Healthy Opportunities

All North Carolinians should have the opportunity for health. Access to high-quality medical care is critical, but research shows up to 80 percent of a person’s health is determined by social and environmental factors and the behaviors that emerge as a result. DHHS is focusing on tackling these fundamental drivers of health. 

To meet our mission of improving the health, safety and well-being of all North Carolinians while being good stewards of resources, DHHS is addressing the conditions in which people live that directly impact health, known as “social determinants of health,” or SDOH. Our initial focus is on housing stability, food security, transportation access and interpersonal safety. Strategies include:

• Creating an interactive statewide map of SDOH indicators that can guide community investment and prioritize resources.
• Developing a set of standardized screening questions to identify and assist patients with unmet health-related resource needs.
• Building a statewide coordinated care network (NCCARE360) to electronically connect those with identified needs with community resources – and allow for a feedback loop on the outcome of that connection.
• Incorporating SDOH strategies throughout the Medicaid 1115 wavier.
• Developing Healthy Opportunities Pilots to test and evaluate the impact of providing select evidence-based, non-medical interventions related to housing, food, transportation and interpersonal safety to high-needs Medicaid enrollees.
• Building an infrastructure to develop and support a Community Health Worker Initiative.
• Examining better ways to streamline cross-enrollment in existing key benefit programs.
• Using the North Carolina Investment Map and other tools to identify opportunities to partner and co-invest in strategies that drive health.