Community Data

We track local data to encourage and support data-informed decision making by community stakeholders at all levels. This information is designed to simplify the process of using data to inform the work that moves our community forward — program planning and evaluation, funding and resource allocation, grant writing, and more.

Community Research Framework

Individual Forsyth Futures reports are generally written to provide focused information on specific issues to inform community action. While these topics are generally measured in separate reports for clarity, it is important to acknowledge that all of the local issues we study are interconnected. For example, food insecurity is generally measured separately from reading proficiency scores, but in reality being a part of a family experiencing food insecurity can have a significant impact on children’s ability to learn and be successful in school.

Two Complementary Frameworks

To guide our reporting as we navigate this complexity, Forsyth Futures uses two frameworks which consider interconnected topical dimensions and dimensions of context and scale, respectively. Taken together, these two frameworks provide an opportunity for community stakeholders to consider how issues that appear separate in their reporting may be interconnected.

Interconnected Topical Dimensions

Community Research Framework Graphic

Built and Physical Environment

Economy and Financial Stability

Education

Health and Wellness

Safety

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Social and Civic Environment

This framework model shows that despite how topics are separated to make information easier to access and communicate, many of the sectors that we study are interconnected, like a student’s economic stability and their ability to be successful in school.

Dimensions of Context and Scale

Dimensions of Scale and Context
Individuals

Individuals

Community Networks

Networks of Familes, Friends, Neighbors and Civic Groups

Community Systems

Community Systems

This framework model is based on a commonly-used social determinants of health model called the Social-Ecological model. This model illustrates how individuals and families are impacted by the broader contexts in which they exist. For example, an individual child’s test score measures their reading proficiency at the individual level, but it is important to acknowledge the impact that a child’s family, neighborhood, and school have on the child’s success.

Demographics

Demographic data includes information on Forsyth County’s population as well as sub-populations within the county based on factors such as geography, gender, age, and race/ethnicity. 

Total Population

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Population by Age

Population by Gender

Population by Race/Ethnicity

Population by Gender and Race/Ethnicity

Population by City

Built and Physical Environment

Community Impact

The conditions of our local environment’s soil, water, and air are fundamental to healthy communities and an attractive quality of life. Associated energy, land use, and waste management systems further indicate the trajectory and health of these communities in ways that support or undermine many economic and healthcare outcomes. These interlinking relationships, and the way they disproportionately impact different areas and populations, are important to consider when exploring the distinct environmental indicators one-by-one.

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Key Measure

Air Quality
The Air Quality Index (AQI) is a measurement used to communicate the level of air pollution to the public and what associated health risks may be a concern. With increasing levels of pollution, the index number will increase. These numbers are determined by calculating the average of readings over a period of time. For Forsyth County, the air quality is calculated hourly at multiple monitoring stations. Each pollutant is measured and considered in the final index.

The AQI is calculated using standards set by the Clean Air Act (CAA). The standards relating to the CCA are focused on five common pollutants: particulate matter (PM), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO). The EPA has established national air quality standards for each of these pollutants to protect public health.

Air Quality Index Levels

LevelIndex RangeExplanation
Good0 - 50Air pollution poses little or no risk.
Moderate51 - 100For some pollutants there may be a moderate health concern for a very small number of people.
Unhealthy for Sensitive Groups101 - 150The general public is not likely to be affected at this AQI range, but people with lung disease, older adults, and children are at a greater risk from exposure to ozone and from the presence of particles in the air.
Unhealthy151 - 200Everyone may begin to experience some adverse health effects, and members of the sensitive groups may experience more serious effects.
Very Unhealthy201 - 300This triggers a health alert signifying that everyone may experience more serious health effects. Everyone should avoid prolonged or heavy exertion.
The chart describes the AQI levels and associated index range. If an area reports an AQI of 25, then that day falls within the ‘Good’ range. However, if they report an AQI of 115, this falls within the orange category: ‘Unhealthy for Sensitive Groups' and so forth. Each level has suggested level of outdoor activity for certain groups of people.

The chart describes the AQI levels and associated index range. If an area reports an AQI of 25, then that day falls within the ‘Good’ range. However, if they report an AQI of 115, this falls within the orange category: ‘Unhealthy for Sensitive Groups' and so forth. Each level has suggested level of outdoor activity for certain groups of people.

There were zero days with AQI over 100 in 2017 in Forsyth County. AQI values below 100 are generally thought of as satisfactory; it corresponds to the national air quality standard that the EPA has set to protect public health. When AQI values are above this threshold, the air quality is considered unhealthy.

The air quality index for Forsyth County is generally good. In 2017, Forsyth county had 290 good days, 75 moderate days, and no unhealthy for sensitive groups, unhealthy, or very unhealthy days.

Notes: This report has been produced to support grant writing efforts. As such, the validity and reliability of the data in this report has not been rigorously statistically tested. Forsyth Futures does not support the use of this data for specific programmatic planning. If you are interested in using data from this report for more rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Sources: https://aqs.epa.gov/aqsweb/airdata/download_files.html#Annual

Economy and Financial Stability

Community Impact

The capacity of local small businesses and corporations to provide important customer goods and services, employment opportunities, and healthy wages is essential. Additionally, how different populations relate to income, wealth, and economic opportunity are key indicators of how well families can meet their needs sufficiently and how well communities can support them equitably.

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Key Measures

Employment

Employment rates play a significant role in understanding our local economy. Employment rates are used as a measure of the extent to which available labor resources are being used. The working age population refers to people between the ages of 15 to 64. The employment rate is one of the economic indicators that is used to examine and understand the state of an economy. Following a recession, the employment rate tends to not grow to any significant extent until the remainder of the economy has recovered, making it a lagging indicator.2

If you are interested in using data from this report for rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literature References

  1. U.S. Department of Commerce. (2012). ACS employment status data by block group, 2006-2010. Retrieved from https://www.census.gov/people/laborforce/about/acs_employ.html
  2. Pew Charitable Trust. (2013). Hard choices navigating the economic shock of unemployment. Retrieved from http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2013/empreportoverviewhardchoicesnavigatingtheeconomicshockofunemploymentpdf.pdf

Data Sources

  1. U.S. Department of Commerce. (2018). Employment status: Table S2301 [Data files from ACS 1-year estimates for the years 2006-2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_S2301&prodType=table
  2. Employment – Employment rate – OECD Data. (n.d.). Retrieved from https://data.oecd.org/emp/employment-rate.htm

An overall decrease in employment rate. In 2017, Forsyth County had an estimated employment rate of 58%. This estimate is an overall decrease compared to an estimate of 63% in 2006.

