Urgently Needed: Equity Tools to Navigate Demographic Gale-Force Wind Gusts

Abstract

Gale-force demographic disruptors such as unequal population growth can potentially prevent our state from achieving the exemplary goals and targeted outcomes set forth in Healthy North Carolina 2030. These forces also present opportunities if carefuly addressed. Policy prescriptions and strategic investments required to ensure success are outlined here, following an overview of demographic drivers that create public health vulnerabilities.

Confronting the Nursing Profession’s Workforce Challenges: Embracing Iceberg Demographics

“…The mixed-race population in the US stands out as one of the nation's most rapidly expanding demographic groups, growing by 33.8 million (276%) between 2010 and 2020 (Parker et al, 2015; Rico et al, 2023). In contrast, during this period the overall U.S. population grew by 7.4%, an absolute increase of 22.7 million people (Johnson, Bonds, & Parnell, 2021). Notably, during the COVID-19 pandemic, while the total population of the U.S. increased by a modest 1.8 million (0.5%), the nation's mixed-race population grew by 406,548 people (5%; Johnson, Bonds, & Parnell, 2021).…”

“…In contrast, during this period the overall U.S. population grew by 7.4%, an absolute increase of 22.7 million people (Johnson, Bonds, & Parnell, 2021). Notably, during the COVID-19 pandemic, while the total population of the U.S. increased by a modest 1.8 million (0.5%), the nation's mixed-race population grew by 406,548 people (5%; Johnson, Bonds, & Parnell, 2021). Contributing to the ongoing demographic transformation, often referred to as the “browning” of America, mixed-race population growth is driven primarily by immigration of individuals from Asia, Latin America, and the Middle East, coupled with intermarriage between individuals from various countries in these regions and White and Black people, and other native-born people of color descent, already in the US (Parker et al, 2015; Rico et al, 2023).…”

“…To be successful in talent acquisition and retention in a labor market that is both browning (becoming more racially and ethnically diverse) and graying (aging due to extended longevity and declining fertility; Johnson, 2023; Johnson, Bonds, & Parnell, 2021), it is imperative that the nursing industry undergoes a substantial overhaul of Human Resources (HR) policies and practices to instill within the current employee pool a strong sense of inclusion and belonging in the workplace (Argo & Sheikh, 2023). Popularly stated, the nursing profession must strive to create workplaces where employees feel that they have been personally invited to the dance and the disk jockey is playing the music perfectly attuned to their preferences.…”

“…Figure 1 depicts iceberg demographic indicators prevalent in the U.S. working-age population. Given the forecasted continued deceleration in total U.S. total population growth and non-Hispanic white population decline coupled with other disruptive demographic shifts, including premature deaths of despair among prime working-age individuals (Johnson, Bonds, & Parnell, 2021; Case & Deaton, 2020), embracing and accommodating these and other iceberg identities is a strategic imperative for the nursing profession (Alexander & Johnson, 2021).…”