Regional interdependence: Health care labor force crosses county lines
A little over a year ago, Brittney Kurhajetz and her family moved to a small plot of land just under 10 acres outside Esko. A long driveway lined with towering pine trees leads to their little cabin in the woods where they raise chickens for eggs and the kids can skate around the pond once the water ices over.
Kurhajetz, along with her husband and three children, moved from Duluth, where she still works as a clinical supervisor for critical care at St. Luke's Health Care System. Her family makes up five of nearly 3,900 residents who have moved to Carlton County since 2000.
And she's just one of half the working residents in Carlton County who commute across county lines for work, about 8,700, according to 2015 U.S. Census data. Duluth's growing health care industry draws at least 10 percent of those commuters.
But that data, like any number, only shares a shining sliver of what's happening in this inter-county relationship.
So the Pine Journal interviewed people who live in Carlton County, but work in Duluth hospitals, and found that for some, though the Pine Journal can't be sure how many, the decision to commute derived not out of a better job opportunity, but a more fitting place for them to go home.
At least 261 of St. Luke's employees, almost 9 percent, live in Carlton County, including Kurhajetz. Essentia Health counted 617 employees, 11 percent, who live in Carlton County.
Despite Kurhajetz's former proximity to her job at St Luke's in Duluth, where she's worked for 11 years, her family moved from their Kenwood neighborhood home, near the College of St. Scholastica and the University of Minnesota Duluth, to the quiet outskirts of Esko.
They wanted more land and a place to raise animals. And they liked what they had heard about Esko Public Schools.
"We really like the community feeling of Esko," Kurhajetz said. "It really seems like the community is kind of based around school and the sports and activities. It's a close-knit community."
It's a common sentiment shared among people who seek a move to Carlton County. Sarah Motschenbacher, a manager in the education department at St. Luke's, not only works in Duluth, she grew up there. Then in 2004, she moved to Esko where she still lives with her daughter.
Motschenbacher was part of the steady wave of people moving into Carlton County when the population grew 11 percent between 2000 and 2010, most of whom moved from elsewhere in the state. That growth has since simmered, with a 0.32 percent growth between 2010 and 2017, according to estimations from the U.S. Census.
Crossing county lines
In 2015, just over half of Carlton County's employed population worked outside the county. And more than half of those residents, 4,500, commuted to St. Louis County.
Meanwhile, more than 5,000 people commuted into Carlton County for work and almost 3,000 of those came from St. Louis County, or 3 percent of its population, according to the most recent U.S. Census data.
So, what do these numbers mean?
In many ways, these numbers show the link between the economic health of St. Louis and Carlton counties, said Cameron Macht, the area's regional analysis and outreach manager with Minnesota Department of Employment and Economic Development.
"Good times in St. Louis County would typically lead to better times in Carlton County because they are so tightly linked and so many people who live in Carlton County are working in St. Louis County," Macht said.
Unemployment rates help tell that story, Macht said. Plenty of job opportunities in St. Louis County can cause unemployment rates to go down in Carlton County, even if nothing changed within Carlton County.
And Carlton County, along with the rest of northeastern Minnesota, has seen historically low unemployment rates, Macht said. In October, Carlton County's unemployment rate was 2.6 percent, the lowest on record. At the same time, St. Louis County also saw its lowest unemployment rate on record at 2.6 percent.
There are so many reasons why people might live in one place and work in another. To Connie Christenson, economic development director for Carlton County, it's a sign of the competitiveness in the industry people are commuting for.
Today, right here, that industry is health care, and it's not unlike what happened on the Iron Range in the 1970s and 1980s, she said, when people were willing to commute from as far as Wisconsin or Duluth to work in the mining industry.
"The willingness to commute is based on the salary and benefits more than anything," Christenson said. "And if you're not competitive, you're struggling, but if you are competitive, they (employees) are all congregating between Essentia and St Luke's."
Despite this, Christenson said she still believes the growing health care industry in Duluth can lead to potential success for Carlton County. Not only does it provide more jobs for residents, but considering Duluth is landlocked, she said additional development might have to expand into Carlton County at some point.
"So many of us in the field believe it is a regional effort and that what benefits one of us benefits all of us," Christenson said.
Though, like any economic development director, she'd like to see more residents working in the county, especially when considering where people do their shopping after work.
"More often, if people live in Carlton County, but work in Duluth, they'll hit the retail sector in Duluth and then come home," Christenson said.
At the same time, the health care industry in Carlton County is growing.
According to a report from the University of Minnesota Extension on Carlton County's economic situation, the number of hospital jobs in the county increased by 69 percent with the addition of 180 jobs between 2001 and 2017.
During that time span, Community Memorial Hospital added 138 of those jobs.
Currently, CMH employs 420 people and 283 of those live in Carlton County — 67 percent, said Rick Breuer, CEO and administrator of the hospital. And 95 employees live in St. Louis County — 22 percent.
The hospital's proximity to larger hospitals in Duluth, good morale among employees as well as competitive wages and benefits help CMH remain a competitive employer, Breuer said.
"You can get the same high-quality experience here, but it's a smaller place. It feels more like family," Breuer said. "We have generally happy employees who help recruit other happy employees. We have very low turnover so we don't have to recruit a ton because not many people leave us once they come."
Gynecological surgeon Verna Thornton started working at CMH in October after moving to Duluth from Atlanta. She commutes into Cloquet and even down to Mercy Hospital in Moose Lake to provide gynecological health care services where their otherwise wouldn't be. She's elated to be treating female patients in Carlton County.
"So many women don't want to drive to Duluth — they want something local," Thornton said. "Fortunately, I'm able to help them."
Mercy Hospital, Min No Aya Win Human Services Center of the Fond du Lac Band of Lake Superior Chippewa and Raiter Clinic in Cloquet didn't respond to requests for employment change numbers between 2001 and 2017.
A sense of home
For those like Kurhajetz and Motschenbacher, a good job was found in the bigger city, but a more intimate and rural setting better served their idea of home. So they headed for Carlton County. Others know where home is from the start, but found work elsewhere.
That's why Cassie McIvor, a special events planner at Essentia Health, commutes. McIvor has lived in Carlton County her entire life, and home is where her family is. She and her husband, who also works in St. Louis County, raise their two young children in Cloquet.
They purchased their first house in 2014, not too far from McIvor's parents. If not for her parents' help with the kids — picking them up after school and babysitting when her son was a baby — McIvor said she wouldn't be able to work. That's just one of the reasons the commute for her and her husband is worthwhile.
"I love the school," McIvor said. "My 6-year-old is in hockey and I love the hockey program that they have here in Cloquet. I love that it's not right in Duluth. It's close enough to travel in for work, but yet I feel like it's still kind of rural."
Others, like Joyce Kyle, had never even heard of Cloquet until shortly before deciding to move there. More than eight years ago, Kyle's husband got a job working on the Fond du Lac Indian Reservation. So she got a job working in the marketing and communication department at Essentia Health in Duluth.
After exploring the housing markets in both cities, the couple decided upon Cloquet. Now, every morning before work, Kyle boards a bus in Cloquet that takes her through Scanlon, with a stop in Esko before dropping her off in Duluth.
"I like the small town," Kyle said of living in Cloquet. "I like that it's quiet. I like that I can go outside in the summer, work in my yard and be at peace. It's slower than where I moved from, but at this stage in my life, I like it."