Texas had the largest net gain of births over deaths among U.S. states between July 2024 and July 2025, while Pennsylvania had the largest net loss, according to an Aug. 13 LinkedIn post from WalletHub.
The ranking draws on U.S. Census Bureau Population Estimates and shows net natural population change. Positive values reflect more births than deaths, and negative values show more deaths than births.
U.S. population changes hold implications for healthcare leaders. The Congressional Budget Office predicts the number of deaths in the U.S. will exceed the annual number of births beginning in 2030. An older population presents a dual challenge for hospitals and health systems: increasing demand for more complex care and exacerbating workforce shortages as more Americans retire.
“The baby boomer generation at 65 is a lot different than they will be at 85 and older,” Terry Murphy, president and CEO of Dover, Del.-based Bayhealth, told Becker’s in December. “It’s a very large cohort of the national population, and it’s going to require a different type and intensity of care delivery in the communities across the country. There’s a lot more that needs to be done to ensure our communities are prepared from a geriatric or senior care perspective.”
Here are the top and bottom states for net change in natural population, along with their year-over-year increases:
Highest increases
- Texas: 158,000
- California: 110,000
- New York: 43,000
- Georgia: 29,000
- New Jersey: 26,000
- Utah: 25,000
- Colorado: 21,000
- Washington: 17,000
- North Carolina: 15,000
- Virginia: 14,000
Highest decreases
- Pennsylvania: -11,000
- West Virginia: -8,000
- Michigan: -5,000
- Maine: -5,000
- Oregon: -4,000
- Mississippi: -3,000
- Alabama: -2,000
- New Mexico: -2,000
- New Hampshire: -2,000
- Vermont: -2,000
