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The North Carolina Division of Public Health requires local health departments to conduct a comprehensive community health assessment every three to four years. During the interim years, local health departments are responsible for issuing an annual report, known as the State of the County Health (SOTCH) Report. The Craven County Health Department is pleased to release the 2019 SOTCH Report. This report provides an annual review of the health of the community, tracks progress in addressing priority health issues, and identifies new initiatives and emerging issues that affect the health status of county residents.