Disparities are present in employment rates for resident by age. Employment rates within the different age groups have remained fairly stable over time. Residents between ages 25 and 44 have the highest rates of employment when compared to the other included age groups.

Disparities are present in employment rates for residents by gender. The employment rate for male workers has consistently been higher than the employment rate for female workers.

Disparities are present in employment rates for residents by race/ethnicity.  The 2017 estimated employment rate for Hispanic/Latino populations was not available. African American and White, non-Hispanic populations have similar rates of employment for 2017 estimates.

Homeownership

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Housing Burden

When a significant portion of a household’s income is devoted to housing expenses, there is less money available to cover other basic needs such as food, health care and transportation, which may in turn result in financial insecurity. The housing cost burden indicator measures housing expenses for homeowners and renters. Expenses include mortgage payments or rent, utilities, real estate taxes, and other fees, as a percentage of household income.

Rates of housing burden stay generally stable. Housing burden rates have remained fairly stable over time with the exception of 2011 where there was a higher rate as compared to 2015, 2016, and 2017.

Housing burden in Forsyth County is higher than the North Carolina average. The 2017 overall housing burden rates for Guilford and Durham Counties were similar to Forsyth County, The overall North Carolina rate was significantly lower than Forsyth County.

Disparities are present in housing burden rates for residents by age. Residents under 25 years generally sustain higher housing burdens than older residents.

Disparities are present in housing burden rates for residents by race/ethnicity. White, non-Hispanic residents have consistently significantly lower housing burden rates than African American and Hispanic/Latino residents.

Data Notes

With the exception of 2017, due to the small sample size of the Hispanic/Latino population, the rate estimate for Hispanic/Latino residents are not as reliable.

If you are interested in using data from this report for rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literature References

  1. Cramer, R. & Shanks, T. (2014). The assets perspective: The rise of asset building and its impact on social policy. New York, NY: Palgrave Macmillan.

  2. Schwartz, M. & Wilson, E. (2007).  Who can afford to live in a home?: A look at data from the 2006 American Community Survey.  Retrieved from: https://www.census.gov/housing/census/publications/who-can-afford.pdf

Data Sources

ACS public use microdata sample (PUMS). Washington, D.C. :U.S. Census Bureau.

Income by Quintile

Changes in community incomes do not always happen uniformly for high-and low-income earners. For example, incomes could rise for households at one end of the distribution and stay the same or drop for households at the other end of the distribution.

Quintiles help illuminate income inequality among earners. Income quintiles are defined in percentiles and read using upper-limit thresholds. For example, in 2017 the 20th percentile quintile has an upper limit of just over $20,000, meaning twenty percent of the population earned income less than just over $20,000. Due to the general nature of quintiles, income thresholds change from year to year.

PercentileMeaning2017 Income Level
20th20% of households have income at or below this level$20,373
40th40% of households have income at or below this level$38,981
60th60% of households have income at or below this level$63,466
80th80% of households have income at or below this level$103,501
95th95% of households have income at or below this level$201,795

Household incomes either remain steady or decrease. Household incomes in Forsyth County have remained steady or decreased since 2006. Specifically, household incomes at the 40th percentile and below are lower than they were in 2006: estimated maximum earnings at the 40th percentile were $44,071 in 2006 and were $38,981 in 2017.

Disparities are present in income percentiles by race/ethnicity. At the lower end of the income distribution, African Americans are overrepresented and White, non-Hispanics are underrepresented. Conversely, at the higher end of the income distribution White, non-Hispanics are overrepresented and African Americans are underrepresented. Considering any income percentage group, African American and Hispanic/Latino residents are similar.

The visualization below shows the percentage of each demographic group that lies within a given income quintile. All values would be 20% if there was parity among race/ethnicities. As an example, the value for Forsyth County African Americans in the 20th percentile and under category is 31%. This means that 31% of all African Americans have incomes at the 20th percentile of the income distribution or lower.

Data Notes

  • Median household income refers to the specific income level that is below the highest-earning 50% of households and above the lowest-earning 50% of households. Because income is closely tied to poverty, the Census Bureau and other studies use household income to determine poverty status.1,2 

 

      • Quintiles help illuminate income inequality among earners. Income quintiles are defined in percentiles and read using upper-limit thresholds. For example, in 2017 the 20th percentile quintile has an upper limit of just over $20,000, meaning twenty percent of the population earned income less than just over $20,000. Due to the general nature of quintiles, income thresholds change from year to year.

If you are interested in using data from this report for more rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Data Sources

U.S. Department of Commerce. (2018). Household Income Quintile Upper Limits: Table B19080 [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_S1903&prodType=table

ACS public use microdata sample (PUMS). Washington, D.C.: US Census Bureau
Income Insufficiency
Income insufficiency is a measure of financial hardship that compares family income to estimated family expenses. While poverty rates are widely used as a measure of financial hardship, there is some evidence that poverty rates rely on outdated assumptions, which can lead to underestimated family expenses and financial hardship.Forsyth Futures developed the income insufficiency measure to supplement analysis of financial hardship based on poverty rates. The income insufficiency measure accounts for factors not considered in poverty calculations.

This report begins by documenting expense estimates, which represent the lowest cost of living that can be generally assumed for various family situations. This is followed by an analysis of income insufficiency rates, which are the percentages of residents living in families with incomes that are lower than their estimated expenses. The expense estimates used to calculate income insufficiency rates were based on demographic and geographic factors not considered in poverty calculations and how each expense changes over time.

