Phase 1: Health and Human Services

(health care facilities)

Primary components of the health services infrastructure include residential and long-term care facilities, hospitals and rural clinics, and emergency centers. Using the latest data available, Indiana has 692 residential and long-term facilities, 215 hospitals and rural clinics, and 956 emergency centers. Residential/long-term facilities, hospitals and rural clinics tend to concentrate in and around metropolitan areas whereas emergency facilities are dispersed throughout the state. Though hard to quantify the impacts, firms, corporations and citizens value a comprehensive health services infrastructure and include it in their location decisions

Nationwide, one physician is available for every 442 Americans.  In Indiana, the ratio increases to one physician for every 469 residents¹, slightly worse than the national average.

Access to physician care varies widely among Indiana's counties. Purdue researchers Unal, Chen and Waldorf developed and estimated an "access to physician care" variable by county using 2005 physician, population, and city boundary data (view map). Counties with the highest and lowest access to physician care are shown below. Marion County, which had the best ratio of physicians to residents, received a score of 1. Posey County, which had the lowest access to physicians, received a score of 0.  All remaining counties fell between 0 and 1.

A state map, "Access to Physician Care in Indiana Counties," (view map) captures the concentration and variability of physician care. The fast growing counties-Boone, Hamilton, Hancock, and Hendricks-surrounding Marion County, Tippecanoe and Monroe counties where Purdue and Indiana universities are located, and regional centers found in Vanderburgh and Allen counties have the most favorable access to physicians. Several counties (Switzerland, Ohio, Perry, and Spencer) that border the Ohio River are only marginally better than Posey, the county with the lowest category of access to physician care. The four northeastern counties of Lagrange, Steuben, Noble and De Kalb also form a pocket of poor access to care.

¹Edna Unal, Susan Chen, and Brigitte Waldorf. "How accessible is Health Care in Your County"? June 2007. Purdue Agricultural Economics Report, Department of Agricultural Economics, Purdue University. 26 Aug. 2008. <http://www.agecon.purdue.edu/extension/pubs/paer/2007/june/waldorf.asp>.

Access to hospital care is another important indicator of a county’s health services. Purdue researchers Unal, Chen, and Waldorf1 developed an “access to hospital care” variable and estimated it using county level population data from the U.S. Census, city boundary data, and hospital and rural clinic location data. Again, the county with the highest score received a value of 1; the worst score, a value of 0. Scores for the remaining 90 counties fell between 0 and 1.

Counties with the highest and lowest access to hospital care are shown below. Marion County again ranked the highest and received a score of 1. Marion plus Vanderburgh, Monroe, St. Joseph and Allen counties show up in the top-ten list of access to physician care. The remaining 5 counties in the top-ten hospital care list represent regional centers for the surrounding rural areas: Vigo County (Terre Haute), Jefferson County (New Albany), Lake County (Gary), Madison County (Anderson), and Porter County (Portage, Valparaiso).

The ten most underserved counties, with the lowest being Ohio, tend to be concentrated in Southern Indiana. Benton is the only northern county, which was ranked 85th in the state. Furthermore, seven of the counties (Benton, Crawford, Spencer, Perry, Posey, Switzerland, and Ohio) on the lowest list for hospital care are also on the lowest list for access to physician care.

An Indiana map of “access to hospital care” (view map) again shows wide variability across the state. Particularly troublesome is the pattern observed in the counties that share a border with another state. Of the 32 border counties, 23 received scores less than or equal to 0.2. The map clearly shows the disparity between the urban areas, especially Marion and its collar counties and the Chicago metropolitan area, and the rural counties where access to health care typically falls in the bottom two categories.