COH Website

Granville County, North Carolina


Rural Granville County has long enjoyed a healthy economy, despite its struggle to provide healthy living environments.

Once a top supplier for major tobacco companies, Granville County’s economy continued to thrive after the Civil War with the contributions of the Black farming community and the discovery of bright leaf tobacco as a cash crop, which attracted professionals to set up shop in Oxford, the county seat. Today, as home to seven of the county’s top 10 employers, downtown Oxford remains a hub for small business, commerce, and industry. Major highways provide direct routes from Oxford to surrounding counties and metropolitan areas like Durham, Raleigh, and Chapel Hill, where several of the state’s largest universities, health systems, and research organizations are located.

Still, Granville County is largely rural and faces challenges typical to rural communities, such as low walkability scores and limited access to opportunities for physical activity.

  • Overview

    Population and Demographics

    Population: 58,000

    U.S. Census Bureau; photography courtesy Flickr user PaytonChung, CC BY 2.0.

  • Context and Actions

    Community Context and Challenges

    • Poverty disproportionately affects children and marginalized groups; 25% of children live in poverty, compared to 21% nationwide, and the poverty rate among Hispanic and Black residents is over twice what it is for white.
    • Granville County has higher rates of chronic disease like type 2 diabetes and obesity in the county than the state and the nation.
    • Historic inequities have led to sharp disparities in health outcomes and educational attainment for Black residents, yet officials have not had much success engaging the Black community in countywide health assessments.
    • Mental health and substance abuse are rising concerns in Granville County; suicide rates exceed that of the state and admissions to mental health facilities and substance abuse treatment centers increased by nearly 60% from 2011 to 2013.

    North Carolina Nutrition and Physical Activity Surveillance System (NC-NPASS). (2009). Prevalence of Obesity, Overweight, Healthy Weight and Underweight Children 2-18 Years of Age by County (2005-2009).

    U.S. Census Bureau. (2014). 2010-2014 American Community Survey 5-Year Estimates.

    N.C. State Center for Health Statistics. (2013). North Carolina Vital Statistics, Volume 2, Leading Causes of Death (2001-2013).

    Taking Action

    Citizens, partner organizations, and policy makers are coordinating to make Granville County a healthier, more livable environment for all.

    In partnership with nearby Vance County, Granville has revitalized the process for engaging residents in health decisions, enabling more active lifestyles, and promoting community well-being as a shared goal. With targeted initiatives taking hold, Granville County has started to see early signs that they’re on the right track.

    These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

    Community Health Opinion Survey

    The Health Department conducted a Community Health Opinion Survey, along with a review of secondary data and input at community forums to help set priorities for action. Current priorities include success in schools, chronic disease prevention, reproductive health and pregnancy outcomes, and mental health and substance abuse services. Leadership recognizes that community engagement efforts continue to fall short in engaging Black residents.

    Promoting Success in Schools

    Granville County multi-sector partnerships to address success in schools include Granville Education Foundation, the Boys and Girls Club, and the Franklin Granville Vance Smart Start program. These partners are involved in several initiatives to promote school success through in class, after class and classroom readiness efforts that address education attainment through a fundamental commitment to child well-being.

    Granville Greenways

    The Granville Greenways project is the result of a partnership between Granville County, its municipalities, and the local school systems to create a system of walking and biking trails. As of spring 2016, more than 12 miles of greenway are complete or in progress, concentrated around Oxford, a location that allows a large portion of the county's population to access the system. 

    Substance Abuse Services

    In response to the county's ongoing problem with access to mental health and substance abuse services, faith-based organizations are attempting to fill the gap. Converting Hearts Ministry and Caring Hearts Youth Services focus on providing substance abuse treatment services for men and youth. It is not clear how integrated these efforts are into the health care, public health and social services systems. 

  • Going Forward

    Questions for Consideration

    Additional surveillance, data and information gathering, analysis, and reporting will examine the extent to which stakeholders’ desire for a more inclusive process and their awareness of social determinants of health lead to more involvement by Granville County’s Black population in community-wide discussions and initiatives to address disparities in health and well-being. Future reports will also examine how stakeholders are working to create a healthier, more equitable community; the impact of new and ongoing initiatives to address priority health concerns; and whether gaps are emerging in priority areas.

    Several questions remain, including the following:

    • In what ways is Granville County evolving its activities to engage more residents, particularly Black residents, in discussions and decisions regarding health and well-being? What are the narratives that drive or inform health in the Black community, and how do key leaders use them for civic engagement around health?
    • To what extent does Granville County consider and plan for active promotion of health and well-being, and not simply disease prevention?
    • What is the structure of the broader health system, and how do actors and key sectors work together to address shared challenges?
    • What are the interrelationships among economic, educational, and other social drivers of health in the county, and how are leaders planning for them in a coordinated way, particularly in the context of equity and opportunity discussions?
    • To what extent are other coalitions and collaborations addressing the social, structural, and economic drivers being leveraged to consider their role in health and well-being, and what efforts have been tried to link across? What are key facilitators and barriers to initiating and/or maintaining those linkages?
    • What models or strategies are being debated to address conditions of the physical environment in order to promote quality living? How can the story/successes to improve walking and biking opportunities be transferred or scaled to other features of the community?
  • Downloads

    Community Snapshot Report

    Community Portrait Report

    Community Landscape Report