A Hospital Unit Shuts Down
Is the Closing of a Labor and Delivery Unit a Demographic Sign of the Times?
Recent media reports this past week hit young families hard when it was announced that Upper Valley Medical Center was shutting down their labor and delivery unit by the end of February. Beginning in March, there will be no babies born at the hosptial and expecting parents will need to make arrangements out of the county to deliver their newborns.
In an article in the Dayton Daily News, the hospital cited four reasons for the decision:
A declining birth rate locally and outmigration of births
The number of births at UVMC in 2023 was about half of what it was less than a decade ago. This averages out to fewer than one delivery each day at the hospital.
In 2022, 70% of patients living in Miami County left the county for obstetrics delivery services. In the first quarter of 2023, across Miami, Darke, and Shelby counties, Miami Valley Hospital accounted for 23.4% of births, while UVMC accounted for 16.4% of births.
Challenges around physician recruitment are industry-wide, especially at smaller community-based hospitals, resulting in temporary provider (locums) expenses that are not sustainable.
One of the most interesting points put forward by the hospital is that there are simply fewer babies being born in Miami County. There is no reason to necessarily doubt the data put forward by the hospital, but it certainly gave this publication pause to think about the demographic health of the community. Questions were immediately raised: Are we seeing less younger people? Are we seeing older people? More importantly, what are the implications of these changing demographics and what are the policies that may need to be addressed to continue to make our community an attractive and growing hometown for generations to come?
Enter the Population Pyramid
Population pyramids are graphical representations that show the distribution of various age groups in a population, typically divided by gender. These pyramids are traditionally shaped like a pyramid, with the youngest age groups at the bottom and the oldest at the top, and they can vary significantly in shape depending on the demographic characteristics of the population. The left side usually displays the male population, while the right side represents females. Each horizontal bar in the pyramid represents an age group, often in five-year intervals, with the length of the bar indicating the proportion of the population in that age group. The distinct shape of the pyramid can immediately convey key aspects of the population’s age structure, such as birth rates, life expectancy, and significant historical events that may have impacted the population.
Population pyramids are invaluable tools for demographers, policymakers, and social scientists as they provide an at-a-glance understanding of the demographic health and trends within a community. For instance, a wide base in the pyramid suggests a high birth rate, indicating a young population with potential implications for education and job market needs. Conversely, a narrow base points to an aging population, signaling potential future needs for healthcare, retirement planning, and social services. Additionally, abrupt changes in the pyramid can reveal historical events like wars, migrations, or epidemics.
By analyzing these shapes and trends, decision-makers can forecast future needs and challenges, plan for resource allocation, and implement policies tailored to the evolving demographic landscape. Population pyramids, therefore, serve as a visual summary of a community's demographic past, present, and potential future, aiding in informed decision-making for sustainable community development.
Troy’s Population Pyramid Through Time
Using data from the United States Census Bureau’s American Community Survey, this publication was able to create the two population pyramids as show below. The one on the left is the most current population pyramid from 2022; the pyramid on the right was from 2010.
Back in 2010, Troy's population pyramid presented a community full of youthful energy. From the data, the city was filled with the laughter of children and the dynamic presence of young families. The broad base of the community’s demographics, particularly with a healthy segment of the population in the under-10 age groups, spoke of a robust birth rate. One would expect a growing and healthy economy given these demographics.
Fast forward to 2022, and the narrative takes a noticable turn older. The once broad base of the pyramid has narrowed, signaling a worrying dip in the younger population. This could be attributed to a myriad of factors – perhaps lower birth rates, or maybe young families seeking opportunities in other cities. Simultaneously, the upper echelons of the pyramid have broadened. The 65 and older segment of the population has swelled, reflecting a community that is simply getting older.
What Does The Future Hold For Our Community?
Given the dramatic demographics from 2010 to 2022, can these population pyramids give us any insights into what our community might look like in the future? Perhaps. As the pages of the calendar turn towards 2034, one can envisage a further evolution of existing trends. The population pyramid, once bottom-heavy in 2010, is likely to invert, becoming top-heavy with an even more pronounced aging population. Once thriving nurseries and schools might find themselves quieter, the playgrounds less frequented. In contrast, the demand for healthcare services, retirement homes, and community centers catering to older adults may rise, reshaping the city's landscape and its priorities.
This demographic transformation brings with it a kaleidoscope of implications for the policymakers of Troy. The health and welfare of an aging population will undoubtedly take center stage. The city's healthcare infrastructure, already a critical asset, will need to expand and adapt, becoming more robust and sensitive to the needs of its elderly residents. Assisted living facilities, home healthcare services, and geriatric care will become vital components of Troy's healthcare ecosystem. Perhaps the closing of the Upper Valley Medical Center’s labor and delivery unit is simply a part of this transition where basic services for younger families will start to dwindle and perhaps more services catering to older populations will take their place.
But the story doesn't end there. As the younger demographic dwindles, the need to attract and retain young families and professionals becomes imperative. The city must reinvent itself as a beacon for the youth – through quality education, vibrant job opportunities, and engaging community programs. The challenge is to strike a delicate balance, nurturing an environment that is as welcoming and enriching for the young as it is comforting and accommodating for the older generation.
This is an imperative challenge for our community right now. Business and Civic leaders for years have championed that the lack of resources in housing, transportation and child care are making the community less attractive to younger families. Ignoring these issues is not just causing short term problems for local businesses to fill necessary workforce needs, but it could lead to a long-term issue of a more stagnant local economy.
The city's infrastructure, too, will need a thoughtful redesign. Housing that caters to the varied needs of its residents, accessible transportation, safe public spaces, and amenities that encourage active aging will more than likely be key elements in Troy's community development blueprint as it will cater to older residents.
Economic sustainability in this evolving demographic scenario will be crucial. As the ratio of the working-age population to the elderly shifts, innovative economic strategies will be needed to maintain, if not enhance, the city's economic health and vitality. Notably, strategies will need to be created to ensure that the city’s income tax base can continue. Seniors with social security and retirement income are exempt from paying City Income Tax. With fewer wage-earners paying income tax for a larger population of seniors, discussions must be had on making the income tax base more sustainable.
In essence, the demographic evolution of Troy, Ohio, from 2010 through 2022, and into the future, is not just a tale of numbers and percentages. It's a narrative of a community in flux, facing the challenges of change with resilience and foresight. For the policymakers of Troy, it's a call to action – to envision and craft a city that embraces every stage of life, ensuring a future that's as bright and promising as its illustrious past.
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