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Which U.S. cities and regions offer the most job opportunities and highest salaries for nurses? (And let’s not forget diversity and livability!)

By Margarette Burnette

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When America's huge baby boomer population hits retirement age a few years from now, their health care requirements will skyrocket, creating an unprecedented need for highly skilled care providers, including nurses. What’s more, with an average age of 46.8 years (up from 42.3 in 1996), the nursing workforce is aging, too. Over the next 20 years, a whole generation of RNs will be retiring from the profession, putting an even tighter squeeze on an already urgent need for more nurses. In fact, the Health Resources and Services Administration (HRSA) projects that demand for nurses will increase 41% between the years 2000 and 2020.

These numbers make it clear that minority nurses can have their pick of jobs anywhere in the country. But what cities and regions offer the most in terms of high salaries and opportunities for career advancement? And how do they stack up in terms of quality of life, affordable housing and cultural and ethnic diversity?

To find out, Minority Nurse surveyed medical centers and traveling nurse agencies to determine which parts of the country have exceptionally high demand for nurses. We researched the latest federal wage and salary data and cost of living indexes to find the places where nurses make the most money, and where they have the lowest living expenses. We also spoke with minority nurses to get their perspective on the career opportunities, livability and opportunities to provide care to a diverse patient population in the cities where they choose to work.

These are the results: the Top Ten Places for Minority Nurses to Live and Work, listed in alphabetical order.

Atlanta, GA.

Annual Mean Salary for RNs¹: $53,360
Cost of Living Index²: 97.7

Atlanta is known for its contributions to the civil rights movement, but this southern city also has an active health care industry. It is home to the headquarters of the Centers for Disease Control and Prevention (CDC), the American Cancer Society and the Arthritis Foundation. The 20-county metropolitan area has over 60 hospitals, including Grady Health System, known for its burn and advanced trauma units. Other acclaimed hospitals include Shepherd Center, which specializes in spinal cord injuries, and Saint Joseph’s Hospital, known for its cardiology care.

“I really enjoy working here,” says Fang Fang Jiang, MSN, RN, a staff nurse at Saint Joseph’s. “The weather is nice, there is a diversity of people here and Atlanta has affordable housing.” Jiang is originally from China, but she has been in the United States for four years, living in California and Ohio before moving to the Peach State. “Atlanta is a good place for a Chinese American,” she adds. “The [Asian population] is small, but you do see [Asian] people moving to the area.”

Demographics³:

White	36.2%
African American	58.6%
Hispanic/Latino (of any race)	4.7%*
American Indian/Alaska Native	0.1%
Asian/Pacific Islander	2.0%

*Percentages add up to more than 100% because “Hispanic/Latino” is not considered a race.

Future Trends⁴: Demand for nurses in Georgia will increase an estimated 51% from the year 2000 to 2020.

Baltimore, MD

Annual Mean Salary for RNs: $70,100
Cost of Living Index: 119.5

Located about an hour from the nation’s capital and home to renowned Johns Hopkins University, Baltimore offers exceptional educational and career opportunities for nurses. At over $70,000, the annual mean salary for RNs is considerably higher than the national average of $56,8801.

“I initially came here as a travel nurse,” says Valencia McCree, MSN, RN, MBA, manager of quality improvement and special projects at Mercy Medical Center in Baltimore. “I liked the area and decided it would be a good place for me to move forward with my academics, because I wanted to go back to college to get my master’s degree.” After graduating from Johns Hopkins University with a dual master’s, McCree chose to stay on and accept a management position in the city. “I decided to stay in Maryland because it is so concentrated with health care opportunities,” she explains. “That’s what makes the area so desirable for me.”

Demographics:

White	30.2%
African American	65.2%
Hispanic/Latino (of any race)	2.3%
American Indian/Alaska Native	0.4%
Asian/Pacific Islander	1.6%

Future Trends: Demand for nurses in Maryland will increase an estimated 36% from the year 2000 to 2020.

Honorable Mention: Washington, D.C. Suburbs

The annual mean salary for nurses in this nearby region is $63,810. It is somewhat lower than Baltimore’s average, but still much higher than the national average. However, the cost of living index for the area is 140.9, making it more expensive to live in than Baltimore. Nevertheless, it’s a place where there’s a big demand for nurses. “[This area] in the shadow of the White House is a wonderful place to work and live,” says Pamela M. Lawson, RN, medical center administrator for Kaiser Permanente’s Mid-Atlantic region. “If you want to be involved in politics or get involved with your community, you have a lot of opportunities here.”

