09 03 Ss Media Release

Young Families Young Families and the Economyand the Economy

Bon Secours Richmond Health SystemMarket Research ● March 2009

Mary Anne GrafVice President

Women’s and Children’s [email protected]

804/ 287-7834

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Ownership and CreditOwnership and Credit

• This presentation includes comparative data from relevant databases nationwide. Please credit these databases if you use this information.

• The primary market research in this presentation, starting with slide 9, is the sole property of Bon Secours Richmond Health System. You may use this information under the following conditions:

• The information used remains essentially unaltered.

• Bon Secours Richmond Health System Women’s & Children’s Services is noted as the source.

• Contact information ([email protected]) is included with the information.

• The date of the market research is shown (March 2009).

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Meeting the Needs Meeting the Needs of Today’s Young Familyof Today’s Young Family

• Know the market• National, local

• Within women’s services, most significant impact nationally so far is undoubtedly on young families $

Review of National Review of National TrendsTrends

See Reference section at end of presentation for more information.

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Employed See Tough Employed See Tough Times AlsoTimes Also

• Those with jobs faring worse than at any time since the Great Depression.

• Furloughs, pay cuts and reduced hours are taking a toll on workers who so far have escaped job cuts.

• Q109 total wages cut 6.2%

• The employed worked fewer hours in May 09 — an average of just 33.1 hours a week — than at any time since the Bureau of Labor Statistics began counting in 1964.

• Part-time work is at a record high.

• Overtime is at a record low.June 12, 2009

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Healthcare and the Healthcare and the Economy: U.S.Economy: U.S.

Most Affected

• Black, Hispanic

• Single, separated, divorced

• Age 18-39

• Income <$48,000/year

• Part-time employment

• Poor to fair health

Least Affected

• Asian

• Married

• Age >60

• Income >$48,000/year, particularly those making >$90,000

• Full-time employed

Young Families and the Young Families and the EconomyEconomy

Bon Secours Market Research

Young Families and the Economy

March 2009

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The Impact of the Economy: The Impact of the Economy: OBOB

08Q1 Pediatrix reports 1st ever NICU volume

downturn

Dec 07: “Recession”

officialAll/majority of

US hospitals feel OB decrease

Many Snowmass May 08Participants note OB

volumes down ~5-10%

Unstable economy already

felt by young families

OB-Neo overlay source: Graf, Health Care Innovations, 2009 ● TeamHCI.com

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Market Research Market Research ComponentsComponents

• Comprehensive review of national data re: young families and the recession from CY07 forward• US, 2008: 57% of those unemployed were between the ages of 20 and 44 –

prime childbearing age

• In Virginia in Dec 08 alone, 36% of those laid off were between 30 and 44, and likely another 40% <30

• Bon Secours market research (Mar 09)• Random phone survey of young families, age 18-44 (N=275)

• At 95% confidence level, the maximum statistical error for the N is +/- 5.9%.• Highly applicable sample to current childbearing age families: 76% (n=205)

either were currently pregnant or had child age 5 or under to ensure target population

• Focus groups: Two groups of young mothers who had delivered in the last six months

• Mirrored national trends, but provided detail on young families

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Bon Secours Research, Young Families and the Bon Secours Research, Young Families and the EconomyEconomy

Survey RespondentsSurvey Respondents• Phone survey, land lines only; random calls, purchased lists

• N=275

• Age 18-44• Male: 112

• Female: 163

• Pregnant or have child age 5 or under: 205

• 92% married

• Insured• Insurance: 87%

• Medicaid: :8%

• No insurance: 4% (Half of these lost insurance when they were laid off)

Bon Secours Richmond Health System market research, 2009. All rights reserved.

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Survey RespondentsSurvey Respondents• Average number of children in

household: 2.1

• Ethnicity• Non-Hispanic Caucasian: 87%

• African American: 10%

• Asian or Hispanic: 1% each

• Survey: Median family income: $55,000 to $75,000 (skewed slightly high; average family income nationally for childbearing demographic is about $50,000)• Likely due to use of land lines only

• Focus group: Skewed low income

2.1 children


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Employment in the Employment in the RecessionRecession

• Laid off: 6%

• Income frozen or reduced: 28%

• No impact: 48%...

