Contents
Acknowledgements ....................................................................................................................................... 3
Introduction .................................................................................................................................................. 4
Executive Summary ....................................................................................................................................... 6
The Value of the Community Health Assessment: ................................................................................... 6
What is a Community Health Assessment? .............................................................................................. 7
History and Geography ............................................................................................................................... 10
Demographics and Social Economic Issues of Stokes County .................................................................... 12
Racial Composition.................................................................................................................................. 14
Population Growth .................................................................................................................................. 15
Education .................................................................................................................................................... 15
North Stokes Average Test Scores .......................................................................................................... 15
South Stokes Average Test Scores .......................................................................................................... 17
West Stokes Average Test Scores ........................................................................................................... 19
School Enrollment ................................................................................................................................... 21
Child Care Programs in Stokes County .................................................................................................... 22
Head Start Centers .................................................................................................................................. 23
Pre-K Locations ....................................................................................................................................... 24
Socioeconomics .......................................................................................................................................... 25
Top 25 Employers in Stokes County ........................................................................................................ 25
Median Household Income ..................................................................................................................... 27
Poverty .................................................................................................................................................... 27
Unemployment Rates ............................................................................................................................. 28
Access to Care ......................................................................................................................................... 29
2020 Active Healthcare Professionals ..................................................................................................... 30
Adult Health ................................................................................................................................................ 31
Stokes County Health Rankings .............................................................................................................. 32
Leading Causes of Death ......................................................................................................................... 32
Cardiovascular Disease ........................................................................................................................... 34
Stroke ...................................................................................................................................................... 35
Diabetes .................................................................................................................................................. 36
2
Colorectal Cancer .................................................................................................................................... 37
Lung Cancer ............................................................................................................................................. 38
Alcohol Related Traffic Crashes .............................................................................................................. 39
Suicide ..................................................................................................................................................... 39
Unintentional Deaths .............................................................................................................................. 41
Pregnancy.................................................................................................................................................... 41
2016-2020 NC Live Births ........................................................................................................................ 42
Cesarean Section ..................................................................................................................................... 42
Births Delivered by Gestation ................................................................................................................. 43
Smoking During Pregnancy ..................................................................................................................... 44
Low Birthweight ...................................................................................................................................... 44
Infant Deaths ........................................................................................................................................... 45
Child Deaths ............................................................................................................................................ 45
Stokes County Communicable Disease Reports ......................................................................................... 46
Stokes County Health Resources Inventory ................................................................................................ 47
3
Acknowledgements
The 2021 Stokes County Community Health Assessment Report was prepared by the Stokes County
Health Department.
Special thanks to the Community Health Assessment Team for helping to develop the survey,
distribution of the survey and selecting health priorities.
2021 Stokes County Community Health Assessment Team:
Wendy Tucker, Stokes County Health Department
Hayley Shelton, Stokes County Health Department
Tammy Martin, Stokes County Health Department
Derrick Vickers, Insight Human Services
Shanda Cox, Stokes Partnership for Children
Stokes County Collaborative
Stokes Citizens for Safe and Healthy Communities
Stokes County Resiliency Collaborative
Cardinal Innovations
Stokes County EMS
Daymark Recovery Services
Stokes County Schools
Youth Haven Services
Parenting Path
Surry/Stokes Friends of Youth
4
Introduction
Local public health agencies in North Carolina (NC) are required to conduct a
Comprehensive Community Health Assessment once every four years. This community health
assessment, which describes both a process and a document, is intended to describe the current
health status of the community, what has changed since the past assessment, and what still needs
to change to improve the health of the community. The process involves the collection and
analysis of a large range of data, including demographic, socioeconomic and health statistics,
environmental data, and public and professional opinion. The document is a summary of all the
available evidence and serves as a resource until the next assessment. Together they serve as the
basis for prioritizing the community’s health needs, and culminate in planning to meet those
needs.
The primary source of health data for this report was the North Carolina State Center for
Health Statistics (NC-SCHS), County Health Data, Behavioral Risk Factor Surveillance System,
Vital Statistics and Cancer Registry. Other health data sources included: National Center for
Health Statistics and local (e.g., hospital, health department and department of social services)
data has been included where appropriate. Primary data was collected via community surveys
and partnership groups throughout Stokes County.
The purpose of the health survey is to provide updates on key health indicators and to
identify emerging public health issues among adults and children residing in the county.
Importantly, the survey allows professionals at the SCHD to track health issues over time. To
properly address the root causes of poor health, the survey looks beyond risk factors for
5
individual diseases to factors in the physical and social environment that influence health, such
as safety, poverty, and educational attainment.
Survey participants were asked to provide demographic information about themselves by
selecting appropriate responses from lists describing categories of age, gender, race and
ethnicity, education level, and household income level. This demographic information was
collected in order to assess how well the survey participants represented the general population
of the county. Other survey items sought participants’ opinions on health problems and
behaviors. Participants also were asked questions about their personal health and health
behaviors. All responses were kept in confidence and not linked directly to the respondents in
anyway.
6
Executive Summary
Ongoing assessment of the health status of the population is a core function of local
health departments, and improving the availability of high quality health information and
services remains a major priority for the Stokes County Health Department (SCHD). The SCHD
Health Education/Promotion Section is charged with carrying out this assessment function by
collecting, assessing and disseminating population-based health information to plan, evaluate,
and develop policies, programs and services by collaborating with individuals and agency
partners within the county. The SCHD is the primary gatherer of information about access to
health care, health care utilization, health behaviors, health status, and knowledge and
perceptions of health-related issues among the Stokes County population.
The Value of the Community Health Assessment:
• Compile community health related data and data interpretation, promotion, collaboration
and partnership among community members and groups.
• Fulfill society’s interest in assuring conditions in which people can be healthy.
• Share the assessment process and findings with the county residents and educate local
partners, residents, health care providers, and students regarding pressing health
problems.
• Create collaborative interventions to promote better health, while empowering
community members to act on issues of concern.
• Advocate for lasting community change with politicians and other local decision makers.
