non-Hispanic) Educational Attainment (25+)
Less than HS 8%
HS/GED 25%
Some College 34%
BA+ 32%
African American (non-Hispanic) Educational Attainment (25+)
Less than HS 15%
HS/GED 27%
Some College 36%
BA+ 22%
Asian (non-Hispanic) Educational Attainment (25+)
Less than HS 17%
HS/GED 16%
Some College 18%
BA+ 48%
Other (non-Hispanic) Educational Attainment (25+)
Less than HS 16%
HS/GED 22%
Some College 36%
BA+ 26%
Hispanic Educational Attainment (25+)
Less than HS 41%
HS/GED 23%
Some College 21%
BA+ 15%
% Currently enrolled in school (18-29) 39.5%
Caucasian (non-Hispanic) 41%
African American (non-Hispanic) 39%
Asian (non-Hispanic) 50%
Other (non-Hispanic) 40%
Hispanic 31%
Source: Carolina Demography analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS). Download

2016NCWHRC_Preventative.jpg
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Observations

  • African American women lag behind women of other races in physical exercise.
  • Healthy People 2020’s target for seasonal influenza (flu) vaccinations is 70%. Only 44.6% of NC women received a flu shot in 2014.
  • The Healthy People 2020 goal for sleep is that 70.8% of women get 7+ hours a night. NC women fall short of that target at 68%, with only 60.5% of African American women and 66% of other minority women reporting 7+ hours of sleep a night. Sleep loss and untreated sleep disorders influence basic patterns of behavior that negatively affect family health and interpersonal relationships. Fatigue and sleepiness can reduce productivity and increase the chance for mishaps such as medical errors and motor vehicle or industrial accidents.
  • Dental care is a weakness for all women, but particularly non-Caucasian women.
  • The number of Caucasian women aged 50-74 who reported receiving a mammogram in the past two years (80.9%) is just below the Health People 2020 target of 81.1%. African American women in the state exceed the target (81.3%).
  • North Carolina women are exceeding Healthy People 2020 targets for colorectal screenings.
  • On the whole, Caucasian women are much more likely to be diagnosed with a range of illnesses, such as chronic disease, cardiovascular disease, and depression. They are also more likely to report cancer, and less likely to die from cancer. This suggests a racial health disparity in doctor willingness to diagnose or a lack of doctor access.
  • Although data is often unavailable, Hispanic/Asian/Other women appear to have very low health screening rates.

The following data represents that reported by NC women in 2014:

All NC Females Caucasian Females African Americans Females Other Minority Females
Women 50+ who have ever had a sigmoidoscopy or colonoscopy 72.8% 77.2% 75.3%
Women age 50-75 who received one or more of the recommended colorectal cancer screening tests within the recommended time interval. 73.9% 74.4% 75.1%
Women 50-74 who have mammogram in last 2 years 80.7% 80.9% 81.3%
Women who have visited the dentist/dental clinic in the past year 66.5% 70.0% 60.3% 53.5%
Women 18+ who have had pap test w/in past 3 years 78.2% 79.4% 76.9% 74.0%
Women 65+ who have ever had a pneumonia vaccination 73.1%
Women 65+ who have had a flu shot within past year 70.6%
Women 18+ who have had a flu shot in the past year 44.6% 52.0% 38.3% 44.8%
Women who participated in physical activities in past month 75.5% 76.9% 70.7% 75.2%
Women who had a routine checkup in the past year 49.5% 79.9% 82.9% 66.2%
Women who sleep, on average, 7 or more hours in a 24-hour period 68.0% 70.4% 60.5% 66.0%
Source: Carolina Demography analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS). Download

2016NCWHRC_ChronicDisease.jpg
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Observations

