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County health needs assessment flags social drivers, chronic disease and behavioral health as top priorities
Summary
A regional Community Health Needs Assessment presented to the Board found the county's population is aging, substance‑use and access to care remain top health concerns, and survey responses (about 1,000) show potential respondent bias toward county employees; the county and its hospital partners adopted three priorities for the next three years.
Davidson County health officials presented findings from the 2025 Community Health Needs Assessment (CHNA) at the April 14 Board of Health meeting, outlining priorities the county and partner hospitals will use for the next three years.
Janna Walker, health promotions director, said the CHNA was done regionally with Novant Health and Atrium Health and included about 1,000 survey responses plus secondary data. The assessment highlights a growing and aging population, persistent leading causes of death (cancer and heart disease), and several socioeconomic gaps in income and education. Walker said the community identified access to health care, substance use and access to affordable medication as the top three health challenges; affordable and safe housing, access to healthy food and affordable childcare were top community concerns.
Walker said the three priorities adopted for the 2026–2028 cycle are social drivers of health, chronic disease prevention and behavioral health. She also noted that overdose deaths remain higher than the state average and that firearm deaths are captured in the county’s unintentional‑injury category.
Health Director Lillian Koontz cautioned that survey responses likely overrepresent county employees and female respondents, and she urged caution in interpreting the primary‑data sample: "We had a poor response to the survey questions... a lot of the responses for Davidson County were from county employees," she said, adding that secondary data were used to balance the primary survey findings.
The full CHNA report and a data workbook will be shared with board members when finalized. Staff also said they will hold a regional hotwash to review methods and seek ways to broaden participation before the next CHNA cycle.