Boston, MA

Annual Mean Salary for RNs: $70,460
Cost of Living Index: 136.4

For nurses who are looking for career opportunities in the busy northeast corridor of the country, Boston is the best bet. The city ranks its health care industry as one of its four primary areas for employment. The New England region also has the highest concentration of employed RNs in relation to the area’s population, according to the Bureau of Labor Statistics. But that doesn’t mean that demand for nurses isn’t high.

“This past year, we hired over 500 nurses, and it’s not because our other nurses left,” says Debra Burke, MSN, RN, MBA, associate chief nurse at Massachusetts General Hospital in Boston. “We have an increasing demand, so we have been progressively adding new nursing positions.”

Demographics:

White	55.3%
African American	24.6%
Hispanic/Latino (of any race)	14.7%
American Indian/Alaska Native	0.8%
Asian/Pacific Islander	8.7%

Future Trends: Demand for nurses in Massachusetts will increase an estimated 29% from the year 2000 to 2020.

Charlotte, NC

Annual Mean Salary for RNs: $54,740
Cost of Living Index: 90.3

With a citywide population of 650,000 and a low cost of living, Charlotte is an attractive choice for nurses who are seeking a medium-sized but growing southern city. Charlotte has been honored as one of the “Top Ten Cities for African Americans to Live, Work and Play” (Black Enterprise magazine), one of the “Best Cities for Women” (Ladies’ Home Journal) and the “Most Livable Community for the Visually Impaired” (American Foundation for the Blind).

RNs may also have an easier time locating here, since North Carolina is a Nurse Licensure Compact state. Compact states have arrangements with each other allowing RNs who live in and are licensed in one such state to practice in another without needing an additional license. Other compact states include Texas, Maryland and Arizona.

Demographics:

White	57.0%
African American	34.3%
Hispanic/Latino (of any race)	9.7%
American Indian/Alaska Native	0.4%
Asian/Pacific Islander	3.9%

Future Trends: Demand for nurses in North Carolina will increase an estimated 51% from the year 2000 to 2020.

Houston, TX

Annual Mean Salary for RNs: $58,720
Cost of Living Index: 88.1

Houston is the only city on our list that manages to have a lower-than-average cost of living and higher-than-average nursing salaries. This lively urban area, the fourth largest city in the U.S., is home to Texas Medical Center, the largest medical facility in the world. The complex employs more than 65,000 health care professionals and treats more than five million patients each year. In total, Houston is home to 95 hospitals (including an above-average number of magnet hospitals) and 36 educational institutions that offer degrees specializing in the health sciences. The area also has a large and growing Hispanic population.

Demographics:

White	56.7%
African American	23.5%
Hispanic/Latino (of any race)	42.3%
American Indian/Alaska Native	0.3%
Asian/Pacific Islander	5.8%

Future Trends: Demand for nurses in Texas will increase an estimated 57% from the year 2000 to 2020.

Las Vegas, NV

Annual Mean Salary for RNs: $59,470
Cost of Living Index: 107.6

Though Las Vegas is best known for its casinos and entertainment offerings, the city has a rapidly growing population that is creating strong demand for nurses. RNs who come to build careers here enjoy an annual mean salary that is higher than the national average. The area has 12 hospitals and many more regional clinics and centers.

Top hospitals include Sunrise Hospital and Medical Center, which includes a 145-bed children’s hospital and a renal transplant center, and the University Medical Center (UMC), a nationally recognized, award-winning hospital affiliated with the University of Nevada School of Medicine. For nurses who are interested in continuing their professional education, the School of Nursing at the University of Nevada, Las Vegas offers opportunities to pursue BSN, RN-to-BSN, MSN and PhD degrees.

The Las Vegas Chamber of Commerce reports that the city’s population now exceeds 1.8 million people, a 32% increase from the year 2000. Another plus is the city’s warm climate, with an average of 320 sunny days a year.

Demographics:

White	74.3%
African American	11.3%
Hispanic/Latino (of any race)	28.6%
American Indian/Alaska Native	0.7%
Asian/Pacific Islander	5.2%

Future Trends: Demand for nurses in Nevada will increase an estimated 59% from the year 2000 to the year 2020.

Oakland, CA

Annual Mean Salary for RNs: $80,270
Cost of Living Index: 143.9

This culturally diverse West Coast city, located in the Bay Area of northern California near San Francisco, has the highest average salary for RNs of all the cities on our list (albeit with a high cost of living index). And it also has an equally strong demand for nurses.

