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Arch City
Dec 8, 2003, 5:55 AM
In total jobs only. The study doesn't suggest which areas are leading in research, or which metro areas have the best medical institutions.

http://www.milkeninstitute.org/img/nav_mi.gif

Boston, New York, Philadelphia, Chicago and Los Angeles Are Nation's Leading Centers for Health Care Industries
For Immediate Release
August 11, 2003

LOS ANGELES – Cities and regions with the greatest health-care resources could be big economic winners in the decades ahead. People are living longer, the elderly population is growing, and demands for better health care are pushing new innovations in medicine. That makes for vibrant local economies, according to a new Milken Institute report.

The report, which examines the potential impact of the growing health-care sector on regional economies, ranks Boston, New York, Philadelphia, Chicago and Los Angeles at the top of the list.

Each has a major stake in health care, from hospitals to pharmaceuticals to biotechnology, which pump millions of dollars into their local economies and provide tens of thousands of jobs.

"The health-care sector provides a huge economic base for some of these regions, and it promises to be a major global economic force in the years ahead," says Ross DeVol, the Institute's Director of Regional Economics. "Nurturing expansion in this sector is increasingly vital to regional economic prosperity, and there is an important race underway that will determine which areas will be the dominant health-care centers."

How important is the health-care industry to the economy? Health-care consumption in the U.S. has doubled since 1970, from 7 percent of GDP to 14 percent. It is expected to reach 17 percent by 2011 as this country's senior population grows.

Globally, the over-65 population is expected to expand from 600 million to more than one billion by 2020.

The Top 20 metros on the Milken Institute Health Pole Index:

1. Boston
2. New York
3. Philadelphia
4. Chicago
5. Los Angeles
6. Washington, D.C.
7. Detroit
8. Nassau-Suffolk
9. Newark
10. Minneapolis-St. Paul
11. Pittsburgh
12. Baltimore
13. St. Louis
14. Cleveland
15. Houston
16. New Haven-Meriden
17. San Diego
18. Rochester, MN
19. Tampa
20. Miami

The study examines more than 300 metropolitan areas as well as all 50 states to quantify the importance of this sector to regional, state and U.S. economies. Applying mathematical models used in the Institute's 1999 groundbreaking study, America's High-Tech Economy, Milken Institute researchers examined employment in 13 health-care industries, from hospitals, drugs and medical supplies to health insurance and medical research.

The heart of the study is the Milken Institute’s list of the Top 20 Metro Health Poles, which ranks metropolitan regions based on the concentration of health-care employment in their economy and as a share of U.S. health-care employment. (The word "poles" is used, since these regions act as magnets, drawing other health industries and related companies, and the employment and incomes associated with them.)

Boston, a center of biotechnology and home to some of this country's top medical schools, is ranked number one on the index. Right behind it in a virtual tie is New York, which employs tens of thousands of workers in its hospitals and other health-related industries.

Philadelphia, a leading employer in pharmaceuticals, is third, Chicago, a leading center for health insurance firms, is fourth, Los Angeles, with its numerous physician offices, clinics and laboratories, is fifth, and Washington, D.C., home to the country's top research organizations, such as the National Institutes of Health, is sixth.

The index includes some metropolitan areas that often do not fare well on economic indexes. These include Detroit, which has become a major player in health-care services (ranked 7th); Pittsburgh, home to the 31,000-worker University of Pittsburgh Health System (11th); St. Louis, where hospitals are the second-biggest employer (13th); and Cleveland, whose world-renowned Cleveland Clinic employs more than 23,000 people (14th).

The report also looks at which states and regions have the largest concentrations of health-care employment. The top-ranked states are, in order, Pennsylvania, Massachusetts and Rhode Island (tie), New Jersey and Connecticut. Regionally, the top areas are the New England and Middle Atlantic states. In 2001, for example, more than 800,000 New England residents held jobs in the health-care sector.

"Biotechnology and biomedicine particularly are important drivers in this field," said DeVol. "These two fields of health care may mean to the first half of the 21st century what electronics and computers meant to the latter half of the 20th century."

Link: Metro Rankings (http://www.milkeninstitute.org/pdf/healthpole_overall_2003.pdf)

Arch City
Dec 8, 2003, 5:57 AM
St. Louis is fortunate to have large health care companies such as Express Scripts, Medicine-Shoppe International, Megellan Healthcare National Technology Center, D&K Healthcare Resources, Pfizer - Chesterfield Valley, fast growing Centene Corporation, Reliable Life Insurance, etc. etc., along with three major medical centers (Washington University, St. Louis University, and St. John's Mercy Medical).

http://www.pbase.com/image/23972369.jpg

Above is Kingshighway Boulevard in St. Louis, which borders Washington University Medical Center facilities.