7
• Create a safe environment for persons living healthy lives to employ good health
practices.
• Identify emerging issues.
• Generate baseline data by which to monitor performance to plan public health
organizational and programmatic changes.
• Provide performance measures for strategic public health planning.
• Serve as a reference point and historical perspective for future county assessments.
• Provide a resource for activities such as writing grant applications. Maintain local public
health accreditation status.
• Comply with the North Carolina Public Health Consolidated Agreement.
• Learn about the level of emergency preparedness of Stokes County residents and the
community.
What is a Community Health Assessment?
A community health assessment (CHA) is the foundation for improving and promoting
the health of community members. The role of the community health assessment is to identify
factors that affect the health of a population and determine the availability of resources within
the community to adequately address these factors.
In a community based assessment, the community members take the primary
responsibility for determining the focus of the assessment activities at every level, including
collection and interpretation of data, evaluation of health resources, identification of health
problems, and development of strategies for addressing these problems. In this view, the
community assessment is done by the community rather than simply an assessment conducted on
a community.
8
The community health assessment process begins with the development of the
community based team. Once the team is established they work to collect data from the
community and other resources, analyze this data, establish health priorities based on this data
and conclude the process by creating a report based on what they have learned about the health
of the county and disseminating it to community partners and members.
Per the NC Public Health Consolidated Agreement, local health departments are required
to conduct a comprehensive CHA once every four years. The CHA is intended to study the
current health status of the community, what has changed since the last assessment, and what
still needs to change to improve the health of the community.
The CHA is also a vital component of the North Carolina Public Health Accreditation
process. The CHA report accounts for seven accreditation benchmarks and numerous activities
required for those benchmarks. The completion of the CHA process and document is essential
for the Stokes County Health Department to remain an accredited health department.
While the CHA is required of the health department it is also considered good public
health practice. Assessment is one of the three core functions of public health and a major part
of the ten essential public health services because the outcome report helps drive strategic plans
for public health activities, programs and services.
The CHA is a combination of primary and secondary data. The purpose of the health
assessment is to provide updates on key health indicators and to identify emerging public health
issues among adults and children residing in the county. Importantly, the assessment allows
professionals at the Stokes Public Health Department to track health issues over time. To
properly address the root causes of poor health, the survey looks beyond risk factors for
9
individual diseases to factors in the physical and social environment that influence health, such
as safety, poverty, and educational attainment.
The CHA survey data is the primary data collected for the health assessment process.
This large sample size enabled the survey to provide estimates not only of the health of the
county population overall, but of people residing in the county’s many different geographic
regions. This assessment also provides valuable information about the health of the county’s
major racial/ethnic sub-groups and numerous other demographic groups. Data are collected from
households of all educational and income levels, including the most vulnerable residents and
those living below the federal poverty level.
The secondary data collected for the health assessment process came from the North
Carolina State Center for State Health Statistics’ Community Health Data Book 2017, the U.S.
Census Bureau American Community Survey, the Kids County Data Center, the NC
Employment Security Commission and other published data as noted within this document.
The CHA Committee members from various constituents and agencies identified,
analyzed and prioritized community health problems using the primary and secondary data that
were both qualitative and quantitative. The following were just a few issues that were considered
when choosing top health priorities: 1) the county’s
growing need for mental health services 2)
continued increase in substance abuse within the
county, 3) the growing number of chronic health
conditions related to obesity or lack of physical
activity 4) the access of care to individual within
very rural parts of Stokes County.
10
History and Geography
Stokes County was founded in 1789 and is a member of the regional Northwest Piedmont
Council of Governments. County government is made up of 5 Elected County Commissioners
with an appointed County Manager and appointed Tax Administrator. Other elected officials are
the Sheriff, Clerk of Court, and Register of Deeds. School Board Members are elected to a five-
member board that appoints a Superintendent and presents the budget to County Commissioners
for approval. The Health Department is a department within the County Government System.
There are nine major divisions (Executive, Clinical Services, Environmental Health, Health
Administration, CMARC/CMHRP, WIC, Health Education and Emergency Preparedness)
within the department and those together employ personnel totaling 29 full time employees who
deliver multiple public health programs and services to the citizens of Stokes County. There are
three facilities from where team members work to serve the public.
According to the U. S. Census Bureau the county has a total area of 456 square miles
(1,181 km²), of which, 452 square miles (1,170 km²) of it is land and 4 square miles (10 km²) of
it (0.89%) is water. The county lies within the Piedmont region of western North Carolina, and
most of the terrain consists of gently rolling countryside. However, the Sauratown Mountains run
across the center of the county. The Sauras are named after the Saura Native American tribe
which lived in the county before European settlement. A chain of jagged ridges, the Sauratown
Mountains are an isolated remnant of the Blue Ridge Mountains far to the west. Although the
Sauratown Mountains occupy only 5% of Stokes County, they dominate the scenery from almost
any direction, abruptly rising from 800 to 1,700 feet (520 m) above the surrounding terrain.
Moore’s Knob, the highest point in the chain, rises to 2,579 feet (786 m). Most of the county is
less than 1,000 feet (300 m) above sea level. The Dan River runs from the Northwest Corner to
11
the Southeastern section of Stokes County (Covering over 56 Miles of River Recreation). Stokes
County is home to Hanging Rock State Park and also has the mass majority of Belews Lake
(located in the southeast corner).
12
Demographics and Social Economic Issues of Stokes County
Stokes County is made up of several incorporated towns and many unincorporated towns.
The incorporated towns include the City of King which is the largest municipality in the county
with a population of 7,197, Walnut Cove with a population of 1,586 and Danbury with a
population of 183. Stokes County Demographics shows the county population standing at 44,553
which is a 4% decrease since the last Community Health Assessment in 2016.
