Trends & Ideas

July-August 2000

Human Resources
Creative Hiring in Iowa

With the nation's jobless rate at its lowest in 30 years, companies everywhere are scrambling to recruit workers. They might take some tips from Iowa employers, writes Ann Harrington in Fortune. The national unemployment rate hovers around 4.1 percent. In February Iowa's rate dropped to 2.2 percent—which means that almost everyone who wants a job has one.

Several factors have contributed to the state's especially severe labor shortage. One is the farm crisis of the late 1980s, when some 280,000 Iowans left the state. The remaining population is graying: Iowa has a large percentage of people who are 85 and older. And more than 70 percent of its 16-and-up teenagers—the usual source of new labor—already have jobs.

Iowa companies have tackled this problem in a variety of ways. For example, Dee Zee, a Des Moines manufacturer of aluminum accessories for trucks, has in recent years hired nearly 200 refugees, including 140 people from Bosnia, 35 from Vietnam, 15 from Sudan, and three from Kosovo. Language differences have caused some problems, of course. On the other hand, job turnover has fallen 30 percent and absenteeism is down now almost to zero.

At Principal, a Des Moines financial services firm, the big need was for skilled Cobol programmers. Unable to find them through the job market, the company decided to develop them itself. At a cost ranging from $20,000 to $30,000 apiece, Principal sent 12 administrative workers for three months of full-time Cobol training in the mid-1990s. Since then, another 78 Principal employees have also had the training. A company vice president estimates that all have doubled or tripled their earning potential.

Meanwhile, Rock Communications, a printing firm in Newton, IA, was about to lose a big contract because it lacked the entry-level workers to do the job. The owner, Tim Rock, turned to a local prison. Offering them the same wages he paid other employees, Rock was able to recruit the first of several dozen inmates who have spent their days working in his shop. Thirteen have chosen to stay on after release from prison.

Black Patients Get Inferior Care

It is not just lack of access that keeps African Americans from getting the healthcare enjoyed by white people. Recent studies indicate that disparities in income, insurance, and related factors do not—as previously thought—account for the fact that blacks get care inferior to that received by whites. The causes are more insidious, writes Deborah Shelton in American Medical News.

The differences are found even in standard services. For instance, a study of 2,200 hospital records revealed that whereas 53 percent of nonblack Medicare patients with pneumonia were given antibiotics within six hours of admission, only 32 percent of black Medicare patients with the same illness got that treatment. White patients were also found more likely than African Americans to have blood cultures drawn in their first two days in the hospital.

"We were surprised to find a racial difference for every basic hospital service," says John Z. Ayanian, MD, of Harvard Medical School, Boston, who helped direct the study.

Other studies have shown that black people are less likely than whites to receive kidney transplants, coronary bypass surgery, and surgery for lung cancer. On the other hand, African Americans are more likely than whites to undergo leg amputations, to have both testes removed as treatment for cancer, to get shunts implanted for dialysis, and to have tissue removed because of bedsores.

Racial disparities in healthcare seem to be the result, at least in part, of a lack of communication. Physicians appear to communicate more easily with white patients than black ones. Still another study showed, for example, that whereas 72 percent of white parents are counseled against laying sleeping babies on their stomachs (to preclude sudden death syndrome), only 48 of African-American parents are told that.

According to some authorities, physicians need increased training in cultural sensitivity to end such subtle kinds of discrimination. However, Reed Tuckson, MD, a black physician, argues that improvement will come only through setting objective standards for doctors. "I'm interested in being able to have appropriate standards in place and in holding people accountable for meeting those standards," he says.

Workplace Safety
Risky Business

Working at home poses more hazards than just the risk of being caught in your pajamas by the FedEx man, according to Patrick Barta, writing in the Wall Street Journal. More and more people work at home these days, but the typical home office is less safe than most traditional offices, which must meet certain safety standards. Government agencies, insurers, and safety experts are taking note.

Hidden hazards of the home office commonly include telephone or computer cords stretched across floors, waiting to trip the unwary; overloaded circuits, which pose a fire hazard; unstable or overloaded bookshelves, liable to crash down at any minute; and weighty files or boxes, too heavy to be safely lifted. These are in addition to the more obvious risks of neck, back, and arm injuries from chairs or keyboards; and the not-so-obvious risk of eye strain or even damage from insufficient lighting. Children's toys, pets, and loose throw rugs can cause anything from stubbed toes to broken bones.

An estimated 55 million Americans now do some work in home offices, compared with 40 million in 1995, and the number will undoubtedly continue to grow. No one knows for certain how many injuries happen in home offices—no national agency tracks such injuries—but insurers and safety experts believe accidents may go unreported because workers do not want to risk losing their work-at-home privileges. One thing that is certain, however, is that home offices can be more dangerous than traditional workplaces, with their mandated safety and fire standards. For example, most traditional offices must have at least two exits in case of fire; many second-floor home offices have only one.

The problem has gained attention recently following a letter released in 1999 by the U.S. Occupational Safety and Health Administration (OSHA), which advised that companies are liable for the safety of employees working at home. Companies protested, claiming they would be held liable for hazards they couldn't control. OSHA rescinded the letter, but Labor Secretary Alexis Herman has called for a "national dialogue" on the issue. Insurers are already taking action to adjust to the changing workplace; several major insurance companies have recently launched home office insurance plans.

A Positive View of Aging

The results of a new Harris Interactive poll that reprises the "Myths and Realities of Aging" survey conducted in 1974 reveal remarkably positive attitudes among adults toward aging, reports Paul Kleyman in Aging Today. Nearly half (44 percent) of Americans age 65 and older describe the present as "the best years of my life," while 84 percent of all respondents would like to celebrate their 90th birthday. Survey results were based on interviews with 3,000 people age 18 or older. Preliminary results of the study were released in March at the 50th annual conference of the National Council on the Aging (NCOA), in Washington, DC.

The study demolished several stereotypes of aging in America. The key factors in older respondents' decision to retire, for example, was not the onset of a certain age, but accumulated savings and decline in health. Only 14 percent said the best marker of the onset of old age was reaching a chronological milestone such as 65. The true beginning of old age, according to respondents, came with the decline of physical and mental abilities. This attitude corresponds with the fact that 45 percent of respondents age 65 to 69, and one-third of Americans in their seventies, said they consider themselves middle-aged.

Surprisingly, the survey showed little conflict between the young and the old on benefits and budgets. Two-thirds of surveyed participants under age 65 rejected the idea that Social Security funds should be used for children instead of elders. A majority in that group also said that Medicare should be expanded to provide long-term care, and that government should provide a tax credit to companies wishing to hire and retrain older workers.

Robert L. Butler, CEO of the International Longevity Center, a cosponsor of the survey, surmises that the positive view of aging expressed by respondents "may be a function of our times. When the first survey was conducted in 1974, we were seeing Watergate, the Vietnam War, long lines at the gas pump, and stagflation. Things are more prosperous now." But, he cautioned, "It's important not to be too cocky in interpreting these results. There could be an element of false optimism."

More information about the survey can be found on NCOA's Web site.


Copyright © 2000 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Trends and Ideas, July-August 2000

Copyright © 2000 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.