New North Dakota health study identifies economic and social disparities, offering opportunities to make North Dakotans healthier

Mental health, teen suicide and early childhood education gaps among growing concerns

FARGO, N.D. – Blue Cross Blue Shield of North Dakota (BCBSND) Caring Foundation, in conjunction with the Center for Social Research at North Dakota State University, today released a study on the “Health and Well-Being in North Dakota, 2022 – A Social Determinants of Health Perspective (SDOH).” The study offers insight into the state of the social determinants of health – the conditions in which people are born, grow, live, work and age – in North Dakota.

The study reveals several economic and social disparities in North Dakota that persist across age, education, income and racial background. Findings show that the average life expectancy for North Dakotans is 77, which is down from 79 just two years ago. In addition to shorter life spans, 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 15 years previous.

Insufficient early education programs and economic gaps are also among the risk factors impacting North Dakotans’ ability to thrive. 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. Many families are facing difficult choices between food, transportation, medical care and housing.

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, along with 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.”

The Center for Social Research, an applied social science research unit at North Dakota State University, was engaged to conduct the study. The SDOH categories used in the report are grouped into five domains, including economic stability, education, health care, physical environment, and social and community context.

“There is much more to a person’s health than medical care,” said Dr. 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 full study is available at To learn more about the Caring Foundation, visit  

About The Center for Social Research at NDSU
The Center for Social Research is a recognized, applied research institute at North Dakota State University focusing on interdisciplinary, socio-economic research relevant to North Dakota communities and its residents. The Center also is home to North Dakota Compass, a critical resource to support decision making in North Dakota by providing public and private stakeholders a curated source of objective and reliable demographic, economic, and public health data that bridges the gap between data-heavy sources and meaningful information.

About the Blue Cross Blue Shield of North Dakota (BCBSND) Caring Foundation
Established in 1989, the BCBSND Caring Foundation ( is a private 501(c)(3) charitable organization. Through giving and investing, the Caring Foundation focuses on key health issues that help improve the health and well-being of North Dakotans and their communities. Caring Foundation staff work with grantees to support nonprofit sustainability, collaborate on shared outcomes and create lasting change.