action planning summit the big picture
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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
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