Inside This Issue:

• Survey of Rural School Nurses Looks at Health Services
  Addressing the Needs of Children with Asthma
• Rural-Urban Income Gap Grows
• Chairman’s Message
• Move Over Decennial Census, American Community Survey Is On Its Way
• The Rural Industry Breakdown
• Behind the Numbers: Industries
• A Closer Look: Rural Poverty and Rural Wealth
• Just the Facts: Finding a Place Where It Pays to Play

 

Survey of Rural School Nurses Looks at Health Services

Addressing the Needs of Children with Asthma

More than 45,000 rural Pennsylvania children had asthma during the 2002-2003 school year, and prevalence rates calculated from school reports show a 20 percent jump in just five years. Are rural schools prepared to meet the needs of these children? According to research sponsored by the Center for Rural Pennsylvania, several factors, including the limited availability of registered nurses or other knowledgeable staff in rural schools, may hamper rural schools’ ability to address the needs of children with asthma.

Addressing asthma in schools
To learn more about how rural schools address the needs of children with asthma, Drs. Marianne Hillemeier and Maryellen Gusic and research assistant Yu Bai of Pennsylvania State University conducted the research in 2004. The goals of the project were to: determine the prevalence of asthma among rural children in Pennsylvania and identify factors that influence the severity of children’s asthma burden; describe current policies and practices related to asthma management in rural Pennsylvania schools and the services available to children with asthma and their families; determine the level of preparedness among school health personnel to care for children with asthma and their perceived needs for additional education and policy change; and identify interventions that have proven to be effective in rural school settings in other states.

The research consisted of a survey of school nurses throughout Pennsylvania, a review of relevant literature on asthma in schools, and an analysis of discharge data for asthma-related hospital stays among Pennsylvania children.

Research findings
The research revealed that:

• 9.3 percent of rural Pennsylvania children have asthma and that asthma hospitalizations among rural children are costly and tend to be prolonged for lower income children;
• asthma management in rural schools is hampered by limited registered nurse availability and lack of other knowledgeable staff;
• rural children are not always assured of quick access to asthma rescue medications during school hours;
• communication about asthma is a problem in rural schools;
• recommended asthma-related equipment and services are often not available in rural schools; and
• rural school nurses would welcome additional education about asthma.

Policy considerations
Based on their analysis of the findings, the researchers offered policy considerations for state government, including the following:

• ensure that all Pennsylvania children with asthma have prompt access to rescue medications by overseeing the universal adoption of 2004 legislation requiring school districts to develop policies allowing students to possess and self-administer asthma inhalers;
• enhance outreach and enrollment of children with asthma in public medical care coverage programs, particularly among rural populations; and
• increase the availability of registered nurses in rural schools.

The researchers also recommended that the Pennsylvania Department of Health develop a state asthma plan, which has been done in several other states with large rural populations.

Other policy considerations specifically for the Department of Health were to:

• increase asthma educational opportunities, reference materials, and sample curricula for school nurses, teachers, coaches, and other staff to use among all age levels; and
• encourage health care providers to improve communication with school nurses about children’s asthma management.

Full report available
For a copy of the research report, Childhood Asthma in Rural Pennsylvania: Building Schools’ Capacity to Optimize Health, call the Center for Rural Pennsylvania at (717) 787-9555, email info@ruralpa.org, or visit www.ruralpa.org.

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Rural-Urban Income Gap Grows

There is an $8,637 per capita income gap between rural and urban Pennsylvania, according to research recently released by the Center for Rural Pennsylvania. The research, conducted by Drs. C.A. Christofides and Pats Neelakantan and Todd Behr of East Stroudsburg University of Pennsylvania, found that, since the 1980s, the income gap between rural and urban Pennsylvania has been growing and that the high-paced total income growth in urban counties and the population growth in rural counties have contributed to the gap.