As for race breakdown, Caucasian make up 90.9% of the population, African American
4.1%, Hispanic of any race 3.31%, races of two or more 1.3%, and 0.4% American
Indian/Alaskan Native. The breakdown of population by age; under the age of five stands at
4.5%, persons under the age of 18 is 18.5%, person 65 years of age or older is 21.8% of the
population. The majority of the population 55.2% is between the ages of 18-64 years of age. Per
Capita money income in the last 12 months (2021) was $27,979 and the median household
income range was $51,668 compared to $56,642 for North Carolina. In Stokes County 12.1% of
individuals live below the poverty level compared to North Carolina’s rate of 12.9%.
The biggest issue that Stokes County is faced with is the lack of mental health resources.
The individuals with mental health issues cycle through county services: hospital emergency
departments and, social services. Even if there is access to care, there are cultural stigmas to
mental illness that are particularly acute in rural areas and may keep people from seeking care. In
a small community where everyone knows everyone, many don’t want their car seen in the
parking lot of a behavioral health specialist. Despite all of the obstacles, a movement toward
changing the balance of access and care in rural regions is showing signs of life.
13
We have found that those individuals with mental health problems that do not seek help
or treatment will often become involved in the aforementioned substance abuse problem in our
county. These individuals may turn to prescription drugs or illegal drugs to help the mental
conditions that they have (self-medicate) instead of seeking help with a professional.
There is a lack of medical providers for this county along with longevity of professional
staff for the health department. The area north of the mountain range is considered medically
underserved. Access to care for primary care physicians and dentists are still very low compared
to the state averages. In 2019, there were 17 primary care physicians (MD), 9 physician’s
assistants, and 5 general dentists in Stokes County.
Stokes County being a rural county our population tends to show higher incidence of
disease in a number of areas including heart disease, respiratory disease, and disability associated
with chronic health conditions, and obesity. Rural populations disproportionately suffer from
chronic disease relative to the general public. Access to quality health care in rural areas is
restricted by poor infrastructure and a smaller health care workforce, hindering the utilization of
preventative health services and compromising the implementation of wellness and healthy
lifestyle programs.
Stokes County has one rural critical access hospital; LifeBrite Community Hospital. In
addition, there are two urgent cares now in King. Stokes County Health Department also sees a
number of individuals in their primary care clinic. Often, many of these patients need referrals to
other medical providers in other counties due to their complicated medical needs that our
practitioners cannot treat to the standard of practice as needed. With the low number of medical
providers, lack of services at the county hospital and ease of access to care, it makes it hard for
individuals to receive medical care in Stokes County. Add individuals for being uninsured and
14
underinsured, lack of county funds, along with the Department of Social Services assigning
individuals to the health department as their primary care providers, makes it a very unique
situation in trying to provide care for the citizens of Stokes County and still address all the public
health mandates.
Racial Composition
Stokes County is predominately white, with minorities making up approximately 8.71% of the
population. In Stokes County, 90.9% of the population consider themselves to be of one race.
Source: U.S. Census.gov 2021
African American/Black Hispanic Caucasian/White Two or more races
Race
4.1 3.31 90.9 1.3
4.1
3.31
90.9
1.3
0
10
20
30
40
50
60
70
80
90
100
Percentage of Residnets %
15
Population Growth
• Stokes County has experienced a -4% growth in population from 2016 to 2021.
• The city of King has the highest population at 7,197 people, the city of Walnut Cove has
a population of 1,586 and the city of Danbury has a population of 183.
Location
2016
2021
Growth %
Stokes County
47,401
44,553
-4%
North Carolina
10,146,788
10,551,162
4%
Source: State Center for Health Statistics, North Carolina
Education
North Stokes Average Test Scores
Average ACT Scores
Subject
Average Score at
This School
This School's State
Percentile Rating
State Average of
All NC Schools
English
15.1
38th
16.1
Math
17.3
33rd
18.1
Reading
16.3
27th
18.4
Science
16.8
35th
18.0
Writing
4.5
23rd
5.5
Nearly all North Carolina public and charter school students who are enrolled in grade 11 for the first time are
required to take the ACT. In the chart above, you can get a sense for how the average ACT scores at North Stokes
High School stack up against those of other high schools in North Carolina.
16
End of Course Scores
EOC Biology:
16% - Level 1
26% - Level 2
7% - Level 3
43% - Level 4 (Solid)
8% - Level 5 (Superior)
EOC English 2:
21% - Level 1
21% - Level 2
9% - Level 3
40% - Level 4 (Solid)
10% - Level 5 (Superior)
Average SAT Scores
Subject
Average Score at This School
Reading
531
Math
541
Composite Score
1072
SAT Participation Rate
29 %
17
North Stokes High School had an average SAT score of 1072 (math and reading combined). This means the school’s
average SAT scores ranked #112 out of 410 NC high schools (73rd percentile). On this site, you can see the SAT
scores of North Carolina high schools. The SAT participation rate at North Stokes High School was 29% in our most
recently available data. Above you can also see how the school’s ACT scores compare to other schools in North
Carolina.
South Stokes Average Test Scores
Average ACT Scores
Subject
Average Score at
This School
This School's State
Percentile Rating
State Average of
All NC Schools
English
13.8
27th
16.1
Math
16.6
25th
18.1
Reading
16.5
29th
18.4
Science
16.9
36th
18.0
Writing
5
34th
5.5
Nearly all North Carolina public and charter school students who are enrolled in grade 11 for the first time are
required to take the ACT. In the chart above, you can get a sense for how the average ACT scores at South Stokes
High School stack up against those of other high schools in North Carolina.
End of Course Scores
EOC Biology:
24% - Level 1
27% - Level 2
11% - Level 3
18
33% - Level 4 (Solid)
5% - Level 5 (Superior)
EOC English 2:
24% - Level 1
16% - Level 2
11% - Level 3
45% - Level 4 (Solid)
< 5% - Level 5 (Superior)
Average SAT Scores
Subject
Average Score at This School
Reading
530
Math
540
Composite Score
1070
SAT Participation Rate
50 %
South Stokes High School had an average SAT score of 1070 (math and reading combined). This means the
school’s average SAT scores ranked #114 out of 410 NC high schools (72nd percentile). On this site, you can see
the SAT scores of North Carolina high schools. The SAT participation rate at South Stokes High School was 50% in
our most recently available data. Above you can also see how the school’s ACT scores compare to other schools in
North Carolina.
