09 03 Ss Media Release

Bon Secours Richmond Health System
Market Research ● March 2009

Young Families
and the Economy
Mary Anne Graf
Vice President
Women’s and Children’s Services
mary_anne_graf@bshsi.org
804/ 287-7834

Ownership 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 (mary_anne_graf@bshsi.org) is included with the
information.
• The date of the market research is shown (March 2009).

2

Meeting the Needs
of Today’s Young Family

• Know the market
• National, local
• Within women’s services,
most significant impact
nationally so far is
undoubtedly on young

$
families

3

Review of National
Trends
See Reference section
at end of presentation
for more information.

Employed See Tough Times
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

8

Healthcare and the Economy:
U.S.
Most Affected Least Affected

• Black, Hispanic • Asian
• Single, separated, divorced • Married
• Age 18-39 • Age >60
• Income <$48,000/year • Income >$48,000/year,
• Part-time employment particularly those making
>$90,000
• Poor to fair health
• Full-time employed

9

Young Families and the Economy

Bon Secours
Market Research

Young Families
and the Economy
March 2009

The Impact of the Economy: OB
08Q1 Pediatrix reports
1st ever NICU volume
downturn

Many Snowmass May 08
Participants note OB
volumes down ~5-10%

Unstable
economy already
Dec 07:
felt by young
“Recession” All/majority of
families
official US hospitals feel
OB decrease

OB-Neo overlay source: Graf, Health Care Innovations, 2009 ● TeamHCI.com 11

Market Research Components
• 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

12

Bon Secours Research, Young Families and the Economy

Survey 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.

13


Survey Respondents
• Average number of children in
household: 2.1
• Ethnicity
• Non-Hispanic Caucasian: 87%
• African American: 10%
• Asian or Hispanic: 1% each 2.1 children
• 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

14


Employment in the Recession

• 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


15


Overall Impact of the Economy
• 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


16


Handling 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%


17


Plans 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

18


Impact 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%

19


Other 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


20


Redefining our picture of
“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.)

21


Summary
• 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.

22

Bon Secours Safe & Sound
Family-Driven Program Design

23

References
• 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-insu
• IMS National Prescription Audit; Kaiser Family Foundation, 2009;
searchable online
• Outsourcing Parenthood, Parenting.com, h
ttp://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

25

References
• 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-prevention8-2009apr08,0,5420
• 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-t
• Inside Facebook (Demographics)
http://www.insidefacebook.com/2008/09/18/latest-data-on-us-facebook-
age-and-gender-demographics/

26

References
• 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/Do
wn-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

27

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