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In spite of improvements in its health care delivery systems and in local and state public health infrastructure, North Carolina continues to face significant challenges in improving the health of its citizens. The state lags behind almost two-thirds of the nation in overall health status, and racial and ethnic disparities exist across multiple indicators of health outcomes. A growing body of knowledge is emerging regarding the effects of various social, environmental, and economic factors ondoi:10.18043/ncm.73.5.353 fatcat:pmecllian5fbtj4dyylgprg5se