Texas is projected to add 10.4 million residents between 2025 and 2050, the most of any state, while Illinois is expected to lose 1.4 million, according to an Oct. 29 WalletHub LinkedIn post.
WalletHub’s figures compare 2050 projections from the University of Virginia’s Weldon Cooper Center for Public Service with 2025 U.S. Census Bureau population estimates. Overall, the U.S. population is projected to grow by about 28 million people during that period.
Growth is concentrated in the South and West, while much of the Midwest and Northeast is expected to shrink. That pattern could mean more pressure on hospitals and their workforces in fast-growing Sun Belt states. Florida, which ranked second, has already seen a wave of health system expansions in recent years, and hospitals there are competing heavily for growth. Systems in shrinking states could face declining patient volumes and fewer working-age residents to hire.
The Weldon Cooper Center also projects that adults 65 and older will make up 21.2% of the U.S. population by 2050, up from about 17% in 2020, according to the Census Bureau. An older population presents a dual challenge for hospitals and health systems: rising demand for more complex care, and worsening workforce shortages as more Americans retire.
Here are the 10 states projected to gain the most residents between 2025 and 2050, per WalletHub’s analysis:
1. Texas: 10.4 million
2. Florida: 7 million
3. North Carolina: 2 million
4. Georgia: 1.8 million
5. Washington: 1.6 million
6. Arizona: 1.5 million
7. Utah: 1.3 million
7. Colorado: 1.3 million
9. South Carolina: 1.2 million
10. Tennessee: 1.1 million
Here are the 10 states projected to lose the most residents between 2025 and 2050:
1. Illinois: -1.4 million
2. New York: -989,000
3. California: -760,000
4. Pennsylvania: -614,000
5. Michigan: -573,000
6. Ohio: -514,000
7. Louisiana: -343,000
8. Mississippi: -324,000
9. West Virginia: -289,000
10. Connecticut: -139,000
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