There were 3,664,292 births recorded in the United States in 2021.  The Mid-Eastern U.S., a region that encompasses the District of Columbia and five states, recorded 532,288 births in 2021, or about 14.5% of the national total.  With 10.67 births per 1,000 population, the Mid-Eastern U.S. regional birth rate was 3.4% below the 2021 national average birth rate of 11.04 births per 1,000 population.  Only New England recorded a lower regional birth rate in 2021 than did the Mid-Eastern region. A deeper examination of data from the National Center for Health Statistics details the following about birth rates in the Mid-Eastern U.S. region:

Birth Rates in the Mid-Eastern U.S

Area Name	Births	Population	Birth Rate*
Delaware	10,482	1,003,384	10.45
District of Columbia	8,660	670,050	12.92
Maryland	68,285	6,165,129	11.08
New Jersey	101,497	9,267,130	10.95
New York	210,742	19,835,913	10.62
Pennsylvania	132,622	12,964,056	10.23
Region	532,288	49,905,662	10.67
U.S.	3,664,292	331,893,745	11.04

(*) number of births per 1,000 population

Report Period: 2021

Source: CDC Wonder. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. Data are from the Natality Records 2016-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed on June 24, 2023

More than half of medical assistants in the U.S. work in physician offices, but large numbers are also found working in hospitals, ambulatory care centers, assisted living facilities, and offices of other types of healthcare practitioners. The U.S. Bureau of Labor Statistics (BLS) estimated that, as of May 2022, nearly 752,500 medical assistants were employed in the United States. According to BLS data from May 2022, the annual mean wage for medical assistants was $40,700. The profession's median annual wage, which separates the bottom and upper half of the wage scale, was $38,270.  From region to region, there was wide variation in medical assistants' mean annual wages, with medical assistants in some regions of the country earning 50% or more than their counterparts elsewhere. This variation is readily seen in BLS data for the nation's top 25 metropolitan areas, home to about 43% of all medical assistant jobs, which reveals the following about medical assistant average pay in the top 25 U.S. metro markets as of May 2022:

Medical Assistant Average Pay in the Top 25 U.S. Metro Markets

	Metropolitan Area		Median Annual Wage	Mean Annual Wage
1	New York-Newark-Jersey City		$44,420	$44,390
2	Los Angeles-Long Beach-Anaheim		$39,310	$43,880
3	Chicago-Naperville-Elgin		$41,970	$42,100
4	Dallas-Fort Worth-Arlington		$38,120	$38,930
5	Houston-The Woodlands-Sugar Land		$37,630	$38,770
6	Washington-Arlington-Alexandria		$44,680	$44,530
7	Philadelphia-Camden-Wilmington		$39,540	$41,520
8	Miami-Fort Lauderdale-Pompano Beach		$37,560	$39,010
9	Atlanta-Sandy Springs-Alpharetta		$37,590	$39,240
10	Boston-Cambridge-Newton		$46,720	$47,730
11	Phoenix-Mesa-Chandler		$40,080	$41,490
12	San Francisco-Oakland-Berkeley		$58,630	$58,710
13	Riverside-San Bernardino-Ontario		$37,320	$41,020
14	Detroit-Warren-Dearborn		$36,780	$37,120
15	Seattle-Tacoma-Bellevue		$52,620	$54,010
16	Minneapolis-St. Paul-Bloomington		$48,850	$48,420
17	San Diego-Chula Vista-Carlsbad		$43,890	$44,960
18	Tampa-St. Petersburg-Clearwater		$36,970	$37,750
19	Denver-Aurora-Lakewood		$45,530	$46,010
20	Baltimore-Columbia-Towson		$39,900	$41,310
21	St. Louis, MO-IL		$37,620	$38,190
22	Orlando-Kissimmee-Sanford		$35,720	$37,130
23	Charlotte-Concord-Gastonia		$39,070	$39,980
24	San Antonio-New Braunfels		$36,260	$35,920
25	Portland-Vancouver-Hillsboro		$47,910	$48,570
	National		$38,270	$40,700

Report Period:  May 2022
Top 25 U.S. Metro Areas from the 2020 Census
Source: U.S. Bureau of Labor Occupational Statistics
Data extracted on June 24, 2023

