R C H Center for Rural Health
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1 What Des My spital ave T D With My Twn s Ecnmic Develpment? AgriWellness, Inc. The Clck is Ticking fr Rural America Cnference Sheratn tel, Siux Falls, SD August 4, 2009 Brad Gibbens, Interim C-Directr and Assistant Prfessr UND Center fr Rural ealth R C Center fr Rural ealth Established in 1980, at the University f Nrth Dakta Schl f Medicine and ealth Sciences in Grand Frks, ND One f the cuntry s mst experienced state rural health ffices Fcus n: Educatin, Training, & Resurce Awareness Cmmunity Develpment & Technical Assistance Native American ealth Rural ealth Wrkfrce Rural ealth Research Rural ealth Plicy Prgram Evaluatin UND Center f Excellence in Research, Schlarship, and Creative Activity Web site:
2 Cmmunity Activities C R
3 C R Cntact RAC fr Custmized Assistance in finding slutins t supprt and sustain yur agency inf@racnline.rg M-F 8am-5pm Central Cmparisn f ealth Care and Ecnmic Develpment Sectrs ealth Care Sectr ealth Status Services Emplyment Finance Resurces Element in the lcal ecnmy Ecnmic Develpment Sectr Wealth and prsperity Prduct gds and services Emplyment Capital, investment, incme Resurces Grw and maintain lcal ecnmy ealth and Ecnmic Cnvergence Glbal r macr level gals Acquisitin and management f resurces Emplyment primary and secndary jbs Finance inflw and utflw Ecnmic impact Overall cmmunity building
4 Cmmunity Develpment and Ecnmic Develpment are different ideas Cmmunity Develpment Enhancement f the verall cmmunity cmmunity sustainability Brader fcus inclusive f all sectrs ecnmic, health, educatin, husing, faith, recreatin, arts and entertainment, envirnmental, gvernment Recgnitin that rural cmmunity needs all sectrs t prgress and each sectr relies n the thers Characteristics r attributes f a cmmunity that attract and retain peple what makes a cllectin f sectrs a cmmunity, a place t live Cmmunity invlvement and engagement Ecnmic Develpment Enhancement f ecnmic activity fcus n ecnmic attributes t sustain and grw cmmunity prductin, finance, emplyment, prsperity net gain f mney flw int the cmmunity create and retain jbs and stable tax base R C Cmmunity Develpment Mdel Envirnmental Impacts - Demgraphics - Ecnmic Cnditins - Plitical Prcess - Wrkfrce - Finance -Technlgy - ealth Organizatins - Culture and Attitude Actin - Assessment and Planning - Cmmunity Frums - Cmmunity Educatin - Cllabratin/Netwrking - Reginal Apprach - Cmmunity and Ecnmic Develpment Integratin - Service Diversificatin - Skill Develpment -Build Cmmunity Capacity - Advcacy Cmmunity r ealth Organizatin - Take Actin - N Actin - Delay Actin Surce: Brad Gibbens, Assciate Directr UND Center fr Rural ealth
5 Cmparative Rural and Urban Strengths and Weaknesses Rural Urban Strengths: Strng infrmal supprt netwrk Fundraising Chesive Established interdependence Cllabratin Mre stable ecnmy Availability f resurces Availability f prfessinals Grwing and diverse ppulatin Change is natural Weaknesses: Skewed ppulatin demgraphics Fluctuating ecnmy Resistance t change Shrtage f prfessinals fundraising Lack f resurces Lack f chesiveness Limited infrmal supprt Cmpetitin amng prviders Cmpetitin fr Mre cntentiusfractinalized Factrs fr Successful Cmmunity Building Cmmunity awareness f an issue Mtivatin frm within the cmmunity Flexibility and adaptability Small gegraphical area Pre-existing scial chesin Ability t discuss, reach cnsensus, and cperate Existing identifiable leadership Prir success with cmmunity building Widespread participatin Minimal cmpetitin in pursuit f gals Benefits accrue t many residents Fcus n the prcess and the prduct cncurrently Surce: Fieldstne Alliance ( _cmty_bldg_wmiw.cfm
