The Washington Metropolitan Region includes 2 counties in Maryland, 4 counties and the City of Alexandria in Northern Virginia, and the District of Columbia. Altogether, the region has a land mass of over 2,300 square miles, which is larger than the state of Delaware. It has a total population of 5,066,147 people, which is greater than that of 28 states.
The population of this region is relatively young, and racially and ethnically diverse. The median age of the region is 36.6 years of age, and 63.6% of residents are between the ages of 18 and 64, while 23.1% of residents are younger than 18 years old. Less than half of the region identifies as White (41.6%); over a quarter identifies as Black (26.4%); over an eighth identifies as Hispanic or Latino (16.7%); and over a tenth identifies as Asian (11.4%).
The DC metropolitan area has the seventh highest number of foreign-born residents among all metropolitan areas in the U.S; nearly one in every four residents is an immigrant (24%), compared to 13% nationwide. This varies across the region; one in seven residents in DC is foreign-born, while as many as one in three residents in Manassas Park City, Fairfax County and Montgomery County are immigrants. A higher percentage of the region’s foreign-born population are from Africa or Asia, compared to national statistics. However, Latin Americans still account for the largest percentage of foreign-born residents in this area. Two-thirds of the undocumented immigrant population in the region reside in Fairfax County in Virginia and Montgomery and Prince George’s Counties in Maryland. Immigration status has wider implications for access to healthcare services for this population, as undocumented and recently-arrived immigrants are not eligible for Medicaid or CHIP, and unable to purchase health coverage through ACA Marketplaces.
In addition to being young, and racially and ethnically diverse, the region is generally well-educated and affluent. Half of adults over 25 years of age in the region have at least a bachelor’s degree, far exceeding the national rate of 29.3%. Additionally, median household incomes in all jurisdictions are higher than the nationwide median of $53,482. Similarly, the region’s unemployment and poverty rates are slightly lower than national statistics of 9.2% and 15.6%, respectively. Even so, wealth is not experienced equally across the region. One measure the Census uses to quantify income inequality is the Gini coefficient, where a coefficient of zero represents perfect income equality (everyone in a population earning the same income), and a coefficient of one represents perfect inequality (one person earns all of the income, while everyone else earns nothing). The Gini coefficient for the nation as a whole is 0.4787; while the DC metropolitan area has a slightly more equal income distribution, with a coefficient of 0.4403. However, the District of Columbia, at the center of the metropolitan area, has a coefficient of 0.5317, signaling less equal income distribution in this jurisdiction. Compared to national income distribution, the DC metropolitan area has a higher percentage of households earning annual incomes above $100,000, and fewer households earning below $50,000. However, wealth is relative, especially as the region has a high cost of living. The Economic Policy Institute’s Family Budget Calculator asserts that to attain a “modest yet adequate standard of living”, a family of four would need to earn an annual household income of $106,493 in DC, $79,330 in the Maryland suburbs, and $82,284 in the Virginia suburbs. The median incomes in DC, Prince George’s County, Manassas, and Manassas Park City all fall below these estimated levels for economic security.
The federal government is a large driver of the region’s economy, with many government agencies and installations, such as the Pentagon, located within the region. Additionally, many work for civilian and defense contracting companies that conduct business directly with the federal government. Science and engineering occupations account for a significant portion of the workforce; in fact, the DC metropolitan area is home to the third highest number of engineers in the country, after Los Angeles and Houston. Among other agencies, the National Institutes of Health (NIH) and Federal Drug Administration (FDA), as well as hospitals and healthcare systems employ scientists, engineers, physicians and other health professionals across the region. National policy, advocacy and non-profit agencies, as well as professional associations, are headquartered in this region because of its proximity to policy-makers. Several universities, colleges and other learning institutions attract students from across the globe.
The region boasts a robust transportation system, with two airports, many bus and rail systems, and a bike share system servicing the area. Public transportation adds to the fluidity of the region, as residents often work, socialize, recreate, worship and shop in jurisdictions outside of the one in which they live. Despite this fluidity, experiences of residents are not uniform across the region. Rates of high school graduation, unemployment, and children living in poverty differ within and between jurisdictions. These and other social determinants that vary across the region, such as access to affordable housing, healthy food, or primary healthcare services, collectively impact the health of affected communities. As a result, very real health disparities exist across the region, evidenced by a number of health indicators, including infant mortality and average life expectancies at birth.
One determinant that varies widely across jurisdictions is access to high-quality primary healthcare services, mainly as a result of state-level policies related to the expansion of Medicaid under the ACA and local investment in safety-net health care initiatives. 11.62% of those living in the region are uninsured and must rely on local safety-net services for their health care needs; however, safety net resources vary in size and depth between counties. Disparities in access to care lead to disparities in health outcomes. For example, counties with larger rates of uninsured residents tend to have higher infant mortality rates. A notable exception is the District of Columbia, which has one of the lowest uninsured rates in the region, yet one of the highest infant mortality rates in the region—showing that many other social determinants interplay to impact health outcomes.
It is important to note that disparities do not only occur between these jurisdictions, but within them as well. For a more in-depth look at each jurisdiction please visit the state and jurisdictional profiles.