  • Obesity plays an important role in the risk factors for diabetes, cardiovascular disease, and stroke.
  • Medical screenings and interventions continue to increase. Particular attention to lifestyle factors such as diet and physical activity have been shown to have a positive impact on weight data.
  • Heart disease is the number one killer of women. While it is a serious concern for women of all ages, rates of heart disease increase dramatically between age groups 55-64, 65-74, and 75+. Women should strive to maintain a healthy weight and diet while engaging in exercise to decrease their risk of heart disease.
  • Arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia is common and experienced by 31.5% of the state’s women. After age 55, over half of women reported arthritis or a related disease. By age 75+, this was the most common chronic disease reported. Older women need to be especially careful about arthritis pain because it can lead to falls.
  • The data shows that after age 65, over half of North Carolina women are living with two or more chronic diseases.
  • African American women are nearly twice as likely as Caucasian women to meet criteria for obesity. This is undoubtedly a major contributor to the finding that 45% of the state’s African American women have been diagnosed with high blood pressure. It also reflects their increased risk for metabolic disorders, such as diabetes. Importantly, 69.5% of African American women are being appropriately screened for diabetes.
  • Many women with diabetes are unaware that they have it, and discovery may not occur until after damage to the heart, eyes, kidneys and other organs has occurred. Risk increases rapidly from ages 35 to 64. Women should talk with their doctor about diabetes prevention and whether they need to be tested for diabetes. African American women in North Carolina have the highest prevalence and risk factors.

The following data represents that reported by NC women in 2014, unless otherwise noted:

All NC Females Caucasian Females African American Females Other Minority Females 18 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75+
Women with no chronic diseases 44.1% 39.6% 52.5% 57.5% 67.2% 54.5% 43.2% 27.1% 20.6% 14.1%
Women with 1 chronic disease 26.5% 28.3% 22.0% 23.2% 24.7% 25.6% 27.9% 28.1% 26.6% 28.3%
Women with 2 or more chronic diseases 29.4% 32.1% 25.5% 19.4% 8.1% 19.9% 28.9% 44.8% 52.7% 57.6%
Chronic disease summary index is comprised of 9 indicators
History of any cardiovascular disease (heart attack/stroke/angina). Consists of yes to any of the following: 9.2% 9.8% 7.9% 8.6% *** *** 9.3% 10.8% 19.6% 29.4%
Ever been told you had a heart attack (also called myocardial infarction)? 4.0% 4.3% 2.9% 4.7% *** *** 4.9% 4.4% 8.0% 12.2%
Ever been told you have angina or coronary heart disease? 4.5% 4.9% 3.9% 3.3% *** *** 4.4% 5.8% 9.3% 15.6%
Ever been told you had a stroke? 3.7% 3.8% 3.5% 4.3% *** *** 3.3% 4.5% 9.2% 10.5%
Women currently with asthma 9.7% 9.8% 10.8% 7.1% 8.4% 10.6% 10.3% 11.5% 11.2% 6.8%
Women ever told they had skin cancer 6.6% 9.0% *** 2.9% *** *** 6.0% 8.5% 15.2% 19.7%
Women ever told they had other cancer 7.4% 9.1% 3.6% 3.9% *** 4.9% 5.9% 10.3% 15.9% 18.9%
Women ever told they had COPD, emphysema, or chronic bronchitis 8.1% 8.9% 6.9% 5.8% 2.5% 5.4% 8.8% 11.7% 15.3% 12.8%
Women ever told they had some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia 31.5% 33.6% 29.1% 21.2% 6.7% 18.2% 33.5% 50.7% 55.3% 64.7%
Women ever told they had a depressive disorder, including depression, major depression, dysthymia, or minor depression 23.6% 27.1% 14.2% 21.8% 20.3% 23.5% 26.7% 31.0% 24.9% 16.2%
Women ever told they had kidney disease 2.9% 2.9% 2.3% 5.0% *** *** 2.3% 3.9% 4.6% 8.2%
Women ever told they had diabetes 10.7% 9.5% 14.9% 9.7% 1.3% 8.0% 11.0% 17.8% 19.4% 21.2%
Other Diabetes
Women ever told by a health professional they have pre-or borderline diabetes 1.8% 1.6% 2.2% 1.6% 2.5% 2.7% 4.1%
(2013 BRFSS) Women ever been tested for high blood sugar or diabetes in the past 3 years 64.4% 62.4% 69.5% 68.0% 54.2% 60.3% 66.2% 76.1% 72.7% 71.6%
Weight range (at recommended, overweight, obese, underweight or unknown) by Race/Ethnicity
Recommended Range 36.8% 40.7% 23.2% 42.5% 44.0% 34.9% 34.5% 29.6% 33.3% 41.3%
Overweight 29.7% 29.8% 30.6% 25.0% 23.1% 29.5% 31.2% 34.2% 35.5% 30.3%
Obese 31.1% 26.7% 44.9% 31.7% 28.8% 34.1% 32.3% 34.9% 30.3% 24.9%
*The estimate for underweight data was suppressed because it did not meet reliability standards.
Other (from 2013 BRFSS)
% of women who have ever told by health professional they have high blood pressure (2013 BRFSS) 34.7% 33.7% 45.1% 16.1% 9.0% 19.9% 40.6% 48.0% 63.0% 70.4%
% of women who have ever told by health professional they have high cholesterol (2013 BRFSS) 40.6% 43.1% 36.7% 27.1% 13.7% 27.8% 41.4% 55.4% 58.6% 59.4%
Source: Carolina Demography analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS). Download

