The 2023 LEAD Conference featured several panels and speakers over two days and a highlight was the annual report from the Department of Health and Human Services.  On Saturday, Elizabeth Cuervo Tilson, MD, MPH, State Health Director and Chief Medical Officer offered the annual report to the NCMS.  Here are some highlights of her report:



As the world continues to recover from one of the largest public health threats in recent history, this past year in North Carolina heralded a transition from COVID-19-specific recovery efforts to broader initiatives aimed at safeguarding and bolstering the overall health of North Carolinians. We leveraged the invaluable lessons learned and the partnerships fortified throughout the pandemic to continue to improve our responses to health  challenges. Systems that have been chronically underfunded were further strained by the stressors of the pandemic, mandating thoughtful strategic investment in those systems. We have prioritized activities to advance whole person health and created roadmaps for strategic investment in the health of our people. This annual report outlines our national, state level, and agency strategic priorities and programming to further our  commitment to health and opportunity for every North Carolinian.

America’s Health Rankings serves as an annual report for states built upon the World Health Organization’s definition of health. North Carolina’s overall health ranking relative to other U.S. states has consistently improved annually, evidencing our public health successes. In the 2022 Annual Report, North Carolina was ranked 30, up from 34 and 41 in the prior two years, respectively. As in years past, many health indicators on which North Carolina needs to improve are driven in part by North Carolina’s large uninsured population.


Medicaid expansion was signed into law by Governor Roy Cooper in March 2023 and represents a critical step forward to improve the health of North Carolinians and enable a substantial economic investment in the state. Operationalization of Medicaid expansion will be an integral step to improve health in North Carolina. The North Carolina Department of Health and Human Services was given final authority to implement Medicaid expansion through enactment of the state budget in early October, allowing for a launch date of December 1, 2023. We have a new website, bilingual toolkit and a sign-up form to stay updated on the most current information and share with your partners, patients, and stakeholders.

Healthy North Carolina 2030, released in 2020, lays out 21 ambitious, population-level goals and shared objectives for the entire state to solve “wicked problems” and improve the health of North Carolinians for this decade. It aims to mobilize and coordinate a broad array of private sector, public sector, and community organizations that can play a role in making North Carolinians healthier. The North Carolina State Health Improvement Plan (NC SHIP) builds upon HNC 2030 to help create a unified strategy across multiple stakeholders to drive improvement in the indicators throughout the decade covered by HNC 2030. The NC SHIP documents are iterative, describe the process for improvement, and report on progress of any improvements. 2023 NCSHIP lays out the efforts of statewide cross-sector collaboration and launches a Year of Action.

NCDHHS works toward five strategic priorities, guided by our strategic plan. Three priorities are areas of activity that bring together multiple divisions and external partners. They are Behavioral Health and Resilience, Child and Family Well-being, and a Strong and Inclusive Workforce. Two priorities are fundamental ways that we approach our work across the department. Our Health Equity Portfolio synthesizes and guides efforts across NCDHHS and beyond to erase gaps in whole-person health. Our Data Office works the numbers to tell us how we are doing.


As we move out of the COVID pandemic, we have the tools needed to manage COVID-19 like we do other respiratory illnesses, including access to vaccines, testing, and treatment. In addition, we have expanded our focus to other respiratory diseases including Influenza and Respiratory Syncytial Virus and communicable diseases, including Mpox, syphilis and HIV for which there are disparities in rates of infections within our population

Our Public Health Infrastructure has been chronically underfunded and the COVID-19 pandemic brought mainstream attention to public health across the globe and highlighted the challenges of this underfunded patchwork of public health infrastructure to respond to the crisis. These challenges and recommendations to response have been identified by the North Carolina Institute of Medicine’s Task Force on the Future of Local Public Health in NC. This report highlights work to strengthen public health foundational capabilities, infrastructure, and workforce to be able to respond to future threats more readily. Finally, this report also serves as the Annual Report on the North Carolina Division of Public Health Strategic Plan as required by Public Health Accreditation Board, and highlights work being done to meet DPH Strategic Priorities.

The full report is available here.