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In the News July 20 – August 3, 2022

Housing Equity:

  1. Treasury Announces New Steps to Increase Affordable Housing Supply and Lower Long-Term Housing Costs for American Families: The U.S. Department of the Treasury announced new guidance to increase the ability of state, local, and tribal governments to use American Rescue Plan (ARP) funds to boost the supply of affordable housing in their communities.
  2. Raleigh first time home buyers priced out despite financial assistance programs: Raleigh’s Homebuyers Assistance Program would typically assist about 50 to 60 people a year before the pandemic and housing boom. So far in 2022, only five people were able to close on their homes with assistance through the program.
  3. Evictions begin to creep back up in parts of central North Carolina: As federal pandemic relief money runs out, evictions across North Carolina are again beginning to increase. While eviction rates are currently lower across a majority of the counties, some counties historically report almost double the rates elsewhere in the state.
  4. Greensboro voters approve $135 million in bond measures: $30 million in housing bonds will go toward affordable housing, making homeownership easier, and making some neighborhoods more attractive to buyers.
  5. Houses were once plentiful across the U.S. Now half of cities don’t have enough homes: More than half of the nation’s metropolitan regions had an undersupply of homes in 2019, a sharp increase from one-third of cities in the 2012. The nation is short 3.8 million homes to meet its housing needs.

Health Equity:

  1. NC Legislature Idles for Now on Medicaid Expansion Agreement: General Assembly leaders acknowledged on Tuesday that a compromise for North Carolina to finally embrace Medicaid expansion likely won’t come quickly and pinned success for a near-future agreement in part on buy-in from a key health care interest group.
  2. NC overdose deaths increased more than the national average in 2020: Drug overdose deaths surged by 30% nationally and 40% in North Carolina during the first year of the pandemic. Across the country, Black and Native American communities saw higher rates of overdose deaths and those disparities are worsening.
  3. Uterine cancer cases rising, outcomes worsening especially for Black women: Researchers at UNC Lineberger Comprehensive Cancer Center are investigating the why Black women die of uterine cancer at twice the rate of white women and are looking at factors of tumor biology, access to care, lifestyle, and behavior to improve outcomes and close the racial disparity gap.
  4. Vanderbilt, UNC and Duke Nurse-Midwives Join Forces to Reduce Black Maternal Health Risks: Nurse-midwives and educators from three prominent research universities form the Alliance of Black Doulas for Black Mamas to improve pregnancy outcomes in Black communities by providing specialized training for doulas.
  5. NC Health Center Aims to Reduce Mental-Health Stigma Among Latinos: Camino Health Center is spreading the word about Spanish-speaking therapists and counselors available to residents in the Charlotte area, addressing the stigma and lack of Spanish language resources in the community.

Economic Development:

  1. Biden-⁠Harris Administration Advances Equity And Economic Opportunity Through Federal Procurement And State And Local Infrastructure Contracting: Administration Announces Record Contract Spending on Small Disadvantaged Businesses and New Steps to Create Contracting Opportunities for Disadvantaged Businesses through the Bipartisan Infrastructure Law
  2. U.S. Senate passes bipartisan bill to boost Cybersecurity Job Training at HBCUs: The Cybersecurity Opportunity Act requires that 50% of grant funds must go to HBCU’s, tribal, and minority serving institutions in order to support greater diversity and equality of opportunity in the cybersecurity field.
  3. Lenovo and Panthers partner to support NC small businesses: Lenovo and the Carolina Panthers have announced the return of the Empowering the Carolinas contest to celebrate and uplift small businesses – especially those that are women and minority-owned – across North America through grant and product donations, mentorship, and community engagement activities.
  4. US sees union boom despite big companies’ aggressive opposition: Wins for Amazon and Starbucks workers shows labor movement surging after years of decline – but pushback has been fierce, and has come amid allegations of union-busting.
  5. UNC Charlotte alum paving the way for diverse developers: Jane Wu, founder of Panorama Holdings LLC, has donated $50,000 to UNC Charlotte to fund a scholarship for students from under represented backgrounds studying commercial real estate.

