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Community Health Assessment Evaluation & SWOT Analysis

Wake County is one of the most highly rated living and working environments in the United States and North Carolina. Thankfully to great opportunities, Wake County keeps growing on big scales. The County has more than 1 million people, and it is the largest population in North Carolina (U.S. Census Bureau, 2020). By 2019 it was the third fastest-growing County in the U.S. (“Demographics”, 2021). This rapid growth is seen in Wake County not only in demographics but also in social and health indicators.

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Based on the numbers provided by “Demographics” (2021), the biggest age group is over 55 years, which counts 46% of the population. The 35-54 years group counts 22%, and the groups 20-34 years and 5-19 years are relatively equal: 16% and 15%, respectively. The smallest age group is under five years – it counts only 1% (“Demographics”, 2021).

In the ethnic diversity, the predominant place takes the White race with 59.6%, the next is the Black or African American race with 21%, and Hispanic or Latino with 10.4%. The minority groups include the Asian race with 7.7%, American Indian and Alaska Native – 0.8%, Native Hawaiian and Pacific Islander – 0.1%, and other races – 2.6%. The immigrant population is 13.5% (U.S. Census Bureau, 2020).

The financial situation in Wake County is better than the general in the U.S. People in poverty are 8% which is 2.5% less than in the U.S. in total. Median household income in 2015-2019 was $80,591, which is $17,748 higher than the average in the U.S. (U.S. Census Bureau, 2020). With 52.8% of persons aged 25 years+ holding a bachelor’s degree or higher, it is 20,7% more than the average U.S. educational rate. High school graduates or higher age 25 years+ is also remarkably high – 93%. Persons without health insurance under age 65 years count 10.1%. That is 0.6% than in the whole country (U.S. Census Bureau, 2020). Therefore, community health assessment will be analyzed in this research to estimate local health issues and their relation to the indicators mentioned above.

Community Wellness Assets and Use

A set of diverse statistics requires analysis for a definition and evaluation of Community wellness assets. It provides an opportunity to identify priority gaps in health care. The collection of such indicators in Wake County is compared to “applicable population health benchmarks and peer counties”, which include Healthy North Carolina 2020 and Healthy People 2020 as criteria (Wake County, 2019, p. 5). The basis for comparing Wake County to other counties was Mecklenburg County, North Carolina, and Travis County, Texas.

Important factors were found in the assessment of critical gaps in the medical system. The Wake County assessment (2019, p. 6) determined that “Wake County performed more than five percent worse than applicable benchmarks, targets, or peer counties on 14 existing data measures” in the health care system. There was a mismatch in population and health care staff and an insufficient number of beds in health care facilities. Those suffering from mental disorders are less likely to go to the ER (Wake County, 2019).

Health insurance coverage has become less available to Wake County residents. Also, opportunities for public access to health care have decreased. It is also related to the small number of medical services working with Medicare and Medicaid insurances. The shortage of bilingual providers creates the following difficulties in access. Another aspect that affects medical conditions is the inaccessibility of transportation in a particular geographic area of the County. In order to solve these problems, the question arises regarding the necessity of introducing measures for disseminating information, encouraging timely access to medical care, and expanding accessible care services.

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The next factor identified in the assessment process was the deterioration in mental health-related to substance use. Wake County had more than “five percent worse indicators than applicable benchmarks”, including suicide death rates, poor mental health days, alcohol-impaired driving deaths, drug poisoning deaths, and opioid pill dispensing (Wake County, 2019, p. 7). In addressing this issue, mental health treatment resources expand with a greater focus on substance use could have positive results.

Community Health Status

Some indicators can determine the overall picture of community health status. N.C. State Center for Health Statistics (2019) indicates that the total pregnancy rate is 68.5, which is 3.1 less than in North Carolina in general. The general mortality rate in Wake County is average – 5.4. This indicator is explained by the significant age difference in population groups, where the number of older people is 46% and children under five years is only 1%. There are 8.5% of adults with diagnosed diabetes among chronic diseases, 462 cancer incidents per 100,000 population. The age-adjusted rate of heart disease is 120.8 per 100,000 population (N.C. State Center for Health Statistics, 2019). The injury death rate is shown in the table:

Figure 18. NORTH CAROLINA STATEWIDE AND COUNTY TRENDS IN KEY HEALTH INDICATORS Air pollution has a high rate in Wake County – 10.1 comparing to the average of 8.5 in North Carolina, and violent crime has a low rate – 115 comparing to the average North Carolina rate – 351 (County Health Rankings & Roadmaps, 2021). North Carolina has a high mortality rate for unintentional poisoning, including Wake County with 10.1 and 548 deaths per 100,000 people (N.C. State Center for Health Statistics, 2019). These indicators show that Wake County’s community health status is high on average, but some factors need improvement.