Expense CategorySource NameSource InstitutionGeographic Level of DataCircumstances Accounted for
ChildcarePersonal CorrespondenceNorth Carolina State UniversityCountyAge, presence of nonworking adults who could provide free childcare
FoodLow Cost Food PlanUS Department of AgricultureRegionAge, sex
HousingFair Market RentsUS Department of Housing and Urban DevelopmentCountyFamily and household size/comparison
TransportationConsumer Expenditure SurveyBureau of Labor StatisticsRegionFamily size
HealthcareMedical Expenditure Panel SurveyUS Department of Health and Human ServicesRegionFamily size
Health InsuranceConsumer Expenditure SurveyBureau of Labor StatisticsRegionFamily size, age
Other ExpensesConsumer Expenditure SurveyBureau of Labor StatisticsRegionFamily size
TaxesFederal and State Tax CodesN/AIncome, wages, standard deduction, exemptions, some credits

This table outlines sources for these expenses, each of which is similar or identical to those used by MIT and/or the United Way. All estimates are as sensitive to location and family circumstance as the available data would allow. Countywide expense data were used whenever possible, however most expense categories were based on expense data calculated at the state or regional (Northeast, Midwest, South, West) level.

 One AdultTwo Working AdultsTwo Parents, One Working, with a 2 and 4 year oldTwo Working Adults with a 2 and 4 year oldOne Adult with a 2 and 4 year old
Childcare$0$0$0$14,371$14,371
Food$2,486$4,639$7,414$7,414$4,928
Housing$7,332$7,332$9,036$9,036$9,036
Transportation$4,037$7,400$10,154$10,154$8,764
Healthcare$413$826$988$988$802
Health Insurance$1,982$4,133$3,741$3,741$3,789
Other Expenses$2,516$4,202$5,330$5,330$4,557
Taxes$3,776$4,424-$1,760$7,935$8,270
Total Estimated Expenses$22,542$32,956$34,903$58,969$54,517

This table shows the estimated expenses for several example households in Forsyth County.Compared to families with no children, families with two preschoolers in need of full-time childcare are estimated to have about $25,000 to $30,000 more in expenses. Over half of this increase is from childcare and associated taxes. The example families above have children not attending school, which have the highest childcare expenses. School-aged children with working parents still have childcare expenses for after-school and summer care.

 One AdultTwo Working AdultsTwo Aduts, One Working, with a 2 and 4 year oldTwo Working Adults with a 2 and 4 year oldOne Adult with a 2 and 4 year old
Total Estimated Expenses$22,542$32,956$34,903$58,969$54,517
Poverty Threshold$12,752$16,493$24,858$24,858$19,749
Difference177%200%140%237%276%

This table shows that total estimated expenses are consistently higher than the federal poverty threshold used by the Census Bureau to determine poverty status.This table shows the hourly wages that workers in each example family would need to cover their estimated expenses with full-time (2,080 hours a year) work. None of the example families would be able to meet their estimated expenses with full-time minimum-wage work. Some families with children would be unable to meet their estimated expenses earning twice or three times the minimum wage.

The income insufficiency rate is generally similar. Income insufficiency in Forsyth County rose significantly between 2010 and 2011 at a time when poverty rates were rising as well. Income insufficiency rates in 2017 are not significantly different than what they were in 2006.

Disparities are present in income insufficiency rates by age. Roughly half of children under 18 live in families that had insufficient income. Children under 18 and adults age 18 to 24 years old had similar income insufficiency rates. Adults 25 to 44 year old and 45 years and older both had lower income insufficiency rates than younger age groups.

Disparities are present in income insufficiency rates by race/ethnicity. African American and Hispanic/Latino residents were roughly twice as likely to live in families with insufficient income as White, non-Hispanic residents. The income insufficiency rates of African American and Hispanic/Latino residents were significantly different in 2017.

Calculation of Expense Estimates

The Census Bureau defines the poverty level of families based only on income, family size, and the number of children and adults 65 and over.2 It does not consider location or any other factor that could influence expenses. As a result, in 2016, the average family of four was not considered to be in poverty if they had an income of at least $24,563, regardless of whether they lived in New York City or rural North Carolina.  Additionally, there is some evidence that these estimates rely on outdated assumptions, which cause them to underestimate family expenses and financial hardship.1 The flaws in the current measure are widely recognized. While researchers have been actively investigating alternative methodologies,3 the Census Bureau has not replaced its poverty calculations and researchers continue to commonly use Census Bureau poverty statistics.4

Forsyth Futures attempted to address shortcomings in poverty calculations by creating alternative expense estimates based on a more detailed consideration of family circumstances. It built on similar analyses in the Self-Sufficiency Standard created by the Center for Women’s Welfare at the University of Washington for the United Way and the Living Wage Calculator developed by Dr. Amy Glasmeier at the Massachusetts Institute of Technology (MIT). Forsyth Futures’ model estimates eight categories of expenses:

  1. childcare
  2. food
  3. housing
  4. transportation
  5. healthcare
  6. health insurance
  7. other expenses
  8. taxes.

These estimates represent the lowest cost of living that can be generally assumed for each family type based on the information available; they are designed to identify income levels that could reasonably support families of different sizes.

Appendix: Notes on data analysis and interpreting expense estimates and income insufficiency rates.

Expense estimates represent the best estimates that Forsyth Futures could make with the data available.  The notes below detail key considerations when using expense estimates and income insufficiency rates.

Note on Data Analysis

The data provided in this report come from the Census Bureau’s American Community Survey (ACS). The ACS asks questions similar to those found in the Decennial Census, but does not survey every household. As a result, there is still some uncertainty around estimates that are based on this survey. This uncertainty is measured before any estimates or comparisons are reported. Estimates that could be off by at least 24% are marked with a cautionary note. Similarly, estimates are only referred to as being higher or lower than another when the difference is statistically significant, meaning that there is at least a 95% likelihood that the two numbers are different when the uncertainty of the estimates is considered.

