2024 State of the County's Health Report for Guilford County

This 2024 State of the County’s Health Report (SOTCH) shares progress on Guilford County Division of Public Health’s Community Health Improvement Plans (CHIP) to address priorities identified in the 2023-2024 Guilford County Community Health Assessment (CHA). 

The links below highlight new and continuing initiatives in the 2024 CHIPs and Progress in 2024 for two health priorities, Firearm (Gun) Violence and Injury and HIV and Other Sexually Transmitted Infection Prevention and Care.

This 2024 SOTCH also highlights Mortality and Morbidity Changes since Guilford County Division of Public Health's (GCDPH) last CHA and emerging issues are impacting our community. 

The section titled New/Paused/Continuing/Discontinued Initiatives Since Last CHA shares progress on the other following CHA priorities:

• Behavioral Health - Drug Overdose and Mental Health  
• Healthy Eating and Active Living 
• Maternal and Child Health and Infant Mortality
• Access to Health Care

Progress on CHIPs

The links below highlight new and continuing initiatives in the 2024 CHIPs and Progress in 2024 for two health priorities:

• Firearm (Gun) Violence and Injury
• HIV and Other Sexually Transmitted Infection Prevention and Care

The following links below highlight new and continuing initiatives and Progress in 2024 for:

Firearm (Gun) Violence and Injury 

Guilford Violence Prevention Initiative (VPI)

Firearm Safety Lock Distribution

Gate City Coalition's Cure Violence Program

Community-Based Violence Intervention and Prevention Initiatives (CVIPI)

Violence Prevention Community Events

HIV and Other Sexually Transmitted Infection Prevention and Care

Integrated Targeted Testing Services (ITTS)

Expanded Testing Services (Testing in Guilford County Jails)

PrEP (Pre-Exposure Prophylaxis) for HIV prevention

HIV and Sexually Transmitted Infection Community Education and Outreach Events

HIV and STI Clinical Care Connections

Life Expectancy Continues to Decline and Disparities Persist

• Life expectancy is an important measure of health defined as the average number of years infants would be expected to live if death patterns remained the same. 
• Guilford County and North Carolina life expectancy has declined about two years from about 78 years to 76 years between 2017-2019 and 2021-2023. This decline aligns with national trends, largely driven by the COVID-19 pandemic, chronic disease burden, and increasing overdose deaths.

• The recent decline in Guilford County life expectancy impacted men more than women, with the disparity increasing from four years in 2017-2019 to six years in 2021-2023.
• Life expectancy is also about four years longer for Whites than for African Americans. Significant racial disparities persist, with White individuals having a life expectancy approximately four years longer than African Americans, indicating continued health inequities that require focused intervention.
• Women’s life expectancy in dropped about a year and half from 80.4 to 79, while life expectancy for men dropped about 2 and a half years. 

Changes in Leading Causes of Death in 2022

Source: NC State Center for Health Statistics. 
* Unintentional injury deaths include those primarily due to unintentional poisonings, falls, and other external causes.

• In 2022, heart disease overtook cancer as the number one causes of death and cancer became the 2nd leading cause of death.
• In 2020 and 2021, the top leading causes of death in Guilford County were cancer and heart disease respectively, followed by COVID-19. 
• COVID-19 deaths dropped from the 3rd leading cause of death in 2020 and 2021 to become the 5th leading cause of death in 2022.
• Unintentional injuries became the 3rd leading cause of death in 2022, Unintentional injury deaths are those primarily due to unintentional poisonings, falls, and other external causes of death (excluding motor vehicle crashes).  
• In 2022, dementia was the 4th leading cause of death, followed by COVID-19 and stroke. 

The following chart highlights trends in select leading causes of death between 2020 and 2022. 

Differences in Mortality Rates by Race and Ethnicity
The following chart highlights the persistent differences in mortality rates by race and ethnicity in Guilford County.

• African Americans are disproportionately impacted with the highest death rates for heart disease, cancer, diabetes, and homicide. 
• Whites have higher mortality rates due to heart disease and cancer than Asians and Hispanics and have the highest rates of unintentional injury death. Whites also have higher rates of suicide than African Americans.
• African American, Asians, and Latinos were disproportionately impacted by COVID-19.