The research, which was completed in 2005, looked at 30 years of data from the U. S. Census Bureau, the U.S. Bureau of Economic Analysis, and the Pennsylvania Departments of Revenue, Labor and Industry, Education, Health, Welfare, and Community and Economic Development.

Measuring income
The goal of the research was to determine if there was a measurable income gap between Pennsylvania’s rural and urban counties and, if so, to identify the causes. 

To conduct the study, the researchers created a database that included information on income and other sociodemographic factors for each Pennsylvania county from 1969 to 2001.

With this database, the researchers performed analytical tests to identify the causes of the rural-urban income disparity. Per capita income was tested against 50 other variables, such as educational attainment, age, labor force participation rates, and unemployment rates.

Different sources of income also were tested against the 50 variables. These income sources included earned income, which is income from wages and salary, and unearned income, which is income from interest, dividends and rent, and transfer payments. 

The analysis was conducted at the county level and, to get a better understanding of the absolute change rather than the relative change, dollar figures were not adjusted for inflation.

Gaps exist
Within Pennsylvania, in 2001, 17 percent of total personal income within the state was in rural counties and 83 percent was in urban counties. Nearly one half of the income in the state was found in six counties: Allegheny, Bucks, Chester, Delaware, Montgomery and Philadelphia. 

Even on a per capita basis, incomes were not evenly distributed. In 2001, the per capita income in Pennsylvania rural counties was $23,941, while in urban counties the per capita income was $32,578, or $8,637 higher. 

Within Pennsylvania, the highest per capita incomes were in Montgomery, Chester, and Bucks counties, each with incomes in excess of $38,900. The lowest per capita incomes were found in Tioga, Greene, and Huntingdon counties, where the per capita income was less than $20,500.

Nationally, there was a similar pattern in income disparity. In 2001, 16 percent of total personal income was in rural counties and 84 percent was in urban counties. Pennsylvania had the 18th   highest income of the 50 states. The states with the highest incomes were Connecticut, New Jersey, and Massachusetts, each with per capita incomes in excess of $38,900. States with the lowest per capita incomes were West Virginia, Arkansas and Mississippi, each with per capita incomes below $23,300.

Certain factors, such as national economic trends, educational attainment and workforce participation tended to affect income growth in rural Pennsylvania.

Other research findings were that: the income gap between upper and lower income households had increased within every Pennsylvania county from 1980 to 1998; variables affecting urban income growth were similar to variables affecting rural income growth; and taxes assessed at the local and county levels had no significant effect on personal income within Pennsylvania counties.

To close the rural-urban income gap, the researchers recommended focusing on efforts to increase educational attainment and labor force participation in rural areas.

Report available
For a copy of the report, Examining the Rural-Urban Income Gap, call the Center for Rural Pennsylvania at (717) 787-9555, email info@ruralpa.org or visit www.ruralpa.org.

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Chairman’s Message

The income gap between rural and urban Pennsylvania is not new. The Center for Rural Pennsylvania first reported on it in 1991 with the release of the report, The Widening Rural-Urban Income Gap: Past Trend or Forecast for the 1990s. To find out how the gap had changed, the Center revisited the topic in 2004. Faculty from East Stroudsburg University conducted the research project by identifying and analyzing factors affecting income growth in rural Pennsylvania. The research generated some expected, and some surprising, results.

As anticipated, the research documented that the income gap still exists. Surprisingly, however, there has been a considerable increase in the gap. According to the earlier report, the per capita income gap between rural and urban Pennsylvania was about $4,000 in 1988. In 2001, the per capita income gap in Pennsylvania increased to $8,637.

To understand the causes and factors of this income gap increase, the researchers looked at more than 50 variables, including educational attainment, age, labor force participation rates, and unemployment rates. They then tested different sources of income, such as earned and unearned income, against the 50 variables. Finally, the researchers also looked at factors that may offset the gap, such as the cost of living and local taxes. The researchers found that cost of living differences did not explain away the gap – in fact, it only mitigated about 19 percent of the gap. They also found that local taxes have no significant effect on local income.