Chase Unperson
Dec 8, 2003, 12:31 PM
Those are exactly the same top 5 I would have picked.

Chase Unperson
Dec 8, 2003, 12:37 PM
Well, I of course never consider how many insurance firms a metro area has, but in terms of quantity AND quality of medical institutions and hospitals those are the same top 5.

Arch City
Dec 8, 2003, 4:12 PM
Well, I of course never consider how many insurance firms a metro area has, but in terms of quantity AND quality of medical institutions and hospitals those are the same top 5.
I think that metro New York should be over Boston. New York, Nassau-Suffolk, and Newark should be counted as one in my opinion.

Also, if they were measuring quality St. Louis would be much higher.

Chase Unperson
Dec 8, 2003, 4:38 PM
No way. Boston is hands down #1. MGH, Brigham and Boston Children are the three of the best hospitals by far and all are better than any hospital in NY in terms of clinical rep and research. Moreover M.I.T. is closely aligned with all three for research. Plus Boston has a few other programs there. Boston is ground zero for clinical and academic medicine in this country. Only Hopkins is better, but Boston has so much more than Baltimore.

It goes 1) Boston 2)NY/Chicago 4) L.A.

Yes Washington in STL is well regarded.

Arch City
Dec 8, 2003, 5:02 PM
No way. Boston is hands down #1. MGH, Brigham and Boston Children are the three of the best hospitals by far and all are better than any hospital in NY in terms of clinical rep and research. Moreover M.I.T. is closely aligned with all three for research. Plus Boston has a few other programs there. Boston is ground zero for clinical and academic medicine in this country. Only Hopkins is better, but Boston has so much more than Baltimore.

It goes 1) Boston 2)NY/Chicago 4) L.A.

Yes Washington in STL is well regarded.
The study is measuring total health care industry employment in a particular region.

Again, it's not about the quality of the hospitals or research programs a particular region has.

hudkina
Dec 8, 2003, 5:28 PM
Detroit is #7, and I'm sure it would rank high for quality and research too.

Ann Arbor is pretty big in medical research. They also have the U of M Medical Center, which is one of the top hospitals in the nation. Though, this ranking doesn't reflect that, as it puts it at #136 behind Fargo, ND.

billyblancoNYCII
Dec 8, 2003, 5:45 PM
No way. Boston is hands down #1. MGH, Brigham and Boston Children are the three of the best hospitals by far and all are better than any hospital in NY in terms of clinical rep and research. Moreover M.I.T. is closely aligned with all three for research. Plus Boston has a few other programs there. Boston is ground zero for clinical and academic medicine in this country. Only Hopkins is better, but Boston has so much more than Baltimore.

It goes 1) Boston 2)NY/Chicago 4) L.A.

Yes Washington in STL is well regarded.

Do you think before you type?

pkp
Dec 8, 2003, 6:52 PM
I'm surprised Birmingham did not make this list.

shoowaa1
Dec 8, 2003, 7:19 PM
(Washington University, St. Louis University, and St. John's Mercy Medical).

Hey Arch City, isn't Barnes pretty large too? If I recall I think it was either along or near Kingshighway but then I haven't been to St Louis in awhile now.

I'm pretty surprised Denver didn't make it in the top 20 but in a few more years once more facilities open at the growing Fitzsimons Medical Complex (it will be the largest in the Interior West) it will move the Mile High City into the top 20 and maybe the top 15. Btw I'm surprised Houston is down aways on this.

Albert (Shoowaa)

Crawford
Dec 8, 2003, 8:12 PM
NY crushes Boston in quality and quantity.

Boston might have a higher proportion of medical employment.
For some reason, New York's suburbs are not included in its totals. I wonder who would be #1 if the metro areas were fairly compared?


NY has three world class medical schools (Columbia, Cornell, NYU). Boston has one, albiet fantastic, medical school (you know who).

NY has two second tier medical schools (Mt. Sinai, Einstein), Boston has one (Tufts).

New York has a bunch of third tier medical schools (Downstate, NY Medical, Rutgers, etc.), Boston has one (BU).

