Flu season in Georgia: Does the state have the healthcare workers to handle it and can people afford the treatment?

The holiday season will see many offices short of workers, but not all workers will be missing work because of the holidays. Some will be home sick with the flu, while others drag themselves into work despite illness. For most workers, the flu is an unpleasant experience at best, but for some it can be deadly.

Employers also suffer as sick workers mean lost productivity and increased lost worktime.

The 2014-2015 flu season has begun and WXIA-TV is reporting that Georgia is facing one of the worst flu outbreaks in years. According to the federal Centers for Disease Control and Prevention, Georgia is one of about a dozen states with widespread activity.

While CDC continues to encourage people to get flu shots, they acknowledge that this year’s flu vaccine is less effective against the flu strain being seen in the state.

For those not feeling well, a visit to one of the many walk-in clinics, their doctor’s office, or a trip to the emergency room of a nearby hospital may be in order. All of which are already seeing increased visits.

In light of the possibility of a particularly bad outbreak this year, does Georgia have sufficient healthcare personnel to cope?

The answer is yes, but just barely and at a greater cost than elsewhere.

According to data from the Bureau of Labor Statistics, approximately 333,000 people were employed in healthcare establishments in Georgia in November 2014. This represents approximately 7.9 percent of the state’s workforce.

Nationally, healthcare employs approximately 8.2 percent of the workforce.

Proportionately, Georgia is falls slightly below the national average when comes to healthcare staffing, which makes it slightly less able to cope if faced with increased demand from more, and more sickly patients.

Healthcare Occupations

Looking at specific health-related jobs, healthcare staffing in Georgia is at the national average in doctors, but below the average in those assisting doctors.

In 2013, Georgia had approximately 16,000 physicians working in the state who are likely to see flu patients. These include family physicians, internists, pediatricians, and other medical doctors who might directly treat patients but excludes surgeons and others who tend not to deal with viruses.

Along with these doctors, the state has approximately 2,480 physician assistants, 66,000 registered nurses, and 24,350 licensed practical nurses. In a flu epidemic, these are the frontline employees for a state with a population of almost 10 million people.

That averages to about 16 physicians, 2 physician assistants, and 90 RNs and LPNs for every 10,000 residents.

Ratios for the U.S. are similar with 16 physicians, 3 physician assistants, and 100 RNs and LPNs for every 10,000 residents.

Overall, staffing levels are adequate as long as the flu remains below epidemic proportions.

Average annual wages, selected healthcare occupations, Georgia and United States, May 2013

Occupation	Georgia	United States
Family and General Practitioners	$ 201,490	$ 183,940
Physician Assistants	93,660	94,350
Registered Nurses	61,630	68,910
Licensed Practical Nurses	37,330	42,910

Hospitals retain a disproportionate role as healthcare providers

Within the healthcare industry, there has been a consistent drive towards non-hospital services, mostly as a way of reducing costs, as hospital care is generally more expensive than outpatient centers.

While Georgia has seen this movement away from hospitals, it has been slow to make the transition. As a result, healthcare workers in Georgia are distributed differently than the nation, with a greater proportion of healthcare in the state being provided by hospitals.

Ambulatory Healthcare Employment in Georgia, 2000-2014

 Hospital Employment in Georgia, 2000-2014

About 54 percent of healthcare workers in the state are employed in so-called ambulatory care businesses (physician offices, outpatient care centers, home healthcare, and related businesses). The other 46 percent are employed in hospitals in the state.

In comparison, 58 percent of healthcare workers are employed nationwide in ambulatory centers, with the remaining 42 percent employed in hospitals.

This in a state where about 16 percent of the population lacks health insurance, where wages tend to be below the national average, and where the poverty rate is above 15 percent.

Combined with a healthcare structure that favors a more expensive option, this results in workers who avoid preventative care, delay seeking medical attention when they come down with the flu, becoming sicker as a result of the delayed attention, and are more prone to spreading the disease at work rather than staying at home to recover.

Conclusion

The state’s healthcare system staffing is near the national average, although its cost structure tends to favor more expensive treatment in hospitals rather than in outpatient settings and treatment by more expensive doctors rather than lower-cost physician assistants and nurses.

This in a state where the poverty rate is high, wages are relatively low, and many lack insurance.

Higher costs for those seeking healthcare contribute to spreading the flu and making potentially more deadly for workers, while causing pain for employers who have to deal with workers or are either absent from work, or come to work sick and spread the flu to their co-workers.  