The researchers suggest that short-term, quick fixes will not alleviate the gap. Instead, they suggest that more long-term strategies, such as increasing educational attainment levels and labor force participation rates, can make a difference. To achieve the former, government, education institutions, communities, families and the business sector must continue to promote successful completion of education and training beyond high school. Simply stated, lifelong learning is a must. The more and better educated we all are, the more we are prepared to compete in this global economy. 

Related to that is the need for increased labor force participation rates in rural areas. The research showed that per capita income was higher in counties where the labor force represented a larger percentage of the population. For rural counties, our aging population may be an issue, especially as the Baby Boomer generation enters its retirement years and leaves the work force. However, continuing to grow that labor pool presents some opportunities for us. Retirement doesn’t necessarily mean an end to all careers. A number of older adults may wish to pursue their entrepreneurial spirit by creating viable businesses to generate additional income. Increased telecommunications capacity in rural areas expands those opportunities so entrepreneurs can sell products and services in new markets and return revenues to rural communities.

Identifying and nurturing an entrepreneurial spirit in our youth also can help build the rural labor force. As we educate our youth in grades K-12, we can expose them to the concepts and practices of owning a business. Matching that classroom study with real-life mentoring and job shadowing from local business owners may open up opportunities for youth to remain in their communities. The Center for Rural Pennsylvania is looking at the issue of succession planning for rural businesses and how that may present retention opportunities for our youth. We'll be sure to share the research results with the General Assembly and our readership.

The income gap between rural and urban areas is not unique to Pennsylvania. Within other states, and the country as a whole, the numbers bear out the fact that rural residents earn less than their urban counterparts. Ways to reduce the gap, and therefore improve the lives of our citizens and their communities, is a matter for all of us to consider and act upon.

Senator John Gordner

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Move Over Decennial Census, American Community Survey Is On Its Way

Communities can change dramatically in the 10 years between each census. And understanding the impacts of community changes can be tough to gauge without more current information. To fill in the data gaps that occur between censuses, the U.S. Census Bureau is moving rapidly toward a whole new way of census taking to answer important community questions.

The American Community Survey (ACS) is a new nationwide survey designed to provide communities with a fresh look at how they are changing. It replaces the long form of the decennial census.

It is a critical element in the Census Bureau’s new approach to future censuses in that: the decennial census will now include the short form only, returning the 10-year census to its original purpose of counting the population; the ACS will replace the long form of the decennial census, providing current, up-to-date numbers every year; and the ACS will help improve the census process and provide communities with information more frequently.

Community support is important
While the ACS doesn’t count the population, it does provide the numbers that reflect what the population looks like and how it lives. That’s where individual community members enter the picture. Your community’s ability to provide the goods and services you need is only as good as the information at your community’s disposal, and federal tax dollars can only be allocated to communities where they are most needed if current information is available. That’s why community support for the ACS is vital.

Each month, an address has about a 1-in-480 chance of being randomly selected to receive a form. No address will be selected more than once in five years. The monthly sample size is designed to approximate the sampling ratio of Census 2000, including the oversampling of small governmental units.

Each selected address will receive a questionnaire in the mail to be completed and returned to the Census Bureau.  The Bureau will send a reminder card then a replacement questionnaire to each non-respondent and will call or visit six weeks later if no reply is received. As with other Census Bureau questionnaires, response to the ACS is required by law. This law also guarantees confidentiality of responses.

The ACS will provide annual estimates of demographic, housing, social, and economic characteristics for the nation and all states, as well as for all cities, counties, metropolitan areas, and population groups of 65,000 people or more.

For less populated areas, it will take three-to-five years to accumulate a sufficient sample to produce data - areas of 20,000 to 65,000 may use data averaged over three years. For areas with less than 20,000 people, it will take five years to accumulate a sample that is similar to that of the decennial census. These averages will be updated every year.

