This 2025 State of the County’s Health (SOTCH) Report for Alamance County shares progress on the Community Health Improvement Plans (CHIP) HNC 2030 Scorecard: Alamance County (2024-2027) developed to address the three priority areas identified by the 2024 Community Health Assessment (CHA). The three priorities are food access and food security, mental health, and substance use and overdose prevention. This SOTCH also shares highlights of changes in mortality and morbidity, emerging issues, and changes in initiatives since the CHA was submitted in March of 2025.

Please click on the links below for 2025 progress reports:

Food Access/ Food Security

  HNC2030 Monthly WIC Participation

Mental Health

  Alamance Behavioral Health Center

  Mobile Crisis Management (MCM)

Substance Use and Overdose Prevention

  Adult Recovery Court

  Opioid Overdose Prevention

There have been no significant changes in morbidity and mortality data at the time of this SOTCH submission in March of 2026.

Two tables for the top ten (10) causes of death may be viewed below with the first table reporting information for the 2014-2018 to 2018-2022 time periods and the second table reporting information for the 2019-2023 period. These rates are unadjusted per 100,000 people and include Alamance County residents of all ages. Diseases of the heart and cancer were in the top 2 causes of death for Alamance County for every time period. The third table provided below compares the Alamance County data for the 2018-2022 and 2019-2023 periods in the same table for ease of viewing.

Notes:

• A total of 9,813 deaths occurred among Alamance County residents from 2019–2023.
• The leading causes of death were heart disease and cancer, accounting for nearly 40% of all deaths.
• Injury-related deaths (including unintentional injuries, motor vehicle crashes, suicide, and homicide) are the leading causes among residents under age 40.
• Chronic diseases dominate mortality among adults 40+.
• Alzheimer’s disease and stroke are major contributors among older adults.

One Change at Rank #10:

• 2018–2022: Pneumonia & Influenza
• 2019–2023: Chronic Liver Disease & Cirrhosis

This suggests:

• A slight decline in pneumonia/influenza mortality relative to other causes
• A relative increase in liver disease mortality

When comparing the 2018–2022 and 2019–2023 time periods, the leading causes of death in Alamance County stayed mostly the same. The top nine causes did not change in order. The only difference was at number ten, where chronic liver disease and cirrhosis replaced pneumonia and influenza. Overall, this shows that death patterns in the county have remained steady, with chronic diseases and injuries continuing to be the main causes of death.

The table below compares the infant mortality numbers and rates for Alamance County for the 2018-2022 and 2019-2023 year periods.  There have been no significant change in the infant mortality rate for Alamance County.

Substance Use

Local partners and law enforcement have reported changes in the types of drugs being used in Alamance County. While opioid-related incidents may be decreasing in some areas, there has been a noticeable increase in the availability and use of methamphetamine, especially crystal meth.

Methamphetamine use is also being seen among some people who use fentanyl. Using more than one drug at the same time increases the risk of overdose and other serious health problems.

These changes appear to be connected to larger supply trends rather than just local behavior. Because of this shift, prevention, treatment, and harm reduction efforts may need to adjust to address changing community needs.

Measles

In the summer of 2025, measles was reported in an international traveler visiting NC. Measles cases have been on the rise throughout the entire state.  While Alamance County had no reported cases in 2025, this continues to be monitored. 

These emerging issues are being monitored and inform ongoing refinement of CHIP strategies.

The following are new initiatives since the 2024 CHA was submitted in March 2025. There have not yet been any paused or discontinued initiatives related to the 2024 CHA.

Please click on the links below for information on new initiatives since last CHA:

Food Access/ Food Security

  Community Bread Program

  Food Sovereignty - Return to Your Roots Initiative

Mental Health & Substance Use and Overdose Prevention

  Mobile Medication Unit