Where Americans are moving: 5 trends reshaping healthcare markets

Celina, Texas, was the fastest-growing U.S. city in the year ending July 1, 2025, with its population increasing 24.6%, according to U.S. Census Bureau data.

Dallas-based Methodist Health System met that growth with the spring 2025 opening of the 51-bed Methodist Celina Medical Center — the city’s first hospital and third-largest employer. Celina also was the fastest-growing city in the U.S. in 2023, according to a May 14 bureau news release.

Health systems in Southern states are among those planning to expand. Of the 15 capital projects Becker’s has reported on so far in May, three are in Florida, two are in Tennessee and one is in Alabama. 

Here are five census trends to know from the bureau’s Vintage 2025 population estimates, published May 14:

1. The exurb surge. The five fastest-growing U.S. cities with populations of 20,000 or more were all in Texas, and four were in the Dallas-Fort Worth-Arlington area’s suburbs. After Celina, the next four were Fulshear (21%), Princeton (18.1%), Melissa (14.5%) and Anna (10.2%). Fulshear sits outside Houston; the other three are in the Dallas-Fort Worth exurbs. 

In 2025, the cities had populations of 64,427, 64,630, 43,524, 29,969 and 35,245, respectively.

2. Charlotte leads the nation in numeric growth. Charlotte, N.C., gained 20,731 residents, more than any U.S. city. But Charlotte was only the seventh fastest-growing city in its own metropolitan area by percentage. Fort Mill, S.C., about 20 miles from downtown Charlotte, grew 6.8% to 38,673. The bureau highlights this as a national pattern: Even where big cities grew, surrounding midsize cities outpaced them. 

3. The midsize “Goldilocks zone.” Large cities’ growth slowed significantly, but midsize cities — with populations of 5,000 to 249,999 — held closer to prior-year patterns through a mix of domestic and international migration and new housing. 

4. The South dominates — and Austin hits 1 million. The South claimed 10 of the 15 fastest-growing cities: eight in Texas (Celina, Fulshear, Princeton, Melissa, Anna, Forney, Hutto and Greenville), plus Haines City, Fla., and Foley, Ala. The Midwest contributed Waukee, Iowa, while the West added Eagle Mountain, Utah; Johnstown, Colo.; Kuna, Idaho; and Queen Creek, Ariz. 

Austin, Texas, became the 12th U.S. city to cross 1 million residents, and Raleigh, N.C. crossed 500,000, bringing the total at that threshold to 39 nationwide.

5. Big cities are struggling, especially in the Northeast. The largest U.S. cities — with populations of 250,000 or more — saw average growth drop from 0.9% to 0.3% year over year. New York City lost 12,196 residents, the largest numeric decline in the country. The bureau attributes the Northeast slowdown to a drop in net international migration and domestic migration toward warm-weather locations.

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