For Your Health
For Your Health

News from the University of North Dakota School of Medicine & Health Sciences

SMHS Advisory Council publishes Sixth Biennial Report on health in North Dakota

The UND School of Medicine & Health Sciences (SMHS) Advisory Council, a legislatively mandated group of 16 stakeholders connected to North Dakota’s health care enterprise, has published the School’s Sixth Biennial Report: Health Issues for the State of North Dakota.

Highlights from the Report include:

  • Although North Dakotans have a lower prevalence of diabetes than the rest of the U.S., and are less likely to report fair or poor health, they have a higher risk of certain cancers and a mortality rate that exceeds the national average.
  • Behavioral risks tend to increase as population density decreases; rural areas have the worst behavioral risk, with an increased frequency of obesity, smoking, and drinking, especially in males.
  • North Dakota is tied for fourth in the country in the percentage of its state population 85 years of age or older. Because demand for health care increases with age, demand for services of all types is especially pronounced in the state. Likewise, many diseases of older age such as Alzheimer’s and dementia are more common in North Dakota than other states.
  • North Dakota has fewer rural physicians per 10,000 residents than the United States as a whole, but more primary care physicians on average. Our physicians are older and more likely to be male than elsewhere in the U.S. Also, North Dakota has the lowest number of residency slots per medical school student in the country, meaning fewer residents on a proportional basis than any other state.
  • While North Dakota has a lower percentage of uninsured people than America as a whole, the rates of non-insurance climb for persons living in rural areas and on American Indian reservations.
  • A majority of hospital nurses are licensed practical nurses (LPNs) or registered nurses (RNs). A majority of RNs and LPNs were trained in-state, with a majority working in an in-patient setting. A majority of nurse practitioners were trained in North Dakota with a majority working in primary care.

Healthcare in North Dakota is delivered through more than 300 ambulatory care clinics, 52 hospitals, 80 skilled-nursing facilities, 68 basic-care Facilities, and 72 assisted-living facilities, supported by an array of emergency medical services (EMS) providers, trauma centers, 28 public health units, oral health providers, behavioral health providers, and pharmacies. Generally, the further a facility is from a metropolitan area, the more its operation is threatened by financial and other pressures, including staff recruitment and retention. Rural health organizations tend to be small in size but have a significant impact on both the health of individuals and the economic base of the community in which they are situated.

The Sixth Biennial Report: Health Issues for the State of North Dakota, updates the previous five editions with a comprehensive examination of healthcare workforce licensure data. Data were gathered in January 2020 and examined number of licensed professionals, locations, specialties, and demographics. A secondary scan of the data of this informed a new chapter on social determinants of health which serves to tie the population and socioeconomic influences of the state on health outcomes. The statewide problem of unmet mental and behavioral health needs, especially related to the ongoing opioid abuse issue, is highlighted in the current Report.

The School’s First Biennial Report was published by the Advisory Council in 2011 to coincide with the state’s 62nd Legislative Assembly. The primary stimulus for the preparation of the Report was a revision in the North Dakota Century Code (NDCC) in 2009 by the 61st Legislative Assembly in which the duties of the SMHS Advisory Council were modified.

The full Report can be read online at