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Progress in Spatial Analysis pp 381–403Cite as

Is Growth in the Health Sector Correlated with Later-Life Migration?

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Part of the book series: Advances in Spatial Science ((ADVSPATIAL))

Abstract

The aging population of the United States has long been a subject of debate and inquiry for development planners, policy makers, and researchers. The doubling of the population of Americans older than 65 since 1960 (while the population younger than 65 has grown by only one half) (Fuguitt et al. 2002), has prompted interest in their effect on the economies in which they live (Serow 2003) and their potential as a resource for rural economic development (Fagan 1988; Fagan and Longino 1993; Reeder 1998). Interest in these issues intensified as the baby boomer generation approached retirement age. The retirement of this age cohort is likely to have profound effects on the nation and its economy as this cohort is not only much larger than previous age cohorts, but also healthier and wealthier due to economic growth and advances in the quality of healthcare. Older Americans increasingly have the means and the motivation to migrate to a different area upon retirement. For example, it is estimated that over the next 18 years, approximately 400,000 retirees each year – with an average of $320,000 to spend on a new home – will choose to relocate beyond their state borders (Vestal 2006). The South and West have been and continue to be popular destinations for these migrants (Serow 2001; He and Schachter 2003), although more are choosing to locate outside of the traditional retirement areas of Florida and Arizona (Vestal 2006). One driving force of this shift is the “halfback” phenomenon in the Southeast where retirees who had previously migrated to the coast are returning halfway back to their ancestral homes by relocating to areas such as the Southern Appalachian mountain regions of eastern Tennessee, western North Carolina, and northern Georgia (Park et al. 2007). Further, later-life migrants are frequently settling in rural places or small towns (Fuguitt et al. 2002). For example, in 2000 a half million more persons above 60 moved into non-metro counties than out of them (Beale 2005). These trends beg the question of how the recent in-migration of older Americans is affecting local economies, particularly in rural areas where the marginal effect of in-migration may be proportionally greater than in more populous urban areas.

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Notes

  1. 1.

    The mailbox economy is a term which refers to the source of income for many retirees. Examples include Social Security, private pensions, etc. all of which are derived from outside the local economy.

  2. 2.

    A primary concern in this literature is measuring access to physicians or to other health care services (e.g., Joseph and Bantock 1982; Wing and Reynolds 1988; Rosenthal et al. 2005; Pathman et al. 2006).

  3. 3.

    Due to data limitations, it was not possible to examine the other direction; i.e., to what extent was growth in the health care sector correlated with in-migrating seniors?

  4. 4.

    The rurality index controls for 2000 “base” level effects since it is determined in part by population density, inter alia additional demographic measures of settlement concentration. Because of this, 2000 population concentration measures were not included in the regression models.

  5. 5.

    In the case of the lag model, the relationship between W 1 y and y is usually much clearer. Hypotheses about how agents or spatial units react to and interact with one another can be guided by the choice of elements in W 1 (e.g., Bao et al. 2004).

  6. 6.

    In many empirical studies, the spatial autoregressive parameter (λ) is considered a nuisance parameter, suggesting that the main advantage gained from its estimation is one of efficiency rather than theoretically informed information. In other studies, some researchers assume that the error parameter explains “knowledge spillovers” due to unobserved heterogeneity across spatial units (e.g., Cohen and Paul 2005). In our approach, we assume the former interpretation of the parameter describing the spatial error process.

  7. 7.

    We multiply the covariance by \(n/(n - k)\) to correct for bias.

  8. 8.

    This matrix is also called the “spectral density” matrix in the usual GMM terminology.

  9. 9.

    Experimentation with alternative kernel structures yielded no substantial differences between the standard errors of the lag model.

References

  • Aday RH, Miles LA (1982) Long-term impacts of rural migration of the elderly: implications for research. Gerontol 22:331–336

    Article  Google Scholar 

  • Anselin L (1988) Spatial econometrics: methods and models. Kluwer, London

    Google Scholar 

  • Anselin L (2002) Under the hood: issues in the specification and interpretation of spatial regression models. Agric Econ 27:247–267

    Article  Google Scholar 

  • Anselin L, Florax RJGM (1995) New directions in spatial econometrics. Springer, Berlin

    Book  Google Scholar 

  • Anselin L, Lozano-Gracia N (2007) Error in variables and spatial effects in hedonic house price models of ambient air quality. Empir Econ 34:5–34