Gun Violence Highlights

• In 2023, Guilford County experienced 2,612 violent crime incidents, with 1,581 or 60% involving firearms.  
• 58% of aggregated assaults involved a firearm.
• 90% of homicides, 59% of suicides, and 100% of accidental shootings involved a firearm.
• These numbers represent a profound loss of life and a deepening crisis that impacts individuals, families, society as whole. 

HIV and Other Sexually Transmitted Infections (STIs) Highlights

• Chlamydia remains the most commonly reported STI in Guilford County, with 4,667 new cases (848.8 per 100,000) in 2023, followed by gonorrhea with 2,123 new cases (386.1 per 100,000). 
• Rates of new cases of early syphilis dropped from 65.0 per 100,000 population in 2022 to 51.6 per 100,000 population in 2023. 
• The rate of new HIV cases decreased in Guilford County from 29.4 per 100,000 in 2021 to 19.7 in 2023.
• Cases of congenital syphilis increased from 1 annually in previous years to 4 in 2023, highlighting a growing concern.
• Disparities exist amongst racial and ethnic minorities as well as sex and gender minorities. It is important to note that these higher rates are not directly caused by a person’s race, ethnicity, heritage, gender, sex, or sexual orientation but likely by social and systemic conditions that are more likely to affect these vulnerable groups.

Other Communicable Disease Highlights
Tuberculosis  

• Since 2019, TB rates in Guilford County have remained below 2.0 per 100,000, demonstrating sustained control efforts. Ongoing prevention, surveillance, and control efforts are essential to protect those most vulnerable and the community at large.

Water or Foodborne 

• In 2023, the most commonly reported foodborne illness in Guilford County was Campylobacter, with 119 cases, followed by Salmonellosis with 91 cases.
• Escherichia coli (STEC) cases increased from 25 in 2022 to 34 in 2023, from a rate of 4.6 to 6.2 per 100,000.

Hepatitis

• The number of chronic Hepatitis C cases declined significantly from 533 cases in 2021 to 263 cases in 2023.

Airborne

• COVID-19 cases reached their highest point in 2022, with 75,963 cases (13,910.1 per 100,000). 
• Legionellosis cases increased in 2021 and remained consistently high through 2023, with 15 cases (2.7 per 100,000) in 2023.
• Haemophilus Influenzae cases have risen significantly, reaching 16 cases (2.9 per 100,000) in 2023, the highest in five years.

Zoonotic Disease

• Lyme Disease cases have increased since 2021, rising to 5 cases (0.9 per 100,000) in 2023.
• Malaria cases doubled from 4 in 2021 to 8 in 2023 (1.5 per 100,000), indicating a possible increase in travel-related or locally acquired infections.
• Spotted Fever Rickettsiosis slightly increased in 2023 from 2021 and 2022.

Bacterial and Healthcare-Associated Infections

• The number of invasive Group A Streptococcal infections more than doubled, rising from 17 cases in 2022 to 42 cases in 2023.
• Cases of Carbapenem-Resistant Enterobacteriaceae (CRE) increased from 4 in 2022 to 11 in 2023, indicating a rise in antibiotic-resistant infections.

Source: North Carolina Communicable Disease Data Dashboard (NCD3 Dashboard); NC Electronic Disease Surveillance System (NCEDSS). 

Drug Overdose Highlights

• According to the NC Overdose Epidemic Data Dashboard, 237 people in Guilford County died of an overdose in 2023, for an overdose death rate of 43.1 out of 100,000 residents This rate is among the highest rates seen in NC and a 3% increase from the previous year. 
• In 2024, there were 812 overdose Emergency Department (ED) visits in Guilford County for a rate of 147.7 per 100,000 residents. This is a 21% decrease from 2023 in which 1,029 overdose ED visits were reported. 

