Action Planning SummitThe Big Picture

Billy U. Philips, Jr. Ph.D., M.P.H., Vice President and Director F. Marie Hall InstituteMarie Hall Chair and Professor, Family and Community Medicine

Big Spring, TexasOctober 28, 2011

Considerations

• The Landscape of West Texas• The Health Issues • The Changing Demography• The Economy• The Collaborative Opportunities• The Challenges

Geography of the Health Infrastructure

PCPs (MDs and DOs)

PAs NPs RNs LVNs

U.S., 2005 79 27.7 33.7 825 132.6

Texas, 2008 68.4 (56) 17.3 22.1 671.3 277.5

Number of Providers per 100,000 population. Comparison between U.S. and Texas

7

Projected Increase of Obesity in Texas by Ethnicity, 2006-2040

Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011 Source: Texas State Data Center. Population Projections, 2000-2004 Migration Scenario.

8

Projected Number of Adults with Diabetes by Race and Ethnicity for Texas, 2010-2040

2010

2020

2030

2040

0

2,000,000

4,000,000

6,000,000

8,000,000

Total Latino Anglo African American Other

Proj

ecte

d Pe

rson

s w

ith D

iabe

tes

Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011 Source: Office of the State Demographer. 2006 Population Projections, 2000-2004 Migration Scenario.

9

Growing States, 2000-2010

2000Population*

2010Population*

NumericalChange

2000-2010

PercentChange

2000-2010

United States 281,421,906 308,745,538 27,323,632 9.7%

Texas 20,851,820 25,145,561 4,293,741 20.6%

California 33,871,648 37,253,956 3,382,308 10.0%

Florida 15,982,378 18,801,310 2,818,932 17.6%Georgia 8,186,453 9,687,653 1,501,200 18.3%

North Carolina 8,049,313 9,535,483 1,486,170 18.5%

Arizona 5,130,632 6,392,017 1,261,385 24.6%

Population values are decennial census counts for April 1, 2000 and April 1, 2010.

15.7% of numerical change in U.S.

Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011 Source: U.S. Census Bureau. 2000 and 2010 Census Counts.

10

Percent ChangeDue to

Year* PopulationNumerical

ChangeNatural

IncreaseNet

MigrationPercentChange

NaturalIncrease

NetMigration

1950 7,711,194 -- -- -- -- -- --

1960 9,579,677 1,868,483 1,754,652 113,831 24.2 93.91 6.09

1970 11,196,730 1,617,053 1,402,683 214,370 16.9 86.74 13.26

1980 14,229,191 3,032,461 1,260,794 1,771,667 27.1 41.58 58.42

1990 16,986,510 2,757,319 1,815,670 941,649 19.9 65.85 34.15

2000 20,851,820 3,865,310 1,919,281 1,946,029 22.8 49.65 50.35

2009 24,782,302 3,930,484 2,124,124 1,781,785 18.8 54.04 45.33

*All values for the decennial dates are for the indicated census year. Values for 2009 are for July 1 as estimated by the U.S. Census Bureau.

Source: Derived from U.S. Census Bureau Estimates for dates indicated by the Texas State Data Center.Note: Residual values are not presented in this table. Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011

Total Population and Components of Population Change in Texas, 1950-2009

11

0

50,000

100,000

150,000

200,000

250,000

2000 to 2001

2001 to 2002

2002 to 2003

2003 to 2004

2004 to 2005

2005 to 2006

2006 to 2007

2007 to 2008

2008 to 2009

International

State-to-State

Source: U.S. Census Bureau. 2009 Population Estimates.

Estimated Annual Net Migration to Texas, 2000-2009

12

Percent of Migrants to Texas by Race and Ethnicity, 2000-2009

Net domesti

c migr

ation

Internati

onal migr

ation

Total0%

10%20%30%40%50%60%70%80%90%

100%

44%24% 33%

28%50% 40%

23% 8% 15%

5%18% 12%

OtherBlackHispanicWhite

67% of all migrants

Sources: Percentages of domestic and international migrants by race and ethnicity derived from the 2006-2008 American Community Survey. Total numbers of domestic and international migrants between 2000-2009 are from Table 4. Cumulative Estimates of the Components of Resident Population Change for the United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1, 2009, U.S. Census Bureau.

