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III. DEMOGRAPHICS
The Austin Metropolitan Statistical Area (MSA) is comprised of five counties, including Travis County and the four adjacent counties of Bastrop, Caldwell, Hays, and Williamson. Issues important in assessing the health of the community as well as developing and implementing prevention efforts include dispersion, age of the population, diversity, and economic disparity. The population size may vary depending on the source of the data; these are estimates and not exact numbers.
DISPERSION
The metropolitan area has grown by 32.5 percent from 1990 to January 1, 1999. In comparison, Texas' population grew 1.9 percent from 1990 to 1996 and the United States grew by one percent in the same time period (Texas State Data Center, August 31, 2000)
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The largest rates of growth have taking place outside the core of the Austin metropolitan area.
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The rapid growth of the past decade has greatly increased urban sprawl, with the largest rates of growth taking place outside the core of the Austin metropolitan area.
From the perspective of health services delivery, an important consequence of this growth is the relative size of the City of Austin and Travis County compared to the entire region. As growth occurs in surrounding counties, the regional population densities will change and the resulting demand for services will shift. In 1990, Travis County's population was 68 percent of the five-county metropolitan area. In January of 1999, it was just 64 percent. Increased regional cooperation in planning and delivery of services will certainly be required since very large parts of the population will be in the areas closer to the border counties.
AGE OF THE POPULATION
The population of the MSA is young. The adult workforce between 18 and 64 years of age is the largest portion (65.2 percent). Youth, individuals less than 18 years of age, make up 27.4 percent of the total population. The smallest portion is the elderly, those greater than age 64, who make up 7.4 percent of the population. In theory, a young population should be less of a strain on health care services because older populations generally seek services more frequently than younger populations. However, a young workforce requires a flexible system able to meet their needs for services with minimum time off of work.
DIVERSITY
The cultural diversity of the Austin area will continue to increase. For example, Travis County's Hispanic population has steadily increased by 43 percent over the past decade and is now approaching 25 percent of the total population. Hispanic children are already 37 percent of Travis County's total population of young children (age four or younger) (Texas Department of Health [TDH], September 2000).
Projections for the region in 2004 have the populations of Whites dropping to 58.5 percent of the population, Hispanics increasing to 28.8 percent, Blacks increasing to 9.4 percent, and Asians increasing to 3.2 percent.
Other populations that impact local services include migrations from other countries. In the past ten years there have been a significant number of federally sponsored refugees resettled into our community. These individuals bring a unique demand on health care services. Generally they arrive in poor health, speak no English, and have compelling cultural issues that providers are unfamiliar with. Most refugees come as a family unit with 33 percent of all new arrivals being children under the age of 15 (personal communication with Elaine Adair, Director of Cross Cultural Programs, Refugee Health Services, Texas Department of Health, September 2000).
ECONOMIC DISPARITY
Studies conducted by the University of Texas on wages in the MSA suggest a mixed picture of the benefits occurring as a result of the region's economic boom. Both rich and poor wage earners in Austin, particularly at the margins, are doing better than those in the rest of Texas. Fifty-two percent of Austin workers earn more than other Texans working in the same occupation. The median wage in Austin is currently $23,700 (for Texas, $22,832); the average wage in Austin is $29,154 (for Texas, $27,375) (Capital Area Workforce Development Board, May 30, 2000).
However, a persistent income gap between the poor and the more prosperous continues to exist in the region. Standard measures of wage equity show that even though Austin's pay is higher, it is distributed in the same pattern as the rest of the state. The top ten percent of wage earners in Austin made more than $56,000 annually; the bottom ten percent earned less than $15,040, in both cases annual earnings are only slightly higher than the Texas distribution.
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There are significant income gaps between the poor and the more prosperous. |
In 1990, fifty percent of the population made twenty-eight percent of the community's income. In 1999, fifty percent of the population made only twenty-three percent of the income, and thirty-five percent of the total community income is made by ten percent of the population.
A large number of full-time Austin workers earn wages that hover near the federal poverty level of $16,700 for a family of four; approximately 35 percent of all workers in Austin are in occupations that pay less than $20,000 (Capital Area Workforce Development Board, May 30, 2000).
According to the State Data Center population estimates for 1999 in Travis County, over 13 percent of the total population lives at or below the U.S. poverty standard.
Due to the high cost of living in the area, too many of the area wage earners can be classified as "working poor" because their wages fail to cover the basics of housing, childcare, food, and health care. The upward economic trends show no signs of leveling. This will continue to raise the cost of living, further widening the gap between poor and wealthy. Race, socioeconomic status, and social class will continue to be factors in improving health and social well being. Many of the area wage earners are "working poor" whose wages fail to cover the basics of housing, childcare, food, and health care.
Health is affected less by change in absolute material standards across affluent populations than by income differences among groups.
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The significance of income gaps has been studied in other countries. In general, health appears to be closely associated with income differentials within countries. However, there is only a weak link between national mortality rates and average income in developed countries. This pattern suggests that health is affected less by change in absolute material standards across affluent populations than by relative income differences among groups in each country.
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It is not the richest countries that have the greatest life expectancy, rather, it is those nations with the narrowest income differentials between rich and poor (Turnock, 1997). Keeping this in mind, a report by the World Health Organization ranks the U.S. as spending more per capita on health care than any other country, yet ranks the overall U.S. health care system performance as 37th among the 191 countries ranked (World Health Organization, 2000).
REFERENCES
Capital Area Workforce Development Board. (Draft as of May 30, 2000). Local workforce development board integrated plan for program years 2000-2004. Austin, TX: Author.
Texas Department of Health. (September 2000). Epigram population and mortality data analysis [Online]. Available: http://www.tdh.state.tx.us/discon/chronic/epigram1.htm
Texas State Data Center. (August 31, 2000). Texas and US population change, 1990-1996 Texas - state level data [Online]. Available: http://txsdc.tamu.edu/tuspc.html
Turnock, B.J. (1997). Public health: What it is and how it works. Gaithersburg, MD: Aspen Publication.
World Health Organization. (2000). The world health report 2000: Health systems-improving performance. France: Author.
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