1. 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

2. The Economic Impact of the Health Sector on XYZ County

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

5. Health Services Promote Job Growth

8. Table 1 Services that Impact Rural Development Services Important Type of Growth to Attract Growth Industrial and BusinessHealth and Education RetireesHealth and Safety

9. Table 2 National Health Expenditures and Employment Data 1970-2001 Total Per Capita Expenditures Employment Annual ExpendituresExpendituresas 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%

10. Table 3 Estimated Potential Primary Care Expenditure For Atoka County, Oklahoma 2001 1 Percent PrimaryAtoka County U.S. PerPrimary Care Potential Health Services Capita CarePer CapitaExpenditures Hospital Care$1,58061%$964$13,379,356 Professional Services Physician/Clinical Services1,09975%82411,436,296 Dental Services22875%1712,373,309 Other Prof. Services15175%1131,568,327 Other Prof. Health Care14775%1101,526,690 Home Health Care127100%1271,762,633 Nursing Home Care351100%3514,871,529 Prescription Drugs50275%3775,232,383 Other Medical Products18775%1401,943,060 Gov’t Administration and Net Cost of Insurance3280%00 Gov’t Public Health Activities17550%881,221,352 Investment (Research)1640%00 TOTALS$5,03965%$3,265$45,314,935

11. Table 4 Selected Demographic Data for Atoka County and the State of Oklahoma Selected ItemAtoka CountyCounty %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

12. (Continued) Table 4 Selected Demographic Data Selected ItemAtoka CountyCounty %State % Population by Race (2000) White 10,528 75.9 76.2 Black 814 5.9 7.6 American Indian 1 1,578 11.4 7.9 Other 2 114 0.8 3.8 Two or more races 3 845 6.1 4.5 Hispanic 4 196 1.4 5.2

13. (Continued) Table 4 Selected Demographic Data Selected ItemAtoka CountyCounty %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

14. 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%

15. Table 6 Personal Income Data for Atoka County, The State of Oklahoma, and the Nation 2000 & 2001 CountyCountyStateNation Total % of% of % of Source ($000) TotalTotal Total Total Personal Income (01)$214,113,453 Earnings by Place of Residence (01)$131,499,24266.270.672.4 Transfer Payments (01)$54,287,80223.115.013.1 Total Earnings (01)$119,826,712 Wages and Salaries (01)$75,008,84862.674.179.5 Proprietor’s Income (01)$34,331,68228.716.311.7 Other Labor Income (01)$10,486,1828.89.68.8 Transfer Payments (00)$52,334,000 Retirement and Disability (00)$20,485,00036.043.039.7 Medical Payments (00)$18,060,00034.435.739.5 Other (00)$13,789,00026.321.420.7

16. Figure 1. Employment by Sector for Atoka County

17. Table 7 Availability of Selected Medical Providers - Atoka County CountyCountyState ProviderNumberRate / 1,000Rate / 1,000 Hospitals (98,99) Licensed Hospital Beds 15 1.1 NA Staffed Hospital Beds 15 1.1 NA Geriatric Day Services (99) Number Licensed0NA709 Total Persons Served0NA761 New Referrals0NA402 Estimated Need- Persons Age 65+26NA5699 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 COGME 4,5 Midpoint (00)105-1 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

18. Table 8 Heath Status and Health Indicators for Atoka County and the State of Oklahoma County County State Status of IndicatorNumberPercent/Rate Percent/Rate Hospital Admissions/Occupancy Rate (%)76459.5n/a Medicare Enrollment (99): Aged (65 and over)1,82113.314.7 Disabled (Under 65)3322.42.0 Medicaid Enrollment (00): Medicaid Eligible2,43417.712.6 Medicaid Served2,27493.492.7 Medicare Discharges (98,99)39853.1n/a Medicaid Discharges (98,99)597.9n/a TAN-F Recipients (00)1481.11.0 Adult Recipients250.20.3 Child Recipients1233.83.0 Food Stamps (persons) (00)1,52311.07.4 Infant Mortality (95-99)78.78.2 Births to Teens (97-99)11.038.632.2 Child Abuse Cases Confirmed (00)5015.315.0 Children Receiving Medicaid Ages 0-17 (00)1,41243.630.0

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

20. Hospitals1201.64197 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 Table 9a Atoka County Health Sector Impact on Employment IMPLAN Type III Health Sectors EmploymentMultiplierImpact

21. (Continued) Table 9b Atoka County Health Sector Impact on Income IMPLAN Type III Health Sectors IncomeMultiplier 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

22. (Continued) Table 9c Atoka County Health Sector Impact on Retail Sales and Sales Tax Collections 1 Cent RetailSales Tax Health Sectors SalesCollection 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

23. 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?

24. 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

25. 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