North Dakota covers an area of 70,704 square miles with 9.2 persons per square mile. The economy is primarily dependent on agriculture, which consists of wheat, cattle, barley, sunflowers, sugar beets and potatoes. According to the U.S. Census Bureau, North Dakota 's 2005 population was 637,000; an estimated -0.9% change from the year 2000. ( http://www.census.gov/prod/2006pubs/07statab ). In 2005 the median household income was $41,030, with 11.2% living below the poverty level. According to the Department of Health and Human Services for a family of four with two children under the age of eighteen, the poverty threshold is $19,157 ( http://www.census.gov/hhes/poverty/threshld/thresh04.html ).

Of those who live in poverty, approximately 14% are children under the age of 18 years of age. This is a drop from the 17.1% state in the 1990 census. According to the 2000 Census Data from KIDS COUNT, there are approximately 5.6% of children in North Dakota who have disabilities ( http://www.aecf.org/kidscount/sld/index.jsp ). The 2005 population estimates revealed that 92.4% were white; 5.3% were American Indian or Alaska Native, 0.6% were African American, 0.6% were Asian, 1.2% were Hispanic and 0.4% reported they were of other ethnic origin (US Census Bureau). According to the US Census Bureau, the ethnicity of children under eighteen years of age in North Dakota include 86.1% white, 7.1% American Indian, 1.5% black or African American, 1.1% Asian, and approximately 3.3% of the children were two or more races. Approximately 3% of children in North Dakota are being raised by their grandparent (US Census Bureau).

North Dakota 's population has grown slightly and is the smallest relative growth of all 50 states. According to NDSU's Population Projection Report, there are three leading trends which influence North Dakota 's future population . These are rural depopulation, out-migration of young adults, and increasing proportion of elderly. Serious concerns for the state to consider are: how will the state, or counties, remain viable with continued rural depopulation? Can North Dakota , or the counties, ensure adequate healthcare? Moreover, with the decreased availability of healthcare services North Dakotans will have increased travel expenses to obtain primary healthcare, as well as any specialty care (Rathge, pg. 6).

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