Educational Equity:

  1. NC legislative proposal would dramatically overhaul how North Carolina governs its public schools: GOP sponsors push for an elected state school board, but Democrats warn against further politicizing public education.
  2. 144 organizations sign onto brief asking Supreme Court to order compliance with school funding plan: Attorneys filed an amicus with the North Carolina Supreme Court this week in the long-running Leandro school funding lawsuit contending the state has consistently failed to provide every child in North Carolina with access to the educational opportunities to which they are constitutionally entitled under the previous ruling.
  3. New report delves into state of early childhood education in Western NC: Early childhood education opportunities and challenges across the state’s 18 westernmost counties have decreased since 2019 and put a cost burden on families, leaving many to enroll in lower-quality programs.
  4. Half of NC’s community colleges not within walkable transit: In North Carolina, more than 500,000 people attend community colleges annually. Without consistent and easily accessible transit options students that lack access to a car could be discouraged from seeking higher education — a significant driver of economic mobility in the state.
  5. NCAE opposes plan to pay NC teachers based on performance instead of their experience: A state commission is working on a new licensure and compensation model that would pay teachers based on their ratings on student test scores.
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FHHP RELEASES NEW STUDY THAT EXAMINES SOCIAL DRIVERS OF HEALTH IN HIGH POINT

The Foundation for a Healthy High Point has released a new study highlighting summary data on health and economic disparities. The study shares new recommendations to help alleviate social and financial hardship issues across the Greater High Point community.

A new report compiled by the UNCG Center for Housing and Community Studies and the National Institute of Minority Economic Development’s The Research, Policy and Impact Center goes beyond health and medical needs to identify the specific socioeconomic conditions which continue to impact residents across the Foundation’s service area negatively.

The report underscores that in some High Point neighborhoods, resource inequality and structural impediments are directly linked to poor community health outcomes such as chronic lifestyle diseases like diabetes, hypertension, and heart disease; respiratory issues like asthma and COPD; and poor self-reported mental health.

Dr. Stephen J. Sills, who led the research, states, “I found many citizen groups, nonprofit organizations, and other agencies committed to making the city a better and healthier place to live. It is well recognized that High Point’s diversity is its strength and that there has been recent momentum in economic development and growth, affording more resources and assets to the community. However, it will take the efforts of all sectors to fully address the social drivers of health in High Point.

Using community surveys, focus groups, and one-on-one interviews, participating residents shared their personal experiences, including positive attributes and barriers to accessing key needs, like healthcare, transportation, and food. Using this approach, the findings offer a fresh look at our community’s needs, capturing how community members live, work, engage, and access services on a day-to-day basis and outlining the opportunities for our medical and nonprofit entities, municipalities, funders, and other agencies to work together to improve our overall community health.

“It is eye-opening to hear firsthand stories of continued disparities from community members,” states Curtis Holloman, executive director of the Foundation. “These neighborhood-based feedback sessions provided details around the upstream issues causing the downstream problems, yet this information offers great hope. As funders, service providers, employers, and neighbors, we know precisely where we need to work harder to create a community where all can thrive.”

The findings from this study serve as another source for our community partners and other stakeholders to use as a reference and will help to prioritize the Foundation’s community investments going forward.

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In the News 7.20.2022

Housing Equity:

  1. New Policy Protects People with Vouchers Seeking City-Supported Housing: The Charlotte City Council on Monday voted to adopt a new city policy that protects prospective tenants in City of Charlotte-supported housing developments from being disqualified from renting a unit because they participate in a rental subsidy program.
  2. Residents urge High Point city council members to rethink vote against fair housing: Residents in the city of High Point are urging city council members to rethink their vote against becoming a fair housing assistance program in May which would provide freedom from housing discrimination based on race, color, national origin, religion, sex, familial status, or ability.
  3. Congress Finds Private Equity Kept Buying Homes, Hiking Fees Over Pandemic: A survey by the house financial services committee found private equity homeownership has been growing in low-income neighborhoods where companies have increased tenants fees 40% between 2018 and 2022.
  4. HUD Announces 24 Programs to Join Biden-Harris Administration Justice40 Initiative: The programs included in today’s announcement create affordable and sustainable housing and meet a range of different housing needs for individuals and communities, including single- and multi-family housing and housing for seniors, persons with disabilities, and tribal communities.
  5. New NC funding will help expand affordable housing for those with specific needs: The North Carolina State Housing Finance Agency has approved $4.3 million in funding for properties geared toward those with special housing needs, including military veterans, children aging out of foster care, and people with disabilities who fall below 50 percent of the area median income.
  6. Housing Connections Initiative working to combat affordable home crisis: The North Carolina Coalition to End Homelessness has helped house more than 2,300 people by providing financial incentives and assistance to landlords willing to work with households coming out of homelessness.

