Raleigh, N.C. — Every day, 66 people move into Wake County. How some services will keep up with the growth is an unanswered question, but a group of community-service leaders is saying which areas are most in need of attention.

The growth is making it more and more difficult for the county to meet its residents’ needs. The group arrived at its list based on the members' understanding of the most serious challenges.

Increasing obesity; low-income housing; youth violence, including gang activity, and the need for community services in light of the closing of Dorothea Dix Hospital topped the list that emerged from a day-long meeting, said Gibbie Harris, the county's community health director.

Those areas will come under the most stress as the population grows, the leaders decided, and should get more attention over the next four years.

For three months last year, Wake leaders assessed the community and how it could meet needs in behavioral, economic, environmental and personal health and in other social-service areas. The result was a report, "Wake County: Opportunities and Challenges."

The 18 beds at county’s only domestic violence shelter, Interact, are full every night, for example. The number of beds hasn’t changed since 1989.

“There's an extreme demand. For every one woman and family we are able to house here at Interact, there's another that we are not able to bring into our shelter,” said Executive Director Adam Hartzell.

Wake County has the lowest number of domestic violence shelter beds per capita of any county in the state—about one for every 40,000 people. Mecklenburg County, for example, has about one per 26,000. Some are lower. Durham County is one per 17,000 people.

Another issue is adult obesity, which is nearly 6 percentage points higher in Wake County than the state average. The problem is growing among children, too.

The number of HIV cases is on the rise, and the imminent closing of Dix puts Wake County in the middle of mental health reform.

“As we have more people in the community, we have to think about ways we can deliver services differently to make sure that all their needs are met,” said Harris.

For victims of domestic violence, help is on the way. Interact bought the YWCA on Oberlin Road, allowing it to expand to 45 beds, but the leaders say that many issues may be harder to solve.