of the Health Care Sector on the Economy of Atoka County, Oklahoma The Importance of the Health Care Sector on the Economy of Atoka County, Oklahoma By Gerald A. Doeksen, Regents Professor and Extension Economist Cheryl F. St.Clair, Assistant Extension Specialist Fred C. Eilrich, Assistant Extension Sprcialist Oklahoma State University and Val Schott, Director Oklahoma Office of Rural Health

The Economic Impact of the Health Sector on XYZ County Community

What's the Economic Potential for Health Care in Your Community

Health Services Promote Job Growth

Services that Impact Rural Development Table 1 Services that Impact Rural Development Services Important Type of Growth to Attract Growth Industrial and Business Health and Education Retirees Health and Safety

National Health Expenditures and Employment Data Table 2 National Health Expenditures and Employment Data 1970-2001 Total Per Capita Expenditures Employment Annual Expenditures Expenditures as a Percent in Health Sector Increase in Year ( $$Billions) ($$) of GDP (000 Jobs) Employment 1970 $ 73.1 $ 348 7.0 3,052 1980 245.8 1,067 8.8 5,278 7.3% 1990 695.6 2,738 12.0 7,814 4.8% 1996 1,038.0 3,842 13.3 9,478 2.7% 1997 1,093.9 4,011 13.2 9,703 2.4% 1998 1,149.8 4,177 13.1 9,852 1.5% 1999 1,215.6 4,377 13.1 9,977 1.3% 2000 1,299.5 4,637 13.2 10,096 1.2% 2001 1,423.8 5,039 14.0 10,344 2.5%

Estimated Potential Primary Care Expenditure Table 3 Estimated Potential Primary Care Expenditure For Atoka County, Oklahoma 20011 Percent Primary Atoka County U.S. Per Primary Care Potential Health Services Capita Care Per Capita Expenditures Hospital Care $1,580 61% $964 $13,379,356 Professional Services Physician/Clinical Services 1,099 75% 824 11,436,296 Dental Services 228 75% 171 2,373,309 Other Prof. Services 151 75% 113 1,568,327 Other Prof. Health Care 147 75% 110 1,526,690 Home Health Care 127 100% 127 1,762,633 Nursing Home Care 351 100% 351 4,871,529 Prescription Drugs 502 75% 377 5,232,383 Other Medical Products 187 75% 140 1,943,060 Gov’t Administration and Net Cost of Insurance 328 0% 0 0 Gov’t Public Health Activities 175 50% 88 1,221,352 Investment (Research) 164 0% 0 0 TOTALS $5,039 65% $3,265 $45,314,935

Selected Demographic Data for Atoka County and the State of Oklahoma Table 4 Selected Demographic Data for Atoka County and the State of Oklahoma Selected Item Atoka County County % State % Population Growth (1980-90) 12,748-12,778 0.2% 4.0% Population Growth (1990-00) 12,778-13,879 8.6% 9.7% Population Growth (1980-00) 12,748-13,879 8.9% 14.1% Population Projections: Year 2005 = 14,103 Year 2010 = 14,327 Year 2015 = 14,635

Selected Demographic Data (Continued) Table 4 Selected Demographic Data Selected Item Atoka County County % State % Population by Race (2000) White 10,528 75.9 76.2 Black 814 5.9 7.6 American Indian1 1,578 11.4 7.9 Other2 114 0.8 3.8 Two or more races3 845 6.1 4.5 Hispanic4 196 1.4 5.2

Selected Demographic Data (Continued) Table 4 Selected Demographic Data Selected Item Atoka County County % State % Population by Age (2000) 0 - 9 1,710 12.3 13.9 10-19 1,899 13.7 15.1 20-24 806 5.8 7.2 25-34 1,817 13.1 13.1 35-44 2,218 16.0 15.2 45-54 1,915 13.8 13.1 55-59 779 5.6 5.0 60-64 685 4.9 4.1 65-74 1,089 7.8 7.0 75-84 703 5.1 4.5 85+ 258 1.9 1.7

Economic Indicators for Atoka County, the Table 5 Economic Indicators for Atoka County, the State of Oklahoma and the Nation Indicator County State Nation Total Personal Income (01)1 $214,113,453 $84,049,891,783 $8,541,068,616,916 Per Capita Income (01) $15,394 $24,145 $29,985 Employment (01) 4,800 1,601,917 NA Unemployment (01) 201 63,507 NA Unemployment Rate (01) 4.0% 3.8% 4.8% Poverty Rate (98)1 27.0% 16.1% 12.7% Transfer Dollars (01)1 $54,287,802 $13,107,079,560 $1,116,837,268,785 Transfer Dollars as % of Total Personal Income (01) 25.4% 15.6% 13.1%

