Special to IFN

RALEIGH — The latest data from the N.C. Department of Health and Human Services shows major improvements in the health and well-being of people across the state. The newly released 2024 death data shows North Carolina’s infant mortality rate declined to the lowest rate in state history, and overdose-related deaths decreased by more than a third in the same time frame.

During this same year, the state marked major investments in health with Medicaid expansion, historic behavioral health funding from the N.C. General Assembly, and national opioid settlement funding.

“As attorney general, I held big opioid drug companies accountable for their roles in sparking an addiction epidemic that harmed communities across the state, and we secured $1.5 billion to reinvest in those communities to help folks get the care they need while keeping drugs off the streets,” said Gov. Josh Stein. “Medicaid expansion is also enabling more people to get the health care they need. This sharp decline in overdose-related deaths is a clear demonstration of the investments North Carolina has made to keep people safe and healthy.”

“The decrease in deaths in North Carolina marks progress in building healthier communities and is a testament to what we can accomplish when we work together,” added NCDHHS Secretary Dev Sangvai. “We are moving in the right direction in improving health outcomes in North Carolina, but we know there is more work to be done. We are committed to increasing access and affordability so that everyone gets the care they need when they need it.”

North Carolina’s infant mortality rate declined 8.7 percent from 2023 to 2024, from 6.9 to 6.3 deaths per 1,000 live births. The improvement was driven by a 14.9 percent decline in neonatal deaths, meaning more babies are surviving the earliest and most vulnerable weeks of life.

This historic decline highlights how Medicaid expansion continues to improve health outcomes for children and families in North Carolina. Just over two years since North Carolina became the 41st state to expand Medicaid, more than 700,000 people have gained health care coverage, giving more people access to necessary and critical care and ultimately leading to healthier pregnancies. Studies show states that have expanded Medicaid have better maternal and infant outcomes than states that have not. Extending Medicaid coverage for pregnant women from 60 days to one year postpartum is another effort focused on improving maternal and infant health outcomes in our state.

Despite the historically low infant mortality rate and declines across most racial/ethnic groups, disparities persist. Non-Hispanic Black infants had mortality rates nearly three times higher than non-Hispanic white infants. NCDHHS is continuing our work to improve these disparities through public health efforts that include the “I Gave Birth” campaign, NC Maternal Mental Health MATTERS, the Rural Health Transformation Program, and North Carolina’s Perinatal Health Strategic Plan.

Separately, the latest data also shows a sharp decline in overdose deaths, which fell 34 percent from 4,442 deaths in 2023 to 2,934 in 2024. This is the first decline since 2019. This decline reflects a large reduction in opioid-related overdose deaths, which fell 38.3 percent from 3,656 in 2023 to 2,254 in 2024. While these rates declined in all major demographic groups, the largest declines were among Hispanic and Black residents.

Several strategies have contributed to this decline. Along with Medicaid expansion, expanded efforts for naloxone distribution across the state have also played a key role. In 2024, NCDHHS distributed more than 150,000 doses of the overdose reversal medication to community-based organizations across the state. Other efforts include increasing access to evidence-based treatment like medications for opioid use disorder (MOUD), developing mobile opioid treatment programs, increasing community-based behavioral health urgent care facilities, and ensuring low-barrier access to wraparound health services across the state. NCDHHS has also partnered with local jails to provide MOUD for individuals during and after incarceration.

In 2023, the North Carolina General Assembly made a historic investment in mental health, with funds targeted for expanding and improving mental health care in North Carolina. This funding has been used to directly strengthen the crisis system, enhance services for children and youth, support people involved in the justice system, and build a stronger behavioral health workforce.

Key Data

Other key points from the 2024 death data include:

♦ Statewide deaths declined for the third year in a row following the pandemic peak (106,155 in 2024, down 1.6% from 2023 and far below 118,040 in 2021).
♦ Cancer became the leading cause of death for the first time since 2019.
♦ Chronic diseases like cancer, heart disease, diabetes, and obesity remain the primary causes of death in North Carolina.
♦ Unintentional injuries like drug overdoses, traffic crashes, and falls were among the top five causes of death statewide.

“We are encouraged by the declines in overdose-related deaths and infant mortality rates in North Carolina, which coincide with recent investments in our health system,” said Kelly Kimple, NCDHHS Director of the Division of Public Health. “However, other trends show that there is still work to be done, and our department remains committed to improving health outcomes for everyone who calls North Carolina home.”