Inside This Issue:
Research Provides Insights on Home and Community-Based Alternatives to Nursing Homes
Pennsylvania has the fourth highest population of residents age 65 and over in the nation, according to 2010 data from the U.S. Census Bureau.
As our residents age, their anticipated end-of-life-care needs may grow. Research has shown that keeping older adults in their community is more cost effective than living in institutions, such as nursing homes. However, research has also shown that there are fewer community-based, in-home services and residential care options for seniors living in rural areas.
To determine how many home and community-based care alternatives to nursing homes are available in rural Pennsylvania, Dr. Janet Ann Melnick and Geraldine Ferrer of Penn State-Worthington Scranton and Dr. Heather Shanks-McElroy and Sara Dunay of Keystone College conducted research in 2012, which was sponsored by the Center for Rural Pennsylvania.
The researchers also looked to determine the need for rural home and community-based care alternatives to nursing homes among adults age 65 years old and older who need help with one or more daily living skills and persons with disabilities who are under age 60 who need help with daily living skills.
In addition, the researchers compared the supply of and demand for rural home and community-based (HCB) care alternatives to nursing homes, and identified existing and potential gaps in service.
The research included all 48 rural counties, as defined by the Center for Rural Pennsylvania, and nine urban counties that border rural counties.
The research found that 77 percent of HCB care providers in the 57 study counties were nonprofit agencies and that individual HCB care agency budgets varied significantly. On average, the HCB care providers offered 3.8 types of services for consumers, with a reported range of one to eight services.
Agencies and organizations that participated in the study survey identified a total of 126,461 unduplicated individuals who received HCB care services in 2011. When compared with a Census-based projection of 339,641 viable candidates for HCB care services in Pennsylvania’s rural counties, the research determined that 213,180 viable candidates for HCB care services were not being served by the existing service system.
The researchers also estimated the current number of rural constituents who could be eligible for HCB care alternatives to nursing homes – if such services existed – to be 319,450.
The research identified two viable funding models of successful rural home and community-based care alternatives to nursing homes used in other rural states that could be implemented and expanded in Pennsylvania. These were the Minnesota Health Care Home model and the federal PACE program, which is called the Life Program in Pennsylvania.
Policy considerations offered by the researchers focused on funding considerations and addressing the weaknesses in service provision as follows:
In November, the Center for Rural Pennsylvania presented the report, Analysis of Potential Demand for the Extension and Expansion of Natural Gas Distribution Infrastructure in Pennsylvania, to the Pennsylvania General Assembly. The report is in response to Senate Resolution 29, which directed the Center to study the potential for the increased extension of natural gas distribution infrastructure by Pennsylvania’s natural gas public utilities to unserved and under-served areas.
Specifically, the Center was charged with studying the residential, commercial and industrial extension of natural gas distribution infrastructure by collecting and analyzing information on the:
To accomplish this charge, the Center worked with Dr. Richard Ready, who developed a telephone survey and analyzed the survey findings, and Mr. Berwood Yost, director of the Center for Opinion Research at Franklin and Marshall College, and his staff, who administered the telephone survey. The telephone survey included more than 1,000 Pennsylvania households from four regions of the state. These regions encompassed both rural and urban areas and were selected to provide geographic and demographic diversity to the research.
The survey revealed several important findings including the following: the study respondents were well informed about the relative operating costs of different heating systems; there may be a large potential pool of households interested in connecting to natural gas to save money on heating; and the probably of households converting to natural gas service increases as the upfront costs decrease and as the payback time decreases.
To complement these and the other research findings, the Center for Rural Pennsylvania developed a demographic and socioeconomic profile of Pennsylvania communities in which natural gas distribution infrastructure is and is not available.
For a copy of the report, Analysis of Potential Demand for the Extension and Expansion of Natural Gas Distribution Infrastructure in Pennsylvania, visit www.rural.palegislature.us, or call or email the Center at (717) 787-9555 or email@example.com.
It is hard to believe another year is coming to a close.