Eventually, the flu season will pass, but Georgia’s healthcare system will remain an industry struggling to serve its lower-wage, less-insured population. 

Data provided by the U.S. Bureau of Labor Statistics, CDC, and U.S. Census Bureau. Photo courtesy of EIU.edu.

Is Georgia next in the sights of farm worker advocates?

 Vidalia onions are one of the labor-intensive crops grown in Georgia

According to National Public Radio (Florida Tomato Pickers' Wins Could Extend To Dairy, Berry Workers), recent successes in  improving wages for Florida tomato pickers may soon reach other farm fields, based on a report released by the Fair Food Standards Council, or FFSC, a labor oversight group based in Sarasota, Fla.

“In the last four years, the 30,000 tomato pickers covered by the FFSC have earned an additional $15 million in wages, translating to a 50-to-70 percent raise for each worker, and other working conditions have improved, the report found. The increase comes from a premium of a penny-per-pound that 12 corporate buyers, including Whole Foods and Wal-Mart, began paying to growers.”

The NPR story, published on Dec. 12, 2014, says that “FFP advocates are working with retailers and even other industries to duplicate their model. This winter, Wal-Mart will be expanding the program to tomato fields along the Southeast coast, where agribusinesses participating in the FPP have additional fields.”

Each year, the state’s Vidalia onion harvest depends on migrant labor. In past years, growers have reported problems in hiring sufficient numbers of workers to harvest the crop. This year, Georgia became the number one state for blueberry production, a fruit that also requires a great deal of labor at harvest time. Increasingly, Georgia farmers are producing more fruits and vegetables including a fledging olive oil industry. In general, fruit and vegetable production require more labor than traditional corn or cotton where mechanization has replaced workers in many of the tasks.

Is it possible that successes achieved by tomato pickers in Florida will translate into new efforts in Georgia to improve the lot of migrant laborers working in Georgia’s large agricultural industry? If it does, how will the state’s producers react?

Metro Georgia unemployment rates are flat. The mystery continues.

Metropolitan, State, and U.S. Unemployment Rates, 

Not Seasonally Adjusted and Seasonally Adjusted

	Not Seasonally Adjusted				Seasonally Adjusted
	Oct  2013	Sep  2014	Oct  2014		Oct 2013	Sep 2014	Oct 2014
United States	7.0	5.7	5.5		7.2	5.9	5.8
Statewide Georgia	7.9	7.4	7.2		7.8	7.9	7.7
Albany	8.6	8.2	7.9		8.5	8.5	8.3
Athens	5.7	5.7	5.4		5.7	5.9	5.7
Atlanta	7.6	7.3	7.0		7.4	7.5	7.3
Augusta	7.9	7.3	7.0		7.7	7.5	7.3
Brunswick	9.7	8.3	8.0		8.7	8.7	8.5
Columbus	8.2	8.1	7.8		8.1	8.4	8.2
Dalton	9.7	8.9	8.8		9.7	10.0	9.5
Gainesville	6.4	6.0	5.7		6.3	6.4	6.1
Hinesville	8.9	8.2	8.0		8.6	8.5	8.3
Macon	8.4	7.7	7.7		8.2	8.1	7.9
Rome	8.4	7.5	7.2		8.4	8.1	7.7
Savannah	7.3	7.0	6.7		7.2	7.2	7.1
Valdosta	7.6	7.6	7.2		7.5	7.9	7.7
Warner Robins	7.1	7.1	6.9		7.0	7.3	7.1

Georgia’s metropolitan areas showed little movement in their unemployment rates from September to October and over the past 12 months, according to the Bureau of Labor Statistics.

For metropolitan areas of the state, in October 2013, their rates ranged from 5.7 percent in the Athens area to 9.7 percent in Dalton. A year later, the range was 5.7 to 9.5 with the same two areas acting as bookends for the rates again.

These data contrast with the Bureau of Labor Statistics’ nonfarm jobs report that shows Georgia with a sizeable increase in jobs over the same 12 months, rising by 96,000 jobs or 2.4 percent, the largest job increase recorded in the state since before the start of the recession.

It remains difficult to reconcile the two surveys. If the unchanging rates were due to large numbers of people re-entering the labor market with renewed hope of employment, it would explain the metro areas uniform failure to register decreases, but that does not seem to be the case.

Using the household survey, the number of employed in Georgia are well below their pre-recession numbers, while the number of unemployed remains elevated. Over the year, the number of employed Georgians rose by 64,807, while the number unemployed dropped by 31,910 with a result that the overall labor force rose by only 32,897, certainly less than the population rise in a state with almost 10 million residents.