“I’ve been in the Bay Area for 16-and-a-half years, with the same employer, in the same department,” says Eleanor M. Dixon, BSN, RN, a nurse manager in the outpatient surgery department of a Kaiser Permanente facility in Oakland. She recalls visiting the area in years past for vacations and family visits before deciding to settle there herself. “This facility is one of the most diverse in the Bay Area,” Dixon continues. “The people here are very supportive about helping you further your education and move up the career ladder. I did not even get my bachelor’s degree until after I came here to work. I have since worked my way up from staff nurse to manager.”
Dixon believes the city offers good prospects for new nursing graduates just entering the profession. “There are a lot of nurses who’ve been here for many years who’ll be retiring soon, including me (in 2007). There’s a lot of room for new people to come in.”

Demographics:

White	56.7%
African American	23.5%
Hispanic/Latino (of any race)	25.0%
American Indian/Alaska Native	0.3%
Asian/Pacific Islander	5.8%

Future Trends:
Demand for nurses in California will increase an estimated 58% from the year 2000 to 2020.

Phoenix and Mesa AZ

Annual Mean Salary for RNs: $56,960
Cost of Living Index: 100.4

Nurses in these neighboring southwestern cities have the opportunity to care for a relatively high percentage of Spanish-speaking patients, so bilingual nurses are in high demand. “I have lived in Phoenix throughout my entire career, and I actually work in Mesa,” says Corina Chick, RN, a labor and delivery nurse at Mesa General Hospital. “[Our patient population is] about 80-90% Hispanic, and since I am Hispanic, it feels very rewarding. I find that my bilingual skills are very useful.” The Phoenix/Mesa area also has the largest American Indian population of all the cities on our list.

Nurses who work and live here enjoy an average of 325 days of sunshine and an average temperature of 85 degrees. In addition to Mesa General, other nursing employers in the area include Banner Good Samaritan Medical Center, Mayo Clinic Arizona, St. Joseph’s Hospital and Medical Center, and the Phoenix Indian Medical Center.

Demographics:

White	73.7%
African American	5.1%
Hispanic/Latino (of any race)	41.8%
American Indian/Alaska Native	2.1%
Asian/Pacific Islander	2.1%

Future Trends: Demand for nurses in Arizona will increase an estimated 61% from the year 2000 to 2020.

Tampa and St. Petersburg, FL.

Annual Mean Salary for RNs: $52,960
Cost of Living Index: 98.8

Tampa/St. Pete has a relatively low cost of living in a state known for high-priced real estate. There is no state income tax. The area is home to over 20 hospitals—including two teaching hospitals—and four trauma centers. Noted medical facilities include H. Lee Moffitt Cancer Center and Research Institute, Johnnie B. Byrd Sr. Alzheimer’s Center and Research Institute, and St. Joseph’s Hospital. Tampa also has a strong demand for travel nurses, according to Howard Goldman, spokesman for Cross Country Healthcare, a national health care staffing company based in Boca Raton, Florida.

Demographics:

White	62.7%
African American	28.6%
Hispanic/Latino (of any race)	21.3%
American Indian/Alaska Native	0.7%
Asian/Pacific Islander	2.8%

Future Trends: Demand for nurses in Florida will increase an estimated 63% from the year 2000 to 2020.

West Palm Beach, FL

Annual Mean Salary for RNs: $57,930
Cost of Living Index: 118.9

According to the U.S. Census Bureau, 16% of West Palm Beach’s population is over age 65, a figure that’s almost one-third higher than the national average. An aging population means an increased need for health care services and dedicated nurses. Other advantages for nurses working in this city include higher-than-average annual salaries, no state income tax and a mild climate.

There are also many opportunities to help improve the health of the community’s underserved and disadvantaged residents. The recently established Health Care District of Palm Beach County provides a source of funding for low-income residents to gain access to health insurance coverage, children’s health services, trauma care, skilled nursing home services and hospital care in the Glades region. (The Glades is a mostly rural area in western Palm Beach County that has very high poverty and unemployment rates.) West Palm Beach’s Chamber of Commerce also publishes a comprehensive health care guide.

Demographics:

White	49.1%
African American	35.3%
Hispanic/Latino (of any race)	20.2%
American Indian/Alaska Native	0.3%
Asian/Pacific Islander	2.3%

Future Trends: The percentage of elderly citizens in West Palm Beach will continue to grow at a rate that outpaces the rest of the country.

Data Sources

^1. Bureau of Labor Statistics, Occupational Employment Statistics for Registered Nurses, May 2005.
^2. American Chamber of Commerce Researchers Association (ACCRA) Cost of Living Index for Second Quarter 2006. An index of 100 is considered to be the national average.
^3. U.S. Census Bureau 2005 Estimates.
^4. HRSA Report: What is Behind HRSA’s Projected Supply, Demand, and Shortage of Registered Nurses?(Exhibit A-2. Baseline FTE RN Demand, by State and Year, 2000 to 2020.)

Margarette Burnette is a free-lance writer based in Acworth, Georgia.