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It’s a Great Time to be in North Dakota
Last month the coronavirus hit nationwide, affecting all 50 states. The day after Census 2020 forms started arriving at each household’s mailbox, the president declared a “National Health Emergency.” Shortly thereafter every state instituted their own Emergency Operations Centers (EOC) and best practices.

In his news conference upon opening the state’s EOC, Gov. Doug Burgum mentioned that in a pandemic, North Dakota is probably one of the best places in the nation to be. The demographics and select social characteristics strongly support this assertion. No population is completely safe from this pandemic, but comparatively speaking, it’s a great time to be a resident of North Dakota! It is now that we can take stock of what we have in this great state, and why we can be thankful to reside here.
A Younger Population at Lower Risk
Numerous news reports have pointed to a higher mortality rate for older populations. This is one area in which North Dakota appears to have an advantage. The most recent data available shows North Dakota is the fourth-youngest state.

As COVID-19 appears to affect older individuals to far greater degree than younger ones, the overall youth of our population is in our favor. This means the smaller portion of the population that is in that age range is less impacted to our overall population than that of other states.

Nationally, a total of 16% of the population is age 65 or older. 
In North Dakota, the percentage is slightly less at 15.3% of the population falling into this age range. Only six states have a smaller percentage of their populations in this age range.

According to data from the 2018 population estimate, Utah had the lowest percentage of 65 or older residents at 11.1%. Utah was followed by Alaska, Texas, Georgia, Colorado and California.

At the opposite end of the scale, 20.6%, or one in five of Maine's population was age 65 or over. Maine was followed by Florida at 20.5% and West Virginia at 19.9%.


North Dakota’s population is far younger than that of Italy's, which is considered to be the second-oldest nation in the world. The small percentage of older individuals in North Dakota means that there are fewer individuals likely at risk.

The chart below shows the distribution by age and sex of the population of North Dakota and of Italy.
Italy has often been used as an example of what could happen if the U.S. does not respond immediately to take those necessary steps to reduce the spread of COVID-19. Most news reports on the coronavirus impact in Italy was a result of a lack of a response to the virus. However, its demographics also explain why Italy is likely more vulnerable than the U.S. and especially, North Dakota.

Compared to the U.S., Italy is much older. According to populationpyramid.net, the median age in Italy appears to be 45.8 years of age in 2019 compared to 38.2 in the U.S. Italy has the second-highest percentage of its population age 65 and older of the 194 largest countries after Japan. For comparison, the United States is ranked 37th
.

Another factor related to age in the state is the distribution of the state’s older residents. In the more urban areas of the state, the population of individuals ages 65 plus tends to be lower. For example, in our states’ largest populated county, Cass County, the percentage of individuals age 65 plus was is only 12%.

For Grand Forks County and Ward County, the percentage is 13%. Of the four major counties, only Burleigh, at 16%, exceeds the state's average. Of course, there can be some fluctuation because these counties also consists of cities with highly populated college towns.

Conversely, in the more rural areas, with greater distance between individuals, the percentages tends to be much higher. For example, in McIntosh County, 31% of the population was made up of individuals age 65 plus in 2018.
It’s a Great Time to Have Wide-Open Spaces

Italy’s percentage of urban population is about 70%, somewhat less than that of the U.S.’s 83%. Compared to Italy and the U.S. as a whole, North Dakota is far less densely populated with just 10 persons per square mile. In fact, of the 50 states, North Dakota is the fourth least densely populated. Given that COVID-19 is spread person to person, our more sparsely populated area appears to be a characteristic that is in our favor. Population density may also be a factor in the spread of the disease, based upon news reports. Italy has a population density of 501 persons per square mile compared to the U.S. overall density of 13.8 persons per square mile.
Population Density – Fewer People per Square Mile
The most recent measurement of individuals in urban and rural areas was during Census 2010. In that Census, 46% of the state’s population was in areas of the state considered to be rural.

As this article is being written, New York City has become the epicenter of COVID-19 outbreaks in the U.S. The city of New York had an estimated 8,400,000 residents in 2018 and 302 square miles of land. That gives it a population density of just under 28,000 individuals per square mile. An estimated 95% of its housing consists of multi-family units of more than five units per complex, with the vast majority of housing in the city consisting in buildings of 20 or more units.