Table 6 Personal Income Data for Atoka County, The State of Oklahoma, and the Nation 2000 & 2001 County County State Nation Total % of % of % of Source ($000) Total Total Total Total Personal Income (01) $214,113,453 Earnings by Place of Residence (01) $131,499,242 66.2 70.6 72.4 Transfer Payments (01) $54,287,802 23.1 15.0 13.1 Total Earnings (01) $119,826,712 Wages and Salaries (01) $75,008,848 62.6 74.1 79.5 Proprietor’s Income (01) $34,331,682 28.7 16.3 11.7 Other Labor Income (01) $10,486,182 8.8 9.6 8.8 Transfer Payments (00) $52,334,000 Retirement and Disability (00) $20,485,000 36.0 43.0 39.7 Medical Payments (00) $18,060,000 34.4 35.7 39.5 Other (00) $13,789,000 26.3 21.4 20.7

Employment by Sector for Atoka County Figure 1. Employment by Sector for Atoka County

Availability of Selected Medical Providers - Atoka County Table 7 Availability of Selected Medical Providers - Atoka County County County State Provider Number Rate / 1,000 Rate / 1,000 Hospitals (98,99) Licensed Hospital Beds 15 1.1 NA Staffed Hospital Beds 15 1.1 NA Geriatric Day Services (99) Number Licensed 0 NA 709 Total Persons Served 0 NA 761 New Referrals 0 NA 402 Estimated Need- Persons Age 65+ 26 NA 5699 Nursing Homes Beds (98) 192 200 164 Health Service Practitioners: M.D.'s (00) 3 0.22 1.43 D.O.'s (00) 2 0.14 0.28 Primary Care Physicians (00)1 5 0.36 0.70 COGME4,5 Midpoint (00) 10 5 -1 Physician Assistants (99) 3 0.22 0.12 Dentists (98) 3 0.22 0.44 Emergency Medical Technicians (99): First Responders 2 0.14 0.22 EMT Basics & Intermediates 13 0.94 0.62 Paramedics 3 0.22 0.34

Heath Status and Health Indicators for Table 8 Heath Status and Health Indicators for Atoka County and the State of Oklahoma County County State Status of Indicator Number Percent/Rate Percent/Rate Hospital Admissions/Occupancy Rate (%) 764 59.5 n/a Medicare Enrollment (99): Aged (65 and over) 1,821 13.3 14.7 Disabled (Under 65) 332 2.4 2.0 Medicaid Enrollment (00): Medicaid Eligible 2,434 17.7 12.6 Medicaid Served 2,274 93.4 92.7 Medicare Discharges (98,99) 398 53.1 n/a Medicaid Discharges (98,99) 59 7.9 n/a TAN-F Recipients (00) 148 1.1 1.0 Adult Recipients 25 0.2 0.3 Child Recipients 123 3.8 3.0 Food Stamps (persons) (00) 1,523 11.0 7.4 Infant Mortality (95-99) 7 8.7 8.2 Births to Teens (97-99) 11.0 38.6 32.2 Child Abuse Cases Confirmed (00) 50 15.3 15.0 Children Receiving Medicaid Ages 0-17 (00) 1,412 43.6 30.0

Overview of Community Economic System Households Industry Basic Services Goods & $ Inputs Products Labor Figure 2. Overview of Community Economic System

Atoka County Health Sector Impact Table 9a Atoka County Health Sector Impact on Employment IMPLAN Type III Health Sectors Employment Multiplier Impact Hospitals 120 1.64 197 Medical Professionals 54 1.63 88 Nursing & Protective Care 149 1.44 219 Other Medical & Health Services 63 1.52 96 Pharmacies 16 1.42 23 TOTALS 402 623

Atoka County Health Sector Impact (Continued) Table 9b Atoka County Health Sector Impact on Income IMPLAN Type III Health Sectors Income Multiplier Impact Hospitals $2,406,564 1.53 $3,682,043 Medical Professionals $1,951,000 1.30 $2,750,910 Nursing & Protective Care $1,806,000 1.56 $2,925,720 Other Hlth & Med Svcs $1,195,000 1.45 $1,637,150 Pharmacy $425,753 1.60 $736,553 TOTALS $7,784,317 $11,732,376

Atoka County Health Sector Impact (Continued) Table 9c Atoka County Health Sector Impact on Retail Sales and Sales Tax Collections 1 Cent Retail Sales Tax Health Sectors Sales Collection Hospital $1,489,936 $14,899 Medical Professionals $1,023,904 $10,239 Nursing & Protective Care $1,137,368 $11,374 Other Hlth & Med Svcs $699,511 $6,995 Pharmacy $275,003 $2,750 TOTALS $4,625,722 $46,257

A. Where is the community now? NEXT STEPS If you, the local decision makers, wish to promote your health sector, here is how we can help you: I. Strategic Health Planning A. Where is the community now? B. Where does the community want to go? C. How will the community get there?

II. Feasibility Studies Primary Care Physician Obstetrics/Gynecology Physician Pediatrician Emergency Medical Services (Basic and Advanced) First Responder Systems Outpatient Rehabilitation Adult Day Services Fire Protection Solid Waste Transportation Systems

Budget Studies Under Construction Kidney Dialysis Rural Health Clinics Federally Qualified Health Centers Primary Care Physician Dentist Pharmacies Assisted Living Facilities EMS Add Others, as Requested