current demographic changes in texas relevant to health workforce demand
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Current Demographic Changes in Texas Relevant to Health Workforce Demand. State Health Plan Population Working Group Presented by Karl Eschbach , Ph.D. Current population trends with implications for health care demand. Rapid growth rate Geographic shifts Shifts in ethnic composition - PowerPoint PPT PresentationTRANSCRIPT
Current Demographic Changes in Texas Relevant to Health Workforce Demand
State Health Plan Population Working Group
Presented byKarl Eschbach, Ph.D.
2
Current population trends with implications for health care demand
• Rapid growth rate• Geographic shifts• Shifts in ethnic composition• Aging of the population• Increases in morbidity
Fastest Growing States, 2000-2009
State2000
Population2009
Population
NumericalChange
2000-2009
PercentChange
2000-2009
Rank in Percent Change
Texas 20,851,820 24,782,302 3,930,482 18.8 6
California 33,871,648 36,961,664 3,090,016 9.1 19
Florida 15,982,378 18,537,969 2,555,591 16.0 9
Georgia 8,186,453 9,829,211 1,642,758 20.1 4
Arizona 5,130,632 6,595,778 1,465,146 28.6 2
North Carolina 8,049,313 9,380,884 1,331,571 16.5 8
Virginia 7,078,515 7,882,590 804,075 11.4 15
Washington 5,894,121 6,664,195 770,074 13.1 11
Colorado 4,301,261 5,024,748 723,487 16.8 7
Nevada 1,998,257 2,643,085 644,828 32.3 1
Source: 2000 Census and 2009 Vintage Census Bureau Estimates
Sources of population growth 2008 to 2009
• + Births: +410,000• -Deaths: -164,000
• +Migration from other countries: +88,000• +Migration from other states: +143,000
• Total: ~477,000
Source: U.S. Bureau of the Census, 2009 Vintage Estimates
Natural Increase in Texas(Births minus Deaths)
• Birth Rate: 16.8 per 1,000 vs. 14.0 for US (2nd highest)• Death Rate: 6.8 per 1,000 vs. 8.3 for US (5th lowest)• Natural Increase: 10.0 per 1,000 vs. 5.7 for US (3rd high)
• Texas is young: – Median Age: 33.2 vs. 36.8 for US (2nd lowest)
• Texas has a high total fertility rate (Children per woman)– 2.34 vs. 2.05 for US (4th highest)
Source: NCHS Vital Statistics Data, 2005 http://wonder.cdc.gov/
Natural Increase per 1,000 by state
West V
irginia
Pennsy
lvania
Rhode Isla
nd
Florida
Montana
Connectic
ut
Louisian
a
Kentuck
y
Michigan
Tennes
see
North Dak
ota
Wisconsin
South Carolin
a
New Je
rsey
Delaware
Kansa
s
North Caro
lina
United Stat
esIllin
ois
Virginia
Minnesota
New M
exico
Georg
ia
Arizona
Idaho
Alaska
0
2
4
6
8
10
12
14
16
Source: NCHS Vital Statistics Data, 2005 http://wonder.cdc.gov/
Total Fertility Rate by Ethnicity, Texas, 2000
Latina Immi-grant
Latina, U.S. Born
Anglo African American
Other (Primarily
Asian)
00.5
11.5
22.5
33.5
43.89
2.36 1.94 2.09 1.87
Sources: Calculated from Census 2000 5% Public-Use Microdata File and National Center for Health Statistics Natality Detail File, 2000,
Annual Net Migration to Texas, 2000 to 2008
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
InternationalState-to-State
8Source: U.S. Bureau of the Census 2008 Estimates
Projected Population of Texas to 2040 (Millions)
2000 2005 2010 2015 2020 2025 2030 2035 204020.0
25.0
30.0
35.0
40.0
45.0
24.3
28.0
31.8
35.8
20.9
25.4
30.9
37.3
44.9
1/2 of 1990 to 2000 (Long-Term) Estimated 2000 to 2007 (Short Term)
Source: Texas State Data Center Population Projections
4
Population Change by Area, 2000-2008
County
PopulationPercentIncrease
Births-Deaths
Migration
2000 2008 Change Foreign DomesticBig 5 Cities 5,524,315 6,334,169 809,854 15 na na naBig 5 Counties 9,270,907 10,768,709 1,497,802 16 981,509 580,088 -129,327Suburban to Big Five 3,567,510 4,943,487 1,375,977 39 328,966 93,530 953,905Border Metros 1,777,429 2,098,343 320,914 18 288,302 93,173 -51,103All Other Metros 3,328,702 3,533,922 205,220 6 196,143 38,559 -16,024All Non-Metro 2,907,272 2,982,513 75,241 3 90,027 46,559 -45,666
Total 20,851,820 24,326,974 3,475,154 17 1,884,947 851,909 711,785
Big 5 Cities: Houston, San Antonio, Dallas, Austin, Fort WorthBig 5 Counties: Harris, Dallas, Bexar, Tarrant, TravisSource: U.S. Bureau of the Census, 2000 Counts, 2008 Vintage Estimates
Growth of Texas Race/Ethnic Groups 2000-2008
Race/Ethnic Group
2000 2008 Growth Percent Increase
Percent of Growth
Black 2,349,641 2,748,323 398,682 17.0 11.5Anglo 10,927,538 11,525,623 598,085 5.5 17.2Latino 6,670,122 8,870,475 2,200,353 33.0 63.3Asian 549,054 810,967 261,913 47.7 7.5Other/Two + 355,465 371,586 16,121 4.5 0.5Total 20,853,820 24,328,982 3,475,154 16.7 100.0
Sources: 2000 Census, Census 2008 Vintage Estimates10
Projected Population (Millions) by Race/Ethnicity 2000-2010
Long-term Growth Migration ScenarioYear Total Anglo Black Latino Asian and other2000 20.9 11.1 2.4 6.7 0.72010 24.3 11.5 2.8 9.1 1.02020 28.0 11.8 3.1 11.9 1.32030 31.8 11.8 3.3 15.1 1.62040 35.8 11.5 3.4 18.8 2.0
Short-term Growth Migration Scenario
Year Total Anglo Black LatinoAsian and
Other2000 20.9 11.1 2.4 6.7 0.72010 25.4 11.4 2.9 9.8 1.22020 30.9 11.6 3.4 13.9 1.92030 37.3 11.5 3.9 19.0 2.92040 44.9 11.2 4.3 25.1 4.2
Source: Texas State Data Center ProjectionsLong-term: ½ of 1990 to 2000; Short-term: Estimated 2000 to 2007
When do Hispanics pass Anglos in Texas?When do Hispanics become a majority in Texas?
