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Waning support for higher education impacts Iowa’s rural and low-income areas most

MahurinEcon_Thumb1_768.jpg
MahurinEcon_Thumb1_768.jpg

DES MOINES — Lyndsay Harshman grew up in a small southern Iowa town that had no pediatrician. In May she’ll graduate from medical school to go into pediatrics while balancing $135,000 in student debt.

“I really have some concerns for small-town Iowa,” Harshman said. “For me it’s certainly a concern that my hometown … would be able to maintain physicians. Because the cost to pay a physician keeps going up because we have to pay off loans. It’s a 1,000 bucks a month for 30 years.”

Harshman, the president of the University of Iowa’s graduate student government, and Joel Anderson, the president of the University of Northern Iowa’s student government, explained the continued cuts to Iowa’s public universities have a domino effect for the entire state. Harshman’s university has already closed 12 graduate programs in recent years, and the increased cost of law school is making it harder for people like Anderson to consider attending colleges in state.

Iowa has been ranked in the top five for average student debt load by the Project on Student Debt since the organization began keeping rankings.

Twenty-two of UI’s graduate professional programs are listed as one of the 10 best in the country, including their medical program, but the cost has been rising.

Access To Health Care In Small Towns

In 1990, tuition and fees for a medical student were approximately $5,000 for in-state students. Today it’s approximately $25,000 and nursing students are facing one of the largest tuition increases in the country with a nearly 40 percent hike.

“We just shoulder the burden,” Harshman said. Once medical students reach graduate school and have a mounting debt load, she argued, it becomes more difficult to consider locating in a small town. Despite Iowa being a relatively low wage state, locating in a rural area with few patients means it’s less likely she’d make enough to cover her loans.

Her assumption is backed up by a 2010 study by the Dartmouth Institute for Health Policy and Clinical Practice, which found there are enough pediatricians in the country, but too many are located in wealthy areas.

Rural areas tend to have trouble keeping up with wage because the further away from urban areas where colleges are generally located, the lower the percentage of residents with a college degree. Only eight counties in Iowa meet or exceed the national average for percentage of the population with a degree. And that statistic has remained virtually unchanged during the past 60 years.

Part of the reason there are enough pediatricians and family physicians is that there has increasingly been more new doctors than children. The study found the number of pediatricians increased by 51 percent from 1996 to 2006, and family doctors grew by 35 percent. Meanwhile, the population of children grew by 9 percent during those same years.

Family physicians make up 15 percent of the U.S. outpatient physician work force and, according to the National Center for Health Statistics, they receive 23 percent of doctor visits. That number is higher in rural areas, where family physicians see 42 percent of the visits, but rural physicians only account for 10 percent of their field’s workforce. U.S. Census data shows 20 percent of Americans live in rural areas.

A study from the Robert Graham Center for Policy Studies in Family Medicine and Primary Care indicated that without those family physicians, 68 percent of counties in the country would become Primary Care Health Personnel Shortage Areas.

An article from the Western Journal of Medicine similarly concluded physicians tend to live in affluent urban and suburban areas.

Although this year it was Republicans in the House and a Republican Governor proposing cuts to higher education, Harshman said she doesn’t blame them specifically.

“If I was blaming Republicans I would be blaming myself,” she explained. Regardless of which political party controls state government, the Regents universities have been suffering declining support, which has accelerated over the past 10 years.

“It’s not a Republican thing, it’s not a Democrat thing; it’s an Iowa thing,” Anderson added, referring to the cuts.

Keeping Teachers In Iowa

Anderson, an accounting major, argued many students at UNI are majoring in fields like teaching and business, which aren’t necessarily high-paying careers, leaving graduates struggling to pay down their student loans.

In order to restore Regent funding to the level seen during 2009, tuition would have to be raised 38 percent, Anderson said.

“I don’t want to sound cynical but every time you take a cut from the university, especially UNI, you’re basically saying to future students ‘Oh, it’s okay; you don’t need to be a teacher. No, I mean obviously we don’t want to invest in you to be a teacher because we know you’re not going to be paid well enough to pay off your student debt, so we want you to go into the industries that are going to make a lot of money,’” Anderson proclaimed.

Anderson said education is vital not only for training, but for the sake of a society. By that, he means the social norms of treating people with respect, that violence is not okay and how to behave in a social setting.

“I’m all for K-12 education, but if we keep cutting higher education, who’s going to be teaching it?” Anderson asked.

Dr. Jason Glass, the new education director for the state of Iowa, doesn’t buy the assumption that graduates are fleeing Iowa to seek better wages.

“Iowa is in the middle of the pack in terms of teacher salary,” Glass said, “but we’re also a very low cost of living state. So that has an effect, right?”

Glass said it is important for college students to consider when entering school what wages can be expected for their chosen course of study. He said compensation reform for teachers should be implemented, however, advised those interested in teaching seek to avoid debt knowing their profession’s expected salaries.

“What we know about compensation based on research is it’s an important factor in attracting and keeping talent,” Glass elaborated. “But it’s not something that sort of inspires and pushes people to higher level of performance. So I think as a compensation strategy for the state we should be trying to think about how we use the limited resources that we have to offer a starting teaching salary that attracts high-caliber people into the field and keeps them in the field.

Glass did say Iowa has a tough attrition problem early on in the teaching field. Yet, he believes there are other factors not necessarily related to salaries that impact the ability to keep teachers in Iowa.

Harshman said the issue for doctors and lawyers isn’t being able to afford a Mercedes Benz. Rather it’s the ability to live comfortably in a small-town setting. Research shows teachers are generally better paid in urban areas over rural, and other factors such as limited possibility for professional achievements work against rural school districts.

Reform

When Glass was announced as Gov. Terry Branstad‘s pick for education chief, he told The Iowa Independent he’d like to look into a way to help with tuition assistance or forgiveness for prospective teachers in Iowa. With a high profile education summit occurring this summer in Iowa, and U.S. Secretary of Education Arne Duncan scheduled to be the keynote speaker, Glass said that’s still in the cards for the state.

“I think it would be safe to say that we will be putting forth some options for consideration of the legislature that would involve tuition forgiveness, or scholarships, or some kind of student loan forgiveness in exchange for so-many years of teaching,” Glass said, “Or perhaps something like Teach for America.”

He said it would be a central part of a comprehensive reform effort.

Although funding for higher education may still decline for FY 2012, the Branstad administration has also launched a blog focused on education. In conjunction with Iowa Student Loan, they have also started the “Student Loan Game Plan” to help students understand debt when entering college. They also teamed with the College Student Aid Commission to open a financial literacy website.

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