Anthony Cirillo
Anthony Cirillo

According to the Center for Retirement Research at Boston College, when economic times are good, deaths in the United States increase. While the negative health effects of over-work are often cited, conversely losing a job when the economy sours causes individuals’ health to deteriorate too. So there’s more behind this.

The College found that most of the additional deaths due to a falling unemployment rate occur among elderly women. And factors unrelated to work point to the healthcare labor force as a culprit.

Working-age men and women accounted for just 9% of the 6,700 additional deaths in 2006 caused by a 1-point decline in the unemployment rate. Deaths among people ages 65 and older accounted for 75% of the 6,700 additional deaths and women over 65 alone accounted for 55% of the additional deaths.

Researchers note that employment levels in the healthcare sector decline during economic expansions as low-paid, low-skill health workers find better jobs elsewhere. This worsens shortages of direct caregivers. And nursing homes are most affected.

The effect of a 1-point decline in the unemployment rate on nursing home deaths was statistically significant. The impact of the unemployment rate on deaths at locations other than nursing homes was not.

The analysis revealed that a 1-point decline in the unemployment rate causes more than a 3% drop in overall full-time employment at nursing homes. A 1% drop in the unemployment rate caused employment to decline by 3% for aides and by more than 2% for nurses.

A greater scarcity of these frontline caregivers may have a direct impact on the elderly, causing them to die in greater numbers concluded the authors. Of course, a combination of less numbers of staff with new staff still learning the ropes probably is not good for resident health either.

The idea of consistent assignment and staff retention are central to this report. On a level playing field, it is usually not salary and benefits that drive employees elsewhere. These extrinsic benefits notes Daniel Pink in his book “Drive” are not what motivate people. Yes they have to be fair and equitable and yes even a dollar or two per hour matter in this industry, but he contends, and I agree, that if staff feel that they belong, that they are part of a bigger vision, they will stay.

By helping them belong, you help them to stay.

The people cited here who leave were in healthcare because it was a job not a calling. Employees must uncover purpose and passion or reignite it and employers need to help them do that. Only people whose purpose and passion align with the organization’s mission should be in the organization or recruited to it. The adage is, “It’s about getting the right people on the bus.” We say we are developing a star ship crew.

Here’s a taste for the meaning we see behind the bus metaphor: 

• There’s only one driver   

• Everybody else is just a passenger

• Driver creates a command and control environment

• The bus travels predictable roads, making predetermined stops

• If the driver’s lost, everyone’s lost  

• Driver turns a blind eye to back-of-the-bus behavior

• Passengers have to find their own way to an open seat  

• Passengers are expected to passively sit through the ride   

• Idle passengers are prone to complaining

• Driver and passengers react to external circumstances

• Somebody’s routinely thrown under it   

Here’s some of the meaning a Sleek, Futuristic Starship conveys:

• Shared leadership

• Staffed by the Crew

• Support and empower environment

• Celebrated crew members beamed aboard for long-term voyages

• Crew is custom-stationed by purpose and passion

• Engaged crew is expected to stand, move around, actively participating

• Multiple navigators use multiple state-of-the-art navigational devices

• Everybody’s responsible for helping the ship stay on course

• Everyone has access to the expansive shared viewpoint of the bridge

• Crew creates and reacts from inner resources

• Charts its own unique course

So, first it’s about the people. But then it becomes about the process. Many organizations begin by identifying those things that need attention. They start with the environment, are quick to map solutions and then script people to execute. Opportunities for improvement need to be identified and worked upon.

But without transforming people, attempts to activate them usually fall flat, or worse, spiral out of control.

When you uncover personal passion and purpose starting with the CEO, you synchronize the organization around a common vision and start the foundation of trust.

Then everyone has experienced an internal shift of such magnitude that they now see themselves, others and the world around them from an entirely new perspective. Those same old problems look entirely different because the people looking at them have been transformed.

And who wouldn’t want to stay with or come to an organization that works like this!

Anthony Cirillo, FACHE, ABC, president of Fast Forward Consulting , is a sought-after speaker, healthcare expert, elder advocate and blogger. He works with long-term care facilities in the area of resident experience and strategic marketing. Anthony is the Healthcare Channel Partner for CEO2 and the expert guide for assisted living for  A board member of CCAL, Anthony is the author of “Who Moved My Dentures?” In his spare time, he entertains residents in assisted living and nursing facilities.