Source: North Carolina Overdose Epidemic Data Dashboard. https://www.dph.ncdhhs.gov/programs/chronic-disease-and-injury/injury-and-violence-prevention-branch/north-carolina-overdose-epidemic-data#data-dashboard 

Maternal and Child Health Highlights

• In 2022, 52 infants out of 5,883 live births died before their first birthday in Guilford County, for an infant mortality rate of 8.8 per 1,000 live births. 
• Guilford County has a large and persistent racial disparity in infant mortality rate. The 2022 infant mortality rate for Black babies was more than twice that of White babies (11.7 per 1,000 live births as compared to 5.5 live births). 

Source: NC State Center for Health Statistics.

The Impact of Medicaid and Medicaid Expansion

In Guilford County, Medicaid makes it possible for over 180,000 of Guilford children, parents, pregnant women, people with disabilities and seniors to get the health coverage they need to stay healthy, well, and manage health conditions. Approximately one of three Guilford County residents secure their health coverage through Medicaid. Of those 180,870 Guilford County residents with Medicaid, 45% or 82,638 of those are children under the age of 18.  Since Medicaid expansion went to effect in December 2023, an additional 39,029 adult residents in Guilford County have been enrolled. Read more about the impact of Medicaid expansion, through March 2025.

Affordability of care and lack of health insurance are leading reasons why Guilford County residents may not seek or receive the health care services they need. Many of these community members are employed but do not have coverage through their jobs and do not make enough to cover the cost of health insurance coverage on their own. Medicaid is an important safety net for Guilford County’s most vulnerable individuals and families that enables cost saving preventive care and reduces preventable death through earlier detection, diagnosis, and treatment of serious medical conditions.

Sources:
About NC Medicaid: https://medicaid.ncdhhs.gov/about-nc-medicaid
NC Medicaid Enrollment Dashboard:  https://medicaid.ncdhhs.gov/reports/dashboards/enrollment-dashboard 

New Guilford County Business Developments announced in 2024 

In 2024, the following new business developments in Guilford County were announced:
High Point 

• Cosmetics & Cleaners International LLC, a leading contract manufacturer of cosmetics and personal care products, will invest $8.4 million to locate a new state-of-the-art manufacturing facility in the City of High Point. adding 24 new jobs in Guilford County. 
• Maola Local Dairies of High Point was awarded a $980,600 grant from the NC Department of Agriculture and Consumer Services. This grant will support the expansion of the cooperatives’ High Point plant to add a school milk packaging line.  Maola also plans to invest $4.95 million and potentially create 9 new jobs.  
• Superior Glove, which designs and produces safety gloves and sleeves, intends to locate its first US manufacturing facility in High Point creating over 100 jobs in the next 5 years.

Greensboro

• Clearly Clean Products, LLC, a packaging company that manufactures 100 percent recyclable plastic food trays for the meat and produce industry will create at least 80 new jobs in Greensboro to expand its current production capacity. 
• James M. Pleasants Company Inc. (JMP), a major distributor and sales representative for HVAC, plumbing, and other industrial equipment, will consolidate the company’s headquarters, distribution, and light manufacturing operations into one Greensboro facility in Greensboro, creating 40 jobs over five years.  
• Banknote Corporation of America, US-based commercial security printer, will construct a 20,000-square-foot expansion in northeast Greensboro/Guilford County, creating 50 new jobs and bring an investment of $28 million to the community.
• Gilero LLC, a contract design and manufacturing business for medical and drug delivery devices and pharmaceutical packaging, will expand its operation into Greensboro, creating a $6.4 million investment and 37 new jobs. 
• PartnerHero, a leading business process outsourcing organization dedicated to fostering strategic partnerships and alliances, plans to expand its operations to Greensboro, hiring 200 employees and investing almost $7 million.
• Semiconductor manufacturer IQE, Inc. plans to expand its production operations in Greensboro, a $305 million project that is expected to create 109 jobs. 
• Core Technology Molding Corporation, a minority-owned leader in plastic injection molding in Greensboro, plans a significant expansion from its 36,000 square foot facility to a 104,000 square foot facility, an investment of $27 million. The expansion is expected to create at least 26 new positions over the next four years. 