19
West Stokes Average Test Scores
Average ACT Scores
Subject
Average Score at
This School
This School's State
Percentile Rating
State Average of
All NC Schools
English
15.5
41st
16.1
Math
17.6
36th
18.1
Reading
18.2
43rd
18.4
Science
17.8
45th
18.0
Writing
5.1
36th
5.5
Nearly all North Carolina public and charter school students who are enrolled in grade 11 for the first time are
required to take the ACT. In the chart above, you can get a sense for how the average ACT scores at West Stokes
High School stack up against those of other high schools in North Carolina.
End of Course Scores
EOC Biology:
12% - Level 1
8% - Level 2
6% - Level 3
44% - Level 4 (Solid)
31% - Level 5 (Superior)
20
EOC English 2:
18% - Level 1
20% - Level 2
6% - Level 3
54% - Level 4 (Solid)
< 5% - Level 5 (Superior)
Average SAT Scores
Subject
Average Score at This School
Reading
544
Math
540
Composite Score
1085
SAT Participation Rate
31 %
West Stokes High School had an average SAT score of 1085 (math and reading combined). This means the school’s
average SAT scores ranked #101 out of 410 NC high schools (75th percentile). On this site, you can see the SAT
scores of North Carolina high schools. The SAT participation rate at West Stokes High School was 31% in our most
recently available data. Above you can also see how the school’s ACT scores compare to other schools in North
Carolina.
21
School Enrollment
Source: North Carolina Department of Public Instruction
The enrollment for Stokes County Schools for 2021 was 5,592 students which is lower than enrollment
from 2016 which was 9,287.
Elementary Schools:
Germanton Elementary School
King Elementary School
Lawsonville Elementary School
London Elementary School
Mount Olive Elementary School
Nancy Reynolds Elementary School
Pine Hall Elementary School
Pinnacle Elementary School
0
5,000
10,000
15,000
20,000
25,000
Stokes Yadkin Surry Rockingham
5,592
5,105
7,291
20,211
Total Students Enrolled in Schools
# Students
22
Poplar Springs Elementary School
Sandy Ridge Elementary School
Walnut Cove Elementary School
Middle Schools:
Chestnut Grove Middle School
Piney Grove Middle School
Southeastern Middle School
High Schools:
Meadowbrook Academy Stokes Early College
North Stokes High School West Stokes High School
South Stokes High School
Child Care Programs in Stokes County
Program Name
Owner or
Director
Star Rating
Telephone #
Location/Mailing
Address
First Step Child
Care
Amy Mots-
Myers
3
336-591-9151
7384 Hwy 8
South
Germanton, NC
27019
23
Hope Child Care
Center
Shirley Sturgill
4
336-591-1807
1075 Stevens
Acers Rd Walnut
Cove, NC 27052
Kidz
Community
Childcare
Linda Smith
Christy Johnson
4
336-983-8393
336-413-2290
995 Brown Rd
PO Box 1706
King, NC 27021
King First
Baptist Child
Development
Collen Rabenold
4
336-983-9332
108 School
Street PO BOX
1257 King, NC
27021
New Life
Childcare
1 NC Pre-K
Nann Phillips
4
336-591-3109
415 Summit
Street PO Box
855 Walnut
Cove, NC 27052
Kindercare
Ginger Shore
3
336-983-2024
109 Village Way
King, NC 27021
Learn and Grow
Academy
Danielle Motley
Michelle Motley
Prov.
336-591-9351
4547 Pine Hall
Road Walnut
Cove, NC 27052
Head Start Centers
Danbury Head
Start
Donna Sims
5
336-593-8113
1070 Hospice
Drive Danbury,
NC 27016
Mt. Olive Head
Start
5
336-985-5260
336-367-4993
2145 Chestnut
Grove Rd. King,
NC 27021
Sandy Ridge
Head Start
Jill Johnson
5
336-871-2551
1308 Amostown
Rd. Sandy Ridge,
NC 27046
24
Pre-K Locations
King Elementary
Marcia Saunders
4
336-983-5824
152 East School
Street PO Box
1839 King, NC
27021
London Pre-K
Mia Flowers
5
336-591-7204
609 School
Street Walnut
Cove, NC 27052
Pinnacle
Elementary Pre-
K
Anna Jones
5
336-368-2990
1095 Surry Line
Rd Pinnacle, NC
27043
WC Elementary
Pre-K
Penny Linville,
Barbara Welch,
Lisa Wyatt
5
336-591-4408
1211 Walnut
Cove School Rd
Walnut Cove,
NC27052
Poplar Springs
Elementary
Casey Campbell
5
336-985-0234
223 Hobe Kiser
Rd. King, NC
27021
Other Childcare or Private Childcare
Little Bears
Wanda Cranfill
2
336-407-0751
116 Brighton Dr.
King, NC 27021
Tonya’s Tots
Tonya Rockhold
3
336-983-8970
2124 Chestnut
Grove Rd. King,
NC 27021
Calvary Christian
1
336-983-3728
536 South Main
Street King, NC
27021
King Moravian
Preschool
Tina Pratt
n/a
336-983-4003
234 W. Dalton Rd.
King, NC 27021
25
Pea Pods
(YMCA)
Heather Adams
n/a
336-983-9622
105 Moore Rd.
King, NC 27021
Praise Place
Dee Dee Pierce
n/a
336-469-2469
Socioeconomics
Socioeconomic status as measured either by income or level of education is strongly
correlated with health status. In general, population groups that suffer the worst health status
also are those that have the highest poverty rates and lower levels of education. Disparities in
income and education levels are associated with differences in the occurrence of illness and
death, including heart disease, diabetes, obesity, elevated blood level, and low birth weight.
