John Lettieri, President and CEO of Economic Innovation Group | Official Website
John Lettieri, President and CEO of Economic Innovation Group | Official Website
Among all government transfer programs, Income Maintenance was the smallest contributor. Social Security was the largest, totaling $41.67 billion, equating to $3,895 per capita and making up 33.9% of total transfers.
Medicare was the second largest contributor in North Carolina in 2022, accounting for $29.85 billion, averaging $2,790 per capita, and represented 24.3% of transfers in the state. Medicaid transfers provided another $19.35 billion, averaging $1,808 per capita and comprising 15.7% of government support, making them the third largest contributors.
Statewide, including all transfer types, government transfer payments totaled $122.94 billion, and accounted for 19.8% of residents’ total income, with an average of $11,491 per resident.
Government transfer payments are non-repayable funds provided by federal, state, or local governments to support individuals in need. These payments aim to stabilize economic conditions and provide financial support during hardships. Key programs include Social Security transfers (retirement benefits), Medicare transfers (healthcare for seniors), Medicaid transfers (healthcare for low-income individuals), and income maintenance transfers (financial assistance for basic needs).
With 17.2% of the population aged 65 and older, North Carolina has a significant demand for programs like Social Security and Medicare. The total per capita income in North Carolina, excluding government transfers was $46,617.9, which is noticeably below the county's total income of $58,109, emphasizing the role of government transfers in overall income.
When comparing 2022 to the previous year, North Carolina saw a decrease in its Income Maintenance transfer dependency by 0.3%.
Government transfers have long been a modest financial safety net, historically comprising only a small fraction of Americans' income. However, since the 1970s—sometimes dubbed the “Great Transfer-mation”—dependency has surged from 8.2% (or $2,022 per capita in inflation-adjusted 2022 dollars) in 1970 to 17.6% (or $11,542 per capita) in 2022 nationwide. In North Carolina, reliance on government transfers has similarly increased from 7.1% (or $1,410 per capita) in 1970 to 19.8% (or $11,491 per capita) in 2022, reflecting broader national trends.
According to the Economic Innovation Group’s analysis, these trends are not merely short-term responses to economic pressures but rather reflect a profound, long-term transformation in how government support is integrated into American life. The study illustrates that structural shifts—from rising healthcare expenses and demographic changes to stagnant wages—have significantly increased dependency on government transfers.