By comparison, North Dakota’s most populous city, Fargo, has just under 125,000 residents and an area of nearly 49 square miles, giving it a population density of 2,200 person per square mile. An estimated 49% of housing in Fargo consists of multi-family units of not less than five units per complex. 
Bismarck, the state’s capital city, has just over 73,000 residents and an area of 31 square miles, given it a population density of about 2,000 persons per square mile. An estimated 32% of housing consists of multi-family units of more than five unit per complex.

Another way of looking at it is, an area that would hold 100 individuals in New York City would be filled by only eight individuals in Fargo and seven in Bismarck. Most other cities in North Dakota tend to have fewer individuals. For more rural areas, the distance between households and individuals is even greater.

North Dakota’s most densely populated city is actually one of the state’s smallest cities. Fort Yates is estimated to have a population density of 3,100 residences per square mile, yet has only an estimated population as of 2018 of 184. Fort Yates’ high density is driven by its small size of just .06 square miles of land. When areas just outside of the city boundaries of Fort Yates are included, the density drops considerably.
More Single-Family Housing Here
Related to population density is housing. As of 2015, only 22% of housing in Italy was made up of detached family units with a majority of the remaining made up of multi-family housing. That compares to nearly 69% in the U.S. and 65% in North Dakota during 2014-2018. Only in Cass and Grand Forks counties is the percentage of single-family housing (detached or single attached) less than 50% of the total housing. The lower percentage in these two counties is likely driven by the higher populations of college-age residents attending North Dakota State University or University of North Dakota. In all other counties in the state, at least 50% of housing is made up of single-family structures. This percentage ranges as high as 90% in some of the state's more rural counties. Single family housing constituted 90% of all housing in Steele and Hettinger counties.
Highest Percentage of Householders Living Alone of Any State
Another strength that North Dakota appears to have in this crisis is the percentage of householders living alone. Nationwide, 28% of householders live alone. North Dakota had the highest percentage of any state at 31% during the timeframe 2014-2018 making “social distancing" a bit easier to accomplish for many of our residents. North Dakota was followed by Rhode Island, Montana, New Mexico, Ohio and Louisiana all tied for 30%. On the other end of the scale, only 24% of the population of California and Hawaii lived alone.

Forty-two of the state’s 53 counties had a higher percentage of householders residing alone than was found nationally. The estimate for some counties in North Dakota was substantially higher than the national average for the percentage of individuals living alone. In Nelson County, for example, an estimated 39% of householders reside alone. No county has less than 20% of householders residing alone. The lowest percent was Sioux at 21%, followed by Oliver at 23%. None of the state’s four largest population counties had a percentage of householders residing alone lower than the national average.
Healthcare Insurance Coverage
North Dakota ranks 20th of the 50 states in the percentage of population that has health care insurance. This compares to 90.6% nationally. 
Another area in which North Dakota residents have an advantage is in health insurance coverage. Presumably, individuals with healthcare insurance are more likely to see a doctor when they are ill. During the timeframe from 2014-2018, the most recent time for which data is available, an estimated 92.6% had health insurance.
Of the state’s 53 counties, 42 have a health care insurance rate higher than the national average. In Slope County, an estimate 98% of residents have health care insurance. Slope was followed by Logan at just under 98% and Ransom and Wells at 97% coverage.
Of the 11 counties in which the health care insurance rates were less than the national average, three (Benson, Mountrail and Sioux) had a high percentage of their populations eligible for care from Indian Health Services, a non-insurance program.
Have you heard? Be a part of the COVID-19 solution in North Dakota and download the NEW Care19 app at belegendary.link/Care19. The app is live now on the Apple App Store for iOS and will be released soon on Google Play for Android devices!
Fill out your Census today!
Sources:  Italy's Istituto Nazionale di Statistica (the nation’s equivalent of the U..S Census Bureau), https://ec.europa.eu/commission/presscorner/detail/en/STAT_09_95  Census Bureau ACS 2014 – 2018, 5-Yr Tables DP04, S1101, S1201 ,S2504 and S2701.
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