    Article  Google Scholar 

  • Area Resource File (ARF) (2005) US Department of Health and Human Services, Health Resources and Services Administration. Bureau of Health Professions, Rockville, MD

    Google Scholar 

  • Bao S, Henry M, Barkley D (2004) Identifying urban-rural linkages: tests for spatial effects in the Carlino-Mills model. In: Anselin L, Florax RJGM, Rey SJ (eds) Advances in spatial econometrics: methodology, tools and applications. Springer, Berlin, 321–333

    Google Scholar 

  • Barsby S, Cox DR (1975) Interstate migration of the elderly: an economic analysis. Lexington Books, Lexington, MA

    Google Scholar 

  • Bates LJ, Santerre RE (2005) Do agglomeration economies exist in the hospital services industry. East Econ J 31:617–628

    Google Scholar 

  • Beale C (2005) Rural America as a retirement destination. Amber Waves (June)

    Google Scholar 

  • Beale CL, Fuguitt GV (1990) Decade of pessimistic nonmetro population trends ends on optimistic note. Rural Dev Perspect 20:4–18

    Google Scholar 

  • Boarnet MG, Chalermpong S, Geho E (2005) Specification issues in models of population and employment growth. Pap Reg Sci 84:21–46

    Article  Google Scholar 

  • Brasure M, Stearns SC, Norton EC, Ricketts T (1999) Competitive behavior in local physician markets. Med Care Res Rev 56:395–414

    Article  Google Scholar 

  • Capalbo SM, Heggem CN (1999) Innovations in the delivery of health care services to rural communities: telemedicine and limited-service hospitals. Rural Dev Perspec 14:8–15

    Google Scholar 

  • Cho S-H, Kim SG, Clark CD, Park WM (2007) Spatial analysis of rural economic development using a locally weighted regression model. Agric Res Econ Rev 36:24–38

    Google Scholar 

  • Cliff AD, Ord JK (1981) Spatial processes. Pion, London

    Google Scholar 

  • Cliff AD, Ord JK (1973) Spatial autocorrelation. Pion, London

    Google Scholar 

  • Cohen JP, Paul CM (2005) Agglomeration economies and industry location decisions: the impacts of spatial and industrial spillovers. Reg Sci Urban Econ 35:215–237

    Article  Google Scholar 

  • Colsher PL, Wallace RB (1990) Health and social antecedents of relocation in rural elderly persons. J Gerontol Soc Sci 45:S32–S38

    Article  Google Scholar 

  • Conley TG (1999) GMM Estimation with cross-sectional dependence. J Econ 92:1–45

    Google Scholar 

  • Connor RA, Hillson SD, Krawelski JE (1995) Competition, professional synergism, and the geographic distribution of rural physicians. Med Care 33:1067–1078

    Article  Google Scholar 

  • Day FA, Barlett JM (2000) Economic impact of retirement migration on the Texas Hill Country. J Appl Gerontol 19:78–94

    Article  Google Scholar 

  • Dine DD (1988) Demand for retirement housing accommodates industry growth. Mod Healthc 18: 56–60.

    Google Scholar 

  • Doeksen GA, Johnson T, Willoughby C (1996) Measuring the economic importance of the health sector on a local economy: a brief review and procedures to measure local impacts. Southern Rural Development Center, Starkville, MS

    Google Scholar 

  • Dwight MB (1985) Affluent elderly want to live where quality care’s readily available. Mod Healthc April:74–76

    Google Scholar 

  • Escarce JJ, Polsky D, Wozniak GD, Kletke PR (2000) HMO growth and the geographical redistribution of generalist and specialist physicians, 1987–1997. Health Serv Res 35:825–848

    Google Scholar 

  • Fagan M (1988) Attracting retirees for economic development. Center for Economic Development and Business Research, Jacksonville State University

    Google Scholar 

  • Fagan M, Longino, Jr CF (1993) Migrating retirees: a source for economic development. Econ Dev Q 7:98–106

    Article  Google Scholar 

  • Freed GL, Nahra TA, Wheeler JR (2004) Relation of per capita income and gross domestic product to the supply and distribution of pediatricians in the United States. J Pediatr 144:723–728

    Google Scholar 

  • Fuguitt GV, Beale CL, Tordella SJ (2002) Recent trends in older population change and migration for nonmetro areas, 1970–2000. Rural Am 17:11–19