2016NCWHRC_MentalHealthandSubstanceAbuse.jpg
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Observations

  • One in four North Carolina women reported three or more adverse childhood experiences. This rate is higher than national averages and should be an area to highlight for intervention efforts. The data underscores not only the prevalence and problem of childhood adversity, but that it cuts across all socioeconomic and racial divides, especially childhood sexual abuse. Depression in later life is a common consequence of childhood adversity.
  • Depression is common and must be part of regular health screening for women— both in the perinatal period and at all other times. There are effective treatments, and women should not hesitate to discuss their concerns with their primary care doctor.
  • Women in minority groups have greater prevalence of depression at all ages and these groups should have targeted assessments and interventions. Rates of depression are substantially higher in North Carolina compared to national averages.
  • Depression peaks in women aged 55-64 (31%), then decreases.
  • Caucasian women in North Carolina are twice as likely to have been diagnosed with a depressive disorder as African American women. Research suggests this may be due to the heavily rural makeup of the state, however the racial difference in childhood adversity is also a likely causal factor.
  • Caucasian women across the state are also somewhat more likely to suffer from two or more chronic diseases compared with African American women. Depression shares a common biological basis with many chronic diseases, including coronary heart disease, diabetes, and rheumatoid arthritis. Consequently, the higher rates of depression seen in Caucasian women may increase their risk for comorbidity of medical illnesses.
  • North Carolina substance use data among women is slightly lower than national data and is generally in line with other states’ data. However, the need for effective prevention and treatment still exists.
  • Smoking continues to be a big problem for Caucasian women, more than women of any other race. Caucasian women smoke more frequently, the lung cancer rate is much higher, and smoking during pregnancy is more common among Caucasian women.

The following data represents that reported by NC women in 2014:

All NC Females Caucasian Females African American Females Other Minority Females
Percent of women ever diagnosed with depressive disorder 23.6% 27.1% 14.2% 21.8%
Percent of women reporting 3+ adverse childhood experiences 26.5% 28.0% 17.8% ***
Percent of women who currently smoke 16.5% 17.1% 15.5% 12.9%
Percent of women who participate in binge drinking 8.3% 8.6% 8.6% 4.3%
Percent of women who participate in heavy drinking 3.9% 4.5% 2.8% ***
Source: NC 2014 HIV/STD Surveillance Report. Download

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Observations

  • North Carolina continues to be well below the Healthy People 2020 goal of having 73.6% of all adolescents and adults tested for HIV.

The following data represents that reported by NC women in 2014:

All NC Females Caucasian Females African American Females Other Minority Females Hispanic Females
Percent ever tested for HIV (2014 BRFSS) 44% 38% 61% 52%
HIV/AIDS/STD Incidence per 100,000 women (newly diagnosed cases in 2014)
HIV infections 6.9 1.7 21.8 9.2
AIDS 5.1 1.0 17.8 5.3
Primary and secondary syphilis 1.3 0.3 4.2
Early latent syphilis 1.3 0.5 3.9 1.6
Gonorrhea 158.2 33.0 385.0 45.7
Chlamydia 736.3 226.8 1,289.0 585.7

Source: Carolina Demography analysis of 2014 NC Live Births. Download

2016NCWHRC_Perinatal
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Observations

  • Reliable data for North Carolina with an adequate sample size has remained unavailable since 2011. Previous data and comments are available from the 2011 PRAMS Survey.
  • More North Carolina babies are born with a low birth weight (8.9%) than the Healthy People 2020 target of 7.8%. African American women were more likely than other ethnicities to experience premature birth, and have babies with a lower birth weight. Preterm birth and low birthweight can both have lifelong implications for the health and well-being of families.