Health Equity:

  1. How healthy are NC’s women, and are their needs ready to be met?: The women’s health report card from the UNC-Chapel Hill Center for Women’s Health Research spotlights promising trends in preventative health and adverse trends in perinatal and chronic health. Notable racial disparities in the data suggest differences in access to health care services and screenings.
  2. UNC, N.C. A&T Team to Lead Project to Address Social Determinants of Health in Women of Color: As part of the American Heart Association’s pledge to address social determinants of health in women of color, Alison Stuebe, MD, and her team of researchers received a $2.4-million grant to develop a curriculum that cultivates trust among patients and health team members.
  3. Biden Signs Executive Order on Access to Abortion Services: Executive order directs federal agencies to take steps within their power to safeguard abortions and reproductive health services, including ensuring the availability of emergency contraceptive medications and providing legal protection for out-of-state patients and abortion providers.
  4. Blue Cross NC taps Headway to expand mental health access for underserved members and children: In its latest effort to address critical mental health needs in the state, Blue Cross and Blue Shield of North Carolina is tapping a fast-growing mental health startup to help expand its network of behavioral health providers to underserved communities including children from diverse racial and ethnic backgrounds.
  5. Medicaid expansion would help people incarcerated in jails and prisons: Thousands of people currently cycling in and out of jails and prisons are among the roughly 600,000 who would get health coverage under Medicaid expansion, potentially transforming North Carolina’s justice system.
  6. NCDHHS Announces New National 9-8-8 Number for People in Mental Health Crisis: Starting Saturday, people in mental health crisis can dial 9-8-8 to reach the National Suicide Prevention Lifeline and get immediately connected to trained crisis counselors 24/7.

Economic Development:

  1. Can people live on minimum wage in NC? Here’s how it compares to cost of living: With inflation affecting the cost of everything from food to gas, it’s getting harder for minimum wage employees to afford necessities. While the minimum wage in North Carolina is $7.25, the living wage for a single adult with no children in the state is $17.14. For single adult with one child, the living wage is nearly double.
  2. Climate Change, Extreme Temps Affect NC Black-Owned Small Businesses: In North Carolina, small Black-owned businesses say they’re struggling to cope with losses and damages from extreme weather events including floods, extreme heat, blackouts or severe storms.
  3. Equal Pay Gains Dampened as Wage Gaps Widen for Women of Color: Some incremental progress has been made in the effort to bring equal pay to women in the workplace, but data indicate women of color still face certain inequities exacerbated by the Covid-19 pandemic, widening their respective wage gaps from last year.
  4. Interest rates, price increases stand to have outsized effect on Black consumers, businesses: Black Americans — who already make less money, have a harder time securing loans for their businesses and have less financial security — stand to be hurt more than other demographic groups in this uncertain economy.
  5. CNBC Names North Carolina as America’s Top State for Business in 2022: North Carolina ranked highly in developing and training a strong workforce due to the Longleaf Commitment Community College Grants Program and the North Carolina Child Care Stabilization Grants and supported businesses through the pandemic with the Business Recovery Grant Program and ReTool NC Program for women- and minority-owned businesses.
  6. Truist announces $120 million commitment to strengthening small businesses: The commitment includes $30 million in philanthropic grants to support nonprofits who assist small businesses and diverse entrepreneurs and $5 million in philanthropic grants, which will support technical assistance, small businesses and volunteerism.

