Health & Well-Being Summary

Health and well-being are integral to one's quality of life. The World Health Organization defines "well-being" as a state in which an individual's abilities are realized, and the normal stresses of life can be handled. Individuals can work productively and fruitfully and make contributions to the community. Health factors can enhance or threaten an individual's or a community's health. Factors impacting health can be matters of individual choice, such as whether to smoke or not, or may be beyond an individual's control as they relate to social, economic, and environmental determinants.

Orange County shows mixed progress in health and well-being: long-run improvements in cancer mortality, uninsurance, and foster-care involvement; persistently elevated child poverty, rising student obesity, and ongoing substance-use harms; and tightening access to primary care relative to other Mid-Hudson counties. Maternal/infant indicators are stable to slightly improved overall, but with notable racial disparities and an overall decline in early prenatal care.

Orange County deaths remained below 2,900 before the COVID-19 pandemic. In 2020, deaths increased to 3,512, decreased to 3,163 in 2021, and increased again to 3,222 in 2022. From 2019 to 2020, 27% more Orange County residents died. During the same period, Rockland saw a 41% increase, and Westchester experienced a 33% increase. Ulster County had the lowest rate but still saw an increase of 13%.

Heart disease and cancer were the leading causes of death in 2021, followed by COVID-19, unintentional injury (accidents), and chronic lower respiratory diseases. The leading cause of premature death (death before age 75) in 2021 was cancer, followed by heart disease, COVID-19, unintentional injury, and chronic lower respiratory diseases.

Sexually transmitted infections continued to challenge medical professionals. Since 2004, all measured STIs have increased in number. Chlamydia, which saw an explosion between 2012 and 2019, began a downward trend in 2020. Syphilis experienced a steady incline from 2012 to 2021 and started to stabilize in 2022. Additionally, gonorrhea cases increased from 2018 and peaked in 2020, with a downward trajectory since then. The number of HIV reported cases has decreased since 2009 overall, but has seen a steady increase since 2020.

Adult obesity in the Hudson Valley was modest in 2008–2009 (6.9%). Students showed an elevated risk in 2010–2012, with 17.5% of students being obese, and 33.1% being overweight or obese. Subsequent student data indicate obesity has continued to rise over time.

Most residents reported no need to see a mental health provider in 2024 (80%). For those who did not go when needed, barriers included no insurance (5%), not enough money (6%), time (6%), transportation (2%), and provider availability (2%).

The patient-to-mental health provider ratio was 390:1 in 2022. In 2011, 371 children and youth received services, including 307 with serious emotional disturbance. Mental health clinic visit totals were stable from 2018–2022, suggesting steady demand through the COVID-19 pandemic.

Overall, poverty in Orange County has edged up over the long term. Trends vary by group: poverty among related children decreased, while poverty among older adults (65+) rose from 7% in 2005 to 10.2% in 2023. Single female householders remain the most affected at approximately 18% in 2023. Children below poverty reached 21% in 2022—higher than Dutchess, Putnam, Westchester, and Ulster, but lower than Rockland and Sullivan. Food insecurity remained high but improved from 27.2% in 2014 to 23.9% in 2021. Among veterans in 2023, poverty rates were lowest for the youngest ages (18-34) at 5.42% and highest for the oldest ages (65+) at 56.3%.

The number of people who died from overdoses in Orange County between 2020 and 2024 dropped significantly by 41%. Drug-related hospitalization rates fell from 65.6 per 10,000 people in 2019 to 52.2 per 10,000 in 2022, still higher than Rockland, Westchester, and Putnam but lower than Dutchess and Ulster.

Low birthweights fell to 6.7% in 2021 from 7.5% in 2008 and were lower than most neighboring counties except Rockland and Sullivan. Early prenatal care declined from 71.5% in 2004 to 67.3% in 2022 and trailed Dutchess, Putnam, Westchester, and Rockland. Infant mortality averaged 3.6 per 1,000 (2020–2022), with higher rates among Black infants at 5.6 per 1,000. Maternal mortality eased to 25.6 per 100,000 women from 2020–2022 (two deaths), lower than earlier periods but higher than Sullivan, Westchester, Dutchess, and Ulster, and lower than Putnam and Rockland. Births to women 25+ without a High School diploma declined from the mid-2000s peaks to 12.7% in 2022—still higher than Dutchess, Putnam, Westchester, and Ulster but below Rockland and Sullivan. Childcare capacity in 2025 is tight, with 226 licensed daycares with 6,128 total slots.

The primary-care physician ratio worsened to 1,498:1 in 2024 from 1,314:1 in 2016, with less access than Dutchess and Rockland but more than Putnam and Sullivan. Dental access measures improved: among children on public insurance, 48.4% (2023) had a dental visit, similar to Putnam and Westchester, but less than Rockland, and above Dutchess, Sullivan, and Ulster counties. 52.5% of Medicaid enrollees aged 2–20 saw a dentist in 2023, again in the mid-range regionally. Uninsurance dropped sharply over the decade: 5.0% in 2023 versus 10.3% in 2010, though still slightly higher than Dutchess, Putnam, Westchester, and Sullivan, and lower than Ulster and Rockland counties.

Foster care use dropped markedly: from 4.2 per 1,000 in 2001 to 1.5 in 2023, with children in care declining from 268 in 2020 to 163 in 2024. Divorces were essentially flat in 2022 versus 2004 (933 versus 941), though Orange tallied more divorces in 2022 than any neighboring Mid-Hudson county. Household composition shifted: total households grew 11.4% between 2010 and 2023; Orange County has more unmarried partners in 2023 versus 2004 (7.2% versus 4.7%), married-couples stayed roughly the same year over year; and a notable share of grandparents as caregivers at 32.8% in 2023.