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Court ruling could reshape North Carolina coastal fishing

Shrimp trawling and gillnetting face new scrutiny after a judge found decades of state failures.

Climate

North Carolina failed to protect its coastal fisheries, leaving multiple species at risk of collapse, a Wake County judge ruled last week.Why it matters: The ruling found North Carolinians&#x27; constitutional right to harvest fish and shellfish is being violated, potentially requiring the state to overhaul how it manages the coastal ecosystem.

Asheville's Helene recovery gets global G20 spotlight

More than 1,000 visitors are expected in the western North Carolina town hit hard by Helene.

Politics

This weekend, a G20 summit in Asheville will draw finance ministers, economic leaders and heavy-hitting CEOs from around the world.Why it matters: Choosing the Blue Ridge Mountains for the summit is a strategic show of support from the Trump administration for a region still healing from <a class="gtmContentClick" data-vars-link-text="Tropical Storm Helene" data-vars-click-url="https://www.axios.com/local/raleigh/2025/09/26/a-year-on-from-helene" data-vars-content-id="b53e4917-633f-44d4-87fe-cc758283547b" data-vars-headline="Asheville&#x27;s Helene recovery gets global G20 spotlight" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2025/09/26/a-year-on-from-helene" target="_self">Tropical Storm Helene</a>.

The Triangle's 30 best restaurants, right now

Stanbury takes the top spot again as the Triangle's increasingly acclaimed food scene keeps growing.

Food and Drink

Creating a list of the Triangle&#x27;s 30 best restaurants keeps getting harder for us here at Axios Raleigh. <ul><li>We see it as a sign of just how vibrant the region&#x27;s cuisine has gotten over the past decade, with longtime institutions going strong and an ever-growing list of exciting newcomers. </li></ul>

Meta settlement gives social media its Big Tobacco moment

North Carolina will get at least $451 million as Facebook and Instagram add protections for kids.

News

<a class="gtmContentClick" data-vars-link-text="Meta" data-vars-click-url="https://www.axios.com/2026/08/18/meta-trial-social-media-children-facebook-instagram" data-vars-content-id="63701f16-5b6c-425c-b3cb-a46e56c27cf3" data-vars-headline="Meta settlement gives social media its Big Tobacco moment" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2026/08/18/meta-trial-social-media-children-facebook-instagram" target="_self">Meta</a> agreed to settle with U.S. states for up to $16.7 billion in a landmark deal over allegations Facebook and Instagram were designed in ways that harm children.<ul><li>The company is calling on its peers to sign on to the pact as well, saying it won&#x27;t work unless they jointly line up behind broad reform.</li></ul>Why it matters: This is social media&#x27;s version of the <a class="gtmContentClick" data-vars-link-text="landmark 1990s tobacco settlement" data-vars-click-url="https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/" data-vars-content-id="63701f16-5b6c-425c-b3cb-a46e56c27cf3" data-vars-headline="Meta settlement gives social media its Big Tobacco moment" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.naag.org/our-work/naag-center-for-tobacco-and-public-health/the-master-settlement-agreement/" target="_blank">landmark 1990s tobacco settlement</a>, a settlement that effectively reshapes the industry and the way young Americans experience some of their favorite platforms.

Vaccine exemptions keep rising in North Carolina

The number of kindergartners receiving MMR and DTaP vaccines has declined.

The vaccination rates of North Carolina kindergartners continues to decrease while the number of students with exemptions grows. The big picture: Vaccination rates among all American kindergartners decreased during the 2025–2026 school year for all tracked <a class="gtmContentClick" data-vars-link-text="vaccines" data-vars-click-url="https://www.axios.com/2026/08/11/trump-vaccines-midterms-measles-order" data-vars-content-id="5d1f8a64-f7c8-4bfb-85fe-044ff8e01dd6" data-vars-headline="Vaccine exemptions keep rising in North Carolina" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2026/08/11/trump-vaccines-midterms-measles-order" target="_self">vaccines</a>, the Centers for Disease Control and Prevention <a class="gtmContentClick" data-vars-link-text="reported" data-vars-click-url="https://www.cdc.gov/schoolvaxview/data/index.html" data-vars-content-id="5d1f8a64-f7c8-4bfb-85fe-044ff8e01dd6" data-vars-headline="Vaccine exemptions keep rising in North Carolina" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.cdc.gov/schoolvaxview/data/index.html" target="_blank">reported</a> on Monday.<ul><li>Exemptions from getting one or more vaccines increased in 41 states and the District of Columbia, growing to 4.2% from 3.6% the year before.</li></ul>

Alzheimer's drug gives Duke patients hope — and risks

The treatment can't cure Alzheimer's, but Duke researchers say it can slow the disease's progression.