The following data is from 2014 NC Live Births:

Total Non-Hispanic Caucasian Non-Hispanic African American
Non-Hispanic Other Hispanic
Low Birth Weight (<=2500 grams) 8.9% 7.5% 13.8% 8.9% 6.6%
Normal Birth Weight 91.0% 92.5% 86.2% 91.0% 93.4%
Premature Birth (<37 weeks) 11.4% 9.9% 15.9% 10.6% 10.6%
Source: Carolina Demography analysis of 2011 Pregnancy Risk Assessment Monitoring System (PRAMS). Download

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Observations

  • Data on intimate partner violence (IPV) is challenging to quantify. Measurement tools vary in their definitions of IPV, making comparisons across groups and time difficult. Additionally, almost all of these measures rely on self-report which in turn depends upon accurate recall and willingness to report the violence.
  • No amount of IPV is acceptable. IPV during pregnancy increases the risk of adverse birth outcomes and complications for women during and after pregnancy. It demonstrates the need for effectively targeted health, community, and criminal justice services for victims, their children, and perpetrators.
  • Intentional efforts by medical providers, social service providers and policy makers have a direct impact on the prevention and treatment of intimate partner violence. Studies demonstrate that children who are exposed to violence may be at risk for repeating those patterns in their adult years.
  • Reliable data for North Carolina with an adequate sample size has remained unavailable since 2011. Previous data and comments are available from the 2011 PRAMS Survey.
Total
Percent pushed, hit slapped, kicked, chocked, or physically hurt in 12 months prior to pregnancy 4.2%
Percent pushed, hit, slapped, kicked, choked, or physically hurt during pregnancy 3.4%
Source: Carolina Demography analysis of 2012-2014 North Carolina State Center for Health Statistics data. Download

2012-2014 County Life Expectancy at Birth for Women
Geographic Area Female Life Expectancy
State of North Carolina 80.7
Alamance County 79.9
Alexander County 80.7
Alleghany County 82.2
Anson County 79.7
Ashe County 81.2
Avery County 82.2
Beaufort County 78.9
Bertie County 78.1
Bladen County 78.4
Brunswick County 81.3
Buncombe County 81.7
Burke County 79.3
Cabarrus County 80.4
Caldwell County 78.3
Camden County 83.2
Carteret County 80.8
Caswell County 78.6
Catawba County 79.3
Chatham County 84.2
Cherokee County 78.6
Chowan County 82.2
Clay County 81.2
Cleveland County 77.2
Columbus County 77.1
Craven County 80.2
Cumberland County 78.9
Currituck County 79.8
Dare County 82.2
Davidson County 78.8
Davie County 81
Duplin County 81.6
Durham County 82.1
Edgecombe County 78.1
Forsyth County 80.3
Franklin County 80.2
Gaston County 78.2
Gates County 82.1
Graham County 78.1
Granville County 81.4
Greene County 80.5
Guilford County 81.2
Halifax County 77.1
Harnett County 80.1
Haywood County 81.2
Henderson County 82
Hertford County 79.3
Hoke County 79.5
Hyde County 81.4
Iredell County 79.4
Jackson County 81.4
Johnston County 80.3
Jones County 80.6
Lee County 81.3
Lenoir County 78.2
Lincoln County 79.7
McDowell County 79.5
Macon County 81.1
Madison County 81.1
Martin County 77.9
Mecklenburg County 82.6
Mitchell County 80.2
Montgomery County 80.5
Moore County 82.9
Nash County 79.7
New Hanover County 82.1
Northampton County 79.4
Onslow County 80.7
Orange County 83.9
Pamlico County 80.3
Pasquotank County 78.9
Pender County 80.5
Perquimans County 82.5
Person County 79.4
Pitt County 80.8
Polk County 81
Randolph County 79.3
Richmond County 77.2
Robeson County 77.3
Rockingham County 78.1
Rowan County 77.7
Rutherford County 78.4
Sampson County 78.8
Scotland County 77.3
Stanly County 78.9
Stokes County 79.7
Surry County 79.6
Swain County 77
Transylvania County 82.8
Tyrrell County 78.4
Union County 81.5
Vance County 78
Wake County 83.4
Warren County 81.1
Washington County 82.5
Watauga County 84
Wayne County 79.8
Wilkes County 78.6
Wilson County 80.4
Yadkin County 80.2
Yancey County 80.1
Source: Carolina Demography analysis of 2010-2014 North Carolina State Center for Health Statistics data. Download full set by Race/Ethnicity

