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Heartbeats (and eats) of an Economy

In honor of the National Association of State Workforce Agencies (NASWA) Workforce Summit/81st Annual Meeting being held October 2017 in Coeur d’Alene, Idaho, we want to provide attendees and other potential visitors with some essential local knowledge and a few insights related to Coeur d’Alene’s economy.


The city is named for its region’s natives, the Coeur d’Alene Tribe, whom French traders in the 18th century dubbed the Coeur d’Alene people, which translates to “heart of an awl.” Apparently, the Coeur d’Alenes were perceived as tough negotiators by their French counterparts.[1]


Coeur d’Alene (CDA) is the seat of Kootenai County and the namesake for the Gem State’s second largest metropolitan statistical area (MSA) behind Boise, with 154,311 residents versus 691,423, respectively.[2] In 2013, CDA became officially recognized by the US Census Bureau as part of the Spokane – Spokane Valley – Coeur d’Alene combined statistical area, a move that was not fully embraced by locals.

As for the economy in CDA, employment in CDA’s economy used to be led by retail trade, thanks in large part to tourism and CDA’s position as a services hub to neighboring rural counties. While the retail sector’s share of employment remains robust at 14.2% in 2016 (compared to 10.8% for the U.S.), the largest share of employment is now held by the health care sector. In fact, since surpassing retail to become CDA’s largest employer in 2010, health care’s share of employment has continued to rise from 14.6% to 17.0% (it’s risen from 13.6% to 14.2% in the U.S.).

According to JobsEQ®, from 2010q2 – 2017q2, the predominant driver of this growth has been hospitals (+1,302), but gains have been widespread across most health care industries. Total gains for the sector (+2,775) have accounted for nearly 40% of all new jobs (+6,984) in CDA during this period.

With Spokane located 30 miles west of CDA, one might wonder how CDA has experienced such rapid growth in Spokane’s shadow, where the health care sector is also the largest employer. Well, for decades Spokane was the main place in the Inland Northwest for patients to seek hospital care and specialized health care services. Spokane became, and remains, a major destination for consuming health care services in the Inland Northwest, with little interregional competition.

Now, judging from the employment growth in many of its health care industries, it appears that CDA is intercepting some of this traffic. For example, see the highlighted industries and their side-by-side average annual growth comparisons in Table X above. Clearly, CDA’s hospitals have been expanding rapidly as have specialized services and some supporting industries. So, CDA is not just a destination for tourists, but a destination for patients too!

Both Spokane and CDA are forecast to continue growing employment in health care for the foreseeable future. Further, both regions currently face potential shortfalls for key health care occupations such as registered nurses, physical therapists, nursing assistants, massage therapists, medical secretaries, and doctors. Below is JobsEQ’s occupation gaps forecast for the Spokane-CDA combined statistical area.

Four of these potential shortfalls – RNs, PTs, nursing assistants, and medical secretaries – match gaps forecast for the nation. So, this challenge in key healthcare occupations is not unique to CDA or the Spokane-CDA combined statistical area. However, there is a stark contrast between these two places relative to wages, which seems rather out of the ordinary given these two places are within 30 miles of one another. See below for a comparison of mean wages by occupation.

Occupation Wages in Coeur d'Alene, ID MSA, 2016
Average Annual Wages Comparison Regions
Percentiles Spokane-Spokane Valley, WA MSA USA
SOC Title Mean 50% (Median) Mean Mean
29-1123 Physical Therapists $67,200 $66,700 $93,700 $87,200
29-1141 Registered Nurses $67,700 $70,700 $80,600 $72,200
31-1014 Nursing Assistants $27,000 $27,300 $28,700 $27,700
31-9011 Massage Therapists $43,100 $40,200 $51,400 $44,500
31-9092 Medical Assistants $32,000 $32,900 $35,500 $32,900
43-6013 Medical Secretaries $30,400 $29,800 $39,700 $35,100
3751 Spokane CDA HC Gaps $49,500 $51,000 $58,000 $53,300
00-0000 Total - All Occupations $40,000 $37,700 $46,900 $49,300
Source: JobsEQ® Data as of 2017Q2 Note: Figures may not sum due to rounding. Exported on: Tuesday, October 3, 2017 3:53 PM

Could these labor markets really be this distinct despite their close geographic proximity? After all, their costs of living are virtually identical.

