Where births and legal capacity are furthest apart
The median U.S. county with 500 or more annual births has 34.3 births per Offices-of-Lawyers establishment. The thinnest counties run to roughly six times that. Separately, 853 counties recorded births in 2024 and contain no lawyer establishment of any kind, covering 74,339 births. This is a market map, not a merit map: establishment counts do not distinguish practice areas and say nothing about where claims exist.
The join
Two federal sources, one key. Births by county come from the Census Bureau's 2024 population estimates, which publish births as a component of population change for every county with no suppression. Legal establishments come from County Business Patterns 2023, filtered to NAICS 541110 exactly, not the 5411 parent, which also contains title abstract and settlement offices.
- Births, 2024
- 3,605,563all counties, no suppression
- Offices of Lawyers
- 164,561establishments, all practice areas
- Median births per office, 500+ birth counties
- 34.3across 1,036 counties
- Counties with births and no lawyer office
- 85374,339 births
The four limits, stated before the findings are used
1. The classification does not distinguish practice areas. A fourteen-attorney medical malpractice practice and a solo doing closings count identically. A county with forty offices may contain nobody equipped to fund a multi-year matter.
2. An establishment is a location, not a firm. Multi-office firms are counted once per office and are concentrated in metropolitan counties, which overstates urban density relative to rural.
3. Employment is noise-infused at this level. County Business Patterns applies noise to employment values to protect confidentiality. We therefore use establishment counts, which are not noise-infused, and publish no county employment figure at all rather than one with an undisclosed error band.
4. Zero means zero establishments reported. Not zero legal services available. Residents of a county with no lawyer office are served from elsewhere, exactly as residents of a county with no hospital deliver elsewhere.
Where the gap is widest by state
| State | Births 2024 | Lawyer offices | Births per office | Counties with no lawyer office |
|---|---|---|---|---|
| Tennessee | 83,223 | 2,231 | 37.3 | 20 |
| Indiana | 79,422 | 2,219 | 35.8 | 13 |
| South Dakota | 11,311 | 322 | 35.1 | 42 |
| Wisconsin | 59,445 | 1,697 | 35.0 | 12 |
| North Dakota | 9,592 | 275 | 34.9 | 38 |
| Kansas | 33,963 | 1,067 | 31.8 | 58 |
| Utah | 45,695 | 1,439 | 31.8 | 12 |
| Nebraska | 24,443 | 773 | 31.6 | 52 |
| Ohio | 126,575 | 4,062 | 31.2 | 2 |
| Alaska | 9,014 | 291 | 31.0 | 23 |
| Iowa | 36,301 | 1,181 | 30.7 | 19 |
| Minnesota | 61,438 | 2,020 | 30.4 | 24 |
| North Carolina | 121,281 | 4,011 | 30.2 | 10 |
| Kentucky | 52,248 | 1,774 | 29.5 | 30 |
| Texas | 388,115 | 13,751 | 28.2 | 108 |
What it is legitimately useful for
| Valid | Invalid |
|---|---|
| Geographic media planning, where to weight paid spend | Inferring that claims are more likely in thin-capacity counties |
| Referral network development, where an originating relationship has fewer competitors | Inferring anything about care quality in those counties |
| Access-to-justice reporting, with the limits attached | Ranking counties by "legal need", which this does not measure |
| County | State | Births 2024 | Lawyer offices | Births per office | Delivering hospitals |
|---|---|---|---|---|---|
| Webster County | MO | 614 | 3 | 204.7 | 0 |
| Franklin County | WA | 1,417 | 7 | 202.4 | 0 |
| Waller County | TX | 776 | 4 | 194.0 | 0 |
| Frederick County | VA | 959 | 5 | 191.8 | 0 |
| Loudon County | TN | 562 | 3 | 187.3 | 0 |
| Mississippi County | AR | 516 | 3 | 172.0 | 1 (+1 unknown) |
| LaGrange County | IN | 687 | 4 | 171.8 | 0 |
| Douglas County | WA | 506 | 3 | 168.7 | 0 |
| Coryell County | TX | 995 | 6 | 165.8 | 0 |
| Pinal County | AZ | 5,128 | 32 | 160.2 | 3 (+1 unknown) |
| Madera County | CA | 2,070 | 13 | 159.2 | 0 (+2 unknown) |
| Van Buren County | MI | 807 | 6 | 134.5 | 0 |
We use it for the first two. Our own state pages apply it to media planning, and the co-counsel service line applies it to the second.
Clinical measures and legal measures are never joined on this site. Adverse-event rates describe medicine; litigation describes a legal process. Where both appear together it is to describe a market, not to suggest that one predicts the other.
Sources
- U.S. Census Bureau: County Population Totals and Components of Change, 2024: births by county, 2021–2024
- U.S. Census Bureau: County Business Patterns, 2023: NAICS 541110, Offices of Lawyers; establishment counts by county
- U.S. Census Bureau: Cartographic Boundary Files, 2023 (1:20,000,000): county and state polygons; projected to Albers equal-area at build time
Cite this analysis
Free to reproduce with attribution, including commercially. Charts may be embedded as published.
Birth Injury Marketing. “Where births and legal capacity are furthest apart.” 7 October 2026. https://birthinjurymarketing.com/insights/births-per-lawyer-office-county-analysis/
Journalists and researchers: the underlying data is already published as CSV at /data/, free and without conditions, no form. Need a different cut, by state, county, hospital or year? Ask, and we will also tell you what the data cannot support.
More
Where the birth happened is not where the family lives
More than a thousand counties record births and have no hospital confirmed to deliver them, which puts residence and venue in different places.
Data · analysisWhere the births actually are, by county
The distribution of U.S. births is far more concentrated than most geographic media plans assume, and the tail is longer than it looks.
Data · methodThe hospitals that never say if they deliver
The federal file most people treat as a hospital census carries no obstetric indicator either way for a fifth of the hospitals in it.
Practice economicsWhat a slow callback costs you here
A familiar marketing rule, worked through for a category where one inquiry can cost more than a month of another practice area.
Practice economicsThe counties your advertising cannot reach, and what does
The counties with no lawyer office at all are not a media opportunity. They are a referral problem, and a different service line answers them.
EconomicsCost per lead can fall while cost per signed case rises
In birth injury both movements are real at the same time, and only one of them matters. Here is the mechanism, and how to tell whether it is happening to you.
OperationsWhy more spend stops producing more birth injury cases
Signed case volume is limited by how many inquiries a firm can competently review, not by how many it receives. Above that ceiling, additional spend buys a queue.
All articles → · The data behind them → · The publications →
Authorship & review
- Author
- Birth Injury Marketing. About the company.
- Last reviewed
- Corrections
- Found an error? Tell us and it goes in the dated corrections log, whether or not it flatters us.