Crain Associates Research LLC

Where in the US are people healthiest?

One measure of serious health risk is the amount of time people spend as patients in hospitals.  There are areas in the US where on average one in every two people spends a day in the hospital each year.  There are places where the average is one in every five people.

I don’t know about you, but the only way I’d like to spend a lot of time in a hospital is if I worked there.

Hospitals report various numbers to the Federal government.  One if these is total “patient days” — the sum of days admitted for all patients over a year.  If we divide that by the state population, that gives us a ratio of patient days per resident.

Obviously, this isn’t a perfect measure.  There are areas such as New Jersey where patients may cross state boundaries for hospital care.   Despite these limitations, the measure is instructive.

The best states (lowest hospital utilization) are

  • Wyoming (.22 days per resident)
  • Idaho (.27)
  • Utah (.27)
  • Vermont (.29)

The worst states/locations are

  • Washington, DC  (.89)
  • Kentucky (.59)
  • New York (.59)
  • Alabama (.58)
  • Tennessee (.57)

Hospitals also report gross revenue from patient admissions.  The national average per state resident (not per patient) is $9,069 spent on hospital care.  Alabama, one of the poorest states in the US, spends $10,344 per resident on hospital care — much of that money coming from the Federal government.

Poverty, ignorance, crime, tobacco and drug abuse go together and probably explain the high rates of hospitalization in these areas.


  • American Hospital Directory, “Hospital Statistics by State”.
  • US Census Bureau


Better, Faster, Cheaper

There are a lot of reasons for doing research, but they all boil down to the basics:

  • Make more money.
  • Make fewer mistakes (which take away from making more money).

DSC00519aEvery new product, new ad, new promotion, new sales office or branch location is an investment. They work if they generate more revenue than they cost.

You can find out the hard way, or you can use research to hedge your bet in your favor.

That works if you get the information when you need it and the cost of the information doesn’t affect your ROI.

That’s where Crain Associates fits.

  • Business planning
  • Brand positioning
  • Location analysis
  • Product features and pricing optimization
  • Sales channel optimization
  • Customer loyalty
  • Ad effectiveness (electronic and print)

We’re y0ur resource when you need bankable information now.


Your Customers: Know More, Spend Less, No Compromises

You know that what your customers tell their friends or blog about you affects your business.  What they think about you affects your staff morale and retention.

You know that preventing a problem is less costly than fixing one.  You know that repeat sales to a satisfied client is less costly than finding a new one.   And heaven help you if a problem gets referred to lawyers or regulators.

Taken together, these factors largely determine how much revenue and profit you make and how well you’re going to sleep at night.

How much do you really know about what your clients are thinking?

  • Some business managers depend on customer feedback – largely complaints after the damage is done.
  • Some have customers fill out report cards using a rating scale.  That’s nice, but what does a “4” rating really mean?  Do you know what you need to do to raise it?

When was the last time you saw a research report that gave you . . .

  • A very specific set of items to fix, as well as
  • A clear list of items that differentiate you from your competitors that you can use in marketing?

The Crain method involves hybrid interviews that combine quantitative data with open ended discussions of the reasons for scores.  The quantitative data can be gathered by web or phone, but the conversation is by phone and we record the conversations to make sure we have exactly what the respondent tells us.

We then sift the data, connect the dots, and generate specific recommendations supported by numbers and verbatim comments.

This is a time-consuming process, but, as a virtual firm with no overhead, we can do this for less than most research firms charge for a simple web survey.  The cooperation rates we achieve are excellent, ranging from 50-80% participation.

The truth will set you free, and we can help you find it.

Retirement: The Fading Dream


Most Americans today will never be able to afford to retire.  Period.  Retirement was a concept basically created in the 1950s, and a number of factors have come together to end the dream for the great majority of Americans.  The end of the dream in turn necessitates changes in how Americans live.  These changes will affect the economy and politics.  Arguably, they already are.

Here are some of the fundamentals:

  1. The average US household has $35,000 in funds at age 65.
  2. The average Social Security payment in 2016 is $1,341 per month.
  3. According to Fidelity Investments, the average couple will encounter $245,000 in out-of-pocket health care expenses after age 65.
  4. The Fidelity estimate excludes long term care costs.  According to Morningstar, we need to add 2.4 years of nursing home or long term care costs, at approximately $13,000 per month per person, to the Fidelity total.  Subtracting what Medicare covers of nursing home expenses, that’s roughly $347,000 per person.

Basically, the average person needs upwards of $800,000 in liquid assets to retire.

It’s pretty easy to see that these numbers don’t work for most people.  And that doesn’t consider the 10% of seniors who are caring for a grandchild.

So, how can the average person cope?  

  • They can work.  However, that takes jobs away from younger workers.  Job creation in the US isn’t strong enough to support both an influx of new high school and college grads and oldsters returning to work.  However, in this competition, older workers are handicapped as large corporations don’t like to hire them.  Seniors will return to the labor market at a much lower rate of pay than they had previously.
  • They can die at an earlier age.  In the US, low income males are doing that today, having lost 4 years of life expectancy since 2000.
  • They can deplete assets and let state aid contribute to covering expenses.  However, that means living one’s last years in extreme poverty.
  • They can move in with children.  The incidence of multi-generational families is on the rise.  That will change the kind of home buyers will want.
  • They can move outside the US to where health care is much less costly.  The number of US citizens who don’t live in the US is increasing,  with Central America as the destination of choice for emigres.

Several of these trends suggest that there will be a glut of single family homes on the market in the near future, with another round of declining home prices, underwater mortgages and foreclosures.

The growing volume of available labor may but a cap on wage increases, and increase deflationary pressure.

The fundamental problem is that today’s Americans reached adulthood with certain expectations about how their life would be.  Those expectations are being dashed, generating the anger that is playing out in the current election season.  The disappointment and anger is still in its early stages, and may get much worse.


In this context, its rather amazing that so many people wanted to run for the Presidency this year.  The next four years are likely to be traumatic, and the next chief executive is likely to leave office after one term as a much hated individual.

About Crain Associates Research LLC

  • How we work for you
  • Who we are

CARLLC is a boutique research practice based in Princeton, NJ.  Our focus is on obtaining the best possible information for clients, and we use an array of primary and secondary data collection and desk research/meta analysis techniques to do that.

  • Methods

Surveys (phone, mail, web)
Depth interviewing (executives, doctors, consumers)
Focus groups
Statistical analysis (SPSS and R) and modeling
Scanning of public data sources

  • Advantages — Quality and Costs

As a boutique, we limit the number of projects we do each year in order to give each assignment the level of attention and effort it warrants.  However, as a boutique, we don’t carry a  corporate overhead burden.  So in most cases, we will offer a pronounced cost advantage over other full service research firms.

  • Examples of recent projects

Customer satisfaction, including CRM cleaning
Custom software development clients (enterprise IT executives)  — US,
India, China
Chemical products
Dermatology product users
Government logistics program managers
Employee surveys
Depth interviews with medical professionals (e.g., neurologists,
oncologists, hospital IT executives)
Depth interviews with large animal veterinarians