| County | Rank | Dependency on Transfers (%) | % Population 65+ | Social Security Transfers (%) | Medicare Transfers (%) | Medicaid Transfers (%) | Income Maintenance Transfers (%) | Per Capita Transfers ($) |
|---|---|---|---|---|---|---|---|---|
| Mecklenburg County | 1 | 10.9% | 12% | 3.4% | 2.4% | 2% | 1.6% | $8,339 |
| Wake County | 2 | 10% | 12.9% | 3.7% | 2.5% | 1.3% | 1% | $7,657 |
| Guilford County | 3 | 20% | 15.9% | 6.7% | 4.6% | 3.3% | 2.8% | $10,982 |
| Cumberland County | 4 | 31% | 13% | 6.8% | 4.9% | 5.1% | 4.3% | $14,252 |
| Forsyth County | 5 | 20.2% | 17% | 6.9% | 5.3% | 3.2% | 2.4% | $11,653 |
| Buncombe County | 6 | 19.7% | 21.3% | 7.4% | 4.8% | 2.9% | 1.8% | $12,130 |
| Durham County | 7 | 15.3% | 14.6% | 5.3% | 3.5% | 2.8% | 2% | $9,022 |
| New Hanover County | 8 | 19.6% | 19.1% | 7.3% | 5% | 2.5% | 1.7% | $11,942 |
| Gaston County | 9 | 23.9% | 16.6% | 8% | 6.2% | 4.3% | 3% | $11,893 |
| Brunswick County | 10 | 29.3% | 33.7% | 13.4% | 8.2% | 2.4% | 1.6% | $17,083 |
| Onslow County | 11 | 21.2% | 10.2% | 4.9% | 3.3% | 2.7% | 2.4% | $10,936 |
| Johnston County | 12 | 18.2% | 13.8% | 6.3% | 4.1% | 3.1% | 2.4% | $9,060 |
| Cabarrus County | 13 | 16.5% | 13.6% | 5.7% | 4.2% | 2.6% | 1.9% | $9,017 |
| Pitt County | 14 | 22.6% | 14.7% | 6.4% | 5.2% | 4.2% | 3.2% | $12,108 |
| Catawba County | 15 | 23% | 18.7% | 8.4% | 5.8% | 3.4% | 2.4% | $12,724 |
| Union County | 16 | 12.3% | 13.6% | 4.5% | 3.1% | 1.7% | 1.3% | $8,303 |
| Iredell County | 17 | 16.2% | 16.7% | 6% | 4.2% | 2.2% | 1.5% | $10,417 |
| Davidson County | 18 | 24.2% | 19% | 9.1% | 5.7% | 3.9% | 2.9% | $11,732 |
| Alamance County | 19 | 23% | 17.1% | 8.1% | 6.1% | 3.8% | 2.7% | $11,282 |
| Robeson County | 20 | 40.8% | 16.1% | 9.3% | 9.1% | 9.5% | 7.5% | $16,746 |
| Rowan County | 21 | 26.2% | 17.8% | 9% | 6.4% | 4.5% | 3.1% | $12,331 |
| Randolph County | 22 | 26.3% | 18.3% | 9.3% | 7.1% | 4.1% | 3.2% | $12,314 |
| Henderson County | 23 | 25.8% | 26.4% | 10.8% | 7.2% | 2.9% | 1.8% | $14,228 |
| Wayne County | 24 | 27.7% | 17.3% | 7.8% | 6.4% | 4.8% | 3.9% | $13,690 |
| Harnett County | 25 | 25.2% | 13.7% | 6.7% | 6.3% | 3.9% | 3.3% | $11,114 |
| Craven County | 26 | 27.2% | 21.1% | 8.8% | 6.7% | 3.2% | 2.6% | $14,750 |
| Moore County | 27 | 22.2% | 23.8% | 8.6% | 5.4% | 2.1% | 1.5% | $13,932 |
| Cleveland County | 28 | 31.9% | 19% | 10.5% | 7.7% | 6.3% | 4.3% | $14,377 |
| Rockingham County | 29 | 32% | 21.3% | 11.2% | 8.8% | 5.3% | 3.6% | $14,506 |
| Nash County | 30 | 26.7% | 19.5% | 8.7% | 7% | 4.4% | 3.4% | $13,546 |
