Where are all the babies?
South Carolina's population has been steadily rising — soaring, in some coastal and urban areas — but the number of annual births has hardly changed. Yearly births now, about 58,000, are roughly the same as in the early 1990s, when the Palmetto State had 1.5 million fewer residents.
What has been rising fast is the number of deaths.
In most South Carolina counties there are now more deaths than births. That's true not just in rural counties, but also in the Myrtle Beach area, which was the nation's second fastest-growing metropolitan area last year due to all the people moving there.
The combination of a graying population — a nationwide demographic shift as the baby boomer generation ages — and annual births that are barely rising has broad implications for local governments, social service providers and the communities they serve. The elderly population has different needs, which can translate into demand for more senior centers and meal-delivery programs, but also to things like a desire for municipal garbage cans that are smaller and weigh less and street signs with larger lettering.
"You can see the aging of Mount Pleasant in the monthly reports," said Mark Smith, a councilman in the fast-growing coastal town who serves on the Lt. Governor’s Advisory Council on Aging. "One of the things they are tracking now is the number of (fire department) medical calls with lift assist — that's helping mom or dad because they fell."
In Richland County, retired law enforcement officers and other volunteers with Project HOPE ("helping our precious elderly") visit residents at senior centers and in their homes, where they might change the batteries in smoke detectors, help put them in touch with service providers or just visit.
In Charleston, the police department hired an advocate last year specifically to help crime victims who are age 60 and above.
In Myrtle Beach, "it feels like every other week a new senior living community is popping up," said Justin Blomdahl, Aging Program coordinator at the Waccamaw Region Council of Governments.
He said much of the regional need for services, such as home-delivered meals, comes from rural areas.
"Our phone is always ringing with seniors trying to get on our programs," Blomdahl said.
Nonprofit groups and volunteers — many of whom are seniors themselves — are increasingly providing assistance to the state's older residents, along with governments at the local, county and state levels.
Mary Kelly, 71, is a volunteer and board member at TheFriendShip in Columbia, a 2-year-old nonprofit created to help support residents who want to age in their homes. Members pay a small annual fee, and volunteers provide most services.
"Sometimes it’s not a big thing, but if you can’t manage it that might mean moving into assisted living or something like that," Kelly said. "Right now our most-requested service is for driving; people who need to go to the doctor or the beauty parlor or the airport."
TheFriendShip is part of a movement to create volunteer-driven "villages" modeled after Beacon Hill Village in Boston. Kelly said TheFriendShip targets people who are "kind of in between those who are getting public assistance and those wealthy enough to pay for whatever they need."
'The gray tsunami'
Five years ago, then-Lt. Governor Glenn McConnell urged state lawmakers to prepare for "the Gray Tsunami that has already begun to reach our state."
At the Lowcountry Food Bank, Chief Development Officer Kathryn Douglas said awareness has not meant more funding.
"State officials acknowledge the exponential growth of the senior population, but the state’s budget writers haven’t focused on the needs of seniors," she said.
The Lowcountry Food Bank serves 10 counties from a main facility in North Charleston and distribution centers in Myrtle Beach and Yemassee. More seniors means more people who need meals, Douglas said, because nearly a third of seniors have no income except Social Security, and that's "not very much."
"There are frequently overlooked pockets of poverty, amid the affluence of the area," she said, referring to greater Charleston.
Hundreds of organizations get food for their own programs from the food bank, and about 2,000 seniors get monthly supplies of groceries through a U.S. Department of Agriculture program.
"The senior population is expected to double in South Carolina," Douglas said. "By 2030, seniors will outnumber school-aged children in our state."
For now, more than 22 percent of the state's population is under 18 and more than 16 percent is 65 or older.
That gap will close, partly due to the difference between annual births and deaths known as the "natural increase" in population. In most counties, it's become a natural decrease, with populations shrinking unless more people move to the area.
"The greatest challenges are going to be in rural communities where resources are limited," said Smith, a funeral home operator in Mount Pleasant. "The more isolated they are, the more difficult it is to provide services — transportation, medical services, home-cooked meals."
Smith grew up in Bamberg, one of South Carolina's smallest rural counties. The county's population dropped below 15,000 in 2016 after losing nearly 9 percent of its residents in just five years.
Some areas, such as Horry County, keep on growing despite deaths outnumbering births because new residents keep moving in. But most counties with a naturally decreasing population are just getting smaller and older.