North Carolina is seeing major improvements in two long-standing public health challenges: Infant mortality and overdose-related deaths.
According to newly released North Carolina Department of Health and Human Services reports from 2024, the state’s infant mortality rate declined to 6.3 deaths per 1,000 live births – the lowest ever recorded.
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“We are very pleased to see meaningful improvements in health in North Carolina,” said Dr. Kelly Kimple, the director of the Division of Public Health and State Health officer. “More babies are celebrating their first birthdays.”
The decline in infant mortality is in part driven by fewer deaths in the earliest days of life, with neonatal deaths dropping 14.9%. A neonatal death is reported as infant deaths that occur in the first 28 days.
The data still highlights persistent racial disparities with Black infants in North Carolina nearly three times more likely to die than white infants.
“We are not making progress where we need to on unacceptable disparities with regards to infant mortality,” Kimple said. “That’s where we remain committed at DHHS to ensure we continue this work moving forward, and continue the investment so that we can make more progress and close that gap.”
Health leaders point to expanded postpartum Medicaid coverage, broader access to prenatal care, and statewide maternal health initiatives, like the ‘I Gave Birth’ initiative, as efforts to improve maternal and infant outcomes.
The same 2024 report found overdose deaths fell by 34% compared to 2023, the first recorded decline since 2019.
Increased distribution of opioid reversal medication, like naloxone, have contributed to fewer overdose-related deaths, according to the state. More than 150,000 doses of the overdose-reversal drug were distributed across North Carolina in 2024.
“We are excited about seeing a decline in overdose deaths for the first time in many years, and fewer families are losing loved ones to overdose deaths,” Kimple said. “We know that there have been significant investments in behavioral health funding and opioid settlement funding that has gone to communities to really help ensure that there is access to services and programs to support individuals that may be struggling.”
Kimple said one of the state’s main focuses currently in overdose-prevention is improving access to resources in rural communities.
The improvements in overdose-related deaths and improved outcomes for infants come alongside the state’s Medicaid expansion. More than 700,000 people in North Carolina became eligible for health coverage through Medicaid over the past two years.
“I think that is all of our challenge as we work together to ensure that these trends continue in a positive direction, that we continue to see declines in deaths, whether that’s infants or overdose deaths or deaths overall. At the end of the day, we are all striving for a healthier North Carolina,” Kimple said. “Every community is different, and I think the needs are different. We're trying to understand where those needs are and how we can help at a statewide level.”
Kimple added, “We are moving in the right direction and improving health outcomes in North Carolina, but we know there is more work to be done.”
While overall deaths have declined for three consecutive years, state data shows chronic diseases like cancer, heart disease, diabetes and obesity remain the leading causes of death in North Carolina.
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