6 Factrs fr Successful Cmmunity Building Linkage t rganizatins utside the cmmunity Systematic gathering gf infrmatin and analysis f cmmunity issues Training t gain cmmunity skill building Use f technical assistance Cntinual emergence f leaders, as needed Cmmunity cntrl ver decisin making Sincerity f cmmitment Understanding f the cmmunity Relatinship f trust Flexible and adaptive Surce: Fieldstne Alliance ( 06_cmty_bldg_wmiw.cfm What is the Relatinship Between Rural ealth and Ecnmic Develpment? It is a significant part f the natinal ecnmy ealth care spending in 2008 reached $2.4 trillin and prjected at $4.3 trillin in 2018 (CMS prjectin) In 2008, abut $7,900 per persn was spent n health care U.S. spends abut twice as much per capita n health care as ther cuntries ealth care spending is ver 4 times that spent n natinal defense In 2008, health care accunted fr 17.6% f GDP (20% by 2018 CMS prjectin) F 95% France 9.5% Canada 9.7% Germany 10.7% 7 f the tp 10 fastest grwing jbs are in health care U.S. lst 467,000 in June 2009 but added 21,000 health care jbs
7 What is the Relatinship Between Rural ealth and Ecnmic Develpment? Emplyment 10 percent f direct emplyment and 5 percent indirect (15%) Rural hspital first r secnd largest emplyer Nrth Dakta - 36 CAs payrll impact $117 millin (direct) $ 59 millin (indirect) $ 4.9 millin (mean fr each CA, direct and indirect) ND CA average 80 emplyees (120 D and I) Statewide CA s cntribute 2,880 jbs (4,320 D and I) Rural physician practice (5-7 emplyees) - $320,000 ND rural physicians --$29.9 millin ND 8 f tp 10 private emplyers ND health care is 8.4% f state GDP fr 2008 (18 western states = 6.4 %; SD = 8.8%; MN = 8.7%, NE = 7.4%, IA = 6.8%) ND hspital s accunt fr 19,700 jbs (36,000 D and I) ND ranks 6 th fr percentage f wrkers in health care jbs ealth jbs rank 2 nd nly t business jbs fr grwth in ND ( ) What is the Relatinship between Rural ealth and Ecnmic Develpment? Attracting and Retaining Lcal Residents fr Business and Public Sectrs Anchr fr ther ecnmic activity Stabilize and maintain (even grw) area ppulatin Building a reginal ecnmy ealth care is majr emplyer and creates jbs Educated wrkfrce Dual emplyment Generating Lcal/Area Investment Funds Lcal ecnmic impact Cash and shrt-term investment available frm lcal financial centers Surce fr lcal investments lans fr ther business Transfer payments Medicare and Medicaid Retirement incme
8 What is the Relatinship between Rural ealth and Ecnmic Develpment? Enhancing Lcal Leadership Capacity Frmal invlvement as cmmunity leaders Lcal gvernment Civic rganizatins Lcal ecnmic develpment Schl and educatin Faith cmmunity Building skills and cmmitment t civic respnsibility catalyst Linkage t external resurces and knwledge Examples f ealth Care and Ecnmic Develpment Cnfluence Ecnmic r Jb Develpment Authrities Wellness Centers as part f ecnmic develpment Cavalier Cunty Jb Develpment, spital, and Public ealth WILL Outreach Grant Bttineau Cunty Ecnmic Develpment Authrity Washburn Ecnmic Develpment ealth Occupatins Tday and Tmrrw (OTT) Center fr Rural ealth (SOR and Flex funding) with rural hspitals, schls, and ecnmic develpment new Eastern AEC will cntinue apprach Flex plan three cmmunity case studies n health and ecnmic develpment Flex Ecnmic Develpment Cmmittee (3 CA administratrs and 3 EDA directrs) Flex Prgram use f Rural ealth Wrks IMPLAN mdel presentatin n health and ecnmic develpment t state Ecnmic Develpment Assciatin in 2008 presentatin n health and ecnmic develpment t tw reginal hspital bard educatin wrkshps Bt-Camp 09 EDA bard member f new ND Rural ealth Assciatin
9 What are the Next Steps Where D We G Frm ere? Recgnize the significance f the lcal health sectr in ecnmic matters Recgnize the significance f the lcal health sectr in cmmunity develpment Search fr pprtunities t link ecnmic develpment and rural health develpment state and cmmunity level Fr bth ecnmic develpment and rural health develpment remember the imprtance, the legitimate rle, and the impact f cmmunity participatin Recgnize that ne size des nt fit all change must fit with lcal needs Build a relatinship with yur state Rural ealth Assciatin Cntact yur State Office f Rural ealth t wrk with yu C R Fr mre infrmatin cntact: Center fr Rural ealth University f Nrth Dakta Schl f Medicine and ealth Sciences Grand Frks, ND Tel: (701) Fax: (701)
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