Population and demographic trends are important to the ACHIEVE initiative. With growth and population migration into Whatcom County in the 1990s and early 2000s, housing prices rose in more urban areas, increasing the number of households with lower incomes seeking housing in rural areas. Nationally, increased driving times and distances to physical activity and nutrition resources impact health outcomes, and the trends are reflected in Whatcom County where people with lower incomes, less education, and those who live in rural areas have higher rates of chronic disease and related indicators of health risks, such as obesity.

Whatcom County is located in the furthest northwest corner of Washington State and is the furthest northwest county in the continental United States. It is the twelfth largest county in Washington State and is bordered by British Columbia, Canada to the north, North Cascades National Park and Okanogan County to the east, the Strait of Georgia and Puget Sound to the west, and Skagit County to the south.  Whatcom is situated almost equidistant between two international, metropolitan cities (Seattle and Vancouver, British Columbia). 

According to the Washington Office of Financial Management's April 2009 data, the population of Whatcom County is 193,100. Its largest city, Bellingham, has a population of 76,130. Additionally, there are six small cities and towns: Lynden (11,350), Ferndale (11,080), Blaine (4,740), Everson (2,285), Nooksack (1,163), and Sumas (1,326). Unincorporated areas of the county that have significant populations centers are commonly known as the Foothills, Birch Bay, and Lummi Island.  Whatcom County has 90.12 people per square mile. The average population growth rate over the previous eight years has been 13.5 percent; slightly higher than the 11.1 percent average growth rate for Washington State.  Whatcom County is projected to grow at a rate of 7.7 percent for the next five years.

Prior to white settlement, the Lummi, Nooksack, and other Coast Salish tribes lived in the area now known as Whatcom County, and the Lummi Nation and Nooksack Tribe are now federally-recognized tribal peoples. According to the Bureau of the Census, 90.2 percent of Whatcom County residents are U.S. native born and 9.8 percent are foreign born. Nearly 85 percent of the population is non-Hispanic white, 6.7 percent is of Hispanic or Latino ancestry, 3.7 percent are of Asian ancestry, 2.9 percent of county residents are Native American or Native Alaskan, 2.4 percent of the population identifies with two or more races, and 1.1 percent are black. English is the primary language used in Whatcom County, with Spanish, Russian, and other languages being spoken by nearly 10 percent of the population.

According to the Census Bureau, 15.1 percent of Whatcom County residents live below the federal poverty level, higher than the Washington State average of 11.1 percent.  In total, 41.8 percent of children in the county's public schools qualify for reduced or free lunches, but the range (from 4% to over 73%)  illustrates that there are significant income disparities between certain neighborhoods and between rural and urban areas.
 
Significant disparities in health status and chronic diseases are exhibited in populations affected by socio-economic factors  including residing in a rural area, having low income, and being less educated, as well as minority or underrepresented populations. Chronic diseases associated with being overweight and physical inactivity are among the leading sources of morbidity and mortality in Whatcom County in adults. Since 1996, the obesity rate in adults has risen from 13 percent to 26 percent. Sixty percent of adults are now overweight or obese. Diabetes rates have doubled from three to six percent. Additionally, youth with poor nutrition or physical inactivity also exhibit lesser health outcomes. At least 25 percent of Whatcom County eighth graders are overweight or at risk of being overweight, 51 percent of tenth graders have no days in a physical education class, and only 31 percent of twelfth graders get the recommended 30 minutes of physical activity five days a week.

Most troubling are rates of obesity, chronic disease, and poor physical health in low- and middle-income populations. Thirty-six percent of adults living in households with income less than $20,000 per year are obese, compared with 23 percent of those with income over $50,000. Ten percent of adults in the lowest income bracket have been diagnosed with diabetes, compared with four percent of those at the highest income levels. The proportion of individuals with fair or poor health status increases significantly from four percent in households with annual income over $50,000 up to 41 percent in households with income under $20,000. Currently, nearly 15 percent of county residents live below the federal poverty level, with up to a quarter of residents in some Bellingham zip codes and outlying rural areas at the lowest income levels. In a county with per capita income below the national average, many other families live in middle income ranges that are also associated with less than optimal health status.