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What's a 'Midwestern' health system, anyway?

A dozen states make up the Midwest, but many more Americans in neighboring states think they, too, are part of the region. 

Researchers with Emerson College Polling and the Middle West Review published findings last fall on Midwestern identity, with a broad survey in 22 states that drew more than 11,000 responses to the simple question, "Do you consider yourself to live in the Midwest?" 

The findings? Respondents from states designated as the Midwest region by the U.S. Census Bureau largely self-identified with the region. The surprise is that a large percentage of respondents in other states did, too. 

The government defines the Midwest as North Dakota, South Dakota, Kansas, Missouri, Iowa, Nebraska, Illinois, Indiana, Minnesota, Wisconsin, Michigan and Ohio.

Sixty-six percent of Oklahoma respondents said they see the state as the Midwest; same for more than half (54%) of respondents in Wyoming. A significant number of respondents in Colorado (42%), Kentucky (31%), Montana (30%), Arkansas (27%) and Idaho (25%) said they consider themselves to live in the region. 

"These intriguing results underscore the strength of Midwestern identity, despite what some have claimed, and further justify the efforts being made to study the Midwest and its history," Jon Lauck, editor of Middle West Review, said about the study findings.

The survey findings are interesting for health systems with footprints in the U.S. heartland and as organizations increasingly pursue cross-regional integrations, in which organizations that operate in different geographic markets for patient care come together. Cross-regional organization already makes it more difficult for systems to describe themselves in regional terms. As this survey suggests, the distinction is fuzzy even for some midland residents, as well. 

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