2010-2014 NC Resident Live Births by County of Residence
County of Residence Births Percent
North Carolina 53,990 9
Alamance 856 9.7
Alexander 145 8.1
Alleghany 40 8.6
Anson 151 11.6
Ashe 105 8.6
Avery 54 7.5
Beaufort 231 9.3
Bertie 115 12.4
Bladen 185 10.2
Brunswick 421 8
Buncombe 1,011 7.8
Burke 329 7.6
Cabarrus 1,017 8.8
Caldwell 387 9.6
Camden 39 8.6
Carteret 232 7.5
Caswell 94 9
Catawba 790 8.9
Chatham 274 8.8
Cherokee 116 10.6
Chowan 83 10.9
Clay 27 6.6
Cleveland 524 9.7
Colombus 349 10.9
Craven 637 8
Cumberland 2,780 9.6
Currituck 70 5.8
Dare 106 5.8
Davidson 830 9.6
Davie 161 8.5
Duplin 299 7.8
Durham 1,956 9.1
Edgecombe 406 12.3
Forsyth 2,357 10.3
Franklin 284 8.5
Gaston 1,221 9.6
Gates 57 10.6
Graham 49 10.6
Granville 241 8.6
Greene 116 10.3
Guilford 2,910 9.6
Halifax 343 11.7
Harnett 791 8.7
Haywood 250 9.1
Henderson 358 6.7
Hertford 149 12.5
Hoke 431 9.1
Hyde 22 8.6
Iredell 742 8.4
Jackson 143 7.3
Johnston 857 7.6
Jones 59 11.6
Lee 427 10.5
Lenoir 362 10.8
Lincoln 310 8
McDowell 207 9
Macon 115 7
Madison 68 7.3
Martin 149 12.4
Mecklenburg 6,530 9.4
Mitchell 66 9.4
Montgomery 148 9.1
Moore 399 8.1
Nash 516 9.4
New Hanover 869 7.7
Northampton 112 12
Onslow 1,517 7
Orange 448 7.2
Pamlico 40 8.7
Pasquotank 242 9.6
Pender 251 8.3
Perquimans 50 7.6
Person 179 8.6
Pitt 1,016 9.5
Polk 61 8.8
Randolph 630 7.8
Richmond 315 11.4
Robeson 1,119 11.7
Rockingham 440 9.4
Rowan 712 9.2
Rutherford 317 9.3
Sampson 389 9.1
Scotland 296 12.8
Stanly 302 9.2
Stokes 172 8.5
Surry 300 7.8
Swain 77 7.8
Transylvania 114 8.4
Tyrrell 32 15
Union 956 8
Vance 360 12.4
Wake 5,083 8.1
Warren 123 13.2
Washington 59 9.1
Watauga 105 5.9
Wayne 714 8.3
Wilkes 289 8.6
Wilson 522 10.8
Yadkin 213 10.9
Yancey 69 8.1
Source: Carolina Demography analysis of 2011-2014 North Carolina State Center for Health Statistics data. Download