• All• 76% personally know someone

who was laid off since recession start

• 50% personally know someone who has had their income frozen or reduced


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Overall Impact of the Overall Impact of the EconomyEconomy

• Specifically related to the economy• 87% have changed how their family spends money

• 29% have had weight management problems (up or down)

• 40% have trouble sleeping

• 77% changed how they shop for groceries

• 16% started or increased smoking

• 40% acknowledge strained relationship with spouse/partner, and another 30% say economic concerns have hurt their sex life

• Of the 27 women who were pregnant, 20% felt their pregnancy negatively interfered with finding a new job


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Handling Family Health CareHandling Family Health Care• Limiting health care expenses for the family: 79%

• Fewer visits to doctor: 16%

• Delayed procedures or surgery: 7%

• Difficulty paying for hospitalization: 7%

• Cancelled or delayed annual exam: 6% or mammogram: 3%

• Difficulty paying for medications: 6%

• Delayed medical tests: 5%

• Used free clinic: 3%


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Plans for ChildrenPlans for Children• The impact of the economy on plans for

children• Decided not to have any more children: 15%

• Decided on few children than when economy was better: 7%

• More careful about using birth control, started birth control or had sterilization: 8%

• Delayed a pregnancy: 4%

• Of the 10% who considered adoption or infertility treatments during the last two years, one out of four stopped because of the economy


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Impact on PregnancyImpact on Pregnancy• Of 27 respondents expecting a baby

• Had planned to move, cannot do now: 15%

• Cannot afford the right foods for pregnancy: 15%

• Had fewer prenatal/doctor visits: 11% or no visits: 7% (total, 18%)

• Could not afford birth control: 7%

• Did not take prenatal classes: 7%

• Biggest concerns:

• Cost of childbirth at the hospital: 22%

• Cost of baby supplies, e.g., diapers, nursery: 22%

• Rising household costs (mortgage, utilities): 22%

• Cost of raising the child: 19%

• Can marriage relationship take the stress? 19%

• Worries about job (self or spouse): 19%

• Cost of prenatal care: 11%


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Other StressorsOther Stressors• Supporting adult relatives

• 13% started providing financial support to an adult relative in the last two year

• 5% have a relative (not immediate family) living with them

• Another 22% consider it likely that a relative will be living with them soon

• 23% rate their health insurance coverage as worse than two years ago

• Focus groups: Women don’t have money for the very basics (diapers, pads) for their first days at home…let alone later• For these women, breast-feeding is a luxury they cannot afford


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Redefining our picture of Redefining our picture of “Indigent”“Indigent”

• Today’s ‘uninsured’ or ‘homeless’ could have been making $200,000+ per year for most of their recent career and today be unemployed, losing their home, and without insurance (Cobra doesn’t apply if company dissolves.)

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SummarySummary• As is the case nationwide during, half of the parents are

experiencing no economic stress, but are worried and working longer and harder.• Pregnant women and young moms working outside the home are

particularly concerned about not letting personal concerns or home needs interfere with their job; worried about job security

• Half of the parents are impacted, many profoundly. As the group with the least seniority and the lowest pay, any loss of job, hours or pay threatens their financial security immediately. • Loss of health insurance—or inability to obtain a job that offers health

benefits—is negatively impacting the health of all members of these young families.

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Bon Secours Safe & Sound Bon Secours Safe & Sound Family-Driven Program DesignFamily-Driven Program Design

ReferencesReferences

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• USA Today March 09 research series on Americans, the economy and health care, March 09 (available online; terrific graphics); http://www.usatoday.com/money/economy/2009-03-10-well-being-index_N.htm

• 1 in 5 American workers uninsured, USAToday.com, Mar 24, 09, http://www.usatoday.com/money/industries/insurance/2009-03-24-health-insurance_N.htm

• IMS National Prescription Audit; Kaiser Family Foundation, 2009; searchable online

• Outsourcing Parenthood, Parenting.com, http://www.parenting.com/article/Mom/Work--Family/Outsourcing-Parenthood

• Patients skip medicine, doctor visits due to sick economy, http://www.usatoday.com/news/health/2008-10-22-medical-financial_N.htm

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• Recession affects family planning, with abortions and vasectomies up, http://www.tampabay.com/news/health/article988131.ece

• Roan, Sheri, In an ailing economy, the doctor can wait, Los Angeles Times, Apr 09, http://www.latimes.com/features/health/la-sci-prevention8-2009apr08,0,5420195.story

• Shah, Gina, Down Economy Provides Opportunities to Improve Physician Relations, Healthcare Leaders Media, Apr 2009

• http://Erickson, Baby boomers flock to social networking sites, http://www.norwichbulletin.com/lifestyles/x1098998426/Baby-boomers-flock-to-social-networking-sites

• Inside Facebook (Demographics) http://www.insidefacebook.com/2008/09/18/latest-data-on-us-facebook-age-and-gender-demographics/

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• Twitter links businesses to customers, http://www.denverpost.com/business/ci_12258514

• Malone, Michael, The Twitter Revolution: The brains behind the Web's hottest networking tool, Wall Street Journal, http://online.wsj.com/article/SB124000817787330413.html

• www.healthleadersmedia.com/content/230802/topic/WS_HLM2_MAR/Down-Economy-Provides-Opportunities-to-Improve-Physician-Relations.htmlWheeler and Hirsh, Channel Champions: How leading companies build new strategies to serve customers, 1999, Jossey-Bass

• Tanner and Johnson, Patients skip medicine, doctor visits due to sick economy, USA Today, Oct 08, http://www.usatoday.com/news/health/2008-10-22-medical-financial_N.htm

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