This 2024 State of the County’s Health (SOTCH) Report for Orange County shares progress on the Community Health Improvement Plans (CHIP) [link: HNC 2030 Orange County (2023-2027)] developed to address the three priority areas identified by the 2023 Community Health Assessment (CHA). The three priorities are access to care, behavioral health, and connections to community support. This SOTCH also shares brief highlights of changes in mortality and morbidity, emerging concerns, and new initiatives since the CHA was submitted in March of 2024.

Orange County submitted the latest CHIP to NCDHHS in September of 2024, therefore some data is unavailable at this time of this SOTCH report being submitted in March of 2025. Please click on the links below for 2024 progress reports.

Access to Care

  Orange County Community Health Advocacy and Mobilization Partners (OC CHAMPS)

  Medicaid Expansion

Behavioral Health

  Trainings related to Mental Health and Substance Misuse

  Connection to 988

Connections to Community Support

  Trainings Related to Healthy Eating

  Connection to 211 or Other Resource Platform

There has been no significant changes in morbidity and mortality data at the time of this SOTCH submission in March of 2025.

Two tables for the top ten (10) causes of death may be viewed below with the first table reporting information for the 2017-21 time period and the second table reporting information for the 2018-22 period. These rates are unadjusted per 100,000 people and include Orange County residents of all ages. Suicide and chronic liver disease were in the top 10 causes of death for Orange County for both time period and were not in the top ten  for North Carolina residents..  The third table provided below compares the Orange County data for the 2017-21 and 2018-22 periods in the same table for ease of viewing.

The table below compares the infant mortality numbers and rates for Orange County for the 2017-21 and 2018-22 year periods. There has been no significant change in the infant mortality rate for Orange County.

Weather and Climate

The year of 2024 was filled with unusual weather for the entire state of North Carolina with extreme heat and cold, flooding, tropical storms and hurricanes.

• Chapel Hill is a host site for weather data collection for the North Carolina State Climate Office at NC State University. The lowest temperature recorded at the site was 15˚F on January 22, 2024 while the highest recorded temperature was 101˚F on July 6, 2024. During the colder months of 2024, multiple Cold Weather Shelters were open at various times to accommodate those who needed a safe, warm place to shelter. Numerous heat advisories were placed in effect during the summer of 2024, with a Hot Weather Resource guide providing information to those in need of a location to shower and/or cool-off. (https://econet.climate.ncsu.edu/stations/?id=CHAP)
• Tropical Storm Debby brought almost 7” of rainfall to northern Orange County during August 7-11, 2024, with the rest of the county experiencing 4.5-6.5” of rainfall. This storm resulted in county-wide flooding issues and power outages. The county had two shelter locations staged for full activation, prepared with resources to provide care to residents such as medical and hygiene, that were open to all residents and their pets. (https://www.newsobserver.com/news/weather-news/article291042850.html)
• Hurricane Helene hit Western NC late September of 2024. Although Orange County did not suffer the devastation of Hurricane Helene in the same way as Western North Carolina, the Orange County community, along with many others in the state, felt the effects. Orange County Government sent numerous employees, on multiple occasions, to Western NC to assist in managing shelters, shipping supplies, and coordinating logistics. From the Orange County Health Department, seven staff were deployed for assistance in Yancey County, along with other staff assistance provided to Buncombe and Macon counties. Participation in the response efforts  allowed staff to practice skills, and gain valuable experience and ideas for preparing for and addressing future natural disasters. The full news release can be read at https://www.orangecountyngov/CivicAlerts.aspx?AID=1218.

Respiratory Infections

1. While not new infections, respiratory illnesses like respiratory syncytial virus (RSV), flu, and COVID-19 continue to impact the health of population. Older adults, young children, people with weakened immune systems, people with disabilities and pregnant or recently pregnant women are at higher risk of respiratory illnesses. Wastewater monitoring of virus shed began to be tracked for COVID-19 during the pandemic as a collaboration between the North Carolina Department of Health and Human Services (NCDHHS), University of North Carolina system researchers, wastewater utilities, and public health departments. This method of monitoring offers a different way to track viral shed and community impacts. The NCDHHS wastewater monitoring dashboard includes information on RSV, flu, and COVID-19. The dashboard may be viewed at this link: https://covid19.ncdhhs.gov/dashboard/wastewater-monitoring.