Educational Equity:

  1. Budget bill sent to Cooper puts NC’s controversial school voucher program on path to dramatic expansion: If the bill becomes law, funding for the underutilized voucher program would grow from $120.54 million to $176.54 million for the 2023-2024 school year, while traditional public schools are grappling with funding challenges and staffing shortfalls.
  2. U.S. Department of Education Awards Final $198 Million of American Rescue Plan Higher Education Funds to Support Students at Community Colleges, Rural, and Minority-Serving Institutions: Of the funds awarded, almost 90 percent will go toward Historically Black Colleges and Universities (HBCUs), Minority Serving Institutions (MSIs), community colleges, rural institutions, and institutions serving large populations of low-income students. The majority of institutions are also required to distribute roughly half of all grant funds directly to students with the greatest need.
  3. Education advocate joins task force to increase teacher diversity: Monique Perry-Graves, the executive director for Teach for America North Carolina, recently joined the State’s DRIVE Task Force to recruit teachers of racially, ethnically and linguistically diverse backgrounds to prioritize equity and inclusion in the educational system in North Carolina.
  4. N.C. A&T Works with Guilford County Schools to Build Community Education Center: The facility will be used to address the negative impact of COVID-19 on the district’s students, families, staff and community by providing flex spaces with tutoring, adult education and community meeting rooms for students and adults.
  5. U.S. Department of Education Announces Engage Every Student Initiative to Ensure Every Student Has Access to High-Quality Learning: The Initiative will help communities utilize American Rescue Plan funds alongside other state and local funds to allow more students to access more programs year-round to support their academic and mental health needs.
  6. NCDHHS Launches Raise NC to Highlight the Value of the State’s Early Care and Learning Network: The public education campaign highlights the value of the state’s early care and learning network to support children’s healthy development as well as families’ participation in the workforce.
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RPIC Policy Agenda – Reduce Disparities in Health due to Social Drivers of Health

The effects of systemic racism are visible throughout the health care system and in the disproportionately negative health outcomes among communities of color. Black Americans remain the least healthy group.[i] Black patients fare significantly worse than whites in the categories including infant mortality and neonatal health; [ii] HIV/AIDS; cardiovascular disease; cancer screening and management; adult and child immunizations; diabetes; asthma; end-stage renal disease;[iii] nutritional risk; breast cancer; as well as anxiety, depression, and substance misuse.[iv]

There are a variety of factors, or social determinants, that play a role in driving these inequalities in health. Conditions of the social environment are shaped by how the political and economic systems distribute resources, and these conditions contribute as much or more to health outcomes as one’s DNA. Social Determinants of Health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. [v]

Access to care is critical. Across the US we find that 11.4% of African Americans and 20.0% of Hispanics lack any form of health insurance. In North Carolina, those numbers are even worse with 13.6% of African Americans and 32.0% of Hispanics uninsured. Health care access and insurance coverage were major factors that contributed to racial and ethnic disparities before the Affordable Care Act (ACA). Though disparities in access to insurance have been reduced significantly as a result of ACA implementation[vi] research continues to show that health care access especially among minority communities lags and health insurance discrimination occurs.[vii] Recent surveys have shown a strong perception of discrimination in health care among African American respondents.[viii] Studies have clearly demonstrated inferior care received by Black patients in doctors’ offices; disparities in cardiac care, where Black patients are less likely than white patients to be prescribed certain cardiac medications;[ix] less access to curative surgery for early-stage lung, colon, or breast cancer; and higher rates of syphilis in counties which exclude Black professionals from boards of health and county commissions.[x]

Where communities of color are located plays an important role in health disparity. Many studies have shown that communities of color are more likely to experience place-based environmental health hazards such as poor air quality, [xi]hazardous waste[xii] and pre-regulatory landfills,[xiii] pesticide use and toxic chemical releases, [xiv] and often lack safe recreational areas.[xv] They are also more likely to live in areas that are considered food deserts,[xvi] medical deserts,[xvii] pharmacy deserts, [xviii]and in communities with persistent poverty and high rates of social vulnerability.[xix] Researchers have offered overwhelming evidence that Black people receive a lower quality of health care than whites, have less access to care, and have worse health outcomes –even when controlling for income and other factors unrelated to race. This racial dimension of health equity is manifested across all health categories.[xx]

Solution #1: Increase healthcare access among LMI communities

Reform(s) Needed:

  1. Expand Medicaid in Non-Expansion States like NC.
  2. Promote local health system and provider networks.[i]
  3. Provide insurance to working poor who fall into the coverage gap.
  4. Expanded funding for Federally Qualified Health Center (FQHC).
  5. Develop community health worker, health navigator, and home visitation programs.

