The U.S. Census Bureau released data in January 2012 with sobering implications: The bad economy and slowdown in immigration are shrinking the numbers of children in the U.S. for the first time in a generation. The number of people under 18 was 73.9 million on July 1, 2011. That is a decline of 260,000 from the previous year. Overall, the U.S. population is growing at its slowest rate since the mid-1940s.
It is a truism that orthodontists are more affected by changes in the birthrate than any other dental specialty with the exception of pedodontists. So, is it time to consider a career in long-haul trucking or try to get a degree in engineering? Well, not really. It might help to get a little more perspective on how these numbers will really touch upon a practice before you take out another loan.
The news is actually a little worse than just that the number of adolescents will be far less in 10 years than there are today. These statistics are national. Orthodontic practices are local. Therefore, in order to get perspective, you have to break down the country a little bit more to see if this is going to hurt all orthodontic practices or just a few.
New England has been in a long decline in birthrates for decades so it comes as no surprise that Massachusetts, for instance, will not be a place with “low hanging fruit” locations. These states have depended upon people who have moved from other states to retire or because of friendly same-sex marriage legislation. Therefore, their growth rates are not negative but their birthrates are very low.
Birthrates are highest in the South and West. The exceptions are in North Dakota (oil boom) and the District of Columbia (government employment boom). But just because an area has significant births should not be taken as a firm indication that the households to which babies are born are going to be orthodontic patients. A significant percentage of new births in the U.S. are to African American and Hispanic households, both of which have much larger-than-average single parent households and poverty. This is how things are a little worse than they first appear. The newborns are not born into families that have a tradition of orthodontic care.
So, are there no populations having babies that are likely to seek orthodontic care? Certainly, there are! These include Utah, Idaho, Arizona, Texas, Colorado, and parts of South Carolina, Tennessee, Kentucky, and Virginia. These states have segments of them that have growth areas, but we have to take a serious look at the competition ratios we find in each of the communities being considered for start-up practices.
Another glimmer of hope comes from Census projections. These projections, while not perfect, do provide some insights into trends orthodontists should follow.
Not only have births gone down but so have the rates for marriage. In every serious economic decline the rates of marriage go down. It is hard to think about settling down when one or both of you is either unemployed or worried that you will lose your job. Incidentally, these same economic clouds have a tendency to reduce divorce. Demographers expect that when there is an economic recovery, marriage rates will increase and so will the birthrate among all socioeconomic segments of the population. In short, if we look at the long-term trends, while the birthrate has declined, it is not permanent. But what we don’t know is how much the birthrate will rebound.
We recommend that our clients keep a close eye on those locations with serious job creation (such as Texas and South Carolina) because new jobs tend to attract younger, well educated families who are more likely to have children, and who will in turn get care from an orthodontist.
Scott McDonald is the owner of Scott McDonald & Associates, a firm specializing in marketing services and research for professional practices. The company is a low-cost, high results option to advertising agencies and marketing consultants.