Health

Duke researchers are finding promise in an Alzheimer&#x27;s drug first approved for patients three years ago. Why it matters: The treatment can&#x27;t cure Alzheimer&#x27;s disease, but it can slow its progression.<ul><li>“This is about buying time in a disease that takes it away,” <a class="gtmContentClick" data-vars-link-text="Andy Liu," data-vars-click-url="https://urldefense.com/v3/__https://zwly9k6z.r.us-east-1.awstrack.me/L0/https:*2F*2Fneurology.duke.edu*2Fprofile*2Fandrew-john-liu/1/0100019fd8508724-1cec6069-a267-4bff-bf91-88204592e277-000000/OiBaOpMM0sYCuuXNx8ExREcQtzU=473__;JSUlJQ!!Al82Z4c!yZ0RoCabVQtUJO2UDDhzbDaRKSFFZK-DeypMAy8lKW7wr_F9IRKx0_JrvJpJ3Dx-WHF7WTCb99Y0viH-9RfIHaXQ$" data-vars-content-id="74e2d308-0b3c-470c-a081-9c1111eefa36" data-vars-headline="Alzheimer&#x27;s drug gives Duke patients hope — and risks" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://urldefense.com/v3/__https://zwly9k6z.r.us-east-1.awstrack.me/L0/https:*2F*2Fneurology.duke.edu*2Fprofile*2Fandrew-john-liu/1/0100019fd8508724-1cec6069-a267-4bff-bf91-88204592e277-000000/OiBaOpMM0sYCuuXNx8ExREcQtzU=473__;JSUlJQ!!Al82Z4c!yZ0RoCabVQtUJO2UDDhzbDaRKSFFZK-DeypMAy8lKW7wr_F9IRKx0_JrvJpJ3Dx-WHF7WTCb99Y0viH-9RfIHaXQ$" target="_blank">Andy Liu,</a> an associate professor at Duke University School of Medicine, said in a press release describing new research into Duke patients&#x27; experiences with the drug. </li></ul>

Important nutritional research is being piloted through North Carolina's sewers

Researchers from Duke and UNC have been tracking diet habits through wastewater.

Environment

During the height of the COVID-19 pandemic, North Carolina public officials plumbed the sewers <a class="gtmContentClick" data-vars-link-text="looking for signs" data-vars-click-url="https://www.dph.ncdhhs.gov/programs/epidemiology/communicable-disease/respiratory-diseases/dashboard/wastewater-testing" data-vars-content-id="50dffb7a-378d-416d-a559-230fd32616b3" data-vars-headline="Important nutritional research is being piloted through North Carolina&#x27;s sewers" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.dph.ncdhhs.gov/programs/epidemiology/communicable-disease/respiratory-diseases/dashboard/wastewater-testing" target="_blank">looking for signs</a> of the virus&#x27; prevalence was in the state. <ul><li>Now, that same infrastructure is being tested as a way to track the diets of entire cities and neighborhoods.</li></ul>Why it matters: The tracking method —  which captures food DNA left behind in sewage — could become an important tool for studying the nutritional health of a community or determine food access disparities by neighborhoods.

Some North Carolina schools still lack AEDs as lawmakers push bill

Advocates say quick access to AEDs can help save students during cardiac emergencies.

Education

North Carolina lawmakers are considering requiring <a class="gtmContentClick" data-vars-link-text="AEDs" data-vars-click-url="https://www.axios.com/local/raleigh/2025/11/21/north-carolina-911-drone-defibrillator" data-vars-content-id="1f389ccf-67b0-4f16-b7cb-a5f120894d36" data-vars-headline="Some North Carolina schools still lack AEDs as lawmakers push bill" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2025/11/21/north-carolina-911-drone-defibrillator" target="_self">AEDs</a> on every public school campus.Why it matters: During cardiac arrest, getting a shock from a defibrillator in time can be the difference between life and death.