2011-2014 Number and Percent of NC Resident Births where Mother Smoked During Pregnancy
County Number Percent
North Carolina 50,024 10.4
Alamance 983 14.1
Alexander 262 18.5
Alleghany 84 23
Anson 187 18.2
Ashe 195 20.4
Avery 89 16.2
Beaufort 278 14.4
Bertie 73 10
Bladen 239 16.6
Brunswick 631 15.1
Buncombe 378 3.6
Burke 676 19.6
Cabarrus 943 10.2
Caldwell 736 22.9
Camden 34 9.4
Carteret 458 18.5
Caswell 143 16.6
Catawba 1,121 15.8
Chatham 205 8.3
Cherokee 222 25.5
Chowan 101 16.6
Clay 96 29.2
Cleveland 980 22.8
Columbus 433 17.1
Craven 661 10.5
Cumberland 2,619 11.4
Currituck 107 11.2
Dare 147 10.2
Davidson 1,271 18.4
Davie 198 13.1
Duplin 281 9.2
Durham 965 5.6
Edgecombe 435 17
Forsyth 1,335 7.3
Franklin 354 13.3
Gaston 2,113 21
Gates 43 10.2
Graham 126 34.1
Granville 290 13.2
Greene 113 12.9
Guilford 1,759 7.2
Halifax 335 14.5
Harnett 908 12.3
Haywood 452 20.3
Henderson 449 10.5
Hertford 96 10.2
Hoke 398 10.5
Hyde 26 13.3
Iredell 862 12.3
Jackson 321 21.1
Johnston 857 9.6
Jones 58 14.2
Lee 464 14.4
Lenoir 435 16.4
Lincoln 490 15.8
Mcdowell 398 22
Macon 275 20.7
Madison 55 7.2
Martin 151 15.9
Mecklenburg 2,111 3.8
Mitchell 114 20.1
Montgomery 186 14.4
Moore 485 12.3
Nash 562 12.9
New Hanover 714 7.9
Northampton 91 12.5
Onslow 1,321 7.6
Orange 301 6
Pamlico 67 18.8
Pasquotank 191 9.6
Pender 258 10.7
Perquimans 70 13.3
Person 293 17.8
Pitt 895 10.5
Polk 86 15.3
Randolph 907 14.2
Richmond 494 22.8
Robeson 1,424 19.1
Rockingham 684 18.2
Rowan 1,130 18.3
Rutherford 606 22.3
Sampson 433 12.8
Scotland 363 20.2
Stanly 391 14.9
Stokes 309 19.5
Surry 663 21.8
Swain 219 27.5
Transylvania 183 16.9
Tyrrell 29 17.4
Union 725 7.7
Vance 343 15
Wake 1,573 3.2
Warren 115 15.9
Washington 74 14.2
Watauga 128 9
Wayne 719 10.4
Wilkes 584 21.6
Wilson 387 10.2
Yadkin 278 17.9
Yancey 124 18.3
Source: Carolina Demography analysis of 2010-2014 North Carolina State Center for Health Statistics data. Download