In 2021, approximately 3,664,300 births were recorded in the United States.  The seven-state Great Plains region registered 251,508 births in 2021, or about 6.9% of total births in the U.S. that year.  With 11.62 births per 1,000 population, the Great Plains' regional birth rate was nearly 5.3% higher than the national average birth rate.  Moreover, all seven states in the region recorded a birth rate in 2021 that was above the national average of 11.04 births per 1,000 population.  Three states in the region (Nebraska, North Dakota, and South Dakota) experienced 2021 birth rates that topped the national average by more than 13%. An additional review of data from the National Center for Health Statistics provides the following state-level details about birth rates in the Great Plains region:

Birth Rates in the Great Plains Region

Area Name	Births	Population	Birth Rate*
Iowa	36,835	3,193,079	11.54
Kansas	34,705	2,934,582	11.83
Minnesota	64,425	5,707,390	11.29
Missouri	69,453	6,168,187	11.26
Nebraska	24,609	1,963,692	12.53
North Dakota	10,112	774,948	13.05
South Dakota	11,369	895,376	12.70
Region	251,508	21,637,254	11.62
U.S.	3,664,292	331,893,745	11.04

(*) number of births per 1,000 population

Report Period: 2021

Source: CDC Wonder. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. Data are from the Natality Records 2016-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed on June 24, 2023

There were approximately 101,000 family physicians working in the U.S. as of May 2022 according to data from the U.S. Bureau of Labor Statistics (BLS). Most family physicians are employed at physician offices, but smaller numbers can be found working in hospitals, ambulatory care centers, educational institutions, and local government entities. Like many other health professionals with advanced degrees, family physicians earn higher salaries than American workers in most other occupations. As of May 2022, the BLS reported that the national mean salary for family physicians was $224,460 annually. The median annual wage, which divides the lower and upper half of earners on the wage scale, for family physicians was $211,300 as of May 2022.  Pay for family physicians varies widely from region to region, with practitioners in some states making 50% or more than what their counterparts earn elsewhere. This wage variation is readily visible in BLS data from May 2022, which shows the following wide disparity in family physician average pay in the top 25 metro areas of the U.S.:

Family Physician Average Pay in the Top 25 U.S. Metro Areas

	Metropolitan Area		Median Annual Wage	Mean Annual Wage
1	New York-Newark-Jersey City		$177,210	$179,210
2	Los Angeles-Long Beach-Anaheim		$221,230	$224,930
3	Chicago-Naperville-Elgin		$80,000	$147,810
4	Dallas-Fort Worth-Arlington		$201,620	$229,850
5	Houston-The Woodlands-Sugar Land		---	---
6	Washington-Arlington-Alexandria		$215,000	$223,270
7	Philadelphia-Camden-Wilmington		$218,240	$233,860
8	Miami-Fort Lauderdale-Pompano Beach		$222,210	$224,350
9	Atlanta-Sandy Springs-Alpharetta		$221,370	$280,740
10	Boston-Cambridge-Newton		$210,810	$250,940
11	Phoenix-Mesa-Chandler		$220,110	$232,750
12	San Francisco-Oakland-Berkeley		---	$278,260
13	Riverside-San Bernardino-Ontario		$209,240	$220,900
14	Detroit-Warren-Dearborn		$131,780	$167,660
15	Seattle-Tacoma-Bellevue		---	$223,710
16	Minneapolis-St. Paul-Bloomington		$169,100	$193,500
17	San Diego-Chula Vista-Carlsbad		$225,850	$238,020
18	Tampa-St. Petersburg-Clearwater		---	---
19	Denver-Aurora-Lakewood		$210,100	$205,480
20	Baltimore-Columbia-Towson		$224,360	$242,010
21	St. Louis, MO-IL		$227,250	$257,020
22	Orlando-Kissimmee-Sanford		$211,030	$244,850
23	Charlotte-Concord-Gastonia		$217,200	$253,870
24	San Antonio-New Braunfels		$214,460	$277,540
25	Portland-Vancouver-Hillsboro		$213,830	$205,790
	National		$211,300	$224,460

Report Period:  May 2022
Top 25 U.S. Metro Areas from the 2020 Census
Source: U.S. Bureau of Labor Occupational Statistics
Data extracted on June 24, 2023

In 2021, there were nearly 3,664,300 births in the United States.  The five-state Great Lakes region recorded 508,687 births in 2021, or about 13.9% of all births in the U.S. that year.  With 10.78 births per 1,000 population, the Great Lakes' regional birth rate was about 2.4% lower than the national average birth rate.  Only one state in the region, Indiana, registered a birth rate in 2021 that exceeded the U.S. national average of 11.04 births per 1,000 population.  Further examination of state-level data from the National Center for Health Statistics, a unit of the CDC, provides the following details about birth rates in the Great Lakes region:

Birth Rates in the Great Lakes Region

Area Name	Births	Population	Birth Rate*
Illinois	132,189	12,671,469	10.43
Indiana	79,946	6,805,985	11.75
Michigan	104,980	10,050,811	10.44
Ohio	129,791	11,780,017	11.02
Wisconsin	61,781	5,895,908	10.48
Region	508,687	47,204,190	10.78
U.S.	3,664,292	331,893,745	11.04

(*) number of births per 1,000 population

Report Period: 2021

Source: CDC Wonder. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Natality on CDC WONDER Online Database. Data are from the Natality Records 2016-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed on June 24, 2023

The most recent U.S. Bureau of Labor Statistics (BLS) occupational reports estimated that there were approximately 95,440 paramedics working in the U.S. as of May 2022.  Paramedics mostly work for local government agencies and ambulance service providers, with smaller numbers employed in hospital environments or elsewhere. Paramedics earn more modest salaries and wages than workers in many other healthcare occupations.  According to BLS data, as of May 2022, the national mean wage for paramedics was $53,560 annually, while the national median wage level was $49,090 annually. BLS data indicated that about one-third of all U.S. paramedic jobs as of May 2022 were in the top 25 metro areas. Pay for the profession varied widely from region to region, with paramedics in some areas making 50% or more annually than their counterparts elsewhere. The wide average pay disparity was evident in the largest U.S. metro areas, with paramedics earning annual mean wages below $50,000 in five of the top 25 metro areas, while in eleven other top 25 metro areas, the paramedic annual mean wage topped $65,000.  A closer examination of May 2022 federal data revealed the following about paramedic average pay in the top 25 U.S. metropolitan areas:

Paramedic Average Pay in the Top 25 U.S. Metropolitan Areas

	Metropolitan Area		Median Annual Wage	Mean Annual Wage
1	New York-Newark-Jersey City		$65,820	$69,200
2	Los Angeles-Long Beach-Anaheim		$61,400	$70,930
3	Chicago-Naperville-Elgin		$50,010	$67,050
4	Dallas-Fort Worth-Arlington		$50,840	$54,530
5	Houston-The Woodlands-Sugar Land		$48,920	$49,120
6	Washington-Arlington-Alexandria		$66,410	$66,570
7	Philadelphia-Camden-Wilmington		$61,820	$63,790
8	Miami-Fort Lauderdale-Pompano Beach		$48,380	$58,230
9	Atlanta-Sandy Springs-Alpharetta		$49,740	$50,380
10	Boston-Cambridge-Newton		$61,450	$65,200
11	Phoenix-Mesa-Chandler		$47,750	$49,450
12	San Francisco-Oakland-Berkeley		$71,810	$89,950
13	Riverside-San Bernardino-Ontario		$60,140	$66,840
14	Detroit-Warren-Dearborn		$48,540	$50,390
15	Seattle-Tacoma-Bellevue		$106,900	$106,790
16	Minneapolis-St. Paul-Bloomington		$63,490	$66,440
17	San Diego-Chula Vista-Carlsbad		$63,680	$70,330
18	Tampa-St. Petersburg-Clearwater		$45,690	$51,170
19	Denver-Aurora-Lakewood		$56,750	$56,480
20	Baltimore-Columbia-Towson		$63,740	$64,220
21	St. Louis, MO-IL		$46,680	$47,780
22	Orlando-Kissimmee-Sanford		$46,790	$50,980
23	Charlotte-Concord-Gastonia		$47,170	$49,190
24	San Antonio-New Braunfels		$47,210	$48,030
25	Portland-Vancouver-Hillsboro		$66,420	$79,990
	National		$49,090	$53,560

Report Period:  May 2022
Top 25 U.S. Metro Areas from the 2020 Census
Source: U.S. Bureau of Labor Occupational Statistics
Data extracted on June 19, 2023

Medicare Advantage (MA) Plans can be a great value compared to traditional Medicare, thanks to added benefits and typically lower premium costs.  Managed care cost control protocols notwithstanding, Medicare-eligible seniors continue to gravitate to the better value MA plans offer.  In roughly more than six-and-one-half years, from October 2016 through May 2023, the market share of MA plans across the U.S. has grown from under 31% of Medicare-eligible Americans to 48%.

