January 2020 almost seems like a lifetime ago. With the COVID-19 pandemic and all the changes in the political landscape, it seems so much has happened over the last five years. One positive thing that did happen in January 2020 was the release of the “Healthy North Carolina 2030” (HNC 2030) report.1 In this issue of the North Carolina Medical Journal, we revisit the “HNC 2030” report and consider how far we have come toward meeting our 10-year goals at the mid-way point of the decade.

I had the good pleasure of co-chairing the HNC 2030 Task Force, along with Jack Cecil, President of Biltmore Farms, Dr. Laura Gerald, President of the Kate B. Reynolds Charitable Trust, and Dr. Betsey Tilson, Former State Health Director and Chief Medical Officer for the North Carolina Department of Health and Human Services. The diversity of the leadership for HNC 2030 was intentional. It was the goal of the North Carolina Institute of Medicine to take a different approach with this iteration of the state’s ten-year map to address the health of our citizens. That change led to the structuring of our goals around the social determinants of health, recognizing the importance of upstream factors, not only to overall health, but to racial/ethnic, geographic, and economic disparities in health outcomes.

The HNC 2030 leadership was very fortunate to have a group of talented individuals from various walks of life across the state leading our 4 work groups: the Health Behavior Work Group, the Clinic Care Work Group, the Social and Economic Factors Work Group, and the Physical Environment Work Group. These groups worked diligently to develop the 21 indicators that were adopted for the final report. This work involved finding the appropriate wording, baseline measures, potentially achievable goals, and disparate populations. We also had a tremendous turnout for our 8 listening sessions across the state, which were invaluable in helping us understand the health challenges faced in our North Carolina communities.

Unfortunately, when the report was released in January 2020, we had no idea that the world would change forever in a couple of months with a global pandemic. While our report obviously didn’t consider the role of COVID-19 on the health of North Carolinians, COVID-19 did elucidate many of the issues that we wanted to convey in the report. There were, and continue to be, major disparities across underserved populations in health outcomes related to COVID-19, reflecting the broader theme of the HNC 2030 report.

I hope that you enjoy this issue of the journal and find yourself impressed as I am with how far we have come in this last half decade!