The State of the County Health (SOTCH) Report is an annual report that provides information on health priorities identified in the 2019 Community Health Assessment and reviews recent mortality and morbidity data for Cumberland County. In North Carolina, the state requires each local health department to conduct a Community Health Assessment (CHA) every three or four years. During the years between health assessments, health directors submit an abbreviated SOTCH report. This report will highlight the progress of local programs and initiatives in addressing the top five health issues as identified by Cumberland County. The identified issues are: Access to Health Services; Economy (employment, housing, food security, and living below poverty); Exercise, weight, and nutrition; Public Safety, and Substance Abuse. These snapshots of progress support the Healthy North Carolina 2020 goal of making North Carolina a healthier state.