Guest Column: Chronic conditions, aging hit health care work force

Looking at southwest Missouri health care and where it's headed in 2009 is daunting, but a few major trends stand out.

Missouri is the 13th most obese state, with 63.3 percent of Missouri adults either obese or overweight. Obesity is linked to diabetes, heart disease, and cancer, and chronic problems such as these are the leading causes of death and disability in our area and nationwide. Almost as many people die now from cancer as from heart conditions, nationally and locally.

Fewer Missourians have health care coverage this year than last, and that downward trend will probably continue in the current economic climate.

Southwest Missouri also is aging. The area's greatest population growth is occurring in the 55-64 age bracket.

While each of these trends has a direct impact on our health care needs and costs, the aging of our population is arguably the most significant, because of both the increased chronic health problems of older people and the impact on our health care work force.

More than half of the health care labor force is currently between the ages of 60 and 64, up from 43 percent in 1986, according to the Economic Policy Institute. By 2029, all of the baby boomers will be age 65 years and older.

While the labor force in general, and health care workers in particular, are growing older, the supply of new health care practitioners is not increasing as rapidly as needed. Nursing, the largest segment of the health care work force, has suffered from years of low enrollment in nursing schools, caused partly by a shortage of qualified nursing faculty. An estimated 40 percent of the registered nurse work force will be older than 50 by 2010, according to a Government Accounting Office report and the American Nurses Association.

In Greene County, the average age of RNs is 46, and statewide it's 46.6, according to the Missouri State Board of Nursing. The average age of physicians in the American Medical Association was 49.9 in 2006. Nationally, physicians and RNs retire from work - which is often physically demanding - at an average age of 59.

The Bureau of Labor Statistics reports that registered nursing will have the greatest job growth of all U.S. professions from now to 2016. The shortage of registered nurses is projected to grow to more than 1 million by 2020, meaning there will be 36 percent fewer RNs than needed to fill available positions. There are 3,620 licensed RNs currently living in Greene County, according to the Missouri State Board of Nursing, and 68,469 RNs in Missouri. In the next eight to 10 years, many of those nurses will retire, and the number of new nurses entering the profession will not keep up with those leaving it - let alone keep up with the increased demand created by the chronic health care needs of our aging population.

Nursing is one of many health care jobs affected by work force shortages: Physical therapists, pharmacists, physicians and others will be in significant demand in our area for the foreseeable future. According to a study by the University of Missouri-Columbia and the U.S. Department of Health and Human Services, by 2025, we will be short as many as 44,000 adult care primary care physicians.

Hospitals in other parts of the country have instituted aggressive programs of recruitment and retention, achieving official recognition for being "nurse-friendly" or achieving "magnet status," terms that refer to hospitals that have created exceptionally positive work environments.

As we head into 2009 and beyond, we will need to create institutions where health care professionals want to work.

Carole Eldridge is dean, campus director and associate professor of St. John's College of Nursing & Health Sciences of Southwest Baptist University in Springfield. She may be reached at celdridge@sbuniv.edu.