State of the County Health Report 2023

Undertaking a Community Health Assessment is an unceasing process that involves an interdisciplinary team in identifying community assets and strengths, as well as existing needs. Leadership for this collaboration is provided by Lincoln County Health Department alongside our Partnership for Health team. The following State of the County Health (SOTCH) Report serves as an update and documented progress following the findings of the 2022 Community Health Assessment. The 2023 Lincoln County SOTCH was submitted to the North Carolina Department of Human Services (NCDHHS) on February 26, 2024. 

Lincoln County Profile

Lincoln County, North Carolina is a Metropolitan. In Lincoln County, 54.6% of the population lives in a low population density area (500 or fewer people per square mile and less than 2,500 people) (County Health Rankings).

The population of Lincoln County in 2023 was 96,320 which is an increase of 27.41% from the 78,127 residents who lived in the county in 2010. For comparison, the U.S. population grew 4.91% and North Carolina’s population grew 14.2% during that same time period. According to the County Health Rankings database, Lincoln County shows strength in clinical prevention measures, such as mammography screenings and flu vaccinations; the low percentage of children living in single-parent households; and the low percentage of children living in poverty. The database also suggests areas to explore for improvement, which includes health behaviors, such as adult smoking, adult obesity, excessive drinking, and alcohol-impaired driving deaths; increasing insurance access; and air pollution ratings.

Total Lincoln County Population: 96,320

County Health Rankings & Roadmaps

U.S. Census, American Community Survey 1- Year Estimates

U.S Census Bureau, Quick Facts

The 2022 Community Health Assessment (CHA) determined three community health priorities that should be addressed in Lincoln County: Access to Care; Health Behaviors; and Substance Use. Each of these priorities have activities and programs that are designed to improve health outcomes and have a positive impact on the overall health and wellness of the community. These programs have measurable outcomes as Performance Measures to determine if the programs and activities were on the path toward growth.

The Community Health Improvement Plan (CHIP) encompasses all priorities for Lincoln County. Please refer to the links below to view the progress achieved in 2023.

For the priority area Access to Care see Progress in 2023 note tabs for each program below.

Adult Health Clinic 

988 Suicide & Crisis Lifeline Promotion

For the priority area Health Behaviors see Progress in 2023 note tabs for each program below.

NC Quitline

CATCH My Breath

Nutrition Education

Lincolnton Fire Department Youth Firesetter Intervention Program

City of Lincolnton Homeless Committee

For the priority area Substance Use see Progress in 2023 note tabs for each program below.

Naloxone Kit Distribution

Recovery Court

Post-Overdose Response Team

Lincoln County Drug Prevention & Recovery Coalition

Lincoln County is ranked among the healthiest counties in North Carolina. Currently, the county is 24th out of the 100 counties in North Carolina.

Changes in Lincoln County's Morbidity and Mortality rates from 2022-2023 are located below.

The charts shows that there have not been any significant changes to the Morbidity and Mortality data for Lincoln County since the last CHA in 2022.

The Lincoln County Partnership for Health and the Lincoln County Board of Health chose and approved the initiatives that are being used to address the 2022 Community Health Assessment priorities.  Action plans were submitted to the State of North Carolina in September of 2023.

Behavioral Health Services: 

According to the 2022 CHA, Lincoln County residents shared that there has been an increased need for behavioral health services. Respondents shared that they would like to see more education and information on substance use prevention, stress management, positive teen activities, and counseling/mental health support groups. The Lincoln County Health Department, along with key community partners, continues to work toward a happier, healthy, and well county. This includes making investments in early intervention and prevention services, outpatient services, acute intervention services, and residential and inpatient services. It remains important to champion for behavioral health services to be treated as essential healthcare. 

Lincoln County also witnessed a report that 81.2% of overdose deaths involving illicit opioids in 2021 (compared to North Carolina which reported 78.4%) in 2021 (NCDHHS, Injury and Violence Prevention Branch). The drug overdose death rate continues to climb in Lincoln County and the State. From 2019 to 2020, drug overdose deaths increased by 40% in North Carolina and by nearly 62% in Lincoln County (North Carolina Center for Health Statistics, 2023). In reflection to this data, the Lincoln County Health Department continues to work across the community to develop and deliver strategic and intentional programming to its citizens.

