Lifetime Fertility Rates Short of Replacement in Nearly All States

Only South Dakota and Utah had rates high enough to sustain a population

By Molly Walker, Staff Writer, MedPage Today

Lifetime fertility rates in the U.S. varied widely by state and racial/ethnic group, and only two states had a total fertility rate above the level required to sustain a population, researchers found.

South Dakota and Utah were the only two states in 2017 with a total lifetime fertility rate above 2,100 births per 1,000 women, the rate needed to keep a population level in the absence of immigration. The Mount Rushmore State topped the ranking with 2,227.5 lifetime births per 1,000 women, reported T.J. Mathews, MS, and Brady E. Hamilton, PhD, of the CDC.

Lifetime fertility rate is defined as “the expected number of births that a group of 1,000 women would have in their lifetimes according to the current age-specific birth rates,” and thus, it also measures the potential growth of the population, the authors noted.

Researchers examined 2017 birth certificate data from the 50 states and the District of Columbia, which contained self-reported information on mothers’ race and Hispanic origin.

Overall, the total lifetime fertility rate for the U.S. as of 2017 was 1,765.5 per 1,000. The District of Columbia had the lowest 2017 total fertility rate at 1,421.0 per 1,000. Compared to South Dakota, this was a difference of 57%, the authors said.

The national rate for 2017 represented a drop from the CDC’s 2016 analysis, which put the figure at 1,820.5 per 1,000. The rate last stood at 2,100 or above in 1971.

Utah also boasted the highest total fertility rate among non-Hispanic white women (2,099.5) — just a shade below population replacement level.


By contrast, total fertility rates for non-Hispanic black women were at or above population replacement level in 12 states, with the highest total fertility rate in Maine (4,003.5).

Total lifetime fertility rates for Hispanic women were at or above population replacement level in 29 states. The highest was in Alabama (3,085.0).

Number of births was small for some groups, the authors noted, which is a potential limitation to this data.

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