Number and Percent of NC Resident Births delivered by Gestation, 2010-2014
Total Births, 2010-14 Gestation
Preterm (<37 weeks) 37+ weeks Unknown
County Number Percent Number Percent Number Percent
North Carolina 602,403 71,138 11.8 530,692 88.1 573 0.1
Alamance 8,837 1,172 13.3 7,661 86.7 4
Alexander 1,796 219 12.2 1,576 87.8 1 0.1
Alleghany 465 67 14.4 398 85.6
Anson 1,305 164 12.6 1,140 87.4 1 0.1
Ashe 1,222 171 14.0 1,050 85.9 1 0.1
Avery 724 86 11.9 638 88.1
Beaufort 2,483 328 13.2 2,150 86.6 5 0.2
Bertie 930 157 16.9 773 83.1
Bladen 1,808 290 16.0 1,513 83.7 5 0.3
Brunswick 5,233 567 10.8 4,660 89.1 6 0.1
Buncombe 12,961 1,652 12.7 11,302 87.2 7 0.1
Burke 4,314 506 11.7 3,804 88.2 4 0.1
Cabarrus 11,573 1,387 12.0 10,172 87.9 14 0.1
Caldwell 4,028 480 11.9 3,547 88.1 1
Camden 453 55 12.1 398 87.9
Carteret 3,098 363 11.7 2,735 88.3
Caswell 1,042 122 11.7 919 88.2 1 0.1
Catawba 8,907 993 11.1 7,909 88.8 5 0.1
Chatham 3,121 351 11.2 2,768 88.7 2 0.1
Cherokee 1,095 146 13.3 947 86.5 2 0.2
Chowan 760 103 13.6 657 86.4
Clay 407 40 9.8 364 89.4 3 0.7
Cleveland 5,417 677 12.5 4,733 87.4 7 0.1
Columbus 3,207 451 14.1 2,749 85.7 7 0.2
Craven 7,979 885 11.1 7,081 88.7 13 0.2
Cumberland 28,833 3,759 13.0 25,043 86.9 31 0.1
Currituck 1,200 107 8.9 1,090 90.8 3 0.3
Dare 1,823 161 8.8 1,654 90.7 8 0.4
Davidson 8,623 985 11.4 7,631 88.5 7 0.1
Davie 1,898 233 12.3 1,664 87.7 1 0.1
Duplin 3,850 446 11.6 3,399 88.3 5 0.1
Durham 21,504 2,566 11.9 18,897 87.9 41 0.2
Edgecombe 3,305 518 15.7 2,785 84.3 2 0.1
Forsyth 22,968 2,960 12.9 20,001 87.1 7
Franklin 3,350 399 11.9 2,944 87.9 7 0.2
Gaston 12,663 1,521 12.0 11,124 87.8 18 0.1
Gates 538 76 14.1 462 85.9
Graham 461 59 12.8 401 87.0 1 0.2
Granville 2,815 329 11.7 2,485 88.3 1
Greene 1,123 137 12.2 982 87.4 4 0.4
Guilford 30,470 3,440 11.3 26,987 88.6 43 0.1
Halifax 2,944 490 16.6 2,447 83.1 7 0.2
Harnett 9,135 1,123 12.3 8,005 87.6 7 0.1
Haywood 2,753 378 13.7 2,373 86.2 2 0.1
Henderson 5,346 586 11.0 4,754 88.9 6 0.1
Hertford 1,194 210 17.6 982 82.2 2 0.2
Hoke 4,717 644 13.7 4,067 86.2 6 0.1
Hyde 257 29 11.3 227 88.3 1 0.4
Iredell 8,827 987 11.2 7,834 88.8 6 0.1
Jackson 1,970 221 11.2 1,746 88.6 3 0.2
Johnston 11,203 1,196 10.7 9,995 89.2 12 0.1
Jones 507 58 11.4 446 88.0 3 0.6
Lee 4,082 538 13.2 3,530 86.5 14 0.3
Lenoir 3,354 444 13.2 2,907 86.7 3 0.1
Lincoln 3,893 432 11.1 3,459 88.9 2 0.1
Mcdowell 2,299 298 13.0 1,999 87.0 2 0.1
Macon 1,646 166 10.1 1,478 89.8 2 0.1
Madison 929 109 11.7 820 88.3
Martin 1,205 186 15.4 1,019 84.6
Mecklenburg 69,706 8,083 11.6 61,576 88.3 47 0.1
Mitchell 701 81 11.6 618 88.2 2 0.3
Montgomery 1,627 186 11.4 1,440 88.5 1 0.1
Moore 4,896 529 10.8 4,356 89.0 11 0.2
Nash 5,517 654 11.9 4,860 88.1 3 0.1
New Hanover 11,235 1,208 10.8 10,018 89.2 9 0.1
Northampton 937 159 17.0 778 83.0
Onslow 21,768 1,913 8.8 19,845 91.2 10
Orange 6,217 606 9.7 5,607 90.2 4 0.1
Pamlico 461 50 10.8 411 89.2
Pasquotank 2,515 303 12.0 2,209 87.8 3 0.1
Pender 3,018 338 11.2 2,676 88.7 4 0.1
Perquimans 659 81 12.3 578 87.7
Person 2,083 225 10.8 1,853 89.0 5 0.2
Pitt 10,695 1,447 13.5 9,239 86.4 9 0.1
Polk 692 85 12.3 606 87.6 1 0.1
Randolph 8,076 909 11.3 7,160 88.7 7 0.1
Richmond 2,759 357 12.9 2,401 87.0 1
Robeson 9,576 1,439 15.0 8,128 84.9 9 0.1
Rockingham 4,697 531 11.3 4,163 88.6 3 0.1
Rowan 7,716 905 11.7 6,801 88.1 10 0.1
Rutherford 3,425 354 10.3 3,071 89.7
Sampson 4,266 570 13.4 3,688 86.5 8 0.2
Scotland 2,305 330 14.3 1,974 85.6 1
Stanly 3,295 410 12.4 2,883 87.5 2 0.1
Stokes 2,020 235 11.6 1,783 88.3 2 0.1
Surry 3,857 428 11.1 3,429 88.9
Swain 982 123 12.5 858 87.4 1 0.1
Transylvania 1,352 167 12.4 1,183 87.5 2 0.1
Tyrrell 213 24 11.3 189 88.7
Union 11,906 1,264 10.6 10,635 89.3 7 0.1
Vance 2,898 456 15.7 2,438 84.1 4 0.1
Wake 62,546 6,671 10.7 55,834 89.3 41 0.1
Warren 935 147 15.7 786 84.1 2 0.2
Washington 650 91 14.0 558 85.8 1 0.2
Watauga 1,765 156 8.8 1,609 91.2
Wayne 8,564 923 10.8 7,637 89.2 4
Wilkes 3,376 398 11.8 2,973 88.1 5 0.1
Wilson 4,834 707 14.6 4,120 85.2 7 0.1
Yadkin 1,960 276 14.1 1,684 85.9
Yancey 853 96 11.3 756 88.6 1 0.1
Source: Carolina Demography analysis of 2010-2014 North Carolina State Center for Health Statistics data. Download

