North Carolina top state for business, addressing healthcare concerns
Writer: Mariana Hernández Sevilla
August 2024 — North Carolina continues to demonstrate strong economic potential, bolstered by improvements in infrastructure and business friendliness. However, recent indicators suggest underlying challenges that could impede its long-term success.
North Carolina maintained its position as one of the strongest economies, ranking No. 2 in CNBC’s list of top states for business last month. And more recently as part of their incentives to help “aspirational” businesses become self-sufficient, N.C. Secretary of State Elaine Marshall announced the creation of over 24,000 new jobs annually. This initiative is expected to add an estimated $1.5 billion to $2 billion to North Carolina’s economy each year.
Workforce opportunities and business empowerment will be key in the future development of North Carolina. “The Secretary of State’s Office is one of the first stops new businesses make in their entrepreneurial journey. This office is uniquely positioned to help our entrepreneurs make the important connections that will increase their chances for success,” said Marshall.
According to a report conducted by the North Carolina Department of the Secretary of State and Fayetteville State University faculty, self-sufficient business represent 37% of the workforce in the state, with an average of nine employees.
This effort to boost business operations and investment to help entrepreneurs is reflected in North Carolina’s scorecard in the latest CNBC state rankings.
Compared to 2023, North Carolina performed better in several key categories: access to capital increased by 15 points; the cost of doing business fell by 9 points, and overall business friendliness rose by 68 points. The state also saw an 11-point improvement in infrastructure and maintained a consistent cost of living. These factors positioned North Carolina just three points below No.1 Virginia in the overall ranking.
However, despite these gains, North Carolina’s overall score decreased by 36 points from 2023 to 2024. Categories reflecting quality of life, education, workforce, technology, and economy declined by 7, 11, 22, 27 and 54 points, respectively.
According to America’s Health Rankings, North Carolina ranks in the bottom half of U.S. states for healthcare outcomes. The Tar Heel State was listed as the 32nd healthiest state in 2023, ranking 29th in social & economic factors, 3rd in physical environment, 32nd in clinical care, 39th in behaviors, and 36th in health outcomes.
The state faces significant challenges, including a high prevalence of frequent physical distress, a low adolescent HPV vaccination rate, and a high prevalence of high-risk HIV behaviors.
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To address these issues and improve the health conditions in 2024, the North Carolina Department of Health and Human Services recommends, among other points, focusing on investing in behavioral health and resilience, and improving social workforce conditions.
A major focus has been ensuring more North Carolinians receive adequate healthcare insurance coverage. In December 2023, North Carolina’s Medicaid expansion helped more than half a million residents gain much needed coverage. The state is taking an innovative approach addressing key health issues, with NC Medicaid’s $650 million investment in Healthy Opportunities Pilots helping to “create a national model for how the health and social care workforce collaborate to address social determinants of health, such as housing and food insecurity.”
“North Carolina is a national leader in shifting from paying for health care services to buying health,” said Dr. Elizabeth Cuervo Tilson, State Health Director and Chief Medical Officer of NCDHHS, as cited in a May 2024 press release. “This effort matters to North Carolinians because it holds the promise of supporting whole-person care statewide — that is, physical, behavioral, and social health — so all people have the opportunity for health in North Carolina.”
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