Homelessness: 

Homelessness is the third most significant problem affecting quality of life in Lincoln County according to 2022 CHA respondents. According to Lincoln County CHA Survey respondents, low income and poverty was the second leading problem affecting quality of life. Income and one's physical environment has a significant impact on health considering it influences things like safe housing, health care, and access to nutritious foods. The primary data revealed that more affordable housing was the second leading service needing the most improvement (North Carolina Institute of Medicine). 

Housing is a significant component of one’s physical environment and can greatly influence health considering people spend half or more of their day at home. Housing deficiencies can pose many consequences including things like disease transmission, poisoning, exposure and injury. Severe housing problems are a HNC 2030 indicator and include challenges like overcrowding (i.e., more than one person per room), high housing cost (i.e., more than 50 percent of monthly income is spent on housing expenses) and lack of kitchen and/or plumbing facilities (North Carolina Institute of Medicine, 2020). 19.7% of Survey respondents experience the challenges previously stated. 

Tobacco Use: 

Tobacco use is the leading preventable cause of death and disease in North Carolina and the Nation (North Carolina Tobacco Prevention and Control Branch, 2022). North Carolina Region 4 Public Health consists of Cabarrus, Cleveland, Gaston, Lincoln, Mecklenburg, Rutherford, and Union counties and leads the State in tobacco use among adults comparing 20.9% to 20.7%, respectively. The Lincoln County Community Health Assessment reported that 10.6% of respondents use tobacco products.

Data shows there is a decline in cigarette smoking among North Carolinian youth alongside the uptick in electronic cigarette (e-cigarette) usage (North Carolina Tobacco Prevention and Control Branch). In fact, results from the past five North Carolina Youth Tobacco Surveys indicate e-cigarette use has increased by 510% among middle school students and 1,129% among high school.

It is also important to note that of the 19,963 deaths in North Carolina caused by cancer; nearly 26% were caused by lung cancer. If lung cancer were eligible for the leading-causes-of-death rankings, rather than being lumped into the cancer category, it would be the fifth leading cause of death in North Carolina.

Access to Care:

The Lincoln County Partnership for Health chose to focus on two initiatives to positively impact the Access to Care strategy.

• Continuing initiative: Lincoln County Health Department's Adult Health Clinic 
  • The primary objective of this clinic is to offer screenings and connect individuals to a primary care provider. In addition to preventative screenings, patients receive education and support to help them meet their health goals. The Lincoln County Health Department plans to focus its efforts on preventative screenings and addressing chronic illness within the county. 
• New initiative: Expanding access to tele-mental health services 
  • The Lincoln County Health Department is educating and informing local partners and community with 988 branded print materials (e.g., posters, wallet cards, etc.) with partners and utilize the 988 social media resources to raise awareness in the community.   

Health Behaviors:

The Lincoln County Partnership for Health chose to focus on two initiatives to positively impact the Health Behaviors strategy.

• Continuing initiative: Tobacco Prevention and Education 
  • The Lincoln County Health Department is working to continue educating residents and providers about QuitlineNC, a free tobacco cessation program. Media promotion using the CDC's Tips from Former Smokers Campaign is being implemented to expand the reach of QuitlineNC awareness. Providers are also beginning to receive education and information on becoming a QuitlineNC referral site, which will allow their patients to gain information on receiving free cessation services. 
• New initiative: Nutrition Education    
  • The Lincoln County Health Department will incorporate sugar-sweetened beverage (SSB) education into outreach efforts through hands-on demonstrations. The LCHD will also incorporate SSB education in nutrition/cooking classes offered within the community. Lastly, the LCHD will implement public awareness campaigns that encourage healthier choices.

Substance Use:

The Lincoln County Partnership for Health chose to focus on two initiatives to positively impact the Substance Use strategy.

• Continuing initiative: Sustainability  
  • The Lincoln County Health Department is continuing to work on building sustainability and capacity for behavioral health programs. The team works closely with the Partners Behavioral Health agency, the Lincoln County Drug Prevention and Recovery Coalition, the local school systems, and other key stakeholders to deliver intentional and much-needed programming to the community. 
• New initiative: Lincoln County Community Centered Court
  • Treatment Court serves as an alternative to incarceration for individuals who are justice-involved due to substance misuse. This program is designed to reduce recidivism (i.e., subsequent offenses) while supporting an individual through their journey to recovery. Participants are supported with harm reduction education/resources and receive a personalized plan to address any needs related to the social determinants of health.