Higher incomes permit increased access to medical care, enable people to afford better housing
and live in safer neighborhoods, and increase the opportunity to engage in health-promoting
behaviors. The economy has certainly changed since the last Stokes County Community Health
Assessment which was completed in 2016. The North Carolina unemployment rate as of 2021
was 4.2% with the rate for Stokes County being 4.8%.
Top 25 Employers in Stokes County
1
Stokes County Board of Education
Education & Health
Services
500-999
2
Wieland Copper Products LLC
Manufacturing
250-499
3
County of Stokes
Public Administration
250-499
4
Wal-Mart Associates Inc.
Trade, Transportation,
Utilities
250-499
26
5
Melan Construction Company Inc.
Construction
100-249
6
Lifebrite Hospital Group of Stokes
Education & Health
Services
100-249
7
Food Lion
Trade, Transportation,
Utilities
100-249
8
YMCA of Northwest North Carolina
Leisure & Hospitality
100-249
9
Priddy Manor Assisted Living
Education & Health
Services
50-99
10
Autumn Corporation
Education & Health
Services
50-99
11
Universal Health Care/ King Inc.
Education & Health
Services
50-99
12
Forsyth Technical College
Education & Health
Services
50-99
13
City of King
Public Administration
50-99
14
Lowes Foods
Trade, Transportation,
Utilities
50-99
15
Bill Hanks Lumber Co (A Corp)
Manufacturing
50-99
16
Shoreline Healthcare Management LLC
Education & Health
Services
50-99
17
US Postal Service
Trade, Transportation,
Utilities
50-99
18
Dairi-O
Leisure & Hospitality
50-99
19
Parkdale America LLC
Manufacturing
50-99
20
Prn Inc. Pc ( A Corp)
Education & Health
Services
50-99
21
Ingles Markets Inc.
Trade, Transportation,
Utilities
50-99
22
Kindred Hospitals East LLC
Education & Health
Services
50-99
23
NC Department of Transportation
Public Administration
<50
27
24
Hiring Line Inc.
Professional & Business
Services
<50
25
Dollar General
Trade, Transportation,
Utilities
<50
Source: NC Commerce, Labor and Economic Analysis Division, Top 25 Employers by NC County.
Median Household Income
Stokes County came in fifth when compared to peer counties for median household income in
2020. The median for Stokes is $51,668 compare North Carolina at $56,642.
Poverty
In 2020, Stokes County had 12.1% population living in poverty. Overall North Carolina had 12.9%
population living in poverty. When compared to our peer counties we are roughly the same percentage
as all except for Davie and Dare.
$51,668
$62,028
$65,420
$46,954
$51,509
$57,323
$56,642
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
Stokes Davie Dare Yadkin Transylvania Person North
Carolina
2020 Median Household Income
Income
28
Unemployment Rates
Stokes County’s unemployment rate was .6% higher than North Carolina’s rate for 2021. In 2016
Stokes County’s unemployment rate was 4.5% and North Carolina’s rate was 4.9%.
12.1
9.6
8.8
12.1
12.6
13.5
12.9
0
2
4
6
8
10
12
14
16
Stokes (12.1%) Davie (9.6%) Dare (8.8%) Yadkin (12.1%) Transylvania
(12.6%)
Person (13.5%) North Carolina
(12.9%)
2020 Poverty Percentage
County Percentage
2017 2018 2019 2020 2021
North Carolina
4.2 3.7 3.5 6.2 4.2
Stokes County
4.5 4 3.8 7.1 4.8
0
1
2
3
4
5
6
7
8
Percentage %
Unemployment Rates
North Carolina Stokes County
29
Access to Care
For the following data the first percentage is for Stokes County and the second is the percentage for
North Carolina. The year that is listed with this data is also the last time the data was updated. (NCIOM,
North Carolina Health Profile)
Uninsured Adults
% of adults age 18 to 64 years without health insurance
14.6%
15.5%
2018
Uninsured Children
% of children age 18 and under without health insurance
5.3%
5.4%
2018
Medicaid & CHIP Enrollees
% of population enrolled in Medicaid or CHIP
22.7%
25.0%
SFY 2019
Health Care Workforce - Primary Care Physicians
Primary care physicians per 10,000 population
3.7
8
2019
Health Care Workforce - Dentists
Dentists per 10,000 population
1.5
5
2019
Health Care Workforce - Psychiatrists & Psychologists
30
Psychologists, psychiatrists, addiction psychiatrists, and pediatric psychiatrists per 10,000
population
0.4
3.6
2019
Health Care Workforce - Birth Attendants
OBGYNs/family medicine physicians/CNMs per 10,000 population
2.5
4.2
2018
2020 Active Healthcare Professionals
Physicians
Non-Federal Physicians 24
Primary Care Physicians 17
Family Practice 4
General Practice 0
Internal Medicine 0
Obstetrics/Gynecology 0
Pediatrics 3
Federal Physicians 0
Physicians per 10,000 Population 5.17
Primary Care Physicians per 10,000 Population 3.66
Nurses
Registered Nurses 192
Nurse Practitioners 21
Certified Nurse Midwives 0
Licensed Practical Nurses 90
Other Health Professionals
Chiropractors 3
Occupational Therapists 11
Occupational Therapy Assistants 6
31
Optometrists 8
Pharmacists 32
Physical Therapists 17
Physical Therapist Assistants 13
Podiatrists 11
Practicing Psychologists 0
Psychological Associates 1
Respiratory Therapists 6
Dentists and Dental Hygienists
Dentists 5
Dental Hygienists 24
Adult Health
When it comes to adult health, we think of different ways to keep our bodies healthy
from washing our hands and vaccines to cancer prevention. We should be aware that it is just as
important to pay attention to our bodies signs and symptoms to know which adult health
warnings we should report to our doctor at a regular check-up. Some medical attention signs we
should be cautious of includes unexplained weight loss, changes in bowel habits, chest pains,
shortness of breath and sudden headaches. For preventative adult health care, regular physical
exams and health screens are essential. By knowing which screening test you would need and
how often to have the test completed is key to early detection to support successful treatment.