Solution #2: Address Social and Economic Factors contributing to poor health outcomes

Reform(s) Needed:

  1. Provide or expand family and social support systems of care.
  2. Address community safety as public health issue.
  3. Expand resources to maternal and child health programs.
  4. Promote Livable wage advocacy and raising minimum wages.
  5. Expand availability of healthcare and healthy foods in HRSA identified Medically Underserved Areas and USDA designated Low Income/Low Food Access neighborhoods.

Solution #3: Improve physical environments in which people live

Reform(s) Needed:

  1. Treat air quality and pollution as environmental justice issues.
  2. Develop more stringent mitigation strategies to reduce emissions and toxic exposures in LMI areas.
  3. Better assess drinking water quality, especially in pre 1980s homes and in neighborhoods with aging infrastructure.
  4. Involve local residents in LMI neighborhoods in development of remediation plans for Pre-Regulatory Landfills (PRLFs) and other environmental hazards.
  5. Provide more transportation choice and transit access in LMI communities.
  6. Expand HUD lead-safe housing and healthy homes programs.

Download the printable Research, Policy, and Impact Agenda Part 3 Reducing Disparities in Health due to Social Drivers


[i] See https://guilfordccn.org/provider-outreach-program/

[i] Noonan, A.S., Velasco-Mondragon, H.E. & Wagner, F.A. Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public Health Rev 37, 12 (2016). https://doi.org/10.1186/s40985-016-0025-4

[ii] Testa, Alexander and Dylan B. Jackson. 2021. “Race, ethnicity, WIC participation, and infant health disparities in the United States.” Annals of Epidemiology.  58: 22-28.

[iii] Bediako, Shawn M. and Derek M. Griffith. 2007. “Eliminating Racial/Ethnic Health Disparities: Reconsidering Comparative Approaches.” Journal of Health Disparities Research and Practice. 2(1): 49-62.

[iv] Williams, David R. and Selina A. Mohammed. 2009. “Discrimination and racial disparities in health: evidence and needed research.” Journal of Behavioral Medicine. 32:20-47.

[v] Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. 2022. “Social Determinants of Health.” https://health.gov/healthypeople/priority-areas/social-determinants-health.

[vi] Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. N. (2016). “Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act.” Medical care. 54(2), 140–146. https://doi.org/10.1097/MLR.0000000000000467

[vii] Xinxin Han, Kathleen Thiede Call, Jessie Kemmick Pintor, Giovann Alarcon-Espinoza, Alisha Baines Simon. (2015). “Reports of Insurance-Based Discrimination in Health Care and Its Association With Access to Care”, American Journal of Public Health 105, S3:S517-S525. https://doi.org/10.2105/AJPH.2015.302668

[viii] Sills, S., Rich, B., DiMattina, M., Su, H., Gruber, K., (2021). “Dan River Health Collaborative Health Equity Report 2021.” Report Submitted to the Danville Regional Foundation. https://chcs.uncg.edu/dan-river-health-equity-assessment/

[ix] Thomas, Stephen B. and Erica Casper. (2019). “The Burdens of Race and History on Black People’s Health 400 Years After Jamestown.” American Journal of Public Health. 109(10): 1346-1347.

[x] Thomas, Stephen B. (2001). “The Color Line: Race Matters in the Elimination of Health Disparities.” American Journal of Public Health. 91(7): 1046-1048.

[xi] Morello-Frosch R, Jesdale BM. (2006). “Separate and unequal: residential segregation and estimated cancer risks associated with ambient air toxics in US metropolitan areas.” Environ Health Perspect.;114(3):386–393.

[xii] Mohai P, Saha R. (2007). “Racial inequality in the distribution of hazardous waste: a national-level reassessment.” Social Problems. 54(3):343–370.

[xiii] Sills, S. & DiMattina, M. (2021). “Geospatial and Statistical Analysis of Statewide Landfills in NC.” unpublished white paper and presentation as part of the Bingham Park Environmental Justice Research Project.

