Urgently Needed: Equity Tools to Navigate Demographic Gale-Force Wind Gusts

Demographic disruptors could prevent North Carolina from reaching public health goals. Outlined here are policy prescriptions and strategic investments to turn these disruptors into opportunities. 

Article by James H. Johnson Jr., Ph.D, Jeanne Milliken Bonds, MPA
Kenan-Flagler Business School UNC-Chapel Hill
Allan M. Parnel Vice President, Cedar Grove Institute for Sustainable Communities Mebane, NC
January, 2022

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Gale-force demographic disruptors such as unequal population growth can potentially prevent our state from achieving the exemplary goals and targeted outcomes set forth in Healthy North Carolina 2030. These forces also present opportunities if carefully addressed. Policy prescriptions and strategic investments required to ensure success are outlined here, following an overview of demographic drivers that create public health vulnerabilities.



“Healthy North Carolina 2030: A Path Toward Health” draws on the knowledge and expertise of interdisciplinary scholars and leaders and leverages research on the social determinants of health to develop important goals and targeted outcomes for a common set of public health indicators for our state [1]. Successful achievement of the coveted outcomes will enhance North Carolina’s reputation as an attractive, prosperous, and inclusive place to live, work, play, and do business [2].

In this paper, we highlight powerful demographic disruptors—analogous to gale-force winds in an adverse weather event—that, if neglected, will challenge the state’s ability to achieve greater public health equity by 2030 [3]. Economic and residential dislocations of long-term residents in growing urban counties; increasing social and spatial isolation of older adults and less-than-college-educated young adults in declining rural counties; and geographic barriers faced by non-White youth are all manifestations of and precursors to a set of national demographic gale-forces winds that will challenge these efforts [3]. In support of the state’s population health goals, we outline actions required to navigate these changes.


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About the Authors

James H. Johnson, Jr. is the William Rand Kenan, Jr. Distinguished Professor of Strategy and Entrepreneurship in the Kenan-Flagler Business School and Director of the Urban Investment Strategies Center in the Frank Hawkins Kenan Institute of Private Enterprise at UNC-Chapel Hill.

Jeanne Milliken Bonds is a Professor of the Practice, Impact Investment and Sustainable Finance in the Kenan-Flagler Business School and the Department of Public Policy at UNC-Chapel Hill.

Allan M. Parnell is a Senior Fellow in the Kenan Institute’s Urban Investment Strategies Center and Vice President of the Mebane, NC-based Cedar Grove Institute for Sustainable Communities.

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