Regular health exams and tests can help find problems before they start. They also can
help find problems early, when your chances for treatment and cure are better. By getting the
right health services, screenings, and treatments, you are taking steps that help your chances for
living a longer, healthier life. Your age, health and family history, lifestyle choices (i.e. what you
32
eat, how active you are, whether you smoke), and other important factors impact what and how
often you need healthcare.
Stokes County was ranked #40 among the 100 NC counties for overall health outcomes
in the 2021 County Health Rankings (where 1 is “best”). The County Health Rankings provide a
snapshot of the factors that affect health in Stokes County and allow us to compare the health
status of our county to the health status of other counties and of North Carolina. County Health
Rankings provide the reminder that where we live matters to our health. The factors that
influence our health are far greater than access to medical care, although this is also a part of the
overall ranking. The County Health Rankings measure factors associated with community health,
ranging from socioeconomic indicators and behavioral risk factors to environmental health
determinants.
Stokes County Health Rankings
North Carolina
Stokes County
Life Expectancy
78.1
76.9
Frequent mental distress
13%
16%
Diabetes prevalence
12%
16%
Drug overdose
22
34
Motor vehicle crash deaths
14
18
Median household income
$57,400
$52,400
Suicides
13
20
Firearm Fatalities
14
19
Broadband access
81%
70%
County Health Rankings & Roadmaps (2021)
Leading Causes of Death
33
Leading Causes of Death in North Carolina 2019
Location:
STOKES
Race:
all
Gender:
both
Hispanic Origin:
all (Hispanic, Non-Hispanic, and Unknown)
Age:
0 - 99 years
Note: Age 99 indicates age 99 years or older.
Rank
Cause
Number
%
1
Diseases of heart
125
22.7
2
Cancer
107
19.5
3
Chronic lower respiratory diseases
40
7.3
4
All other unintentional injuries
33
6.0
5
Cerebrovascular diseases
25
4.5
6
Alzheimer's disease
19
3.5
7
Diabetes mellitus
16
2.9
8
Nephritis, nephrotic syndrome and nephrosis
13
2.4
9
Influenza and pneumonia
11
2.0
10
Chronic liver disease and cirrhosis
10
1.8
Motor vehicle injuries
10
1.8
All other causes (Residual)
141
25.6
Total Deaths -- All Causes
550
100.0
Source: State Center for Health Statistics, North Carolina
34
Cardiovascular Disease
Source: North Carolina State Center for Health Statistics
This chart displays the number of cardiovascular disease related deaths from 2008-2017 in
Stokes County versus the number of cardiovascular disease related deaths during this time period
in North Carolina. From 2008-2012, Stokes County had 252.6 heart disease related deaths while
North Carolina had 235.6 related deaths. From 2013-2017, Stokes County had 251.8
cardiovascular disease related deaths while NC had 217.9 related deaths. Stokes County has
increased the number of deaths related to cardiovascular disease during this time period.
However, our death rate is roughly the same as states rate. Cardiovascular disease risk factors
that contribute to heart disease mortality include tobacco use, diet, physical inactivity, obesity,
and alcohol. Heart disease is the leading cause of death in the United States, and stroke is the
fifth leading cause.
Healthy People 2030 focuses on preventing and treating heart disease and
stroke and improving overall cardiovascular health.
252.6
235.6
251.8
217.9
200 210 220 230 240 250 260
Stokes County
North Carolina
Stokes County North Carolina
2013-2017
251.8 217.9
2008-2012
252.6 235.6
Cardiovascular Disease Death Rates
35
Heart disease and stroke can result in poor quality of life, disability, and death. Though both
diseases are common, they can often be prevented by controlling risk factors like high blood
pressure and high cholesterol through treatment.
In addition, making sure people who experience a cardiovascular emergency-like stroke, heart
attack, or cardiac arrest; get timely recommended treatment can reduce their risk for long-term
disability and death. Teaching people to recognize symptoms is key to helping more people get
the treatment they need.
Stroke
Source: North Carolina State Center for Health Statistics
The chart to the above compares Stokes County and North Carolina’s age-adjusted death rates
that are stroke related from 2008-2012 and 2013-2017 per 100,000 people. Stokes County has
a higher rate of 64.3 deaths related to stroke for every 100,000 people compared to North
Carolina 43.2 deaths related to stroke for every 100,000 people. Stokes County has a higher
rate of death compared to North Carolina for 2013-2017 as well as our peer counties.
0 10 20 30 40 50 60 70 80
Stokes County
North Carolina
Yadkin
Dare
Davie
Person
Transylvania
Stokes
County
North
Carolina
Yadkin Dare Davie Person Transylvania
2013-2017
64.3 43.2 52.1 35 45.2 40.9 32.8
2008-2012
62.1 45.1 41 28.4 36.8 75.1 30.9
Stroke Death Rates
36
Diabetes
Source: North Carolina State Center for Health Statistics
This chart displays the trends in diabetes death rate for Stokes County and its peer counties as
well as the state from 2008-2017. Stokes County’s diabetes related mortality rates has
remained consistent, since the 2016 Community Health Assessment.
0 5 10 15 20 25 30 35
Stokes County
North Carolina
Yadkin
Dare
Davie
Person
Transylvania
Stokes
County
North
Carolin
a
Yadkin Dare Davie Person
Transyl
vania
2013-2017
17.8 23.3 33.1 8.8 17 32.1 13.6
2008-2012
16.1 21.8 18.8 10.4 12.6 28.6 12
Diabetes Death Rates
37
Colorectal Cancer
Source: North Carolina State Center for Health Statistics
Stokes County has the second highest rate for Colorectal Cancer at 14.3%. Person County has an 20.9%
rate which is the highest of all our peer counties. When compared to the state rate we are
approximately 1% higher.