Sources:
City of Greensboro: https://www.greensboro-nc.gov/ 
City of High Point: https://www.highpointnc.gov/ 
High Point Chamber of Commerce: https://www.bhpchamber.org/chamber-news/ 
Greensboro Chamber of Commerce: https://greensboro.org/ 

High Point, NC Wins All-America City Competition

In June 2024, High Point was named High Point as an All-American City, by the National Civic League, one of 10 municipalities to be recognized in the 2024. This acknowledgment noted:

• The city’s rebranding efforts to promote civic pride, 
• Thrive HP, a groundbreaking minority entrepreneurial initiative and  
• The food insecurity work of the Greater High Point Food Alliance.

Click here to read more.

Other Economic and Employment Highlights 

NC Department of Commerce Labor and Economic Analysis provides a snapshot of key economic and employment measures for Guilford County. 

Source: NC Department of Commerce: https://analytics.nccommerce.com/area-profiles/

Housing Highlights in Guilford County 

The 2023-2024 Community Health Assessment found that disparities in homeownership persist due to historical redlining practices, which exacerbate the existing wealth gap. The 2023 Guilford County Community Health Survey found that one of four survey respondents were concerned about having enough money to their rent or mortgage in the last year. Only about a third of survey respondents agreed or strongly agreed (36.9%) that there is affordable housing that meets the needs of their community.

According to recent data from the NC Housing Coalition (2025):

• 31% of Guilford County families are “cost-burdened,” or spend more than 30% of their income on housing (65,634 households). 
• Guilford County ranks #7 in North Carolina for evictions among renter households. 
• In fiscal year 2023-2024, 708 families faced foreclosure, down from 849 families the previous year; however, 16,342 families faced an eviction filing, up from 16,097 in 2022-2023. 

Key Guilford County Findings from Carolina Core – Housing Needs Assessment

In 2023, NC REALTORS® contracted with Bowen National Research to conduct a regional housing study of the Carolina Core, a 21-county region in central North Carolina that includes Guilford County. In 2024, these findings were published.  Below are a few high points about Guilford County from this assessment:

Guilford County household growth is projected to increase by 5,157 or 2.3% through 2028. Current and planned economic development will add to this demand for housing. 
Multifamily rental housing operates at an overall vacancy of 5.3% and long wait lists exist.
For sale housing is operating with limited availability and Guilford County has a median list price of $330,000 for available homes. 
Housing gaps exist for a variety of housing types and affordability. Between 2024 and 2029 Guilford County will have overall housing gaps of 14,715 housing units and 18,495 for sale housing units. 

For more information on this assessment, go to:  https://www.ncrealtors.org/carolina-core-housing-study-reports/ 

New Schools Open in Guilford County

In 2022, the School Funding and Facilities bond passed to provide $1.7 billion for addressing infrastructure needs, including new schools and renovations. This funding is essential for improving educational facilities and improving outcomes. 

Four new schools opened their doors in the 2024-2025 school year: Claxton Elementary, Peck K-8 Expeditionary Learning, Brooks Global Studies and Foust Elementary School. In 2025, Kiser Middle School and a new Visual and Performing Arts Elementary School are scheduled to open. 

Guilford County Schools School Bond Dashboard provides updates to the current bond project. 

The following links below highlight new and continuing initiatives to date for the remaining health priorities:

Behavioral Health - Drug Overdose and Mental Health  

COALITION - Guilford Overdose Prevention and Education Collaborative

STRATEGY - Guilford County Opioid Settlement  

Healthy Eating and Active Living 

PROGRAM - Guilford County Life in 24

PROGRAM -  Healthy Communities Program

Maternal and Child Health and Infant Mortality

PROGRAM - Reproductive Health Services  

HOME VISITATION PROGRAMS

Family Connects North Carolina Guilford County

Care Management for At Risk Children (CMARC) 

Care Management for High Risk Pregnancy (CMHRP)

STRATEGY - Every Baby Guilford

STRATEGY - Every Baby Guilford’s Strengthening the Continuum of Care of Reproductive Life Planning

PROGRAM - Every Baby Guilford's Community Doula Program

PROGRAM -  Every Baby Guilford's Adopt-A-Mom Program 

Access to Health Care

POLICY - North Carolina Medicaid Expansion 

CLINICAL CARE - Primary Care Services at Public Health 

STRATEGY - Public Health Mobile Units in the Community