In general, these indicators are comparable to average North Carolina indicators or are lower.

Health Equity Indicators

Analyzing health rate indicators makes it possible to define two crucial disparities – air pollution and substance abuse. Air pollution poses a serious health risk, while higher air purity is good for cardiovascular and respiratory health. Supporting cleaner transportation and industry and proper disposal of urban waste will improve this indicator and contribute to the health of the population.

The epidemiological situation is aggravated by the fact that most substance abusers are adolescents and young people. Social work among young people and healthy attitudes and responsible behavior skills can be used as preventive measures. Behavior, improving physical condition, and increasing nonspecific resistance of the body to pathogenic and unfavorable environmental factors should be supported.

The other equity indicator is the low pregnancy rate. Due to the higher senior population percent compared to the younger age group, there is a high death rate, and health insurance becomes less available for people in need. Thus, some innovative programs should be in place to invite the younger generation and to create a more attractive environment for creating families in Wake County.

Strengths Weaknesses
  • Growth of population.
  • High educational rate.
  • High financial rate.
  • High median household income.
  • Low violent crime rate.
  • Low chronic disease death rate.
  • Low unintentional injury death rate.
  • The low death rate of heart disease
  • High rate of uninsured adults.
  • The poverty rate is high to consider it as a weakness.
  • High rate of persons without health insurance.
  • Mismatch in population and health care staff.
  • Limited opportunities for public access to health care.
  • Deterioration in mental health, related to substance use.
  • Air pollution has a high rate.
  • The high mortality rate for unintentional poisoning
Opportunities Threats
  • Development of educational and health care system.
  • Good financial and social opportunities for the younger generation.
  • Ability to improve gaps through investment and timely action.
  • The decline of the younger generation.
  • Development of health problems for a low-income population.
  • Worsening of epidemiological situation.
  • Further development of mental health disorder among young people.

Synthesis of Community Health Status & Conclusion

By analyzing Community Wellness Assets, strategies and predictions can be developed to solve priority problems and engage with the community for its efficient contribution. According to demographic, social, and health indicators, it was possible to assess the general Wake community health status. Wake County is developing swiftly through its population growth for 30 years and shows high results in its social and political activity. It has many strong sides, such as high income and high educational rate, which positively affect the health situation in the County. However, few crucial threats may negatively impact a general health picture of Wake County’s population, such as insufficient health care staff per person and inability to use Medicare insurance in many care services. These factors can create a worse health picture in the future. Thus, effective investment into the health care system can prevent the County from more considerable financial losses and more death-causing diseases.

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The mission of Wake County is to maintain and ensure that all residents have access to health care services and expand the availability of insurance coverage for low-income individuals and children from disadvantaged families. The goal is to ensure that health authorities provide the conditions for a long and healthy life.

Due to specific mental health indicators related to the use of substances, the County must take care of the promotion of healthy choices and productive living. It is essential to acknowledge that people with mental disorders visit the ER less frequently and take steps to facilitate timely treatment. For serious health problems like drug addiction, special measures require an application. Additional health services and rehabilitation centers can help reduce this problem. In addition, support for preventive measures against children who use tobacco and alcohol, minimization of their distribution at the point of sale, and better control of their sale to minors would be the right strategy.

The low rate of insured persons indicates the necessity to provide more opportunities for high-quality and affordable treatment and to increase the number of medical staff. Moreover, promoting an active lifestyle and a clean environment can improve the health status of people in Wake County. That can be achieved by minimizing harmful emissions and creating green infrastructure.

Affordable and comfortable housing and a positive and clean environment are also central elements of the County’s well-being and the physical and mental health of its residents. Expanding the amount of affordable housing and rental assistance programs can prevent the rate of homelessness and thus improve health.

All the mentioned above recommendations may facilitate the County in stable and reliable community growth. To prevent mentioned threats and achieve the best results, the administration of Wake County should take immediate measures. Thus, these problems can be avoided in the future and will find support from the community.


Demographics. (n.d.). Web.

County Health Rankings & Roadmaps. (2021). Wake. Web.

N.C. State Center for Health Statistics (2019). Trends in key health indicators: North Carolina statewide and County. 

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U.S. Census Bureau. (2020). QuickFacts: Wake County, North Carolina; United States. 

U.S. Census Bureau. (2020). County population by characteristics: 2010-2019. Web.

Wake County. (2019). Community health needs assessment.

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