(848,702 migrants ) (933,083 migrants)

52% of all migrants were international

Percent of Population Less Than 18 Years of Age Living Under Poverty During Past 12 Months

by County, 2005-2009

5-20%

20-30%

30-40%

40-55%

Source: U.S. Census Bureau. American Community Survey, 5-Year Sample 2005-2009. Map by the Texas State Data Center. Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011

14

Estimated Domestic Migration (2000-2008) as a Percentage of 2000 Population by County

Source: Population Division, U.S. Census Bureau, March 19, 2009. Map produced by the Texas State Data Center. Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011

Legend

-20 to -45%

-19 to -10%

-9 to -5%

-4 to 0%

1 to 5 %

6 to 20%

21 to 30%

31 to 65%

15

Legend

0-1%

1-2.5%

2.5-3.5%

3.5-5%

5-10%

Estimated International Migration (2000-2008) as a Percentage of 2000 Population by County

Source: Population Division, U.S. Census Bureau, March 19, 2009. Map produced by the Texas State Data Center. Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011

16

Numeric Change of Total Population by County, 2000-2010

Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011. Source: U.S. Census Bureau. 2000 and 2010 Census Counts.Map produced by the Texas State Data Center.

Legend

co48_d00

'PROJECTIONS X$'.totpopch0010

-3,200 - 0

1 - 10,000

10,001 - 50,000

50,001 - 100,000

100,001 - 700,000

2040 Population

P_40

36 - 1000

1001 - 10000

10001 - 50000

50001 - 100000

100001 - 500000

500001 - 1000000

1000001 - 8000000

Projected Population by Texas Counties, 2040

Source: Texas State Data Center and US Census Bureau. Vintage 2008 Population Projections, 2000-2007 Migration Scenario. Dr. Lloyd Potter, Slide taken from State Demographer presentation at 2011 Texas Rural Health Forum, 9/24/2011. Map produced by the Texas State Data Center.

Personal Services Assistant

(PSA)

NursingCAN/LVNAND/RN

Advance Practice Nurse/DPN

NutritionCommercial Nutrition Assistant

Dietician/NutritionistCertified Diabetes Educator

RehabilitationPromatora/CHESocial Worker

OT/PT/OT&PT AssistantsSpeech Language Pathology

Career Trajectory from Stem PSA in Four Major Fields

Diagnostic/ TherapueticsTransportation/Infection Control Aide

PhlebotomistSonographer/Rad Tech/ Resp. Tech

Physician Assistant

Professional ConductWork Habits

Ethics

Medical TerminologyAnatomy/Physiology

Pathobiology

Information TechnologyDocumentation

Quality Improvement

History Physical Exam Procedures

Track Specific Skills

Recruit and Retain professionals

in areas of high need

AHEC workforce strategiesUr

gent

IntermediateLong-term

Distribution of health professionals, particularly in primary care fields, is crucial to addressing disparities

Health professions schools are in need of increased capacity to develop more health care professionals for the future. High-need communities need ways to engage future professionals to recruit workforce

Students from underserved or rural backgrounds are more likely to practice in underserved settings, but often are not aware of opportunities and are not adequately prepared to pursue opportunities

1

2

Promote health careers to young people and foster

preparation for entry into health

professions education

Expand community-based clinical

training to meet need for increased academic

capacity and engage students in high need

communities

3

1

2

3

F. Marie Hall Institute for Rural and Community Health

Exist in 49 states and DCTexas has three AHECs: West Texas AHECEast Texas AHECSouth Texas AHEC

Career Information Provided by the F. Marie Hall Institute

for Rural and Community HealthTexas Tech University Health Sciences Center

Community NeedCommunity Assets Translation Community

Solutions

Stronger Community

Collaboration

Competent Workforce

BUILDS CAPACITY TO DELIVER SERVICES AT THE CLIENT LEVEL