Expense estimates and income insufficiency rates do not reflect actual financial need.

Expense estimates represent the lowest cost of living that can be generally assumed for each family type based on the information available and are designed to identify income levels that could reasonably support different sizes of families. Expenses for some families may be lower due to individual circumstances; for example, extended family may be able to provide childcare, but these kinds of situations cannot be assumed for the general population

Components of expense estimates may not account for all regional differences.

Expense estimates are based on data that best accounts for many important factors, but may not account for all relevant information. For example, healthcare expenses are calculated for Forsyth County based on average healthcare expenses across all southern states. This is more accurate than using a countrywide average, but would not account for any characteristics of expenses specific to Forsyth County.

Income insufficiency rates in this report should not be compared to those published in the Forsyth County Poverty Study.

An earlier version of these calculations was used in the Forsyth County Poverty Study. Forsyth Futures has since refined the expense estimate calculations. As a result, expense estimates and income insufficiency rates in this report should not be compared to their counterparts in the Poverty Study. These changes included completely replacing all healthcare calculations and better accounting for potential shared housing costs among roommates, in addition to other minor changes. For more information, contact Elizabeth Lees (elizabeth@forsythfutures.org). 

Cost of childcare is inflation-adjusted using 2006 rate.

Yearly child care expenses were taken from Child Care Aware’s annual High Cost of Child Care report. Within each yearly report, we used the North Carolina rate representing the average annual costs of full-time family-based child care. The 2007 report, which reflects 2006 data, did not contain any North Carolina data; therefore, we used the 2006 inflation adjusted rate.

Literature References

  1. National Research Council (1995). Measuring poverty: A new approach. Washington, D.C.: National Academy Press. Retrieved from: https://www.nap.edu/read/4759
  2. S. Department of Commerce. (2017). Poverty thresholds – 2016 [Data File]. Retrieved from: https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html
  3. Short, K. S. (2005). Material and financial hardship and income-based poverty measures in the USA.  Journal of Social Policy, 34(1), 21-38.  doi: 10.1017/S0047279404008244
  4. Chetty, R, & Hendren, N. (2015). The impact of neighborhoods on intergenerational mobility: County-level estimates .  Retrieved from: https://scholar.harvard.edu/files/hendren/files/nbhds_paper.pdf

Data References

Median Income

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Poverty

In practical terms, poverty indicates insufficient financial resources needed to pay for basic needs such as food, housing, and health care.1

View poverty thresholds by family size from the US Census Bureau.

Forsyth County's poverty rate is decreasing. Poverty rates have consistently dropped since 2012, but still have not returned to the lower rates of 2006 and 2007.

Disparities are present in residents experiencing poverty by geography. Forsyth County has a higher rate of residents experiencing poverty when compared to National and State rates. Forsyth County’s poverty rate is higher than that of Guilford County but is not significantly different than Durham County.

Disparities are present in residents experiencing poverty by age. Forsyth County’s young adults and children are most at risk of experiencing poverty.

Disparities are present in residents experiencing poverty by race/ethnicity. The poverty rates for Hispanic/Latino residents and African American residents are both more than twice that of White, non-Hispanic residents. The percentage of White, non-Hispanic residents experiencing poverty has remained stable over the past 10 years.

If you are interested in using data from this report for rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literature References

  1. Kushel, M., Gupta, R., Gee, L., & Haas, J. (2006). Housing instability and food security as barriers to health care among low-income Americans. Journal of General Internal Medicine, 21(1), 71-77. doi: 1111/j.1525-1497.2005.00278.x
  2. S. Census Bureau, Poverty thresholds by size of family and number of children. (2017). Retrieved from https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html

Data Sources

  1. U.S. Department of Commerce. (2018). Poverty status in the past 12 months: Table S1701 [Data files from ACS 1-year estimates for the years 2006-2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_S1701&amp&prodType=table
  2. U.S. Department of Commerce. (2017). Poverty status in the past 12 months: Table S1701 [ Data files from ACS 5-year estimates for the years 2012-2016]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_16_5YR_S1701&prodType=table
  3. U.S. Department of Commerce. (2018). Poverty status in the past 12 months: Table S1701 [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_S1701&amp&prodType=table
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Additional Measures

Food Insecurity

The Forsyth County food insecurity rate is 16%.

Homelessness

Home Values

Largest Employers
RankCompanyEmployeesIndustry
1Wake Forest Baptist Medical Center14,271Academic Medical Center
2Novant Health9,896Medical Center and Health Services
3Winston-Salem/Forsyth County Schools8,000Educational System
4Wells Fargo2,890Financial Services
5Reynolds American2,500Manufacturing Headquarters, Tobacco
6Hanesbrands2,300Manufacturing Headquarters, Apparel
7Wake Forest University (Reynolda Campus)2,251Education
8City of Winston-Salem2,287Government
9Forsyth County2,118Government
10BB&T2,134Financial Services Headquarters
11Forsyth Technical Community College1,505Education
12Collins Aerospace1,600Manufacturing, Aerospace
13Wal-Mart1,300Retail Trade
14Winston-Salem State University1,073Education
15YMCA of Northwest North Carolina1,056Nonprofit
16Pepsi1,050Consumer Goods Operations
17Lowes Food Stores1,034Retail Trade, Headquarters
18Inmar912IT/Business Services
19American Airlines900Transportation, Customer Service Center
20Flow Automotive875Automotive Trade and Service
21Deere-Hitachi800Manufacturing, Machinery
22Hayward Industries800Manufacturing, Pool Equipment
23Veterans Administration685Government
24National General Insurance675Insurance
25Aon Consulting650Professional Services
26Cook Medical620Professional Services
27Blue Cross & Blue Shield of NC600Insurance
28WestRock600Manufacturing, Packaging Products
29Truliant Federal Credit Union560Financial Services
30Womble Bond Dickinson507Professional Services
Largest Industries
IndustryEmployees
Health care and social assistance30,473
Manufacturing22,200
Retail trade20,342
Educational services15,179
Professional, scientific, and technical services10,162
Accommodation and food services9,889
Construction9,102
Transportation and warehousing, and utilities8,660
Finance and insurance6,694
Public administration6,006
Administrative and support and waste management services5,432
Other services, except public administration4,132
Information2,268
Arts, entertainment, and recreation1,568
Agriculture, forestry, fishing and hunting, and mining577
Management of companies and enterprises839
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Reports and Briefings

The Benefits Cliff in Forsyth County, 2019

The benefits cliff, or cliff effect, occurs when a small pay increase disqualifies a worker from public benefit programs and abruptly reduces his or her household resources, causing unexpected financial crisis. Forsyth County ranks among the worst counties in the nation for economic mobility. For a working family striving to advance economically, the sudden loss of public benefits is devastating.

