Beyond Metropolitan Startup Rates: Regional Factors Associated with Startup Growth

Understanding what fosters -- and hinders -- firm formation and growth at the metropolitan level across the United States is a challenge. Entrepreneurship can be measured by a variety of indicators, and they each can tell somewhat different stories. Furthermore, because entrepreneurship can refer to the growth of firms from a startup stage to mid- or large-scale, no one dataset covers the full range of companies that fall in this category. This report contributes to the Kauffman Foundation's recent series of analyses on the rate of business creation in metropolitan areas. Going beyond identifying metropolitan areas with higher rates of entrepreneurship, we analyze what regional factors are associated, or unassociated, with entrepreneurial activity. Understanding what drives entrepreneurship at the regional level -- especially high-growth business creation -- will help policymakers and entrepreneurship supporters know where to invest their efforts

The Return of Business Creation

Freshly released government data show that new business formation rebounded in 2011, after four years of decline, from the depths of the Great Recession. This is a welcome development -- new businesses are the engine of job creation in the United States economy and an important source of innovation and productivity. Perhaps most importantly, the rise in new business formation between 2010 and 2011 was geographically dispersed throughout the United States.While the rise of new business creation in 2011 is a significant development -- it is the first annual gain in five years and the largest percentage annual increase in nearly a decade -- the bulk of this paper examines two classes of new businesses that most closely resemble entrepreneurship: companies less than one year old with one to four employees and those with fine to nine. This analysis finds that the smallest of these new firms represent most of the increase in firm formation in 2011:* New companies with one to four employees comprise the vast majority of new businesses formed each year, accounting for, on average, 86 percent of new firms since the late 1970s in the BDS data. * Job creation at new businesses of all sizes increased by 4.3 percent, and rose by 5.4 percent in new companies with one to four employees, reversing four consecutive years of decline for those smallest companies. * Companies less than one year old with one tofour employees have created, on average, more than 1 million jobs per year over the past three decades; those with five to nine employees have added, on average, half a million jobs per year. * With a promise of more detailed analysis infuture reports, this paper presents maps that illustrate the increased share of new business formation in most states and metro areas across the nation

Leveraging Regional Assets: Insights from High-Growth Companies in Kansas City

As a typical Midwestern city, Kansas City and its successful entrepreneurs often are overlooked in economic development studies. We find, however, compelling evidence that the region has ample entrepreneurial success to celebrate, study, and share since numerous Kansas City area firms have appeared on Inc.magazine's list of the fastest-growing companies. We recently interviewed the founders of some of these firms in the city's information technology, biotechnology, and business services sectors about their views on the strengths and viability of Kansas City's entrepreneurial ecosystem. We gained valuable insights for area policy and economic leaders. Key findings of our interviews include:-Lack of venture capital or angel investment does not hinder the growth of Kansas City firms. Only a small percentage of the high-growth firmsinterviewed reported receiving investment from Venture Capital or Angel investors. Instead, most high-growth firms were self-financed or received financial assistance from founders' close friends and families. Some bootstrapped by adapting their firms to customer needs to achieve growth, while others scaled up only as revenues increased and additional customers were found. No matter how they were funded, the firms successfully grew their revenue. -Kansas City firms enjoy a substantial pool of talent in the region. Growing firms often have a long-term employee development strategy to hire young people and train them to be first-class professionals, including technical experts. Entrepreneurs also find the region's low cost of living and strong, Midwestern work ethic to be major strengths.-Most Kansas City entrepreneurs find support from customers, vendors, and/or collaborating firms in the region. This finding runs somewhat contrary to Swiss researcher Heike Mayer's recent conclusion that firms in the Kansas City region are disconnected. These regional connections lead to the firms' innovations and growth. -A number of high-growth firms serve only the Kansas City area or a limited market of regional cities, yet they see this limited regional focus as a business strength. Entrepreneurs and their support community should take note that a firm does not have to capture a national or global market to be highly successful. -Most Kansas City entrepreneurs report that locally based mentors have played a significant role in their success. Whether through informal or 2 formal channels, connecting experienced entrepreneurs to aspiring or nascent entrepreneurs and allowing mentor-mentee relationships to grow organically should be goals of the city's entrepreneurial support community. Further research is needed on how best to create and implement local mentorship programs

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)