the 2000 census; in 2020, however, its population declined to 24,171. In 2010, 25,171 people 10,306 households, and 6,426 families resided in the city. The population density was 588.1 people per square mile (227.4/km); the 11,883 housing units averaged 277.6 per square mile (107.3/km). of all households were made up of individuals, and 15.2% had someone living alone who was 65 or older. The average household size was 2.38 and the average family size was 3.01. In the city, the population was distributed as 25.0% under 18, 10.6% from 18 to 24, 24.1% from 25 to 44, 23.8% from 45 to 64, and 16.6% who were 65 or older. The median age was 37.1 years. For every 100 females, there were 87.3 males. For every 100 females 18 and over, there were 82.9 males. By 2020, the city had 10,522 households according to the American Community Survey, and 3,549 were married-couple households. The average household size was 2.29, and the average family size was 2.99. Of its 2020 population, 933 were foreign-born nationals, 18.9% of whom were naturalized U.S. citizens. As of the census estimates, 49.6% of housing units were owner-occupied and 50.4% were renter-occupied. In 2010, according to the U.S. Census Bureau, the racial makeup of the city was 70.3% White, 24.8% Black and African American, 3.1% American Indian and Alaska Native, 1.1% Asian, and 4.1% from other races. Hispanics or Latinos of any race were 8.2% of the population. In 2020, its racial and ethnic makeup was 56.6% non-Hispanic White, 23.06% Black and African American, 1.35% Native American, 1.42% Asian, 0.08% Pacific Islander, 0.23% some other race, 5.38% multiracial, and 11.88% Hispanic or Latino of any race, reflecting demographic trends of greater diversification. Economy In the past, Paris was a major cotton exchange, and the county was developed as cotton plantations. While cotton is still farmed on the lands around Paris, it is no longer a major part of the economy. Paris' one major hospital has two campuses: Paris Regional Medical Center South (formerly St. Joseph's Hospital) and Paris Regional Medical Center North (formerly McCuistion Regional Medical Center). It serves as the center of healthcare for much of Northeast Texas and Southeast Oklahoma. Both campuses are now operated jointly under the name of the Paris Regional Medical Center, a division of Essent Healthcare. Paris Regional Medical Center South Campus has recently closed and only the North Campus remains