MigrationScenario
PassAnglos
?
AbsoluteMajority
?
No Migration 2034 2040+
1/2 of 1990-2000 2020 2035
Observed 1990-2000 2014 2026
Estimated 2000-2007 2015 2028
Source: Texas State Data Center Projections
15
Population Growth by Age,2000 to 2008
0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 850
300,000
600,000
900,000
1,200,000
1,500,000
1,800,000
2,100,000
2000 2008 Growth
Sources: 2000 Census, Census 2008 Vintage Estimates8
17
2001
2003
2005
2007
2009
2011
2013
2015
2017
2019
2021
2023
2025
2027
2029
2031
2033
2035
2037
2039
0
1
2
3
4
5
1.34
1.11
1.55
2.26
4.24
1.73
1.48
Total Age 65+ Ratio of Age 65+ to Total
Table 2. Projected Annual Growth Rate:Total and Ages 65 and older in Texas, 2000-2040
Observed and projected growth by age, 2000 to 2008, and 2008 to 2016
0-19 20-44 45-64 75+0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
875,710
752,552
1,447,201
399,691
488,194
775,069879,667
767,915708,531
1,506,311
1,195,772
774,471
2000 to 2008 Long Term Short Term
Sources: U.S. Census 2000, 2008 Vintage Estimates, State Data Center Projections
19
20
Projected percent 65-years-old or older, 2000-2040 by area
Metropolita
n
Non-Metro
politan
32-county
Border
Non-Border
State of T
exas0.0
5.0
10.0
15.0
20.0
25.0
9.0
15.5
10.0 9.9 9.912.8
21.4
12.113.9 13.7
15.8
22.0
14.716.4 16.3
2000 2025 2040
Obese or Overweight 1995-2007
19951996199719981999200020012002200320042005200620075052545658606264666870
Texas United States
Source: Centers for Disease Control, BRFSS
Age and Obesity in Texas 1995, 2000, 2007
18-24 25-34 35-44 45-54 55-64 65+0
5
10
15
20
25
30
35
199520002007
Source: Centers for Disease Control, BRFSS
Race/Ethnicity and Obesity in Texas, 1995 and 2007
1995 200705
1015202530354045
White Black Latino/aOther
Source: Centers for Disease Control, BRFSS
Projected Increase in Obesity in Texas by Ethnicity, 2006 to 2040
Source: Texas State Data Center Projections
26
Insurance coverage and no insurance by type for ethnic groups, 2008
18 55 65 75 850.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
Self-care limitationAny-Limitation
Source: State Data Center tabulation of U.S. Bureau of the Census, American Community Survey, 2007
Percent of Texans Reporting a Self-CareLimitation or Any Limitation, by Age, 2007
Anglo Hispanic Black Other0
5
10
15
20
25
30
14
20.7
24.9
14.2
Source: State Data Center tabulation of U.S. Bureau of the Census, American Community Survey, 2007
Percent Age of Texans Age 65 or Older ReportingAn Activity Limitation, 2007, by Ethnicity
Projected Growth of the 65+ Population Reporting aSelf-Care Limitation, 2000 to 2040, Assuming
Constant Age/Sex/Race/Ethnic Rates of Disability
2000 2010 2020 2030 20400
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
332,074413,867
585,149
892,197
1,301,645
Source: Office of the State Demographer, 2000-2004 Projection Scenario
30
Contact InformationKarl Eschbach, Ph.D.Professor and Director of Population ResearchDepartment of Internal Medicine-Geriatrics 0460University of Texas Medical Branch301 University BlvdGalveston, TX 77555-0460(409) 747-3516 Phone(409) 772-8931 [email protected]