0 5 10 15 20 25
Stokes County
North Carolina
Yadkin
Dare
Davie
Person
Transylvania
Stokes
County
North
Carolin
a
Yadkin Dare Davie Person
Transyl
vania
2013-2017
14.3 13.4 9.8 13.2 15 20.9 13.7
2008-2012
11.6 14.8 16.4 13.9 9.6 19.1 10.6
Colorectal Cancer Death Rates
38
Lung Cancer
Source: North Carolina State Center for Health Statistics
This graph displays that for the years 2013-2017 Stokes County has a higher rate (54.3) of lung
cancer deaths per 100,00 population compared to North Carolina’s rate (45.9). Stokes County
also has a higher rate compared to all peer counties except Yadkin.
0 10 20 30 40 50 60 70
Stokes County
North Carolina
Yadkin
Dare
Davie
Person
Transylvania
Stokes
County
North
Carolina
Yadkin Dare Davie Person
Transylv
ania
2013-2017
54.3 45.9 57.1 53.3 49.1 49 35.9
2008-2012
62.1 52.9 53.1 42.7 49.8 62 34.4
Lung Cancer Death Rates
39
Alcohol Related Traffic Crashes
Source: North Carolina Alcohol Facts
Stokes County had 201 traffic crashes where alcohol was involved between 2016-2019. Stokes
County’s has a 5.3 percent alcohol involved crash rate.
Suicide
According to the Vital Records for Stokes County between 2017-2021 there have been a total of 29
deaths that were ruled as suicide. The lack of knowledge on how to obtain mental health treatment is
Stokes County
Total Crashes
3,496
Alcohol Involved
201
Percent Alcohol Involved
5.3
3,496
201
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Crashes that Involved Alcohol 2016-
2019
Total Crashes Alcohol Involved Percent Alcohol Involved
2017 2018 2019 2020 2021
Male
3 5 4 6 5
Female
3 2 1 0 0
3
5
4
6
5
3
2
1
0 0
0
1
2
3
4
5
6
7
Gender
Suicide Deaths 2017-2021
40
The chart to the left displays age-
adjusted suicide death rate per
100,000 population for Stokes
County and North Carolina. Stokes
County has a higher rate of 18.4
deaths related to suicide per
100,000 population compared to
North Carolina that has 12.2
related suicide deaths per
100,000. Stokes County has a
higher rate compared to North
Carolina and the surrounding
counties
poor in Stokes County, proving that mental health disparities are often a leading factor to high suicide
rates. The most suicides per age group was the 60-69 with 9 people.
Source: North Carolina State Center for Health Statistics
Mental Health and suicide rates have been a problem in Stokes County for more than ten
years and are increasing ever year now. Some causes are associated with drug use or misuse of
prescription drugs. The fact that we are a rural county will little to no mental health resources
continues to hurt the citizens. There are individuals that need mental health help desperately in
this county and can’t get it. This is when some turn to substance abuse and sometimes even
suicide.
Covid has also caused more mental health issues with the elderly and school age children.
Physical distancing due to the COVID‐19 outbreak can have drastic negative effects on the
mental health of the elderly and disabled individuals. Physical isolation at home among family
members can put the elderly and disabled person at serious mental health risk. It can cause
anxiety, distress, and induce a traumatic situation for them. Kids can experience anxiety, distress,
Stokes North Carolina
2008-2012
18.4 12.2
2013-2017
23 13.3
0
5
10
15
20
25
Percentage
Suicide Rates per 100,000
Healthy NC 2020 Target=8.3
41
social isolation, and an abusive environment that can have short‐ or long‐term effects on their
mental health.
Transportation is still an issue for some individuals that have to travel outside of Stokes
County for mental health services. Also, being a rural county there is still a stigma with needing
mental health services, sometimes we have seen this based on the age of the individual.
Unintentional Deaths
Source: North Carolina State Center for Health Statistics
Pregnancy
• Stokes County had 1,933 reported pregnancies in 2016-2020.
• Stokes County has rate of 16.4% of women who smoked during pregnancy. This rate is
the second highest among our peer counties. In comparison to North Carolina’s rate
(8.1%) Stokes County is more than double. Women who smoke during pregnancy put
themselves and their child at a greater risk for health problems. Smoking during
pregnancy can cause premature birth, birth defects, and infant death.
Stokes North Carolina
2008-2012
38.2 29.4
2013-2017
48.9 34.6
0
10
20
30
40
50
60
Percentage
Unintentional Death Rates
per 100,000
Excluding Motor Vehicle
Deaths
The unintentional death rates per
100,000 population for Stokes County
and North Carolina are shown in this
chart. Stokes County has a higher
rate of 48.9% in years 2013-2017
than the state which has a rate of
34.6%.
42
2016-2020 NC Live Births
Source: County Health Data Book, NC State Center for Health Statistics
Cesarean Section
Source: County Health Data Book, NC State Center for Health Statistics
Stokes Dare Davie Person Transylvania Yadkin
Short Interval Births
184 84 220 202 85 176
Percent Short Interval
13.9 8 15.6 13.7 10.3 13.3
184
84
220
202
85
176
13.9
8
15.6
13.7
10.3
13.3
0
50
100
150
200
250
<6 Months Conception from Last Delivery
Short Interval Births Percent Short Interval
Stokes Dare Davie Person
Transyl
vania
Yadkin
Total Births
1,933 1,630 1,977 2,105 1,281 1,884
Births by Cesarean
533 493 555 621 402 525
Percent
27.6 30.2 28.1 29.5 31.4 27.9
0
500
1,000
1,500
2,000
2,500
2016-2020 Births Delivered by
Cesarean Section
Total Births Births by Cesarean Percent
43
The chart to the left shows the percentage of births delivered by Cesarean section from 2016-
2020. North Carolina has a slightly higher percentage compared to Stokes County. Compared to
surrounding counties, Stokes County overall has the same percentage of cesarean births as our
peer counties.
Births Delivered by Gestation
Source: County Health Data Book, NC State Center for Health Statistics
Stokes County in has had 1,933 births in this four-year span. The majority of those births were 37+
weeks (1,730). Babies that were delivered at less than 37 weeks were 203. We are somewhat equal to
our peer counties.