    Google Scholar 

  • Fujita M, Krugman P, Venables AJ (1999) The spatial economy: cities, regions, and international trade. MIT, Cambridge

    Google Scholar 

  • Glasgow N, Reeder RJ (1990) Economic and fiscal implications of nonmetropolitan retirement migration. J Appl Gerontol 9:433–451

    Google Scholar 

  • Haas WH III (1990) Retirement migration: boon or burden? J Appl Gerontol 9:387–392

    Google Scholar 

  • Haas WH, Crandall LA (1988) Physicians’ view of retirement migrants’ impact on rural medical practice. Gerontol 28:663–666

    Article  Google Scholar 

  • Haas WH III, Bradley DE, Longino CF Jr, Stoller EP, Serow WJ (2006) In retirement migration, who counts? A methodological question with economic policy implications. Gerontol 46:815–820

    Article  Google Scholar 

  • He W, Schachter JP (2003) Internal migration of the older population: 1995 to 2000. Census 2000 Special Report, US Census Bureau

    Google Scholar 

  • Hodge G (1991) The economic impact of retirees on smaller communities. Res Aging 13:39–54

    Article  Google Scholar 

  • House JS, Lantz, PM, Herd P (2005) Continuity and change in the social stratification of aging and health over the life course. J Gerontol B Psychol Sci Soc Sci 60:15–26

    Article  Google Scholar 

  • Jiang HJ, Begun JW (2002) Dynamics of change in local physician supply: an ecological perspective. Soc Sci Med 54:1525–1541

    Article  Google Scholar 

  • Joseph AE, Bantock PR (1982) Measuring potential physical accessibility to general practitioners in rural areas: a method and case study. Soc Sci Med 16:85–90

    Article  Google Scholar 

  • Kelejian HH, Prucha IR (2007) HAC estimation in a spatial framework. J Econom 140:131–154

    Article  Google Scholar 

  • Lambert DM, McNamara K, Garret M (2006) Food industry investment flows: implications for rural development. Rev Reg Stud 36:140–162

    Google Scholar 

  • Loomis LM, Sorce P, Tyler PR (1989) A lifestyle analysis of healthy retirees and their interest in moving to a retirement community. J Hous Elder 5:19–35

    Article  Google Scholar 

  • McGranahan DA, Wojan TR, Lambert DM (2006) Rural growth as creative enterprise. Paper presented at the 53rd Annual North American Meetings of the Regional Science Association International, Toronto, Canada, Nov 16–18

    Google Scholar 

  • Mistretta MJ (2007) Differential effects of economic factors on specialist and family physician distribution in Illinois: a county-level analysis. J Rural Health 23:215–221

    Article  Google Scholar 

  • Monchuk DC, Miranowski JA, Hayes DJ, Babcock BA (2007) An Analysis of Regional Economic Growth in the U. S. Midwest. Rev Agric Econ 29:17–39

    Article  Google Scholar 

  • Moreno R, López-Bazo E, Vayá E, Artis M (2004) External effects and cost of production. In: Anselin L, Florax RJGM, Rey SJ (eds) Advances in spatial econometrics: methodology, tools and applications. Springer, Berlin, pp 297–317

    Google Scholar 

  • Mullins D, Rosentraub M (1992) Fiscal pressure? The impact of elder recruitment on local expenditures. Urban Aff Q 28:337–354

    Article  Google Scholar 

  • Newhouse JP, Williams AP, Bennett BW, Schwartz WB (1982) Does the geographical distribution of physicians reflect market failure. Bell J Econ 13:493–505

    Article  Google Scholar 

  • Park WM, Clark CD, Lambert DM, Wilcox MD (2007) The long-term impacts of retiree in-migration on rural areas: a case study of Cumberland County, Tennessee. The University of Tennessee Institute for Public Service, Knoxville

    Google Scholar 

  • Pathman DE, Ricketts TC III, Konrad TR (2006) How adults’ access to outpatient physician services relates to the local supply of primary care physicians in the rural southeast. Health Serv Res 41:79–102

    Article  Google Scholar 

  • Patrick CH (1980) Health and migration of the elderly. Res Aging 2:233–241

    Article  Google Scholar 

  • Reardon J (1996) The presence of hospital systems in rural areas. J Econ Issues 30:859–876