As we get older, time seems to move at breakneck speed. Many people over 65 have probably thought about lifestyle changes. If they are having difficulties with basic living skills or have special health care needs, they may be thinking about different living arrangements.
For some seniors, in-home health care may not be available and nursing home care may be the only option.
Our feature article provides valuable information about alternatives to nursing home care in rural Pennsylvania. The article describes how researchers from Penn State Worthington-Scranton and Keystone College used human service agency data and 2010 Census data to identify home and community-based care as an alternative to a nursing home. Their research provides caregivers, advocates and policymakers with recommendations on ways to allow older adults to remain in their homes for as long as possible.
Another article features the release of the Center’s study on the extension of natural gas distribution infrastructure. The Center has shared results of the study with the legislature. It is my hope the study will help the General Assembly, the Public Utility Commission, and the natural gas industry find innovative solutions that will meet consumer needs with Pennsylvania resources. If you are interested in this study, you can visit our website to view a copy of the report.
As the Center looks forward to 2014, it will continue its mission of providing timely research and data to help us better understand the trends, conditions and opportunities of not only our rural communities but also our commonwealth as a whole. While we cannot forecast the future, we can provide useful information to help our citizens manage change and prepare for the times ahead.
On behalf of the board and staff, we wish you a happy holiday season and a prosperous New Year.
Senator Gene Yaw
There were an estimated 108,140 self–employed workers, or 6 percent of all employed people, in rural Pennsylvania in 2011, according to U.S. Census Bureau data. In urban Pennsylvania, there were an estimated 185,894 self-employed workers, or 5 percent of all employed people, in urban Pennsylvania in 2011.
To learn more about the self-employed, the Center for Rural Pennsylvania used data from the 2011 American Community Survey, Public Use Microdata Sample (ACS-PUMS). The Center defined a “self-employed” worker as someone who works for profit or fees in his/her own unincorporated or incorporated business, profession, or trade, or who operates a farm. The analysis included self-employed people who worked 10 or more hours a week and earned an income of $1,000 or more from their business or farm. The analysis excluded anyone under 18 years old and those in an institution, such as a nursing home or prison.
Age, Gender, Race, Marital Status
The average age of rural and urban self-employed workers is 49.2 years old. Fourteen percent of the rural self-employed are under 35 years old, 78 percent are 35 to 64 years old and 8 percent are 65 years old and older. The age distribution among the urban self-employed is similar.
Seventy percent of the rural self-employed are male and 30 percent are female.
Among the urban self-employed, 68 percent are male and 32 percent are female.
Ninety-seven percent of the rural self-employed are white and 3 percent are non-white.
Among the urban self-employed, 88 percent are white and 12 percent are non-white.
Less than 1 percent of the rural self-employed are Hispanic\Latino and 5 percent of the urban self-employed are Hispanic\Latino.
Seventy-three percent of the rural self-employed are married, 14 percent are widowed, divorced, or separated, and 13 percent have never been married.
Among the urban self-employed, 66 percent are married, 15 percent are widowed, divorced, or separated, and 19 percent have never been married.
Three percent of the rural and 12 percent of the urban self-employed are foreign born.
Eighty-seven percent of the rural self-employed live with other people and 13 percent live alone.
Among the urban self-employed, 84 percent live with others and 16 percent live alone.
On average, both rural and urban self-employed households contain 2.9 people.
Thirty-four percent of rural self-employed households and 33 percent of urban self-employed households have children under the age of 18 living in the household.
Three percent of the rural and 5 percent of the urban self-employed live in a multigenerational household, which is a household with three or more generations living together.
Eighty-five percent of the rural self-employed are homeowners. The median value of their homes is $150,000 and their median monthly housing payments, which include mortgages, insurance and utilities, are $967, or 18 percent of their total income.
Among the urban self-employed, 82 percent are homeowners. The median value of their homes is $235,000 and their median monthly housing payments are $1,438, or 22 percent of their total income.
Sixty-two percent of the rural and 56 percent of the urban self-employed have lived in the same home for 10 or more years.
Eleven percent of the rural and 5 percent of the urban self-employed have businesses located in their home.
