Every year, NCRHA publishes an annual North Carolina Rural Health Snapshot that compiles data on statewide rural demographics, rural health, and health care infrastructure. This comprehensive report is a resource for anyone advocating for rural communities, health equity, and access to care. It identifies opportunities for North Carolina to improve how our public health system serves our rural population by outlining differences, disparities, and strengths of underserved North Carolina communities.

In 2025, we had the honor of sitting down with outgoing NCDHHS Secretary Kody Kinsley for an interview that threads throughout the report. Find a preview of the 2025 North Carolina Rural Health Snapshot and download the entire report below. 

Preview: Hurricane Resilience

“Build a coalition of the willing. Grant grace to those who can’t join you yet and leave the table open for when they’re ready. Every grievance, every complaint holds within it a vision of a hoped-for future. Listen to that vision.” — Angela Blanchard

From September 25 through September 28, 2024, rain inundated 17 counties in Western North Carolina, home to the beloved Blue Ridge Mountains, culminating with the arrival of category four Hurricane Helene, the third deadliest in modern history.

As overflowing rivers traveled downstream through the mountains, water continued rising in lower areas, destroying homes, businesses, parks, hospitals, and more. The catastrophic flooding reached over 30 inches, exceeding the historic “Great Flood” of 1916 by more than 1.5 feet at its peak. Busick, in rural Yancey County, recorded a total of 30.78 inches of rain.

The United States Geological Survey reported over 2,000 observed landslides caused by the torrential downpour. Bridges, highways, and roads were washed away, and at one point, all routes in and out of the region were considered closed for non-emergency travel. Neighborhoods and towns, such as Chimney Rock in Rutherford County, were deluged by flood waters, mud, debris, and pollution.

With the hurricane knocking out power lines and cell towers, many residents throughout Buncombe County and surrounding areas were left without electricity or service, unable to communicate or call for outside help for days. Flooding destroyed the North Fork Water treatment plant in Asheville, leaving tens of thousands of people without drinkable water for 53 days.

The National Centers for Environmental Information estimates a total death toll across all impacted states of over 200 people, with nearly half of them dying in North Carolina. According to a North Carolina Governor’s Office report, more than an estimated 70,000 homes were damaged. The region is predicted to experience $50 billion or more in economic losses.

Mirroring the physical effects of the storm, Hurricane Helene has taken a toll on the health and well-being of community members, providers, and frontline workers alike, from inflicting physical injuries to disrupting access to food, water, and resources, accelerating the spread of sickness, and exacerbating chronic conditions.

Damage from the hurricane caused delays in preventative care and intensified challenges related to social drivers of health, such as decreases in income, loss of employment, displacement, and housing instability for hundreds of thousands of people.

According to an NC Health News analysis of preliminary data, at least 2,609 people were experiencing homelessness in the 25 counties impacted by Helene, marking a 20% increase from 2023.

Natural disasters are considered Adverse Childhood Experiences (ACEs), and some researchers estimate that 20-40% of an impacted population may experience post-traumatic stress disorder (PTSD) after a collective disaster like Helene. Symptoms, such as elevated stress, anxiety, depression, sleep disturbances, flashbacks, nightmares, social isolation, and persistent negative thoughts, can continue escalating for months or even years after an event. Along with igniting mental and behavioral health challenges, natural disasters can also compound preexisting conditions.

According to meteorologists, Helene is close to, if not the worst-case, weather event for the region with tiny tributaries suddenly swelling into raging rivers. The full impact—from physical destruction to mental and emotional well-being—is still being realized, and assessing the full scope of the damage will take months, if not years.

Following the aftermath of the storm, the state pledged $25 million in mental health resources, and Congress approved billions of additional dollars for hurricane recovery in December. With natural disasters becoming more common, North Carolina must act now. By prioritizing all forms of preparedness and resilience across the state, we can truly invest in whole-person, whole-family, whole-community, and whole-state health.

In December 2024, WNC Nonprofit Pathways hosted a Nonprofit Leadership Forum called The Power of Nonprofits: Reimagining and Rebuilding a Resilient WNC (Western North Carolina). The keynote speaker, Angela Blanchard, Chief Resilience and Recovery Officer for the City of Houston and expert practitioner in community development and long-term resettlement, shared her abundant wisdom about recovering from natural disasters.

She emphasized the essential need for creative problem-solving, courageous leadership, and cross-sector collaboration to first imagine and then build a better future for everyone where no one gets left behind.

As we examine rural health in North Carolina, the questions Blanchard posed are equally fitting for statewide work and multi-sector partnerships: “What would this be like if it worked for everyone? What would you be willing to do to make that come about?”

To that end, she advised, “Build a coalition of the willing. Grant grace to those who can’t join you yet and leave the table open for when they’re ready. Every grievance, every complaint holds within it a vision of a hoped-for future. Listen to that vision.”