2010-2014 NC Live Births by County of Residence: Number with interval from last delivery to conception of six months or less and percent of all births excluding 1st pregnancies
County Number of Short Interval Births Percent Short Interval (of all births except first pregnancies)
North Carolina 48,837 12.3%
Alamance 705 12.0%
Alexander 160 13.3%
Alleghany 43 14.0%
Anson 139 15.8%
Ashe 118 14.3%
Avery 62 13.9%
Beaufort 193 11.3%
Bertie 94 15.6%
Bladen 155 13.2%
Brunswick 424 12.4%
Buncombe 647 8.2%
Burke 357 12.7%
Cabarrus 929 11.8%
Caldwell 311 12.2%
Camden 46 14.9%
Carteret 252 12.6%
Caswell 84 12.0%
Catawba 796 13.1%
Chatham 221 10.2%
Cherokee 86 13.3%
Chowan 82 16.1%
Clay 23 10.0%
Cleveland 477 13.6%
Columbus 245 11.7%
Craven 665 13.0%
Cumberland 2,497 13.3%
Currituck 76 10.4%
Dare 108 9.5%
Davidson 784 13.5%
Davie 119 9.3%
Duplin 343 12.5%
Durham 1,622 11.7%
Edgecombe 366 16.2%
Forsyth 1,344 8.7%
Franklin 330 14.0%
Gaston 1,185 14.1%
Gates 47 12.9%
Graham 42 13.9%
Granville 219 12.0%
Greene 117 14.9%
Guilford 2,197 10.7%
Halifax 269 13.7%
Harnett 752 11.8%
Haywood 202 12.1%
Henderson 303 8.9%
Hertford 131 15.6%
Hoke 364 11.4%
Hyde 13 6.9%
Iredell 740 12.8%
Jackson 182 13.8%
Johnston 990 12.9%
Jones 44 12.9%
Lee 301 10.7%
Lenoir 320 13.4%
Lincoln 318 12.5%
Mcdowell 166 11.2%
Macon 137 12.8%
Madison 52 9.2%
Martin 111 14.0%
Mecklenburg 5,488 12.1%
Mitchell 62 14.0%
Montgomery 127 11.4%
Moore 405 12.6%
Nash 562 14.8%
New Hanover 1,026 14.0%
Northampton 99 15.4%
Onslow 1,474 12.2%
Orange 513 12.4%
Pamlico 30 10.0%
Pasquotank 192 11.4%
Pender 267 13.2%
Perquimans 50 11.7%
Person 181 13.5%
Pitt 1,029 14.9%
Polk 54 12.0%
Randolph 712 12.9%
Richmond 277 15.1%
Robeson 753 11.4%
Rockingham 355 11.7%
Rowan 709 13.6%
Rutherford 301 13.5%
Sampson 388 13.0%
Scotland 190 12.1%
Stanly 327 15.0%
Stokes 109 8.3%
Surry 332 12.9%
Swain 121 18.0%
Transylvania 79 9.3%
Tyrrell 13 8.2%
Union 1,008 11.9%
Vance 279 14.3%
Wake 5,055 12.2%
Warren 99 16.5%
Washington 74 16.9%
Watauga 122 10.8%
Wayne 879 15.0%
Wilkes 325 14.5%
Wilson 458 13.9%
Yadkin 155 11.9%
Yancey 53 10.1%

The following UNC people were integral to the completion of this report card: Dr. Rebecca Tippet, Carolina Population Center; Dr. Jennifer Smith, Dr. Heather Wasser, and Elizabeth Chase, Gillings School of Global Public Health; Dr. Kim Boggess, Dr. Giselle Corbie-Smith, Dr. Susan Girdler, Dr. Margaret Gourlay, Dr. Hendree Jones, Dr. Samantha Meltzer-Brody, Dr. Wanda Nicholson, and Dr. Alison Stuebe, School of Medicine; Dr. Wendy Brewster, and Jennifer Rumbach, Center for Women’s Health Research.