Fifteen percent of the rural self-employed have agricultural sales of $1,000 or more.
Among the urban self-employed, 13 percent have agricultural sales.
On average, the rural self-employed work 39.7 hours a week and the urban self-employed work 44.0 hours a week.
Seventy-five percent of the rural self-employed work full-time (35+ hours a week). Their median annual earnings are $26,474. Twenty-five percent work part-time (<35 hours a week). Their median annual earnings are $12,219.
Sixty-eight percent of the urban self-employed work full-time. Their median annual earnings are $30,547. Thirty-two percent of the urban self-employed work part-time. Their median annual earnings are $13,746.
The top three industries in which the rural self-employed work are: construction (20 percent); personal services, such as dry cleaning and photography (14 percent); and professional services, such as doctors, accountants, and lawyers (13 percent).
The top three industries for the urban self-employed are the same but in a different order: professional services (21 percent); construction (19 percent); and personal services (14 percent).
The top three occupations among the rural self-employed are: management/consulting (19 percent); construction (15 percent); and sales (15 percent). For the urban self-employed, the top three occupations are: sales (15 percent); construction (10 percent); and management (12 percent).
The average commuting time is 23.2 minutes for the rural self-employed and 25.1 minutes for the urban self-employed.
Seventy-three percent of rural self-employed families have two or more workers and 76 percent of urban self-employed families have two or more workers.
The total median household income for the rural self-employed is $60,921. Among the urban self-employed, the total median household income is $72,804.
Eight percent of the rural and 7 percent of the urban self-employed have incomes below the poverty level.
Ten percent of the rural self-employed do not have a high school diploma, 48 percent have a high school diploma, 15 percent have taken some college courses but do not have a degree, 7 percent have an associate’s degree, and 21 percent have a bachelor’s degree or higher.
Eleven percent of the urban self-employed do not have a high school diploma, 31 percent have a high school diploma, 17 percent have some college education but no degree, 6 percent have an associate’s degree, and 35 percent have a bachelor’s degree or higher.
Three percent of both the rural and urban self-employed were enrolled in school.
Twenty-seven percent of the rural and 22 percent of the urban self-employed have no health care insurance.
Among the rural self-employed with health care insurance, 79 percent are insured through a private provider, 11 percent through a public provider (Medicare, MA, VA, etc.), and 10 percent are insured through a mixture of both private and public providers. These percentages are nearly identical for the urban self-employed.
Nationwide, 8.2 million adults are self-employed, or 6 percent of all employed persons.
The three states with the highest percentages of self-employed workers are Vermont, North Dakota, and Montana; in each, more than 8 percent of employed persons are self-employed.
The three states with the lowest percentages of self-employed workers are Nevada, West Virginia, and Delaware; in each of these states, less than 5 percent of employed persons are self-employed.
Among all 50 states, Pennsylvania has the nation’s 37th highest rate of self-employment with 5 percent.
Rural and Urban Self-Employed Top Three Industries
There are currently 816 operating airports in Pennsylvania, according to 2013 data from the Federal Aviation Administration. These airports are fairly evenly distributed between urban areas (51 percent) and rural areas (49 percent). However, only 61 urban and 68 rural facilities are available for public use, leaving a total of 687 (353 urban and 334 rural) Pennsylvania airports for private use.
In rural Pennsylvania, 65 percent of airports are for planes, 31 percent are for helicopters only (heliports) and 4 percent are for other aircraft, such as gliders (glider ports) and seaplanes (seaplane bases).
Among all rural aircraft facilities, 150 runway surfaces are paved, 246 are unpaved and six are other surfaces, such as water.
In urban Pennsylvania, 41 percent of airports are for planes, 56 percent are for helicopters, and 3 percent are for other aircraft.
Among all urban aircraft facilities, 219 runway surfaces are paved, 188 are unpaved, and seven are other surfaces.
In Pennsylvania, only 17 airports have air traffic control towers: 14 are at urban airports and three are at rural airports. Air traffic control towers are located only at airports with paved runways.
