Comparing North Carolina's Local Public Health Agencies: The Legal Landscape, the Perspectives, and the Numbers (Preliminary Report)

Tuesday, May 1, 2012

This is the preliminary report. For the final version, click here.

North Carolina counties are required by law to provide public health services to their residents. State and local policymakers and public health officials share an interest in providing those services in a manner that is efficient, effective, and responsive to local needs. Over time, different ways of providing public health services have been incorporated into the state laws that define various types of local public health agencies and governance structures. For many years, state and local policymakers, public health practitioners, and others have discussed options for organizing North Carolina’s local public health system. In 2011, the conversation was reignited when several bills were introduced in the state legislature designed to alter the legal and policy landscape for local public health agencies. At the time of this policy debate, comprehensive information about the state’s existing local public health agencies did not exist. With funding support from the Robert Wood Johnson Foundation, the research team conducted a comprehensive analysis of public health laws in North Carolina, interviewed more than sixty state and local stakeholders, and compared local public health agencies across a variety of quantitative measures.


Since legislation was enacted in June 2012, several counties have changed the way their local public health agencies are organized and governed. We try to stay abreast of changes as they happen.

  • Maps: 
  • Blog post: This blog post describes the changes as of April 23, 2013. In the comments below the post, we are adding new updates periodically.

More Information:

North Carolina Public Health

NC Public Health Law: A School of Government resource

NC Institute for Public Health: The service arm of the UNC Gillings School of Global Public Health.

NC Division of Public Health: A Division of the NC Department of Health and Human Services

NC Association of Local Health Directors

NC Association of County Commissioners

NC Local Health Department Accreditation


National Resources

The Robert Wood Johnson Foundation

National Coordinating Center for Public Health Services and Systems Research

National Network for Public Health Institutes

Public Health Accreditation Board

The Network for Public Health Law

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Topics - Local and State Government