For the first time, births to non-Hispanic White women no longer make up the majority in the United States, marking a major demographic shift with implications for maternal health and health care policy, according to a study by the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.
The study, published Jan. 30 by Dr. Amos Grünebaum and Dr. Frank A. Chervenak of the Zucker school of medicine, examined data from more than 33 million live births recorded by the Centers for Disease Control and Prevention between 2016 and 2024.
During that period, the total number of annual live births in the United States declined by 8.4%, falling from 3.9 million to 3.6 million.
At the same time, the racial and ethnic makeup of births changed substantially. Births to non-Hispanic White individuals declined from 52.6% to 49.6% of all U.S. births, dropping below the 50% threshold for the first time.
“What we found is that for the first time in the history of the United States, non-Hispanic White births are not the majority anymore,” Grünebaum said. “The majority of births are now to people who were previously called minorities.”
Hispanic births increased from 23.5% to 27.4% during the eight-year period, making Hispanic women the only major group to see growth both in absolute numbers and as a share of total births.
The study attributed the trend to younger maternal age and higher fertility rates among Hispanic women, as well as immigration patterns.
Births to non-Hispanic Black women declined from 14.3% to 13.2%, while non-Hispanic Asian births fell slightly from 6.5% to 6.3%. Births to individuals identifying as more than one race increased modestly, while births among American Indian or Alaska Native individuals declined and Native Hawaiian or other Pacific Islander births remained stable.
Grünebaum said the findings were unexpected and particularly striking given current national policies.
“The results of our study surprised me,” he said. “This is a big deal because our country is restricting immigration at the same time it’s trying to increase family building and encourage more births.”
The study noted that White women tend to delay childbirth, often resulting in fewer children overall, while minority women are more likely to begin childbearing earlier. As a result, the demographic composition of births has shifted even as overall fertility rates continue to decline.
Beyond the demographic implications, Grünebaum emphasized that the findings highlight urgent concerns for the U.S. health care system, particularly in maternal care.
“This is more than a statistical finding,” he said. “Patients on Medicaid make up at least 40% of births, and Hispanic and Black women — who are at higher risk for pregnancy complications — represent a growing share of deliveries.”
According to the study, Hispanic and Black women account for more than 40% of U.S. births and experience the highest rates of maternal illness and mortality. The authors warned that proposed reductions to Medicaid eligibility or postpartum coverage could disproportionately affect these populations and worsen health disparities.
“As a nation, we should be embarrassed that our maternal mortality and infant mortality rates are the highest among high-income countries,” Grünebaum said. “If these patients are increasing in number and, at the same time, Medicaid support is reduced, I’m very concerned this will not make things better.”
The study also cited ongoing health care workforce shortages and closures of maternity units in underserved areas, calling for expanded bilingual and culturally competent care, particularly in hospitals serving Medicaid populations.
Grünebaum said future research should focus on how these demographic trends will shape maternal health outcomes in the coming decades.
“The big question is what will happen in the future,” he said. “Will these higher-risk patients increase in number while receiving less support from the system?”
He urged policymakers and health care leaders to view the findings as a call to action.
“Babies are our future,” Grünebaum said. “If we don’t support pregnant women, we’re giving away our future.”
The authors noted that while the study’s broad racial and ethnic categories may obscure differences within groups, the large national sample underscores a clear and consequential shift in the nation’s population structure.