Among all counties, Bucks County has the highest number of aircraft facilities, with a total of 47. Cameron County has the fewest, with only one.
Nationwide, there are nearly 19,400 aircraft facilities. The states with the highest number of aircraft facilities are Texas (2,028), California (944) and Florida (839). Pennsylvania has the fourth highest number of aircraft facilities, with 816. Rhode Island has the fewest number of aircraft facilities, with only 24.
In terms of aircraft facility type, Texas has the greatest number of airports (1,459) and Rhode Island has the fewest (nine). Texas also has the greatest number of heliports (553), and Delaware has the fewest (10). As for other facility types, such as seaplane bases and glider ports, Alaska has the highest number at 139. The state with the second highest number of other facility types is Minnesota, with 58.
In Pennsylvania, there are 7,217 registered aircrafts: 2,624 (36 percent) are in rural areas and 4,593 (64 percent) are in urban areas. In both rural and urban areas, most aircraft are owned by individuals (64 percent and 54 percent, respectively) and corporations (23 percent and 34 percent, respectively).
Eighty-five percent of the aircraft registered in Pennsylvania are airplanes, 7 percent are helicopters and 8 percent are other types of aircraft, such as balloons and gliders.
At the county level, Allegheny has the greatest number of aircrafts (542) and Forest County has the fewest number of aircrafts (2).
In 2013, California has the greatest number of registered aircrafts at 30,687 and Rhode Island has the fewest at 432. Pennsylvania has 7,217 registered aircrafts.
In 2013 14,562 pilots resided in Pennsylvania. Allegheny County, an urban county, is home to 1,316 pilots, the greatest number of all Pennsylvania counties. The fewest number of pilots (1) reside in rural Forest County.
Nationwide, the greatest number of pilots resides in California (57,609) and the fewest reside in Rhode Island (942). Alaska has the greatest number of pilots per 100,000 population (1,043) and New York has the fewest (82).
According to an economic impact study commissioned by Pennsylvania Department of Transportation in 2011, Pennsylvania’s public-use airports support approximately 304,462 jobs, generate $9.2 million in annual payroll, and produce $23.6 billion in annual economic activity. Pennsylvania airports not only support 5 percent of Pennsylvania’s workforce, but also many businesses that rely on airport access for the essential transport of people, cargo and mail. According to the economic impact study, 78 percent of Pennsylvania businesses indicated that a commercial service airport nearby was an important factor in choosing their current business location.
According to data from the 2012 Editor and Publisher International Yearbook, there are 38 daily newspapers in rural Pennsylvania, with a total circulation of more than 505,000. Since 1992, nine newspapers have closed and total circulation has declined 29 percent.
In urban Pennsylvania, there are 30 daily newspapers with a circulation of 1.1 million. Three newspapers have closed since 1992, and total circulation has declined 50 percent.
Twenty counties in Pennsylvania, all of which are rural, have no daily newspaper.
There are 58 weekly newspapers in rural Pennsylvania, with a total circulation of more than 305,000. Only two weekly newspapers have closed in rural Pennsylvania since 1992, and total circulation has increased 5 percent.
There are 100 weekly newspapers in urban Pennsylvania, with a total circulation of nearly 800,000. Fourteen weeklies have closed in urban Pennsylvania, and total circulation has declined 30 percent.
There are 10 Pennsylvania counties, both rural and urban, with no weekly newspapers.
According to the most recent data from the U.S. Census Bureau, the number of daily newspapers in the U.S. has declined from 1,570 in 1992 to 1,397 in 2009, a difference of 173 newspapers. During the same period, national circulation declined 23 percent.
The states with the highest number of daily newspapers are California, with 83, Ohio, with 82, Texas, with 81, and Pennsylvania, with 80.
In Pennsylvania, there has been a decline in both the number of persons employed in the newspaper publishing industry and the number of publishing businesses, according to data from the Pennsylvania Department of Labor and Industry. From 2001 to 2012, average employment dropped 39 percent, which equates to a loss of about 8,700 employees, and the number of newspaper publishing businesses decreased 11 percent.