Number of employed and unemployed in Georgia, 

not seasonally adjusted, Jan. 2004 - Oct. 2014

It is also not the case that the rise in jobs is occurring outside the metro areas. In October 2013, Georgia’s unemployment rate stood at 7.8. In October 2014, the rate stood almost the same, at 7.7 percent. Clearly, the metro areas are the job engines.

These rates compare to the decline in the national unemployment rate from 7.2 percent in October 2013 to 5.8 percent in October 2014. It is hard to argue that large numbers of workers are entering the national labor force and not forcing up unemployment rates, while the same effect in Georgia is forcing up the rate.

LAUS data are based on a relatively small sample of households supplemented by state unemployment insurance claims and the survey of a sample of employers’ payrolls.

Given the cutbacks in unemployment benefits in the state, it is certainly possible that many workers do not bother to claim unemployment benefits, while others are ineligible because they have been out of work too long to qualify for benefits. That might explain the relatively low official number of unemployed workers, but adding these workers back in would make the unemployment rate go up, not down.

As long as these two surveys provide seemingly contradictory guidance on the state of Georgia’s economy, anyone can choose to make their own decisions as to whether Georgia is recovering successfully from the recession or whether it has fallen behind other states and the nation.

It brings home again the need for accurate and timely data needed by decision makers, even if the surveys require additional funding to meet their tasks.

Telfair County, Georgia, comes in lowest in the nation in personal income

The Census Bureau has reported per capita personal income for 2013, and it was not pretty for Georgia with Telfair County coming in lowest in the nation at $17,536. This compares to $121,632 in New York County, New York, which recorded the highest income.

Personal income is the income received by, or on behalf of, all persons from all sources: from participation as laborers in production, from owning a home or business, from the ownership of financial assets, and from government and business in the form of transfer receipts. It includes income from domestic sources as well as from the rest of the world.

On average, personal income rose 2.0 percent in 2013 in the metropolitan portion of the United States and rose 2.1 percent in the nonmetropolitan portion. The metropolitan and nonmetropolitan portions grew 5.3 percent and 4.4 percent, respectively, in 2012.

The percent change from 2012 to 2013 in personal income ranged from -35.0 percent in LaMoure County, North Dakota to 32.3 percent in Greeley County, Kansas. Inflation, as measured by the national price index for personal consumption expenditures, slowed to 1.2 percent in 2013 from 1.8 percent in 2012.

For Telfair County, per capita personal income declined 1.2 percent over the year. 

Read more at http://www.bea.gov/newsreleases/regional/lapi/lapi_newsrelease.htm.

Georgia’s reserve labor force

In October, Georgia recorded an 11,600 job increase, while over the year the state has added 95,400 jobs, building on its previous months of job creation.

Despite these good numbers, the actual percentage of Georgians employed stood at nearly 4.4 million, accounting for 57.5 percent of the civilian noninstitutional population age 16 and older.

This compares to 67.5 percent of the population employed in October 2000 in the state.

	October 2000	October 2014
Percentage of Georgians employed	67.5	57.5
Unemployment rate	3.3	7.7

Increasingly, fewer Georgians are employed or seeking work. While the number of unemployed have risen over the 14 years by 223,175, this number pales in comparison to the rise of 1 million residents who are not currently looking to be part of the labor force.

Georgia	Oct. 2000 to Oct. 2014
Population, 16 and older	+ 1,499,237
Not employed persons (Population minus Employed persons)	+ 1,241,025
Employed persons	+ 258,212
Unemployed persons	+ 223,175

Instead, they are a combination of students in school, retirees, and working-age people staying home to care for children and the elderly. Pew Research Service did an analysis at the national level and found that the majority of those outside the workforce were not the elderly, but instead young people.

These people who are outside the labor force represent potential employees. For employers, they are a potential solution to any possible labor shortages in the future.

In any case, their existence does much to explain why wage pressures are not increasing as jobs are added in Georgia.

BEA has reported that Telfair County had the lowest per capita personal income of any county in the U.S. in 2013 at $17, 536.

This low personal income is partially the result of the lack of competition for workers, which depresses wages, especially those who have undifferentiated skills and cannot command higher wages.

Think of this force of people as a reserve labor force that can be drawn upon whenever wage pressures arise.

Data from the U.S. Bureau of Labor Statistics.