Forsyth County Poverty Study, 2017

The Forsyth County Poverty Study was carried out between 2015 and 2017 to inform efforts to improve the conditions of poverty in Forsyth County. A primary goal of the study was to identify which risk factors could contribute to poverty and disparities in poverty in Forsyth County. Forsyth Futures’ role in authoring the study was to provide a source of unbiased analyses to serve as a community resource; it was not Forsyth Futures’ role to identify or advocate for specific actions or policies.

Education

Community Impact

Education is one of the strongest factors that impacts a person’s economic, health, and overall well-being. Several concepts contribute to both Academic Success and Educational Attainment, including neighborhood and family factors, social and emotional skills, health and wellness, enrichment and engagement, and academic behaviors.

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Key Measures

Third Grade Reading

During the elementary and middle school years, students are learning basic reading and math skills. These skills provide the basis for children and young adults to acquire, process, and interpret information about the world. If students do not develop this foundation of basic skills, it can impact their academic success at all levels of education.1

From birth to about age eight, approximately third grade, children learn how to read. After third grade, reading increasingly becomes a key part of instruction and how children learn. Children who are unequipped with basic reading skills at the end of third grade are at much greater risk of falling behind in school.1

The measure used for Reading Proficiency is the reading test taken at the end of third grade. Proficiency on this test is defined as possessing the skills required to read at a third grade level.

The rate of student meeting third grade reading proficiency is generally decreasing. Students meeting third grade reading proficiency decreased by 6% over three years.

Disparities are present among students meeting third grade reading proficiency by economic status. In 2017-18, economically disadvantaged students were about half as likely to meet third grade reading proficiency as students who were not economically disadvantaged. There is a significant and persistent disparity between third grade reading outcomes for both groups over three years. The percent of students meeting third grade reading proficiency is decreasing for both groups; over three years, outcomes for economically disadvantaged students decreased by 5%, while outcomes for students who were not economically disadvantaged decreased by more than 10%.

Disparities are present among students meeting third grade reading proficiency by gender. In 2017-18, males were 8% less likely to meet third grade reading proficiency than females. Over the past 4 years, there is a persistent and significant disparity between between males and females.

Disparities are present among students meeting third grade reading proficiency by race/ethnicity. In 2017-18, African American students were about half as likely as White students to meet third grade reading proficiency; Hispanic / Latino students were less than half as likely to meet third grade reading proficiency than White students. Over four years, there are persistent and significant disparities between all three groups.

Data Notes

If you are interested in using data from this report for more rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literarture References

Annie E. Casey Foundation. (2010). EARLY WARNING! Why Reading by the End of Third Grade Matters.

Data Sources

North Carolina Department of Public Instruction, Accountability Services Division, Analysis and Reporting, 2016-17 State, District, and School Level Drilldown Performance Data Report. Retrieved from: http://www.dpi.state.nc.us/accountability/reporting/

Preparation for College and Career

Colleges expect students to have the skills and knowledge to tackle college coursework. Students unprepared for college frequently spend time and money taking remedial courses, greatly decreasing their chances of success and degree completion.1

The American College Testing (ACT) assessment, which is taken by all 11th grade students in North Carolina, measures college readiness in Reading, Math, Science, and English. In North Carolina, proficiency on the ACT is considered to be a composite score of 17 or above – the minimum score required for admission into the UNC system.

Only 58% of all Forsyth County Students Met ACT Proficiency in 2016-17.

Disparities are present in ACT proficiency among students by economic status. Economically disadvantaged students are less than half as likely to meet ACT proficiency than students who are not economically disadvantaged. There is a persistent and significant disparity between ACT proficiencies for economically disadvantaged students and students who are not economically disadvantaged.

Disparities are present in ACT proficiency among students by race/ethnicity. In 2016-17, African American and Hispanic / Latino students were both less than half as likely to meet ACT proficiency as white students. Over three years, there is a persistent and significant disparity in ACT proficiency among white students and both African American and Hispanic / Latino students.

 

Data Notes

If you are interested in using data from this report for rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literarture References

Alliance for Excellent Education. (2011, May). Saving Now and Saving Later: How High School Reform Can Reduce the Nation’s Wasted Remediation Dollars. Retrieved from http://all4ed.org/wp-content/uploads/2013/06/SavingNowSavingLaterRemediation.pdf

Data Sources

North Carolina Department of Public Instruction, Accountability Services Division, Analysis and Reporting, 2016-17 State, District, and School Level Drilldown Performance Data Report. Retrieved from: http://www.dpi.state.nc.us/accountability/reporting/

Post-Secondary Completion

Education plays a significant role in social mobility, the prevention of poverty, the ability for people to escape the conditions of poverty, and the reduction of crime rates.1-4 Graduating from college or community college significantly increases the likelihood of an individual’s economic success.3-6

Literature suggests that, post-secondary education plays an important role in upward mobility.3 Post-secondary education is defined as education attained after high school. This includes but is not limited to: colleges, community colleges, and universities. The education indicator measures the percentage the population, 25-years-old and older, with at least an associate’s degree.

While it is recognized that certificate programs are also important to a community, the data for such information is not currently available for analysis.

