Impact of population change on the health care delivery system, 2000-2010: A state-level assessment

As the US population ages, the need to prepare the health care workforce to address the increased demand for health care is a matter of national concern. The distribution of health care workers is not geographically uniform: previous findings have shown that the disparities between health care needs and health care workforce are strongest in rural areas. Building on this prior research, the objectives of this study include modeling population change and health care worker flow from 2000 to 2010 to determine how changes in population size and structure were met with changes in the health care workforce. We abstracted data from the Bureau of Labor Statistics and US Census Bureau for 2000 and 2010. We conducted a state-by-state analysis assessing the associations between changes in population size—overall, 65+, and 85+—and changes in major health care workforce categories, including physicians, nurses, technicians, and pharmacists. We used Spearman's correlation to assess associations, and employed dot-plots comparing changes in workforce to changes in population to highlight areas that have the largest disparities between health care need and health care workforce. Despite increases in population size in the Southwest, the flow of physicians and nurses has not matched the increased population, particularly for older adults (65+). In some states where the proportion and size of the older population has decreased, the health care workforce has actually increased the largest. The findings of this analysis can be used to create policies to ensure that the projected health care needs of the US population are addressed through a dedicated health care workforce. In addition, this research can be used to highlight specific geographic areas that can be targeted for increased medical care coverage. We can also use these findings to project health care needs of states and local areas in the coming decade.