Summary:
- North Carolina residents received a total of $152 billion in direct federal government assistance in 2024
- Public assistance from the federal government was a major source of all personal income in most counties in the state – but rates varied widely
- Economic decline has made most rural counties heavily dependent on federal government assistance
Ask most North Carolinians what they think of “welfare” and you’ll get one answer – likely shaded with moral judgment. But ask them whether they’ve benefited from Medicaid, crop insurance, a child tax credit or food stamps, and the reaction tends to shift: a pause, a qualification, or pivot. The data on government assistance in North Carolina reveals why.
In 2024 alone, $152 billion in total federal government assistance flowed directly to men, women and children all across North Carolina. While this public assistance went to residents living in every single county, it went disproportionately to rural counties, primarily in the far-western mountains, the northeast and southeast. For millions of North Carolinians and their communities, public assistance from the federal government is not merely a supplement to their economic life, but a load-bearing pillar that supports their own livelihood and that of their whole community.
Where $152 Billion went in 2024
To understand the scale and distribution of that $152 billion figure, the most useful data is what economists call “personal current transfer receipts.” This is a category tracked by the U.S. Bureau of Economic Analysis that captures the full sweep of assistance distributed by the federal government: Social Security, Medicare and Medicaid, unemployment insurance, veterans’ benefits, disability payments, and SNAP (eg. “food stamps”). Crucially, this measure excludes wages, salaries, and investment income earned through private-sector employment.
When aggregated at the county level, this provides as clear a measure as possible of how much of all personal income in a given county derives from government assistance rather than private economic activity. What it reveals is just how profoundly rural North Carolina’s economy has become dependent on federal government assistance to survive.
The Rural-Urban Economic Contrast
North Carolina has 22 non-rural counties, according to the NC Rural Center. In 18 of those metro counties, government transfers account for less than a quarter of all personal income. (The statewide average is 21.1%.)
Click the map for a fully interactive version with county-level detail.
The picture in rural counties is almost the mirror image: of the state’s 78 rural counties, 69 (nearly nine in ten) derive more than 25% of all personal income from government assistance. In 7 counties – again, all rural – government assistance accounts for 40% or more of all personal income in the county.
The dependency is deepest in the state’s geographic extremes. Western mountain counties and northeastern coastal plain counties are consistently at the top of every relevant measure. In seven counties — Cherokee, Washington, McDowell, Halifax, Clay, Robeson and Northampton — government assistance accounts for more than 40% of all personal income. At the top of the list is Cherokee County, where 45% of all personal income in 2024 was sent from the federal government.
By contrast, large metro counties were the least dependent on government assistance. Wake county ranks at the very bottom of the list, at only 10.9% of all personal income from transfer payments. Mecklenburg county is second to last, at 11.2%.
This widening urban-rural gap reflects not only the steady deterioration of North Carolina’s rural regional economies, but the divergent prosperity of the state’s metro areas. The consolidation of corporate agriculture, exodus of working-age residents to metro areas, and the lack of investment by the state legislature have left an economic vacuum in most of the state’s rural places.
Food Stamps and Medicaid: The Sharpest Edge
The most politically charged components of the federal safety net, food stamps and Medicaid, reveal the rural-urban divide with even more contrast.
Statewide, approximately 1.4 million North Carolinians (about 1 in 10) rely on SNAP, and 3 million (1 in 4) receive Medicaid. Both programs are limited to U.S. citizens with incomes below specific poverty thresholds.
Click the map for a fully interactive version with county-level detail.
Of the top 25 counties with the highest percentage of residents enrolled in Medicaid, 24 are rural. There are 18 counties where more than 20% of each county – 1 in 5 of all residents – are on food stamps. Robeson county tops the list at 32.8%, or roughly 1 in every 3 residents.
Click the map for a fully interactive version with county-level detail.
Compared to their share of the state’s overall population, rural counties account for a disproportionately large share of both SNAP and Medicaid recipients, while urban counties show the reverse. This makes intuitive sense: in urban counties, where North Carolina’s economy has increasingly concentrated, fewer people depend on public assistance as a proportion of their population. Areas with stronger private labor markets also have generally higher incomes, forcing fewer people to rely on public assistance to survive.
The Backstop Is Now Under Attack
North Carolina’s rural counties did not wind up with high levels of dependency on the federal government by accident. The semi-permanent recession our state’s rural communities have suffered over the last 15 years can be connected to specific policy choices made by lawmakers in Raleigh: the decision to allow the rural healthcare system to deteriorate; a refusal to adequately fund rural school systems; banning municipal broadband; and tilting the state’s tax system in favor of high earners in urban areas. Into this already perilous setting, the deep cuts contained in the “One, Big Beautiful Bill” passed by Congress in 2025 and signed into law by Donald Trump was a sledgehammer.
For most people, assistance from the federal government is not their desired permanent economic condition, nor what they want for their regional economy’s economic base. Yet in the absence of any meaningful investment in rural economic development by North Carolina’s own state legislature, federal government assistance is what’s left. It is keeping millions of North Carolina households solvent today in places where the local economy has shriveled.
The $152 billion flowing to North Carolinians from the federal government today is not a symptom of dependency culture. It’s the logical result of rural economies being abandoned by the lawmakers we all send to Raleigh. Whether through deliberate neglect or from misguided policy choices, the result is the same: rural economic decline has increased dependence on the federal government, with enormous human hardship as its toll.