The following are new initiatives since the 2023 CHA was submitted in March 2024. There have not yet been any discontinued initiatives related to this 2023 CHA.

Harm Reduction Coordinator and Opioid Settlement Funds

In 2024, Orange County hired a harm reduction coordinator to administer the efforts of the Opioid Advisory Committee. The harm reduction coordinator is housed in the health department. Orange County also hosted the first Annual Opioid Settlement Fund Community meeting to share information on settlement fund use and discuss ideas for future efforts. This free and public meeting included people with lived experience, community leaders, partners, and community members. The Orange County Opioid Settlement Fund website may be viewed at: https://www.orangecountync.gov/2998/Opioid-Settlement-Funds.

Post-Overdose Response Team (PORT)

• Orange County EMS PORT (Post-Overdose Response Team) was created in July 2024? response to the number of EMS calls serving community members suffering from a drug overdose. This data showed that 26% of those served by EMS had overdosed more than once. A goal of PORT is to connect patients to medications for opioid use disorder (MOUD) treatment programs, other treatment and recovery services, and harm reduction materials. This program is funded for 1 year by the Opioid Settlement Funds and Alliance Health.
• The PORT team consists of one personal support specialist or PSS (Peer Support Specialist) and two Community Paramedics. This program generally operates 7 days a week, 365 days a year. Anyone in Orange County can be served by PORT and PORT  connects the patient(s) to services based on the patient’s needs.
• PORT has goals set to continue their work, to strengthen partnerships and outreach,,  increase naloxone and other harm reduction training , and provide continuing education to their staff.
• For more information, please reach out to Landon Weaver, Bureau Chief- EMS Community Health and Safety, at lweaver@orangecountync.gov or (919) 245-6127. The program itself can be reached at EMS_PORT@orangecountync.gov, (919) 407-2654, or by visiting their site at orangecountync.gov/2973/Community-Health-and-Safety

Please see the below data for PORT from July 1, 2024 to December 31, 2024

Vaping Prevention and Cessation Pilot at Orange High School

Vapor products and other emerging tobacco and/or nicotine products continue to pose concern to public health. In response to this concern, Orange County Health Department began a pilot program in the fall of 2024 with Orange High School to offer cessation and prevention services to high school students.

Unified Development Ordinance (UDO) Affecting Tobacco and Hemp Related Businesses

Orange County Board of Health submitted a letter in April of 2024 regarding potential zoning changes for tobacco and hemp retailers as a way to promote the health of the public. Orange County Planning Board and Board of County Commissioners unanimously passed a unified development ordinance text amendment regarding hemp and tobacco retailers. A major component of this new rule is to require that any new hemp or tobacco retailer be at least 1,000 feet from Orange County schools, parks and recreation facilities, and residential areas. http://server3.co.orange.nc.us:8088/weblink/0/doc/73344/Page1.aspx (p.40)

Bloodborne Pathogen Program

The Orange County Health Department provided an educational session for current or potential tattoo artists, piercers, and other body modification businesses to learn more about health and safety practices relevant to the industry. Artists that participate in the annual training are allowed to post a graphic, which can be found online at https://www.orangecountync.gov/709/Tattoo-Artists-Permits along with additional tattoo shop related information.

Bar Education Legislation (BELS) Program

​​​​​​​The state legislature passed House Bill 125 (SL 2023-129) in 2023, mandating that bars serving food have the same permits in place as other retail food establishments. Orange County Health department developed a Bar Education Legislation Situation (BELS) program in 2024 to address these changes. Health department leadership heard from bar owners that the team was respectful, informative, and timely. Because of the success of the program, it will continue as an ongoing effort by the health department to help all bars implement food safety education programs. Additionally, two staff members received the William “Bill” Smith Outstanding Public Health Award for this project. The Eastern District North Carolina Public Health Association gives this award to one agency or program per year that demonstrates health programming that is creative, innovative, efficient, and effective.