ACA enrollment in North Carolina plummets after subsidies expire

The decline comes after enhanced subsidies for the plans expired.

The number of North Carolinians enrolled in health insurance plans through the Affordable Care Act has fallen significantly this year. <ul><li>More than 200,000 fewer people are getting insurance via the program this year, <a class="gtmContentClick" data-vars-link-text="according to data compiled by KFF" data-vars-click-url="https://www.kff.org/affordable-care-act/state-indicator/marketplace-plan-selections-by-enrollment-type-2/?currentTimeframe=0&amp;selectedRows=%7B%22states%22:%7B%22north-carolina%22:%7B%7D%7D%7D&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" data-vars-content-id="6e746ba5-e2a7-47be-abd4-253030351780" data-vars-headline="ACA enrollment in North Carolina plummets after subsidies expire" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.kff.org/affordable-care-act/state-indicator/marketplace-plan-selections-by-enrollment-type-2/?currentTimeframe=0&amp;selectedRows=%7B%22states%22:%7B%22north-carolina%22:%7B%7D%7D%7D&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D" target="_blank">according to data compiled by KFF</a>. </li></ul>Why it matters: The drop came after <a class="gtmContentClick" data-vars-link-text="enhanced subsidies" data-vars-click-url="https://www.axios.com/2025/12/18/obamacare-marketplace-upheaval-subsidy-extension" data-vars-content-id="6e746ba5-e2a7-47be-abd4-253030351780" data-vars-headline="ACA enrollment in North Carolina plummets after subsidies expire" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2025/12/18/obamacare-marketplace-upheaval-subsidy-extension" target="_self">enhanced subsidies</a> for the ACA expired, making plans more expensive for many people.

WakeMed's CEO makes his case for a merger with Atrium

WakeMed says its main campus needs at least $1 billion to be redeveloped.

Business

WakeMed Health&#x27;s leadership said Tuesday that a merger with Atrium Health is needed to ensure the Wake County-based hospital network will be thriving a decade from now. Why it matters: Atrium&#x27;s potential takeover of WakeMed, which was founded by Wake County in 1961 and is a<a class="gtmContentClick" data-vars-link-text=" safety-net provider," data-vars-click-url="https://www.nyu.edu/about/news-publications/news/2023/september/safety-net-hospital.html" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.nyu.edu/about/news-publications/news/2023/september/safety-net-hospital.html" target="_blank"> safety-net provider,</a> has been the talk of the town since it was <a class="gtmContentClick" data-vars-link-text="announced" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" target="_self">announced</a> last Friday afternoon. <ul><li>State and local officials, however, have <a class="gtmContentClick" data-vars-link-text="raised strong opposition" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/04/atriums-acquisition-of-wakemed-receives-significant-pushback" data-vars-content-id="7603ba51-0c04-418d-ac5c-c0e82ec37b27" data-vars-headline="WakeMed&#x27;s CEO makes his case for a merger with Atrium" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/04/atriums-acquisition-of-wakemed-receives-significant-pushback" target="_self">raised strong opposition</a> to the speed and the scope of the deal. </li></ul>

Atrium's acquisition of WakeMed receives significant pushback

The merger would give Atrium, the state's largest hospital network, a foothold in the Triangle.

A vote on a <a class="gtmContentClick" data-vars-link-text="proposed merger" data-vars-click-url="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" data-vars-content-id="dea2f66d-d10e-45c5-b2bc-62f7be2313b7" data-vars-headline="Atrium&#x27;s acquisition of WakeMed receives significant pushback" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/raleigh/2026/05/01/wakemed-is-seeking-to-combine-with-atrium-health" target="_self">proposed merger</a> between WakeMed Health and Atrium Health has been delayed after significant pushback from state and local officials. Why it matters: The potential merger would give Atrium Health, the state&#x27;s largest health care provider, a significant foothold in the Triangle.