The percentage of residents with a post-secondary degree is increasing. The percent of residents with a post-secondary degree increased 4 percentage points between 2007 and 2017.

Residents with a post-secondary degree is similar by gender2014 was the only year in which females and males had significant difference in percentage of those with an associates degree or higher.

Disparities are present in residents with post-secondary degrees by age. The percentage of residents 65 years and older with a post-secondary degree has risen 12 percentage points between 2008 and 2017.

Disparities are present in residents with post-secondary degrees by race/ethnicity. White, non-Hispanic residents are more likely to have a post-secondary degree as compared to African American residents and Hispanic/Latino residents.

Data Notes

If you are interested in using data from this report for rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literarture References

  1. Haskins, R. (2011). Fighting poverty the American way. Anti-Poverty Programs in a Global Perspective: Lessons from Rich and Poor Countries, Social Science Research Center, Berlin, [Record of a Symposium]. June 20-21, 2011. Berlin, Germany. Retrieved from https://www.brookings.edu/wp-content/uploads/2016/06/0620_fighting_poverty_haskins.pdf
  2. Acs, G. (2011). Downward mobility from the middle class: Waking up from the American dream. Retrieved from http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2011/middleclassreportpdf.pdf?la=en
  3. Furchtgott-Roth, D., Jacobson, L., & Mokher, C. (2009). Strengthening community colleges’ influence on economic mobility. Retrieved from http://www.frbsf.org/economic-research/files/Jacobson.pdf
  4. Sharkey, P., Bryan, G. (2013). Mobility and the metropolis: How communities factor into economic mobility. Retrieved from http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2013/mobilityandthemetropolispdf.pdf
  5. Ross, C., & Wu, C. (1995). The links between education and health. American Sociological Review, 60(5), 719-745. Retrieved from http://www.jstor.org/stable/2096319
  6. Lochner, L. (2007). Education and crime. Retrieved from http://economics.uwo.ca/people/lochner_docs/educationpolicycrime_nov12.pdf

Data Sources

U.S. Department of Commerce. (2018). Sex by Age by Educational Attainment for the Population 25 and Over: Table B15002 [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_S1903&prodType=table

U.S. Department of Commerce. (2018). Sex by Age by Educational Attainment for the Population 18 and Over: Table B15001 [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_S1903&prodType=table

U.S. Department of Commerce. (2018). Sex by Age by Educational Attainment for the Population 25 and Over (Black or African American): Table B15002B [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_B15002B&prodType=table

U.S. Department of Commerce. (2018). Sex by Age by Educational Attainment for the Population 25 and Over (White Alone, Not Hispanic or Latino): Table B15002H [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_B15002H&prodType=table

U.S. Department of Commerce. (2018). Sex by Age by Educational Attainment for the Population 25 and Over (Hispanic or Latino): Table B15002I [ Data files from ACS 1-year estimates for the year 2017]. Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_17_1YR_B15002I&prodType=table

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Additional Measures

High School Graduation Rate

High School Diploma or Higer

In 2018, 88.3% of Forsyth County residents had a high school diploma or higher. ACS Table S1501.

Associates Degree or Higher

In 2018, 41.5% of Forsyth County residents had an associates degree or higher. ACS Table 1501.

Title I Public Schools

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Health and Wellness

Community Impact

An individual’s mental and physical health and wellness impacts his or her quality of life in a variety of ways. People with positive health habits such as exercise and healthy eating can decrease health-related risk factors, while people who smoke or abuse drugs are at greater risk of health problems. Societal issues such as poverty, educational attainment, and safety can impact lifestyle choices that directly impact an individual’s health. A physically and mentally healthy community’s residents have positive health outcomes, practice health-promoting behaviors, and have uninhibited access to health care.

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Key Measures

Infant Mortality

Infant health is often a leading indicator of not only children’s overall health, but also of a community’s health.1 One measure of infant health in a community is the infant mortality rate. Infant mortality rate refers to the  number of deaths per 1,000 live births of children under one year of age.

Rates of infant mortality remain relatively stable. The difference between the 2017 Forsyth County rate and Forsyth County’s rate in all other years is not statistically significant.

Disparaties are present in infant mortality rate by race/ethnicity. In 2017, African American residents had the highest infant mortality rates among all demographics in Forsyth County. The difference between African American residents and White, non-Hispanic residents is significant, while the difference between African American residents and Hispanic/Latino residents is not.

Forsyth County's infant mortality rate is higher than the majority of its peers. Forsyth County’s rate of infant mortality is higher compared to the State and Durham County.

Data Notes

If you are interested in using data from this report for rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literarture References

  1. Kim, D., Saada, A. (2013). The Social Determinants of infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review. International Journal of Environmental Research and Public Health. 10:2296-2335.

Data Sources

NC Department of Health & Human Services State Center for Health Statistics, North Carolina Infant Mortality Report, Table 1 North Carolina Resident Infant Death Rates (per 1,000 live births). Retrieved from: https://schs.dph.ncdhhs.gov/data/vital/ims/2017/

Low Birthweight

Infant health is associated with factors such as maternal health, quality and access to medical care, socioeconomic conditions and public health practices. 1 One measure in determining overall infant health is the percent of low birthweight babies born in a particular area.

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Life Expectancy

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Drug Poisoning Deaths

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Additional Measures

Adult Health
 YearRateSourceGeography
Percentage of adults who report their health to be poor or fair202017%County Health RankingsForsyth County
Average number of poor physical health days reported by adults in past 30 days20203.8 daysCounty Health RankingsForsyth County
Average number of poor mental health days reported by adults in past 30 days20204.2 daysCounty Health RankingsForsyth County
Adult obesity202033%County Health RankingsForsyth County
Adult smoking202018%County Health RankingsForsyth County
Percentage of adults who visited a dentist or dental clinic201658%CDC/500 Cities: Local Data for Better Health, 2017 releaseWinston Salem
Percentage of adults reporting no leisure-time physical activity202023%County Health RankingsForsyth County
Health Insurance — Rate of uninsured individuals201813%U.S. Census Bureau/Small Area Health Insurance Estimates (SAHIE)Forsyth County

Various indicators of adult (individuals 18 years of age and older) health for various years, updated in 2020.