Boston has Mass General and all the Longwood Medical Hosptals. Very impressive hospitals. But NY has Memorial Sloan Kettering (best in cancer), New York Hospital (Cornell), Presbyterian (Columbia), NYU, Montefiore, St. Vincent's, Manhattan Ear, Nose Throat, Hospital for Special Surgery, Cabrini, Beth Israel, St. Luke's, Roosevelt, Einstein, Long Island Jewish (it's in Queens), Maimonides, etc.

NY is the Medical Capitol. It needs to get its act together to compete to be the Biotech Capitol.

Arch City
Dec 8, 2003, 8:13 PM
Yes shoowaa, Barnes-Jewish Hospital does sprawl for a short bit along Kingshighway and it is a part of the Washington University Medical Center.

Also, this study isn't only about medical complexes and their size.

It is about how many health care industry related jobs are in a particular region - including direct medical care jobs.

Fitzsimmons may grow larger, however, if Denver doesn't secure more health care related jobs - not just direct medical care jobs - Denver probably won't move into the Top 20.

For example, St. Louis has many, many medical supply and manufacturing companies. It also has tons of pharmaceutical firms, many corporate headquarters for large health care systems such as Ascension Health System (http://www.ascensionhealth.org/). St. Louis has RehabCare and Correctional Medical Services with corporate offices in St. Louis, etc. etc. - on top of direct medical care jobs.

:)

alex1
Dec 8, 2003, 9:02 PM
i'm surprised that houston is so low.

billyblancoNYCII
Dec 8, 2003, 9:14 PM
NY crushes Boston in quality and quantity.

Boston might have a higher proportion of medical employment.
For some reason, New York's suburbs are not included in its totals. I wonder who would be #1 if the metro areas were fairly compared?


NY has three world class medical schools (Columbia, Cornell, NYU). Boston has one, albiet fantastic, medical school (you know who).

NY has two second tier medical schools (Mt. Sinai, Einstein), Boston has one (Tufts).

New York has a bunch of third tier medical schools (Downstate, NY Medical, Rutgers, etc.), Boston has one (BU).

Boston has Mass General and all the Longwood Medical Hosptals. Very impressive hospitals. But NY has Memorial Sloan Kettering (best in cancer), New York Hospital (Cornell), Presbyterian (Columbia), NYU, Montefiore, St. Vincent's, Manhattan Ear, Nose Throat, Hospital for Special Surgery, Cabrini, Beth Israel, St. Luke's, Roosevelt, Einstein, Long Island Jewish (it's in Queens), Maimonides, etc.

NY is the Medical Capitol. It needs to get its act together to compete to be the Biotech Capitol.

Damn right. The key is building affordable lab space. There are a few plans and a new focus by the city. It has the ingredients, but can't get it all together. People move to NJ and the burbs to expand. There are a lot in the NYC area, though, due to NYC. NYC will come up to speed soon enough. It's instiutions, knowledge capital and access to Wall St. should do the trick sooner or later.

Snowbird
Dec 8, 2003, 9:17 PM
i'm surprised that houston is so low.

It isn't too surprising when you consider that they're ranked according to total number of employees in the health care industry; with that as your basis, you would naturally assume that the larger cities in the midwest and northeast (larger in comparison to other midwest and northeast cities, not in relation to Houston), that are older and have a large medical infrastructure, would be at the top of the list. We're talking about some massive medical complexes in these old cities, centered around enormous hospitals.

alex1
Dec 8, 2003, 9:44 PM
houston has such a large medical center though (said to be the largest in the world). but milken definately knows more then i do about this stuff. I'll take their word for the standings.

I'm still surprised.

glowrock
Dec 8, 2003, 9:44 PM
Yes shoowaa, Barnes-Jewish Hospital does sprawl for a short bit along Kingshighway and it is a part of the Washington University Medical Center.

Also, this study isn't only about medical complexes and their size.

It is about how many health care industry related jobs are in a particular region - including direct medical care jobs.

Fitzsimmons may grow larger, however, if Denver doesn't secure more health care related jobs - not just direct medical care jobs - Denver probably won't move into the Top 20.

For example, St. Louis has many, many medical supply and manufacturing companies. It also has tons of pharmaceutical firms, many corporate headquarters for large health care systems such as Ascension Health System (http://www.ascensionhealth.org/). St. Louis has RehabCare and Correctional Medical Services with corporate offices in St. Louis, etc. etc. - on top of direct medical care jobs.