WakeMed is seeking to combine with Atrium Health

WakeMed, previously owned by the Wake County until 1997, has three hospitals in Wake County

WakeMed Health, a nonprofit hospital that has served the Raleigh area since 1961, is moving to combine with Atrium Health, the state&#x27;s largest hospital system, they said in a joint release Friday. Why it matters: WakeMed is the third-largest healthcare provider in the Triangle, giving Atrium a large foothold here, if the combination is approved by regulators.<ul><li>Atrium, which has a significant presence in <a class="gtmContentClick" data-vars-link-text="Charlotte" data-vars-click-url="https://www.axios.com/local/charlotte/2026/04/29/south-charlotte-arts-hub-nonprofit-campus-plan-feasibility-study-funding-theater" data-vars-content-id="0814822d-8981-4ce6-b306-90cfb940f0af" data-vars-headline="WakeMed is seeking to combine with Atrium Health" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/local/charlotte/2026/04/29/south-charlotte-arts-hub-nonprofit-campus-plan-feasibility-study-funding-theater" target="_self">Charlotte</a> and the Triad, is part of the nonprofit healthcare company Advocate Health. </li></ul>

Duke study: AI model detects ADHD in kids as young as 5

Researchers say the tool could help clinicians identify ADHD sooner using large-scale health data.

Duke University researchers created an artificial intelligence model they say can accurately detect ADHD in 5-year-olds&#x27; health data.Why it matters: That&#x27;s years earlier than most kids are diagnosed, an example of how AI tools that analyze large datasets could <a class="gtmContentClick" data-vars-link-text="reshape health care" data-vars-click-url="https://www.axios.com/pro/health-tech-deals/2026/03/26/health-care-ai-tools-assessment" data-vars-content-id="01610a3d-7732-4821-85a9-bbdce1ddaf22" data-vars-headline="Duke study: AI model detects ADHD in kids as young as 5" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/pro/health-tech-deals/2026/03/26/health-care-ai-tools-assessment" target="_self">reshape health care</a> in the coming decades.

The questions you should be asking your primary care provider — and why they matter

Patients with a primary care provider they trust have better health care outcomes.

Partners

<div data-sponsor-disclosure="&quot;{&quot;logoUrl&quot;:&quot;https://images.axios.com/4CJecxx3TgEaWLyJ9p7cy8u4iS0=/2026/03/25/1774474220755.png&quot;,&quot;headline&quot;:&quot;A message from: Amazon One Medical&quot;}&quot;"></div><div style="display:none"></div>Nearly half of Americans feel anxious before a doctor&#x27;s appointment — and most leave at least one question they forgot or didn&#x27;t feel comfortable asking.Here&#x27;s the deal: The relationship between a patient and their primary care provider (PCP) is one of the strongest predictors of long-term health.Studies show that patients with a PCP they trust have better health outcomes, lower hospitalization rates and higher satisfaction with their care, but the structure of most primary care visits makes that relationship difficult to organically build.

Axios Vitals

Axios Future of Health Care

A line chart that shows kindergartner vaccine exemption rates and the U.S. average from 2011-12 to 2025-26. The local rate rose from 0.6% to 3%, with faster gains after 2020. It remained below the national average each year, which increased from 1.6% to 4.2%.

North Carolina kindergartner vaccination exemptions

Data: CDC; Note: Data collection methods can vary from state to state; Brad Jennings/Axios

A line chart that shows North Carolina Affordable Care Act enrollment annually from 2019 to 2026. Enrollment rose from 501,271 in 2019 to a peak of 1,027,930 in 2024, then fell to 975,110 in 2025 and 761,457 in 2026. The trend climbs steadily through 2024, then reverses.

Affordable Care Act enrollment in North Carolina

Data: KFF; Note: Enhanced ACA subsidies began in 2021 and ended in 2025.; Chart: Zachery Eanes/Axios

Health 🩺

Vaccine exemptions keep rising in North Carolina

Alzheimer's drug gives Duke patients hope — and risks

Important nutritional research is being piloted through North Carolina's sewers

Some North Carolina schools still lack AEDs as lawmakers push bill

ACA enrollment in North Carolina plummets after subsidies expire