Youth Behavioral Health
Alcohol, Tobacco & Other Drug UsePercentage
Offered, Sold, or Given an Illegal Drug on School Property in Past 30 Days20%
Used Marijuana ≥ 1 Times in the Past 30 Days17%
Currently Binge Drink(Had ≥5 Drinks of Alcohol in a Row in a Couple Hours on ≥ 1 Days in the Past 30 Days)13%
Currently Drink Alcohol (Drink of Alcohol on ≥1 Days in the Past 30 days)24%
Currently Use Electronic Vapor Products on ≥ 1 Day in the Past 3013%
Currently Smoke Cigarettes (Smoked Cigarettes on ≥1 Days in the Past 30 Days )12%
Ever Sniffed Chemicals (such as Glue or Paint) to Get a High8%
Ever Taken Drugs (such as OxyContin, Vicodin or Codeine) that were Not Prescribed for Them4%
Psychological HealthPercentage
Felt Sad or Hopeless Continuously for Two Weeks or More in the Past 12 Months31%
Seriously Considered Attempting Suicide During the Past 12 Months16%
Made a Suicide Plan During the Past 12 Months14%
Attempted Suicide During the Past 12 Months9%

Various measures of child health based on  the Winston Salem/Forsyth County High School Youth Risk Behavior Survey Results published by the Forsyth County Department of Public Health, 2017

Births by Race/Ethnicity and Education Level of Mother
 White, non-HispanicAfrican AmericanOther non-HispanicHispanic/LatinoTotal
Less than HIgh School1211278331587
HS Graduation or GED32034219310991
Some College623550271501350
Bachelor's Degree5781605455847
Masters or PhD406675228553
Not Stated10102
2018 Forsyth Totals204912461618744430

Births by mothers’ race and education, 2018. North Carolina State Center for Health Statistics.

 Percent White, non-HispanicPercent African AmericanPercent Other non-HispanicPercent Hispanic/LatinoPercent Total
Less than HIgh School6%10%5%38%13%
HS Graduation or GED16%27%12%35%22%
Some College30%44%17%17%30%
Bachelor's Degree28%13%34%6%19%
Masters or PhD20%5%32%3%12%
Not Stated0%0%1%0%0%
2018 Forsyth Totals46%28%4%20%100%

Births by mothers’ race and education, 2018. North Carolina State Center for Health Statistics.

Mothers and Children
 YearRate or PercentageSource
Adolescent Pregnancy Rate Among Females Ages 15 to 172014-201814.5NC State Center for Health Statistics, 2020 County Health Data Book, 2014-2018 Pregnancy Rates per 1,000 Population
Adolescent Pregnancy Rate Among Females Ages 15 to 192014-201826.6NC State Center for Health Statistics, 2020 County Health Data Book, 2014-2018 Pregnancy Rates per 1,000 Population
Infant Mortality Rate2014-20188.2NC Department of Health & Human Services State Center for Health Statistics, Infant Mortality Rates per 1,000 Births
Percent of Children Ages 1-2 with Elevated Blood Lead Levels >= 520172%Kids Count Data Center/ NC Department of Health & Human Services, Children’s Environmental Health Section: Childhood Lead Poisoning Prevention Program Surveillance Data

Measures for mothers and children, 2014-2018 (updated early 2020).

Death and Disease
 Rate per 100,000
Age-Adjusted Cardiovascular Disease Death Rate205.6
Age-Adjusted Heart Disease Death Rate146.7
Age-Adjusted Stroke Death Rate43.6
Age-Adjusted Diabetes Death Rate22.8
Age-Adjusted Colorectal Cancer Death Rate12.8
Age-Adjusted Trachea, Bronchus & Lung Cancer Death Rate47.4
Age-Adjusted Female Breast Cancer Incidence Rate176.6
Age-Adjusted Prostate Cancer Incidence Rate127.2
Age-Adjusted Unintentional Motor Vehicle Injury Death Rate11.3
Age-Adjusted Unintentional Injury Death Rate (excluding Motor Vehicle Deaths)36.4
Age-Adjusted Homicide Rate6.3
Age-Adjusted Suicide Rate11.2

Disease rates, 2013-2017. NCDHHS; NC County Trends Reports, February 2019
North Carolina Statewide and County Trends in Key Health Indicators: Forsyth County

Leading Causes of Death
 Deaths (2014-2018)Age-Adjusted Rate per 100,000
Diseases of heart3,205146.2
Accidents (unintentional injuries)1,03853
Chronic lower respiratory diseases1,02546.6
Cerebrovascular diseases95643.6
Alzheimer's disease83438.4
Diabetes mellitus49922.8
Nephritis, nephrotic syndrome and nephrosis36316.6
Influenza and pneumonia40818.4
Septicemia32514.7
Intentional self-harm (suicide)22311.4
Chronic liver disease and cirrhosis1878.5
Homicide1216.9

Leading causes of death. NCDHHS; NC 2020 County Health Data Book
2017 Race-Specific and Sex-Specific Age-Adjusted Death Rates by County: Forsyth County

https://schs.dph.ncdhhs.gov/data/databook/

Mortality Rate

Deaths: 3,611

Age-Adjusted Rate per 100,000: 959.6

CDC Wonder, Underlying Causes of Death, 2018.

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Safety

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Community Impact

Safety is foundational to an individual’s happiness and stability in life. Communities with lower crime rates often have a greater sense of community, higher property values, and are more attractive to businesses. Children who are shielded from crime and violence perform better in school, are less likely to be involved in high-risk behaviors such as substance abuse, and are less likely to become involved in criminal activity themselves as adults.

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Key Measures

Accidental Death

Nationally, injuries are the leading cause of death for people between the ages of 1 and 44, and are a leading cause of disability for the general population.1

For this report, accidental death rates are calculated as rates expressed as resident deaths per 100,000 people and to ensure comparison of standard populations, all rates given are age-adjusted.