Cost of Living
Annual Average Salary Cost of Living Index (Base US) US Purchasing Power Cost of Living Index (Base Coeur d'Alene, ID MSA) Coeur d'Alene, ID MSA Purchasing Power
Coeur d'Alene, ID MSA $37,149 98.3 $37,799 100.0 $37,149
Spokane-Spokane Valley, WA MSA $44,196 97.9 $45,144 99.6 $44,368
USA $53,284 100.0 $53,284 101.8 $52,367
Source: JobsEQ® Cost of Living per C2ER, data as of 2017q1, imputed by Chmura where necessary. Exported on: Tuesday, October 3, 2017 6:50 PM

Over dessert (at one of the restaurants I’ve suggested below), you might want to ponder what could be driving these wage gaps between neighboring regions. While the Gem State pays notoriously low wages, CDA could be an awfully nice place to call home. With its quaint size, vibrant main street, and idyllic scenery, very few of its most in-demand workers choose to work outside the region where they live (see below), especially on the higher end of the skills spectrum.

Coeur d'Alene, ID MSA (1766) Spokane-Spokane Valley, WA MSA (4406)
Occupation Empl (Place of Residence) Empl (Place of Work) Ann 50th %ile Wage (Median) Ann 50th %ile Wage (Median)
Registered Nurses (29-1141) 1,496 1,384 $70,700 $78,700
Physical Therapists (29-1123) 126 120 $66,700 $79,700
Nursing Assistants (31-1014) 754 690 $27,300 $27,900
Massage Therapists (31-9011) 105 97 $40,200 $50,200
Medical Secretaries (43-6013) 222 190 $29,800 $38,500
Anesthesiologists (29-1061) 18 18 $283,500 $115,000
Family and General Practitioners (29-1062) 74 75 $190,700 $169,900
Internists, General (29-1063) 25 25 $262,600 $206,600
Obstetricians and Gynecologists (29-1064) 12 12 $233,900 $207,500
Pediatricians, General (29-1065) 17 16 $160,800 $198,800
Psychiatrists (29-1066) 12 11 $103,000 $195,700
Surgeons (29-1067) 24 23 $332,400 $316,800
Physicians and Surgeons, All Other (29-1069) 207 205 $232,300 $168,900
Exported on: Tuesday, October 3, 2017 7:07 PM Source: JobsEQ® Note: Figures may not sum due to rounding. Employment data as of 2017Q2. Wage data are as of 2016 and represent the average for all Covered Employment.

Interestingly, the wage gap moves in the other direction for a few very specialized doctor types, many of whom were likely recruited away from Spokane.

If you get a chance, feel free to seek me out at NASWA’s conference, and we can exchange some ideas on where these gaps may be coming from.

Now, for the most important piece of local knowledge: top spots to dine! Should you opt to skip a conference meal or find a break in the event’s agenda for time “on your own,” the firm recommendations below are backed up by years of this author’s first-hand experience.

Breakfast: The Garnet Cafe is always fresh and its menu is vintage northwest. A long walk from the conference hotel, a shuttle, an Uber ride, or a short jog will get you there.

Lunch: Open midday only, don’t miss Café Carambola. Get there a bit early or risk eating outside, which might not be bad if the sun is shining; also, a long walk or a quick shuttle/Uber ride. For a delicious burger backed by a century of practice, try Hudsons, just two blocks north of the conference hotel. 

Dinner: Two “gastropubs” (both on Sherman Avenue) earn a “strong buy” rating. For authenticity, charm, and more vintage northwest, check out Moon Time; a long walk could land you there, but plan for a ride back to the hotel (due to darkness, weather, and the threat of strong ales). Crafted is a bit more walkable (round-trip) and offers cozy, fireside drinks/dining outside with a more contemporary gastropub menu in a renovated, former auto repair shop. 


[1] See https://en.wikipedia.org/wiki/Coeur_d%27Alene,_Idaho, retrieved 10/03/2017.

[2] Census 2016.

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