| Orange County | 31 | 10.5% | 16.1% | 4.5% | 2.5% | 1.3% | 0.9% | $8,141 |
| Wilson County | 32 | 30.6% | 19.2% | 10% | 7.9% | 5.4% | 4.1% | $14,934 |
| Burke County | 33 | 29.7% | 21.6% | 10.5% | 7.1% | 5.2% | 3.3% | $13,244 |
| Caldwell County | 34 | 31.5% | 21.1% | 10.5% | 8.1% | 5.4% | 3.4% | $14,076 |
| Carteret County | 35 | 24.3% | 27% | 9% | 6.7% | 2.4% | 1.6% | $15,421 |
| Lincoln County | 36 | 19.1% | 19.2% | 7.2% | 5.3% | 2.6% | 1.8% | $11,090 |
| Surry County | 37 | 28.8% | 21.1% | 9.6% | 8.1% | 4.7% | 3.2% | $14,023 |
| Haywood County | 38 | 30.5% | 25.5% | 11.5% | 8% | 4.3% | 2.6% | $15,500 |
| Wilkes County | 39 | 31% | 23% | 10.9% | 8.3% | 5.1% | 3.7% | $14,698 |
| Rutherford County | 40 | 34.6% | 22.3% | 11.9% | 8.5% | 5.9% | 4.2% | $14,732 |
| Chatham County | 41 | 14.8% | 25.5% | 7.1% | 4.1% | 1.4% | 1% | $11,821 |
| Lenoir County | 42 | 31.5% | 21.5% | 9.3% | 7.8% | 6.1% | 4.4% | $16,077 |
| Lee County | 43 | 26.3% | 17% | 7.9% | 6.1% | 3.8% | 3.1% | $13,033 |
| Halifax County | 44 | 39.3% | 22% | 11.8% | 10.1% | 7.4% | 6.1% | $17,613 |
| Sampson County | 45 | 29.8% | 18.2% | 8.9% | 7.3% | 5.6% | 4.3% | $13,970 |
| Columbus County | 46 | 37.5% | 20.8% | 11.3% | 9.5% | 7.1% | 5.4% | $16,523 |
| Pender County | 47 | 24.7% | 18.2% | 8.5% | 5.9% | 3.4% | 2.4% | $12,319 |
| Stanly County | 48 | 26.1% | 19.1% | 9.3% | 7.1% | 4.1% | 2.8% | $12,575 |
| Edgecombe County | 49 | 37.1% | 21.2% | 10.5% | 7.6% | 8.5% | 6.7% | $16,139 |
| Franklin County | 50 | 22.1% | 17.3% | 7.8% | 5.3% | 3.6% | 2.8% | $10,218 |
| Beaufort County | 51 | 31.2% | 25.7% | 11.3% | 7.8% | 4.8% | 3.4% | $17,004 |
| Richmond County | 52 | 36.7% | 18.2% | 9.7% | 8.9% | 7.5% | 5.6% | $16,866 |
| Vance County | 53 | 38.6% | 19.5% | 10.8% | 9.4% | 8.8% | 6.5% | $16,730 |
| Duplin County | 54 | 27% | 20% | 7.7% | 6.9% | 4.9% | 3.8% | $14,246 |
| McDowell County | 55 | 34.3% | 21.6% | 11.5% | 8.6% | 6.2% | 3.8% | $15,084 |
| Hoke County | 56 | 30.2% | 11.6% | 6.4% | 4% | 4.9% | 4.5% | $12,453 |
| Granville County | 57 | 22.3% | 17.9% | 8.3% | 5.4% | 3.6% | 2.7% | $10,463 |
| Stokes County | 58 | 29.3% | 23% | 11.6% | 8.1% | 4.1% | 2.6% | $13,579 |
| Macon County | 59 | 31.9% | 28.7% | 12.6% | 8.5% | 3.9% | 2.5% | $15,420 |
| Davie County | 60 | 21.4% | 22.2% | 8.5% | 6.2% | 2.5% | 2.1% | $12,958 |
| Pasquotank County | 61 | 28.3% | 18.6% | 8.4% | 6.9% | 4.2% | 3.6% | $13,383 |
| Scotland County | 62 | 38.6% | 18.3% | 11.2% | 8.5% | 8.4% | 6.6% | $15,853 |
| Person County | 63 | 30% | 21% | 10.8% | 8.4% | 4.7% | 3.4% | $13,601 |
| Watauga County | 64 | 19.7% | 17% | 7.3% | 5.7% | 1.7% | 1.3% | $9,556 |
| Transylvania County | 65 | 27.6% | 31.7% | 11.5% | 7% | 3.4% | 2.3% | $15,268 |
| Jackson County | 66 | 26.4% | 20.4% | 9% | 6.2% | 4.9% | 2.3% | $11,841 |
