Unemployment is rising, and few businesses are hiring. Spending on everything from houses to horses is slow.
One bright spot in Central Kentucky's economic picture is health care: Lexington's hospitals are hiring, and their administrators anticipate a continuing need for trained professionals.
"In almost every area of medicine, there's a shortage" said Dr. Michael Karpf, executive vice president for health affairs at the University of Kentucky.
According to the Education and Workforce Development Cabinet, health and educational services was one of three major sectors to see increases in the number of jobs between November 2007 and November 2008. The other sectors adding jobs were government and natural resources.
The need in health care goes far beyond nurses and doctors. There are technicians to run MRI machines and take CAT scans, X-rays and ultrasounds; physical therapists; physician assistants; pharmacists; pharmacy assistants; lab technicians; and the many other professionals who make up the allied health professions.
Some of the jobs require as little as a two-year degree, while others are graduate-level programs that take two to three years to complete. The different programs are offered by hospitals, community colleges, four-year colleges and universities. The pay ranges from $11 an hour to more than $100,000 a year.
David Gilles, 27, started a two-year radiography program at St. Joseph Hospital this fall. He has a degree in computer science and spent five years in sales, but he wanted to do something more fulfilling.
"I figured here was a good area to get into," said Gilles, who lives in Lexington. "There's always going to be a need for it."
The certificate he'll earn will allow him to take X-rays or specialize in tests such as ultrasounds or CAT scans.
At the University of Kentucky College of Health Sciences, which trains people for careers as physical therapists and physician assistants, among other options, the economic downturn has not been noticeable at all, said Lori Gonzalez, dean of the college.
"We have virtually 100 percent employability," Gonzalez said. "Many of our students have jobs way before they graduate."
At St. Joseph Health System, there is always a need for nurses, said Ed Carthew, chief of human resources for the company, which has two hospitals in Lexington.
In addition, the hospitals regularly need people who are trained to give direct patient care. St. Joseph is the largest private employer in Fayette County.
The one change Carthew has noticed is the number of people looking for non-medical jobs. For administrative and clerical jobs, the applicant flow is "much stronger," Carthew said.
Central Baptist Hospital has more than 200 openings, said spokeswoman Ruth Ann Childers. The positions include non-medical ones such as food service and environmental services — the people who work in the cafeterias and clean.
"We compete with the hotel and restaurant industry," Childers said. One of the advantages to a hospital job are the benefits: Better days off and access to health insurance, Childers said.
At Lexington Clinic, a large, multi-specialty group practice in Central Kentucky, administrators have noticed a small reduction in the number of patients — a common effect as some people choose to postpone medical care until better economic times, said Dr. Andrew Henderson, CEO for the practice.
But the group is hiring, and employees received a Christmas bonus.
"People still get sick," Henderson said. "They still need health care."