The growing popularity of Medicare Advantage plans nationally is mirrored in every region of the U.S.  Here is a more detailed breakdown of Medicare Advantage market share by region (for state-by-state details, follow the "region" link in the table below):

Medicare Advantage Market Share by Region

	Medicare Eligible (1)			MA Enrollment (1)			% MA Market Share
Region	May-23	Oct-16		May-23	Oct-16		May-23	Oct-16
FrWest	10,100.1	8,679.3		4,954.8	3,286.1		49.1%	37.9%
GLakes	9,604.2	8,553.3		4,647.9	2,469.4		48.4%	28.9%
MidEst	9,828.7	8,804.9		4,367.8	2,639.5		44.4%	30.0%
NwEng	3,236.3	2,828.4		1,305.9	608.8		40.3%	21.5%
Plains	4,348.0	3,814.1		1,802.7	722.0		41.5%	18.9%
Rockies	2,200.1	1,792.5		985.3	536.0		44.8%	29.9%
SE	17,985.3	15,539.5		9,049.7	4,774.8		50.3%	30.7%
SW	7,261.9	6,050.2		3,595.5	1,879.8		49.5%	31.1%
Total(2)	65,390.9	56,888.7		31,362.0	17,489.5		48.0%	30.7%

(1) in thousands

(2) includes U.S. territories

Source:  Medicare Monthly Enrollment Reports

There were 167,720 EMTs (emergency medical technicians) employed in the U.S. as of May 2022 according to U.S. Bureau of Labor Statistics (BLS) reports.  EMTs mostly work for local government agencies, ambulatory healthcare service providers, and hospitals. Emergency medical technicians usually earn lower wages than many other healthcare workers.  Recently published BLS data estimated that, as of May 2022, the mean wage for EMTs in the U.S. was $40,120 per year.  The median annual wage level that divides the top half of the wage scale for emergency medical technicians from the lower half was $36,680. Pay for the profession varies widely from region to region, with EMTs in some parts of the country making substantially more annually than their peers elsewhere. In the top 25 U.S. metropolitan areas, which accounted for 38% of all EMT employment, the mean annual wage ranged from less than $35,000 in the San Antonio metro area to nearly $60,000 in the Washington D.C. area.  A deeper dive into May 2022 federal data revealed that EMT average pay in the top 25 U.S. metro areas looked as follows:

EMT Average Pay in the Top 25 U.S. Metro Areas

	Area Name		Median Annual Wage	Mean Annual Wage
1	New York-Newark-Jersey City		$46,570	$48,820
2	Los Angeles-Long Beach-Anaheim		$35,560	$43,590
3	Chicago-Naperville-Elgin		$37,500	$54,540
4	Dallas-Fort Worth-Arlington		$34,990	$37,000
5	Houston-The Woodlands-Sugar Land		$36,170	$38,050
6	Washington-Arlington-Alexandria		$50,100	$59,430
7	Philadelphia-Camden-Wilmington		$38,480	$41,280
8	Miami-Fort Lauderdale-Pompano Beach		$36,580	$38,900
9	Atlanta-Sandy Springs-Alpharetta		$35,640	$36,920
10	Boston-Cambridge-Newton		$46,730	$50,290
11	Phoenix-Mesa-Chandler		$35,160	$35,820
12	San Francisco-Oakland-Berkeley		$43,050	$58,840
13	Riverside-San Bernardino-Ontario		$37,750	$41,540
14	Detroit-Warren-Dearborn		$34,720	$37,680
15	Seattle-Tacoma-Bellevue		$43,240	$44,120
16	Minneapolis-St. Paul-Bloomington		$41,290	$44,000
17	San Diego-Chula Vista-Carlsbad		$35,060	$39,630
18	Tampa-St. Petersburg-Clearwater		$35,960	$36,910
19	Denver-Aurora-Lakewood		$37,090	$37,780
20	Baltimore-Columbia-Towson		$42,850	$49,400
21	St. Louis, MO-IL		$35,420	$38,940
22	Orlando-Kissimmee-Sanford		$35,860	$37,370
23	Charlotte-Concord-Gastonia		$36,530	$39,040
24	San Antonio-New Braunfels		$33,650	$34,690
25	Portland-Vancouver-Hillsboro		$44,810	$45,600
	National		$36,680	$40,120

Report Period:  May 2022
Top 20 U.S. Metro Areas from the 2020 Census
Source: U.S. Bureau of Labor Occupational Statistics
Data extracted on June 18, 2023