Come on, this will only take two minutes.

Look to your left and look to your right.

Recently, I had occasion to gather demographics and workforce data on the "Upper Midwest," i.e., Iowa, Nebraska, South Dakota, North Dakota, Minnesota and Wisconsin. We may look a lot alike in a flyover, but our six states have as many differences as similarities. For instance, the most populated, Wisconsin, has twice as many people as Iowa, three times that of Nebraska and seven times that of North Dakota. And yet, all four are expected to gain about the same number of new residents from 2020 to 2030.

Of greatest significance to the issue of health care access is the insufficient growth of the workforce in all of these statesand I am referring to potential workers for every industry, not just health care. All six face similar steep challenges in staffing their economies going forward, with the exception of Wisconsin, and it is exceptional not in a good way.

Throughout this decade, Wisconsin is projected to lose 111,000+ working age residents, while needing to fill nearly 31,000 additional health care jobs. Not to single out Wisconsin for shade throwing, Iowa is looking at nearly 28,000 more health care jobs, but a gain of only 6,600 additional workers to fill those 28,000 new jobs. Not nearly enough, by my reckoning. (And I can point to another source projecting Iowa's working age cohort will actually shrink by 40,000 from 2020 to 2030.)

The U.S. Census Bureau stopped making projections for individual states over 20 years ago. It's now up to each one to gather the data needed to make intelligent and actionable plans for the future. The good news is that updated projections based on the 2020 Census will be available very soon for the states who choose to know. Iowa has made a priority of having really solid data and projections (hats off to Gary Krob at the Iowa State Data Center for that). Over the coming weeks, I will be sharing what I learn about Iowa and our neighbors.

If you want to get your data geek on, I've made my spreadsheet of the six states available here: The Upper Midwest: A look ahead (May 15, 2024) Spoiler alert: The plight of Iowa's rural hospitals and nurses' salaries is especially disturbing and humiliating.

Just 30 seconds more.

We will either get our collective act together to overcome these barriers to health care access or continue to compete with each other for very limited resources. The latter will result in countless losers and lost lives. I vote for the former.

Where will you be when the music stops?

Jo has a fix for health care's supply chain crisis. If your organization wants to host a thought-provoking and informative program on the demographics of health care and how to prep for the perfect storm, click here for details about Bridges. Then contact Jo at to explore the possibilities.

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