| Cherokee County | 67 | 42.5% | 31.7% | 16.7% | 10.9% | 5.7% | 3.3% | $17,000 |
| Bladen County | 68 | 35.2% | 23.7% | 10.5% | 9.3% | 6.6% | 4.9% | $17,034 |
| Yadkin County | 69 | 27.7% | 21.1% | 10.1% | 8% | 4.1% | 2.7% | $13,141 |
| Dare County | 70 | 16.6% | 24.6% | 7.2% | 3.9% | 1.4% | 1.1% | $12,655 |
| Alexander County | 71 | 26.7% | 20.4% | 10% | 6.9% | 3.9% | 2.6% | $12,846 |
| Ashe County | 72 | 33% | 27.4% | 12.4% | 8.7% | 4.7% | 3% | $14,667 |
| Martin County | 73 | 40.9% | 25.8% | 12.7% | 11.6% | 6.8% | 5% | $17,387 |
| Anson County | 74 | 31.8% | 20.1% | 9.2% | 8.1% | 6.9% | 4.7% | $15,957 |
| Currituck County | 75 | 17.9% | 17.3% | 6.4% | 4.3% | 1.5% | 1.3% | $10,619 |
| Polk County | 76 | 26.6% | 32.4% | 11.1% | 7.4% | 3.2% | 1.8% | $16,335 |
| Montgomery County | 77 | 26.9% | 22.4% | 9.3% | 5.2% | 5.1% | 3.8% | $12,574 |
| Hertford County | 78 | 37.3% | 22.5% | 11.2% | 9.4% | 7.2% | 5.5% | $15,494 |
| Northampton County | 79 | 38.9% | 29.7% | 12.6% | 10.8% | 6.5% | 5.4% | $18,538 |
| Bertie County | 80 | 36.2% | 25.4% | 11.3% | 10% | 6.9% | 5% | $17,898 |
| Madison County | 81 | 31.5% | 23.1% | 10.9% | 7.9% | 5.1% | 3.1% | $14,018 |
| Caswell County | 82 | 32.3% | 23.5% | 12.4% | 7.8% | 5.3% | 4.1% | $13,292 |
| Yancey County | 83 | 35.9% | 26.5% | 13.3% | 9.5% | 5.4% | 3.2% | $15,092 |
| Warren County | 84 | 36.2% | 27.3% | 12.1% | 8.2% | 6.9% | 5.7% | $13,624 |
| Swain County | 85 | 35.4% | 19.9% | 9.9% | 9.6% | 9.2% | 3.1% | $18,236 |
| Mitchell County | 86 | 33.7% | 25.4% | 12.4% | 8.4% | 5.3% | 3% | $14,804 |
| Avery County | 87 | 27.7% | 23.7% | 10.7% | 6.1% | 4% | 2.6% | $12,622 |
| Chowan County | 88 | 30.9% | 26% | 11% | 8.2% | 4.7% | 3.5% | $15,782 |
| Greene County | 89 | 27.7% | 17.6% | 8.8% | 5.4% | 5.6% | 4.6% | $10,789 |
| Perquimans County | 90 | 29.9% | 28.1% | 10.9% | 8.2% | 3.8% | 2.8% | $15,975 |
| Washington County | 91 | 41.9% | 28% | 13.3% | 10.9% | 7.5% | 5.6% | $19,018 |
| Pamlico County | 92 | 31.5% | 31.8% | 12.8% | 8.2% | 3.6% | 2.4% | $16,459 |
| Clay County | 93 | 39.3% | 33.5% | 16.3% | 10.1% | 4.7% | 3% | $17,203 |
| Alleghany County | 94 | 35.6% | 28.3% | 13% | 9.9% | 4.8% | 3.2% | $15,839 |
| Jones County | 95 | 32.8% | 24.4% | 10.1% | 6% | 4.9% | 3.8% | $15,912 |
| Gates County | 96 | 27.4% | 22.7% | 9.4% | 7.7% | 3.4% | 3% | $13,643 |
| Camden County | 97 | 20% | 17% | 6.6% | 5.2% | 1.8% | 1.5% | $11,398 |
| Graham County | 98 | 36.8% | 24.8% | 11.9% | 8.5% | 8.4% | 3.9% | $15,201 |
| Hyde County | 99 | 26.6% | 24.6% | 8.9% | 6.8% | 3.9% | 3.4% | $12,915 |
| Tyrrell County | 100 | 32.7% | 24.2% | 9.8% | 8.9% | 4.7% | 4.6% | $14,737 |
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