Stokes Dare Davie Person
Transyl
vania
Yadkin
Less than 37 weeks
203 143 210 236 137 213
37+ weeks
1730 1487 1767 1868 1143 1669
Unknown
1 0 0 1 1 2
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2016-2020 Births Delivered by
Gestation
Less than 37 weeks 37+ weeks Unknown
44
8.8
9
8.6
9.4
8.2
8.4
8.6
8.8
9
9.2
9.4
9.6
2011-2015 2016-2020
Percentage of Low Birthweight
Births 2016-2020
Stokes North Carolina
Smoking During Pregnancy
Low Birthweight
317
132
206
257
229
277
16.4
8.1
10.4
12.2
17.9
14.7
0
50
100
150
200
250
300
350
2016-2020 Births Where
Mothers Smoked During
Pregnancy
Number Percent
45
6.5
7.2
6.2
7
5.6
5.8
6
6.2
6.4
6.6
6.8
7
7.2
7.4
Stokes North Carolina
Percentage Infant Deaths per
1,000 Live Births
2011-2015 2016-2020
64.5
57.8
41.9
56.2
0
10
20
30
40
50
60
70
Stokes North Carolina
Child Deaths per 100,000
(Percentage)
Ages 0-17
2011-2015 2016-2020
Infant Deaths
Child Deaths
46
Stokes County Communicable Disease Reports
Disease Classification
Total
confirmed
cases 19/20
Total
confirmed
cases 20/21
Haemophilus Influenza
3
1
Hepatitis C (Chronic)
39
63
Rocky Mountain Spotted Fever
7
2
Ehrlichiosis
1
2
Lyme Disease
4
9
Cryptosporidiosis
1
5
Salmonellosis
4
6
Campylobacter Infection
11
12
Hepatitis B (Chronic)
2
5
E Coli
5
2
Legionellosis
1
1
Hepatitis A
23
3
Chlamydia
105
138
Gonorrhea
36
50
Hepatitis B
-
5
47
Stokes County Health Resources Inventory
ADOPTION
Bennett and West, Attorneys at Law
PO Box 775
607-D South Main Street
King, NC 27021
Phone: (336) 983-317
Family Services, Inc.
1200 South Broad Street
Winston Salem, NC 270101
Phone: (336) 722-8173
Website: Family Services (familyservicesforsyth.org)
Coordinates adoption process for families and assists families after adoption; working with local
agencies as well as international agencies; foster care for our babies awaiting placement.
*Accepts Medicaid, Bilingual Services available for some services.
Hope Pregnancy Care Center
PO Box 604
117 Charles Rd
King, NC 27021
Phone: (336) 983-3990
Website: www.hopepcc.org
R. Michael Bruce, Attorney at Law
PO Box 280
404 North Main Street
Danbury, NC 27016
Phone: (336) 593-9240
Stokes County Department of Social Services
PO Box 30
1010 Hwy 8 & 89
Danbury, NC 27016
Phone: (336) 593-2861
Website: www.co.stokes.nc.us
*Bilingual services available, will provide interpreter when needed.
48
ADULT HEATH PROGRAMS
The Children’s Home Ty Browder, Attorney at Law
1001 Reynolda Road PO Box 550
Winston Salem, NC 27104 404 North Main Street
Phone: (336) 721-7600 Danbury, NC 27016
Website: https://www.crossnore.org/ Phone: (336) 593-9240
*Accepts Medicaid
American Cancer Society
4-A Oak Branch Drive
Greensboro, NC 27407
Phone: (336) 834-0844
Fax: (336) 834-8777
Website: www.cancer.org
American Red Cross- NWNC Chapter
690 Coliseum Drive
Winston Salem, NC 27106
Phone: (336) 724-0511
Fax: (336) 724-0541
Website: www.nwnc-redcross.org
Cancer Services, Inc.
3175 Maplewood Avenue
Winston Salem, NC 27103
Phone: (336) 760-9983
Fax: (336) 760-1282
Website: www.cancerservicesonline.org
*Bi-Lingual Services Available: Leave a message on the Spanish Line and a Spanish speaking person will
return your call. Provides free educational programs to the community about cancer prevention and
early detection. Also provides educational opportunities to cancer survivors to learn more about coping,
health concerns, and treatment issues.
Digestive Health Specialists
JR Jones Medical Center
434 Kirby Road
King, NC 27021
Phone: (336) 768-6211
Fax: (336) 768-6869
Website: King | Digestive Health Specialists
49
ADULT HEATH PROGRAMS (continued)
Forsyth Medical Center
3333 Silas Creek Parkway
Winston Salem, NC 27103
Phone: (336) 718-8233
Website: www.forsythmedicalcenter.org
*Accepts Medicaid
Stokes County Recreation Department Facilitated by the Stokes Family YMCA
PO Box 39
1070 Hospice Drive
Danbury, NC 27016
Phone: (336) 593-8165
Fax: (336) 593-2112
Stokes County Health Department/Family Health Center
PO Box 187
1009 Main Street
Danbury, NC 27016
Phone: (336) 593-2400
Website: https://www.co.stokes.nc.us/departments/health.php
*Accepts Medicaid
50
CHILD HEATH PROGRAMS
Stokes County Health Department/Family Health Center
PO Box 187
1009 Main Street
Danbury, NC 27016
Phone: (336) 593-2400
Website: https://www.co.stokes.nc.us/departments/health.php
*Accepts Medicaid
Stokes Partnership for Children
151 Jefferson Church Rd
King, NC 27021
Phone: (336) 985-2676
Website: HOME | stokespfc
51
The Stokes County Community Health Assessment Committee reviewed the
results from the 2021 Community Health Assessment Community Survey;
discussed focus group questions along with the secondary data collected and
developed a list of health priorities for the county. All members from these two
committees represent various groups of individuals with diverse experience and
knowledge. The top three health priorities chosen to focus on are:
1. Mental Health
2. Substance Abuse
3. Chronic Disease
The committee selected these three health priorities for Stokes County in
hopes to improve mental health care being offered and increasing access to care.
These areas are to be addressed by the various county agencies and committees
and through health promotion within Stokes County.
