Improving Quality of Life

Quality of life can be improved when all people interact with environments that promote good health, engage in healthy behaviors across all life stages, and achieve optimum physical and mental health.

Individual and population health is influenced by a variety of personal, social, economic, and environmental factors. In addition to individual genetic predisposition to disease, factors such as individual behaviors (e.g., smoking, binge drinking, physical activity, eating habits), the environment (e.g., working conditions, built environment, pollutants, incidences of crime, access to healthy food), socioeconomic indicators (e.g., income, education, housing), and the policies and practices of health care (e.g., access to health care, public health funding, immunizations), influence health outcomes.

What's happening

  • The proportion of adults diagnosed with diabetes in North Dakota has trended below the national average since 2011. In 2022, 89.6 percent of North Dakota’s adults (age 18 and older) had diabetes.
  • North Dakota had the 32nd highest adult obesity rate in the nation in 2022 with 35.4 percent of adults being obese, an increase from 27.8% in 2011.
  • In North Dakota, 47,779 (7.5%) residents under age 65 lacked health insurance in 2022.
  • Four percent (4.4%) of children (under 18 years old) in North Dakota lacked health insurance in 2022 (7,868 children), which is a significant decrease from 2019 (8.1% and 14,322 children uninsured).
  • In 2022, 21.6 percent of North Dakota’s adults reported having one form of depression. Women (29.6%) were more than twice as likely as men (13.9%) to have had a depressive disorder. The prevalence of depression decreases as income levels and educational levels increase.

Making connections

Health promotion throughout the life span, from prenatal through old age can lead to optimum growth and development.

Starting early in life, good health gives children the best chance to enter school ready to learn and to be productive throughout their lives. Research has shown relationships between health and education; better-educated individuals live longer, healthier lives than those with less education. This is in part due to increased education leading to higher income and social status that can provide access to healthier food and physical activity, safer neighborhoods, and better health care.

Adolescents who grow up in neighborhoods characterized by poverty are more likely to be victims of violence; use tobacco, alcohol, and other hazardous substances; become obese; and engage in risky sexual behavior.

Environment and features of environment also shape the behaviors and significantly impact the health of individuals. Education about conscious food choices and access to and availability of healthier foods (e.g., better access to retail venues that sell healthier options) may have a positive impact on an individual’s diet and thereby preventing diet-related diseases (e.g., obesity, heart disease, diabetes). Furthermore, a clean and safe environment (e.g., free of pollutants, low crime rates, accessible neighborhood features) is fundamental for good human health. For instance, poor air quality is associated with increased risk of asthma, lung disease, and heart disease. Social and economic features of a community have been linked to mortality, birth outcomes, chronic conditions, disability, and health behaviors. For example, neighborhoods that are or perceived as safe and have less incidences of crime tend to have more physically active individuals.

Collectively, communities benefit when its citizens are physically active and healthy. With a healthy community, businesses retain a vital and productive workforce, which attracts new economic growth to the area. In addition, it provides opportunities for social engagement within the community.


Grace Njau, Nancy Hodur, & Chelsey Hukriede: Risk Behaviors among Women with a Recent Live Birth in North Dakota: Findings from the 2017 North Dakota Pregnancy Risk Assessment Monitoring System (PRAMS).

“The Pregnancy Risk Assessment Monitoring System (PRAMS) is a collaborative agreement research project between the North Dakota Department of Health and the Centers for Disease Control and Prevention (CDC). PRAMS was initiated in 1987 with the overall goal of reducing infant morbidity and mortality. It is the only surveillance system that provides data about pregnancy and the infants’ first few months after birth. PRAMS is especially useful in identifying women and infants at high risk for health problems, for monitoring changes in health status, and in measuring progress toward goals for improving the health of mothers and infants.”


Nancy Hodur: Statewide Group Working to Improve Oral Health for Older Adults in North Dakota.

“Good oral health is just as important later in life, as it is earlier in life. Oral health has a direct impact on overall health and poor oral hygiene impacts more than the mouth. Though there is not necessarily direct causality, evidence suggests that poor oral health and gum disease are linked with increased hospitalizations, readmissions, respiratory infections, diabetes, dementia, poor nutrition, pneumonia, chronic obstructive pulmonary disease, and behavioral change in older adults.”

North Dakota Compass

Center for Social Research
North Dakota State University

Compass created by:
Wilder Research

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