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Work & Health Commuting in Mississippi

Work & Health Commuting in Mississippi. Garen K. Evans, Ph.D. Albert Myles, Ph.D. Community Resource Development MISSISSIPPI STATE UNIVERSITY. Motivation. “First in Worst” -- Dr. Ed Thompson, CDC (frmr MSDH) #1 Diabetes (84 vs. 45) #1 Heart Disease (344 vs. 260)

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Work & Health Commuting in Mississippi

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  1. Work & Health Commuting in Mississippi Garen K. Evans, Ph.D. Albert Myles, Ph.D. Community Resource Development MISSISSIPPI STATE UNIVERSITY

  2. Motivation “First in Worst” -- Dr. Ed Thompson, CDC (frmr MSDH) #1 Diabetes (84 vs. 45) #1 Heart Disease (344 vs. 260) #1 Obesity (tied with AK, 610 vs 560) #2 Infant Mortality (10.5 vs. 6.8) Kaiser Family Foundation, 2000

  3. Work Commuting: 1990, 2000 • Health Commuting • Entropy Maximization Approach Lowry, 1966; Fotheringham, 2000; Sen and Soot, 1981; Roy and Thrill, 2004; Wilson, 1970 Gij = g A1A2 d12-2

  4. Labor Force Trends

  5. Commuting Trends

  6. Commuting vs. Labor Force • Civilian Labor Force: 18% • Commuting: 39% • Statewide commuting grew faster. • Commuting as a fraction of the labor force grew statewide from 1990 - 2000: • Statewide average: 18.7%

  7. Approach • Commuting model • 1990 • 2000 • Vermeulen, 2003 • Framework: Tij = Ai Bj Fij • Extension: health care (?)

  8. Specification • Tij = LiαEjβdijγ • Commuting flow: Tij • Labor force: Li • Employment: Ej • Distance: dij • lnTij = α lnLi +β lnEj + γ lndij

  9. Study Data • U.S. Census • 1990 County-to-County Worker Flows • 2000 County-to-County Worker Flows • USA Counties CD-ROM (1998) - 1990 data • County & City Databook 2000 • U.S. Dept. of Justice

  10. Results

  11. Summary • Change in local labor force has higher impact that distant employment. • Distance deterrence has increased. • More local opportunities. • Limited transportation options. • To whom does this apply? • Cf., urban sprawl

  12. Health Care • What came first? • Why did the chicken cross the road? • Is the grass really greener?

  13. “Health Commuting” • Is the grass greener? • Residents in 10+% of the counties relied solely on health service away from home. • Fifty:50 Phenomenon? • In more than half of the counties, more than 50% of residents seek health care in another county. • They have hospitals.

  14. Why Commute? • Convenience • Familiarity • Necessity • Quality

  15. Why Commute? • Convenience • Commuting to work • Familiarity • Distance • Necessity • Per-capita income • Quality • Education (B.S. +)

  16. Health Model • Framework: • Hij = Tijα IiβEiγdijδ • Data: • MHA Aggregate Patient Origin Study • BEA: income (2000) • Census: bachelors > 25

  17. Results

  18. Implications • The grass is not necessarily more green, but it might be taller. • Convenience • Increased income => lower commuting for health care. An access advantage?

  19. The Next Step • Explore the relation of education with health care. • Model constraints • other members of the family (S.I.M) • New paradigms (McNamara)

  20. Health Commuting Garen K. Evans gevans@ext.msstate.edu 662.325.3144 giwiganz.com

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