Data availability
ACS development began in 1996 with four test sites nationwide and expanded a little each year reaching full implementation in 2005. In August 2006, the Census Bureau released 2005 data for all areas of 65,000 or more, including 38 counties in Pennsylvania.

Upcoming data releases
For areas with populations between 20,000 and 65,000, data will be released in 2008 reflecting a three-year average of 2005-2007. This will account for all but six of Pennsylvania’s 67 counties and for many municipalities. Beginning in 2010, five-year averages of 2005-2009 will be available. So, by 2010, information on demographic, socio-economic and housing characteristics, formerly available only every 10 years, will be available annually for all areas through the ACS.

As with the former decennial long form, the smallest geographic level for which data will be produced is the census block group; the Census Bureau will not publish estimates for small numbers of people if there is a probability that an individual can be identified.

Getting the data
If you have questions about obtaining, understanding or using ACS data, including methodological issues like comparability to existing decennial census data, contact the Center for Rural Pennsylvania at (717) 787-9555 or info@ruralpa.org.

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The Rural Industry Breakdown

Rural Pennsylvania had 77,423 business establishments in 2004, according to the Census Bureau’s County Business Patterns data. 

Rural businesses accounted for 26 percent of the total businesses in the state, and rural businesses in various industries represent both higher and lower portions of all state business establishments. For example, 69 percent of the state’s mining businesses were in rural counties compared to 16 percent of the state’s businesses that manage other companies.

Rural counties also had more than half of the state’s utilities and forestry, fishing, hunting, and agriculture support establishments and less than 20 percent of the wholesale trade and professional, scientific and technical services establishments.

Among rural business establishments, retail trade is the most common (18 percent), followed by other services (13 percent), health care and social assistance (11 percent) and construction (11 percent).  Six industries each comprised less than 1 percent of all rural establishments: forestry, fishing, hunting, and agriculture support; mining; utilities; management of companies and enterprises; educational services; and unclassified establishments.

Business Establishments by Industry, Pennsylvania and its Rural Counties, 2004

Share of Business Establishments by Industry, Rural Pennsylvania, 2004

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Behind the Numbers: Industries

What is an industry?
A group of related businesses.

How is industry data collected?
Most are compiled from direct surveys of businesses.

What types of industry data are collected?
Typically, data include the number of businesses and employees, payroll, and receipts/sales.

Where can I get the data?
Primarily the U.S. Census Bureau, the U.S. Bureau of Labor Statistics, the U.S. Bureau of Economic Analysis, and the Pennsylvania Department of Labor.

When should I use the data?
To track how a community is faring economically.

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A Closer Look: Rural Poverty and Rural Wealth

Rural Poverty
In 2006*, approximately 10 percent of rural Pennsylvania households are in poverty.

The typical rural household in poverty has two persons whose average age is 35 years old. Forty-one percent of these households have children, and the majority of individuals living in these households are female (60 percent).

Thirty-seven percent of households in poverty had one or more persons who are employed. Among these individuals, 67 percent are employed full-time and 33 percent are employed part-time. The median wage in households in poverty is $9,800. Forty-eight percent of households in poverty receive Food Stamps, 40 percent receive heating assistance and less than 5 percent receive cash benefits from Temporary Assistance for Needy Families (TANF).

While most of the characteristics of rural households in poverty did not change significantly from 2005 to 2006, there were some changes worth noting.  In 2005, 25 percent of the households in poverty had no health insurance. This percentage dropped to 13 percent in 2006.

There was also a decline in the percentage of households participating in government programs: in 2005, 54 percent of rural households in poverty received Food Stamps, while in 2006, 48 percent of rural households in poverty received Food Stamps.

There were similar declines in the percentage of students eligible for the Free and Reduced School Lunch Program and in the percentage of households participating in the heating assistance program and TANF.

