We live in the era of “go big or go home” but sometimes the place you call home is small — and North Carolina is big on small towns.

In fact, the Tar Heel State boasts the second largest number of small towns in America after Pennsylvania.

If you’ve been to (or driven through) the likes of Roseboro, Pembroke, or Saluda for example, you’ve only scratched the surface of small town gems that make North Carolina a small town sanctuary.

So, what’s a small town?

According to the US Census Bureau, rural areas in open country with fewer than 2,500 residents are considered small towns. Another way small towns are distinguished is if population densities are less than 500 people per square mile, with less than 2,500 residents within town boundaries. But really, these definitions are often loosely interpreted and it’s not unusual for people who grew up in cities with populations of even up to 10,000 residents to consider themselves from “small towns” too.

Why so many in NC?

North Carolina was the twelfth state to be admitted to the United States of America. Being one of the first and oldest states in the country means more years for people to settle and disperse across its territory.

Another thing? We’ve got highway for days in North Carolina. How much highway? 80,000 scenic miles of it. (The second most in the country after Texas). The NC Department of Transportation states that North Carolina has 15,000 miles of primary highways and 65,000 miles of secondary roads, in addition to 13,500 bridges.

All this highway connects the dispersed towns scattered throughout our great state.

What’s this got to do with healthcare?

Small towns are big on charm, but many are struggling when it comes to healthcare access.

We’ve talked about the economic struggles of small towns before, but many are in rural areas that don’t have hospitals or doctors within convenient driving distance. Statistically, people in rural areas have higher rates of chronic disease than people in urban areas, meaning more necessary trips to the doctor. If an emergency occurs, patients can also be in more serious or critical conditions by the time they arrive at the hospital.

For example, if you live in Rodanthe, North Carolina it can take you at least 32 minutes to reach the nearest medical center. Distance and access is a huge concern when a life or death situation is on the line.

As North Carolina residents, we’re familiar with Charlotte and Raleigh and Greensboro, but we also won’t forget about the small town people who live right around the corner — they’re our neighbors too (and you never know when you may need a cup of sugar).

Fun NC Small Town Facts

If pop culture has taught us anything, it’s that small towns have a lot to offer (think Stars Hollow in Gilmore Girls or Mayberry in the Andy Griffith Show), and North Carolina is no different.

• Did you know that jazz vocalist and music legend Nina Simone was born in Tryon, North Carolina? It’s a tiny town of just over 1,000 people that’s nestled in the Blue Ridge Mountains. (After Simone graduated high school, her community raised money for her to attend college to study music — it truly does take a village!)
• Filmmaker Randy Benson, who instructs at Duke University’s Center for Documentary Studies, took his curiosity about North Carolina’s small towns on the road. Each year he picks a small town and he and his students spend eight weeks there producing short documentaries on the town residents for his documentary project “Anytown USA.”
• Southport, North Carolina has a population of around 3,000 (this is a small town for us!) Its quaint homes and calming beaches served as the setting for the major motion picture Safe Haven based on Nicholas Sparks’ book of the same name. (Sparks calls North Carolina home in real life too.)

Whether you live in a small town in North Carolina or in North Dakota, healthcare access and affordability is a right you deserve. Here in North Carolina we’re fighting against state-based mandates that drive up the cost of health insurance for everyone. Want in? Join us.