[xiv] Lara Cushing, John Faust, Laura Meehan August, Rose Cendak, Walker Wieland, George Alexeeff, (2015). “Racial/Ethnic Disparities in Cumulative Environmental Health Impacts in California: Evidence From a Statewide Environmental Justice Screening Tool (CalEnviroScreen 1.1)”, American Journal of Public Health 105, 11:2341-2348. https://doi.org/10.2105/AJPH.2015.302643

[xv] Moore LV, Diez Roux AV, Evenson KR, McGinn AP, Brines SJ. (2008). “Availability of recreational resources in minority and low socioeconomic status areas.” Am J Prev Med.;34(1):16–22

[xvi] Weinberg, Z (2000) “No place to shop: Food access lacking in the inner city.” Race, Poverty & The Environment 7(2): 22–24

[xvii] Carr, Brendan, Bowman, Ariel, Wolff, Catherine, Mullen, Michael T, Holena, Daniel, Branas, Charles C., Wiebe, Douglas 2017. “Disparities in Access to Trauma Care in the United States: A Population–Based Analysis.” Injury 48(2):332–8.

[xviii] Wisseh, C., Hildreth, K., Marshall, J. et al. (2021). “Social Determinants of Pharmacy Deserts in Los Angeles County.” J. Racial and Ethnic Health Disparities 8, 1424–1434 https://doi.org/10.1007/s40615-020-00904-6

[xix] Ibraheem M. Karaye, and Jennifer A. Horney. 2020. “The Impact of Social Vulnerability on COVID-19 in the U.S.: An Analysis of Spatially Varying Relationships.”American Journal of Preventive Medicine 59: 317-325 https://doi.org/10.1016/j.amepre.2020.06.006.

[xx] Smedley, Brian D., Adrienne Y. Stith, and Alan R. Nelson, eds. 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington: The National Academies Press

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Medicaid Expansion Could Have Prevented 745 COVID-19 Deaths in North Carolina

The COVID-19 pandemic has given North Carolina one more reason to join the 38 other states that have received federal dollars for Medicaid expansion. Given that the United States is the only industrialized country without nationalized health care (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447684/ ) has the highest total death count of any country (https://www.statista.com/statistics/1093256/novel-coronavirus-2019ncov-deaths-worldwide-by-country/) and the fifth highest per capita death rate in the world (https://coronavirus.jhu.edu/data/mortality), we sought out to see if there was any evidence to suggest a correlation between uninsured rates and COVID-19 deaths.

Studies show that people without insurance report delaying or simply foregoing necessary medical treatment due to cost (https://www.kff.org/report-section/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act-how-does-lack-of-insurance-affect-access-to-care/). We hypothesized that counties with a population that have higher percentages of uninsured would have higher rates of COVID-19 deaths when controlling for per capita COVID case rates.  County wide data for all 50 states and Washington DC was downloaded from Policymap.com, which aggregates data from a number of sources including the Census and data from the New York Times COVID Tracking Project,  To create a more robust dataset we also controlled for percentage of those aged 65 plus as well as the percentage of black and Hispanic populations, due to data which suggests that the death rates among blacks and Hispanics is higher than the percentage of blacks and Hispanics among the total U.S. population.  (https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html) We also added underlying health conditions correlated to higher COVID-19 morbidity to the model based on Census data which estimated the percentage of the population with the conditions.

Photo by Nguyễn Hiệp on Unsplash

The model showed that with all the variables being held equal for every one percent increase in uninsured rates an average 1.4 more people will die of COVID per 100,000, which is statistically significant at the 1% level. In 2019,  North Carolina had the 9th highest uninsured rate in the U.S. of 11.4% compared to the national average of 9.2% (https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Uninsured%22,%22sort%22:%22desc%22%7D). According to the dataset Medicaid expansion states have uninsured rates an average 4.95% lower than non-Medicaid expansion states, which is statistically significant at the .001 level. This falls right in line with the estimated 400,000-620,000 people currently in North Carolina’s coverage gap who could benefit from Medicaid expansion and represents 3.8-5.9% of North Carolina’s population (https://www.ncchca.org/community-resources/policy-advocacy/nc-insurance-gap/ ) If North Carolina was a Medicaid expansion state our uninsured rate would be about 5% lower than it is now. According to our model 5 percent lower uninsured rate would have resulted in an average of 7.1 fewer COVID-19 deaths per 100,000, which extrapolated to North Carolina’s population of 10.49 million means that expanding Medicaid could have saved the lives of close to 745 North Carolinians.  

Table 1: Per Capita COVID-19 Deaths by County to March 14, 2020
Table 2: Per Capita COVID-19 Deaths by County to March 14, 2020
Table 3: Percent Uninsured for Medicaid Expansion States Compared to Non-Medicaid Expansion States
Map: Percent People Without Health Insurance