In terms of rural and urban, there is a slight, but statistically significant, difference in the percentage of households in poverty: 9 percent of urban households versus 10 percent of rural households. Rural and urban households in poverty have similar characteristics of age, gender and workforce participation rates.

However, 34 percent of urban households in poverty have children versus 41 percent of rural households. Among households in poverty, rural areas also have a slightly higher percentage of single parent households than urban areas (23 percent and 20 percent, respectively).

Among urban householders age 25 years old and older whose households are in poverty, 19 percent have a bachelor’s degree or higher while only 6 percent of rural households have similar degrees.

Rural Wealth
In 2006*, 20 percent of rural households have incomes of more than $75,000, which is the income threshold the Center for Rural Pennsylvania uses to classify “affluent” households. In urban areas, 29 percent of the households are affluent.

The average age of residents in affluent households is 35 years compared to the average age of 40 years in non-affluent households.

Forty-five percent of affluent households have children under the age of 18 living at home compared to 32 percent of non-affluent households.

Affluent householders are more likely to be married (92 percent) and have a bachelor’s degree or higher (51 percent) than non-affluent householders (72 percent and 18 percent, respectively).

Ninety-five percent of rural affluent householders own their home. Among those paying a mortgage, the median monthly mortgage is $900. Ninety-three percent of affluent households have health insurance and 72 percent of those with insurance have it through an employer.

Between 2005 and 2006, there were no statistically significant changes in the characteristics of affluent rural households. 

There are, however, some significant differences between rural and urban affluent households. For example, there is a $5,000 gap in the median household income of the rural and urban affluent. Among rural affluent households, the median income is $95,000 while the urban median is $100,000.

The rural affluent (68 percent) tends to receive more of its income from wages and salaries than the urban affluent (64 percent).

More urban affluent householders (60 percent) have a bachelor’s degree than affluent rural householders (51 percent).

* Note: All data is from the 2006 RuralPA-CPS unless noted otherwise.The RuralPA-CPS, modeled after the March Supplement of the federal Current Population Survey, was first conducted in 2005 by the Center for Rural Pennsylvania. The RuralPA-CPS provides baseline data on the state’s rural households and individuals. In 2006, the Center expanded the survey of more than 2,000 rural households to include 1,000 urban households and their members.

According to federal guidelines, in 2006 a family of three was considered to be living in poverty if its household income was below $16,600.

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Just the Facts: Finding a Place Where It Pays to Play

Looking to get in on that next Pennsylvania lottery drawing? If you live in rural Pennsylvania, your chances of finding a lottery retail outlet are pretty good.

According to data from the Pennsylvania Lottery, there are more lottery retailers per capita in rural counties than in urban counties.

Of the 8,600 lottery retailers statewide in 2006, 33 percent, or more than 2,800, are located in rural Pennsylvania. Per capita, this comes to 82 retailers for every 100,000 rural residents. Urban areas have 64 retailers for every 100,000 residents.

The counties with the most retailers per capita are Forest, Cameron and Potter, each with more than 140 retailers for every 100,000 residents. The counties with the fewest retailers per capita are Juniata, Chester and Union counties, each with less than 45 retailers for every 100,000 residents. 

Among rural counties, there was a statistically significant negative relationship between the number of lottery retailers per capita and median household incomes. This means that counties with lower incomes have more lottery retailers. The same was true for housing values – the lower the housing values in a county, the more lottery retailers.

However, there was a statistically significant positive relationship between the number of lottery retailers per capita and the percent of senior citizens in the county, which means that counties with higher numbers of lottery retailers per capita also have larger percentages of seniors.

Another positive relationship between Pennsylvania seniors and the Pennsylvania lottery is the money earned through lottery sales that finance state programs for seniors.

In 2005, almost $254 million went to support programs in rural areas that provide qualified seniors with property tax and rent rebates, free and reduced transit fares, prescription drug programs, and county-based senior centers and activities.