Rates of accidental death in recent years. In 2016, Forsyth County had 50 accidental deaths per every 100,000 residents.

Disparities are present in accidental death rates by gender. Males have a significantly higher rate of accidental death than females.

Disparities are present in accidental death rates by race/ethnicity. White, non-Hispanic residents have a significantly higher rate of accidental death compared to African American residents.

Data Notes

This report has been produced to support grant writing efforts. As such, the validity and reliability of the data in this report has not been rigorously statistically tested. Forsyth Futures does not support the use of this data for specific programmatic planning. If you are interested in using data from this report for more rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literature References

Office of Disease Prevention and Health Promotion. (2015, December 16). Injury and Violence: Overview and Impact. Retrieved from www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Injuryand-Violence

Data Sources

United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Underlying Cause of Death 1999-2016 on CDC WONDER Online Database, released 2017.

Data are compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program.

Violent Crime

Crime is often an indication of the safety of a community and can influence a person’s perception of that community. Higher levels of violent crime are associated with higher levels of poverty and racial segregation.1, 2 An increase in the crime rate is detrimental to the health of a community and its residents.3

As defined by the Department of Justice, violent crime includes the offenses of murder, rape, robbery, and aggravated assault.

The rate of violent crime is measured by the number of occurrences per 100,000 individuals in a given population per year.

Violent crime rates have decreased overall. Violent crime in Forsyth County decreased between 2008 and 2010 and then increased again between 2013 and 2016. However, violent crime was lower in 2016 than in 2008.

Aggrevated assualt is the most prevalent type of violent crime. Aggravated assault is by far the most common violent crime in Forsyth County.

Instances of violent crime over time by type. Aggravated assault rates decreased from 2008 to 2013, but have increased between 2013 and 2016. Aggravated assault rates in 2016 were similar to those in 2008. Robbery rates, which are about a third of aggravated assault rates, decreased between 2008 and 2010 and have held steady after that.

Forsyth County's violent crime rate is similar to the major of its peers. In 2016, the violent crime rate in Forsyth County was lower than that of Durham County but higher than that of Guilford County and North Carolina in general.

Aggrevated assualt is the most prevalent type of violent crime among peer communities. Durham County and Forsyth County have similar rates of aggravated assault. Forsyth County has a lower rate of murder compared to Durham County but similar rate of murder compared to Guilford County and North Carolina.

Data Notes

The crime rate is defined as the number of offenses per 100,000 population. It is derived by first dividing a jurisdiction’s population by 100,000 and then dividing the number of offenses by the resulting figure.The population figures used to calculate standard error are based on the bridged race population estimates.

If you are interested in using data from this report for more rigorous purposes, please contact info@forsythfutures.org for a consultation on how best to proceed.

Literature References

  1. Block, R. (1979). Community, Environment, and Violent Crime. Criminology.17(1):46-57.
  2. Speer, P.W., Gorman, D.M., Labouvie, E.W., Ontkush, M.J. (1998). Violent Crime and Alcohol Availability: Relationships in an Urban Community. Journal of Public Health Policy. 19(3):303-318.
  3. Office of Disease Prevention and Health Promotion. (2015). Social Determinants of Health. HealthyPeople.gov. Retrieved from http:/www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health

Data Sources

NC State Bureau of Investigation, Crime Trends, Retrieved from: http://crimereporting.ncsbi.gov/public/2016/CrimeTrds/IndexRateCoTrd.htm

United States Department of Health and Human Services (US DHHS), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Bridged-Race Population Estimates, United States

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Additional Measures

Child Maltreatment and Victimization
  Rate per 1,000 children
Annual rate of assessments for child maltreatment49
Annual rate of child victimization*31.3

Child maltreatment. Point in Time, 2017-2018. AssessmentsAbuse and Neglect.

Abuse and Neglect
 Number of Cases
Abuse and Neglect10
Abuse12
Neglect49
Dependency7
Services Needed119
Services Provided, No Longer Needed59
Services Recommended978
Unsubstantiated183
Services Not Recommended750
Total Number of Children2,167

Abuse and neglect. Longitudinal data, 2018-2019.

Referral Sources
 Number
Anonymous131
Care Provider22
Educational Personnel392
Law Court396
Medical Personnel463
Relative258
Non-Relative212
Human Services175
Victim4
Parental124
Total Number of Children*2167

Referral services. Longitudinal Data, 2018-2019.

http://sasweb.unc.edu/cgi-bin/broker?_service=default&_program=cwweb.tbReport.sas&county=Forsyth&label=County&type=CHILD&fn=FRST&vtype=ref&format=html&entry=11

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Social and Civic Environment

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Community Impact

A community’s level of civic and social engagement is an indication of a community’s resilience, collective problem-solving capacity and ability to advocate for itself. Voter turnout, volunteerism and participation in local organizations are examples of civic engagement measures.

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Key Measures

Electoral Participation

Concentrated Poverty

When a large portion of a neighborhood lives in poverty, there can be negative consequences for the entire neighborhood.1,2 Residents living in areas of concentrated poverty may or may not be in poverty themselves, but are more likely be in poverty in the future.2,4 This effect is particularly pronounced for children; one study found that children were 50% more likely to have significantly less income than their parents when growing up in a high poverty neighborhood.4

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Additional Measures

PLACEHOLDER ONLY

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Reports and Briefings

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Demographics
Built and Physical Environment
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Overview

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Key Measure

Economy and Finanical Stability
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Overview

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Key Measures

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Additional Measures

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Education
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Overview

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Key Measures

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Additional Measures

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Reports and Briefings

Health and Wellness
p

Overview

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Key Measures

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Additional Measures

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Reports and Briefings

Safety
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Overview

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Key Measures

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Additional Measures

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Social and Civic Environment

Key Measures help us better understand how our community is changing over time.

Additional Measures are less detailed than key measures and are intended to provide additional context for community uses such as grant writing and program planning.

 

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