:)

Arch City,

You're probably right about Denver not getting into the top 15, but top 20 is a a definite possiblity, with Fitzsimmons employment alone expected to top 25-30,000 by 2010. Add that to the other large hospitals here, places like the Eleanor Roosevelt Cancer Research Center, among a host of other facilities, and I'd think there's at least a CHANCE Denver can get onto that list. And yes, while I realize that St. Louis (among many of those other cities mentioned) have huge pharmaceutical/biotech firms located there, Denver's got a few of its own, notably a large Amgen facility, along with a major Geneva Phamaceuticals plant. No, nothing like the top cities on that list, but not too shabby, either.

We'll just have to wait and see what the 2010 or 2011 list says! :D

Aaron (Glowrock)

guess
Dec 8, 2003, 10:21 PM
This (http://www.milkeninstitute.org/pdf/healthpole_ppt_2003.pdf) Slide Presentation shows the break down of the Pole Indexes for each of the 13 categories used to determine the overall rankings.

Arch City
Dec 8, 2003, 10:24 PM
houston has such a large medical center though (said to be the largest in the world). but milken definately knows more then i do about this stuff. I'll take their word for the standings.

I'm still surprised.
I know that a lot of people see Houston as a force in health care simply because it has the world's largest medical center with several reputable institutions, however, it is the only major medical complex in Houston.

Also, Houston just doesn't have the number of health care companies that other cities have, which is what Milken measured. If Houston did, it would certainly rank higher in the study.

I personally think that St. Louis should have ranked higher, but oh well.

Below, is a rarely heard about major medical center in St. Louis.

http://www.mdnetlink.com/sjmmcobgynres/medcenter.jpg
old aerial of St. John's Mercy Medical Center, St. Louis

St. John's Mercy Medical Center is in the midst of a $500-million expansion. A new cancer center, heart center, new office building, etc.

Arch City
Dec 8, 2003, 10:35 PM
Arch City,

You're probably right about Denver not getting into the top 15, but top 20 is a a definite possiblity, with Fitzsimmons employment alone expected to top 25-30,000 by 2010. Add that to the other large hospitals here, places like the Eleanor Roosevelt Cancer Research Center, among a host of other facilities, and I'd think there's at least a CHANCE Denver can get onto that list. And yes, while I realize that St. Louis (among many of those other cities mentioned) have huge pharmaceutical/biotech firms located there, Denver's got a few of its own, notably a large Amgen facility, along with a major Geneva Phamaceuticals plant. No, nothing like the top cities on that list, but not too shabby, either.

We'll just have to wait and see what the 2010 or 2011 list says! :D

Aaron (Glowrock)
Good luck to Denver (no pun intended).

However, every region is beefing up health care sector facilities - even Indianapolis, which is #25. Denver is #35. Denver has a lot of work to do to crack the Top 20 in the next 10 years.

Granted Indianapolis doesn't have a massive Fitzsimmons type project in the works, it is steadily gaining and pursuing health care/biotech jobs just like every other region.

Chase Unperson
Dec 9, 2003, 12:07 AM
To the folks above that think NY is #1 in medicine over Boston.

No way.

I am not from Boston nor do I care about Boston at all. But MGH, Brigham and Boston Childrens are heads and shoulders more influential and more well regarded than any hospital in NY or the US outside of Hopkins.

And kids that can't get into HMS go to Columbia, Cornell and NYU.

Don't take it personally. It is just the way it is, and you absolutely get fine care in both cities. But MGH is the mothership.

Shawn
Dec 9, 2003, 12:45 PM
What happened to those guys who were trying to say that Rochester, MN was the health care center of North America or something like that? Wish this report had been out for that discussion....

toggie
Dec 9, 2003, 2:05 PM
Rochester HAS one of the most important health care centers in North America if not the world. the Mayo clinic. as far as being a health care city. they really don't have that much else being a metro of 200,000 not many other big health care companies will settle there.

Freaky D
Dec 9, 2003, 6:36 PM
i'm surprised springfield isn't on there....


no but really, Dallas easily clenches a spot in the top ten no matter what some random paper says in Los Angy. Dallas has some major medical centers scattered all over the place including the gigantic Children's Medical Center, the place where the Egyptian Siamese Twins(conjoined at the head) were seperated successfully. Also, tis' be where the LASIC surgery was created, now being used daily across the country. I'm sure i can expand on why D/FW has a big time medical society combined with an already known technological environment to make one to top, but i gotta go. nice thread btw.

Chase Unperson
Dec 9, 2003, 11:36 PM
Dallas is a medical powerhouse too for sure.