    Google Scholar 

  • Reeder RJ (1998) Retiree-attraction policies for rural development. Agriculture Information Bulletin No. 741. U.S. Dept. of Agriculture, Economic Research Service, Washington, DC

    Google Scholar 

  • Reeder RJ, Glasgow N (1990) Nonmetro retirement counties: strengths and weaknesses. Rural Dev Perspect 20:15–30

    Google Scholar 

  • Regnier V, Gelwicks LE (1981) Preferred supportive services for middle to higher income retirement housing. Gerontol 21:54–58

    Article  Google Scholar 

  • Ricketts TC (2000) The changing nature of rural health care. Annu Rev Public Health 21:639–657

    Article  Google Scholar 

  • Rosenthal MB, Zaslavsky A, Newhouse JP (2005) The geographic distribution of physicians revisited. Health Serv Res 40:1931–1952

    Article  Google Scholar 

  • Rowles GD, Watkins JF (1993) Elderly migration and development in small communities. Growth Change 24:509–538

    Article  Google Scholar 

  • Serow WJ (2001) Retirement migration counties in the southeastern United States: geographic, demographic, and economic correlates. Gerontol 41:220–227

    Article  Google Scholar 

  • Serow WJ (2003) Economic consequences of retiree concentrations: a review of North American studies. Gerontol 43:897–903

    Article  Google Scholar 

  • Serow WJ, Charity DA (1988) Return migration of the elderly in the United States: recent trends. Res Aging 10:155–168

    Article  Google Scholar 

  • Sickles RC, Taubman P (1986) An analysis of the health and retirement status of the elderly. Econ 54:1339–1356

    Article  Google Scholar 

  • Stallmann JL, Deller SC, Shields M (1999) The economic and fiscal impact of aging retirees on a small rural region. Gerontol 39:599–610

    Article  Google Scholar 

  • Toseland R, Rasch J (1978) Factors contributing to older persons satisfaction with their communities. Gerontol 18:395–402

    Article  Google Scholar 

  • Vestal C (2006) Retirees boosting states’ rural economies. Available at: www.stateline.org, 15 Sept. 2007

  • Waldorf B (2006) A continuous multi-dimensional measure of rurality: moving beyond threshold measures. Paper presented at the Annual Meetings of the Association of Agricultural Economics, Long Beach, CA, July

    Google Scholar 

  • Wall TP, Brown LJ (2007) The urban and rural distribution of dentists, 2000. J Am Dent Assoc 138:1003–1011

    Google Scholar 

  • Wing P, Reynolds C (1988) The availability of physician services: a geographic analysis. Health Serv Res 23:649–67

    Google Scholar 

  • Whittle P (1954) On the stationary process in the plane. Biometrika 41:434–439

    Google Scholar 

  • Wojan TR, Lambert D, McGranahan DA (2008) Emoting with their feet: Bohemian attraction to creative milieu. J Econ Geogr 7:711–736

    Article  Google Scholar 

  • Wolinsky FD, Mosely II RR, Coe RM (1986) A cohort analysis of the use of health services by elderly Americans. J Health Soc Behav 27:209–219

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Agricultural Economics, University of Tennessee, 321 Morgan Hall, Knoxville, TN, 37996-4511, USA

    Dayton M. Lambert

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  1. Dayton M. Lambert
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  2. Michael D. Wilcox
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  3. Christopher D. Clark
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  4. Brian Murphy
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  5. William M. Park
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Correspondence to Dayton M. Lambert .

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Editors and Affiliations

  1. School of Geography & Earth Sciences, McMaster University, Main Street West 1280, Hamilton, L8S 4K1, Canada

    Antonio Páez

  2. CRESE, Universite de Franche Comti, avenue de l'observatoire 45D, Besancon CX, 25030, France

    Julie Gallo

  3. Dept. Geography, University of Toronto, Mississauga, Mississauga Road N. 3359, Mississauga, L5L 1C6, Canada

    Ron N. Buliung

  4. Regional Economics Applications, University of Illinois, S. Mathews Ave. 220 607, Urbana, 61801-3671, U.S.A.

    Sandy Dall'erba

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Lambert, D.M., Wilcox, M.D., Clark, C.D., Murphy, B., Park, W.M. (2010). Is Growth in the Health Sector Correlated with Later-Life Migration?. In: Páez, A., Gallo, J., Buliung, R., Dall'erba, S. (eds) Progress in Spatial Analysis. Advances in Spatial Science. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-03326-1_18

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