While a recent report from the University of North Dakota indicates the health of North Dakotans has been improving, another newly released report indicates economic and social disparities persist when it comes to health and well-being.

“Prior to the pandemic, North Dakota was showing varied trends in health behaviors, with improvements being seen in areas over time that suggested positive behavior changes,” said Mandi Leigh Peterson, senior research analyst with UND’s Center for Rural Health and lead author for the “Seventh Biennial Report on Health Issues for the State of North Dakota.”

“And according to national data, North Dakotans now are more likely to report good general health compared to the U.S,” she said. For example, the percentage of survey respondents who report smoking, binge drinking, and drinking and driving are all down relative to 2019, according to the report. Up in the past few years is the percentage of North Dakotans who wear a seatbelt regularly.

Accordingly, the percentage of North Dakotans who report merely fair or poor health is down nearly two percentage points since 2019.

However, life expectancy has declined, according to another study, “Health and Well-Being in North Dakota 2022,” by Blue Cross Blue Shield of North Dakota Caring Foundation, in conjunction with the Center for Social Research at North Dakota State University. That study found the average life expectancy for North Dakotans is 77, which is down from 79 two years ago. In addition, rates of poor mental health are on the rise. One in five North Dakota high school students seriously considered suicide in 2021, up from one in 10 in data from 15 years ago.

Insufficient early education programs and economic gaps are also among the risk factors impacting North Dakotans’ ability to thrive, the study reported. North Dakota has the lowest percentage of young children enrolled in early learning programs nationwide, and most of the state’s third graders do not read proficiently. Nearly 80,000 North Dakotans are living in poverty and another 107,564 live very near poverty.

These trends are among the comprehensive study findings that will provide a compass as the Caring Foundation, the Community Engagement Unit, North Dakota Health and Human Services and other leaders from across the state convene through a series of discussions in Bismarck and Fargo this month to understand the causes and solutions to help address these challenges.

“Gaining insight into North Dakota’s social determinants of health will help us identify barriers that impact people’s health,” said Dan Conrad, Caring Foundation board chair and BCBSND president and CEO. “Our hope is that the report will lead to greater collaboration and alignment among government, industry, academia and community organizations as we work to elevate the state of health in North Dakota.”

“There is much more to a person’s health than medical care,” said Nancy Hodur, director at the Center for Social Research. “The circumstances and conditions in which people live and work have a substantial impact on health and well-being. Recognizing the importance of social considerations and taking a comprehensive approach that incorporates quality of life considerations and social disparities is necessary to advance health and well-being in North Dakota.”

The biennial report released by the UND School of Medicine & Health Sciences also cited issues in the state related to healthcare workforce.

“It goes without saying that COVID put our state’s health and healthcare system to the test over the past two years,” said Joshua Wynne, dean of the medical school. “Not only in how it affected our population and its access to care, but our healthcare workforce.”

For a state already grappling with not only a shortage of healthcare providers but a maldistribution of those providers, said Wynne, COVID hit many rural hospitals and clinics especially hard. As the report notes, the pandemic exacerbated “burnout” across health professions, resulting in early retirements and resignations among some providers – thus a greater shortage overall – at the same time as it increased workloads for those physicians, nurses, and therapists who remained in their professions.

The need for healthcare workers is particularly important in rural and western parts of North Dakota, where there has been a chronic shortage especially of primary care providers for many decades, notes the report’s executive summary.

“Without direct intervention, the difficulty of providing adequate healthcare in North Dakota will worsen over the coming decades from the aging of the population (including aging and eventual retirement of the healthcare workforce) which will increase the demand for healthcare services in those areas,” the report stated.

Even so, the healthcare workforce news is generally good for North Dakota, Peterson said.

“North Dakota’s efforts to train our own appears to be working,” she said. “In previous reports, North Dakota has had fewer physicians per capita than our Midwest and U.S. peers. While this still holds true, we have narrowed the gap in the provider-to-population ratios. Another area where we’re going in the right direction is that we’ve seen an increase in the number of health professionals in the state. The number of in-state graduates practicing in the state has gone up as well.”