Healthy Eating and Active Living in Western North Carolina

Why is healthy eating and active living a key health issue in western North Carolina?

An “abnormal or excessive fat accumulation that present a risk to health” is what defines someone as overweight or obese.  A body mass index (BMI) of 25 is considered overweight while a BMI over 30 is considered obese (WHO, 2022). The majority of obesity cases are preventable with a healthy lifestyle. As indicated by the World Health Organization, the four primary ways to promote a healthier life include eating a healthy diet, being physically active, abstaining from cigarette use, and reducing overall alcohol use (WHO, 2019). In Western North Carolina, approximately 2 out of 3 adults reported being overweight or obese in 2021 (WNCHN – WNC Healthy Impact Community Health Survey, 2021).


What do the numbers say about obesity?

Western North Carolina (WNC) Data:

In 2021, approximately one third (35.4%) of adults in WNC reported being obese (BMI of 30 or higher); of those adults:

  • 49% were diagnosed with high blood pressure
  • 33% were diagnosed with high cholesterol
  • 22% were diagnosed with diabetes
  • 25% reported fair/poor mental health in the past month

Percent of Adults Obese or Overweight in WNC, by Year 

Source: WNC Healthy Impact Community Health Survey, 2012-2021

The following adult populations were significantly more likely to be obese in 2021:

  • Adults age 40-64 (40.1%)
  • Low income (45.2%)
  • Those identifying as Black (44.3%) or American Indian/Alaska Native, Indigenous (55.8%)

(WNCHN – WNC Healthy Impact Community Health Survey, 2021)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/or discrimination. See our data story on the Social Determinants of Health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families.

For more information on Diabetes please visit the Chronic Disease page linked.

State and National Findings

In 2021, North Carolina had an obesity rate of 36%, up from 32.1% in 2017.

(America’s Health Ranking, 2022)

The United States obesity prevalence in 2017 was 41.9%.

(CDC, 2022)

The annual medical cost of obesity in the United States was roughly $173 billion dollars in 2019.

(CDC, 2022)

Healthy Living

What is Healthy Living?

The top three aspects that make up a healthy life are nutrition, physical activity, and good mental health and relationships.

(US Department of Health and Human Services, 2022) 

For more information on mental health, please visit the Mental Health  page linked.

Healthy Eating

Healthy eating “emphasizes fruits, vegetables, whole grains, dairy, and protein.’

(CDC, 2022)

The percent of adults in WNC consuming 5+ fruits and vegetables per day has decreased from 8% in 2015 to 5.6% in 2021.

(WNCHN – WNC Healthy Impact Community Health Survey, 2021)

For more information on recommendations for age specific healthy eating please visit the Dietary Guidelines for Americans, 2020-2025.


State and National Findings

In the United States fruit and vegetable intake continues to decline. Research has found that fruit and vegetable intake is down 10% in the United States since 2004.

(Produce for Better Health, 2021)

In 2019, of the adults surveyed in the United States, 12.3% were meeting fruit  intake recommendations with only 10% meeting vegetable recommendations. 

(CDC, 2022)

Consuming 5+ Servings of Fruits & Veggies per Day, by Year

Source: WNC Healthy Impact Community Health Survey, 2012-2021

Physical Activity

Physical activity is anything that gets your body moving. The CDC suggests that adults need 150 minutes of moderate intensity physical activity and 2 days of muscle strengthening activity each week.

(CDC, 2022)

Only 23% of adults in WNC were meeting physical activity recommendations in 2021.

(WNCHN – WNC Healthy Impact Community Health Survey, 2021)

Physical activity contributes to preventing and managing noncommunicable diseases such as cardiovascular diseases, cancer, and diabetes while also reducing symptoms of depression and anxiety.

 (WHO, 2022)

Percent of Adults in WNC Meeting the Physical Activity Guidelines, by Year 

Source: WNC Healthy Impact Community Health Survey, 2012-2021

State and National Findings:

Individuals who are insufficiently active have a 20% to 30% increased risk of death compared to people who are sufficiently active.

(WHO, 2022)

In 2018, roughly $117 billion in annual health care costs and about 10% or premature mortality were associated with inadequate physical health.

(, 2018)

What’s the Regional Story Behind the Numbers? 

The items below are paraphrased themes that emerged from a 2021 regional survey of key informants. These responses do not necessarily:

  • Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change.
  • Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.

(WNCHN – Online Key Informant Survey, 2021)

The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.

What’s Helping?

  • Nutrition and cooking classes
  • Parks, trails, ect.
  • Advocacy groups/coalitions
  • Easier access to healthy alternatives
  • Affordable options

What’s Hurting?

  • Funding
  • Lack of knowledge of available programs
  • Previous health habits
  • Lack of gyms in some areas
  • Stigma

What we are hearing:

“The efforts of non-profits and individuals to make food available within distance of the individual’s and family’s homes and communities. Providing education and access to affordable, healthy, good tasting food is essential for healthy communities.”

“Physical environments that promote active lifestyles and public and nonprofit facilities that provide safe and engaging physical health opportunities.”

“I have seen more advocacy groups promote the importance of health.”

“I am seeing an increased interest in making fresh fruits and vegetables available to clients of food pantries.”

“We have many parks, trails and recreational amenities already in place and are planning for the development of even more, subject to funding availability.”

How is the region prioritizing this issue?

The western North Carolina region includes 17 communities: 16 counties and the Eastern Band of Cherokee Indians (EBCI)

In the 2021 CHA cycle, 10 out of 17 communities chose a priority related to healthy eating, active living, or obesity.