When economic conditions worsen, people curb shopping, forgo buying bigger houses and delay business expansions. But they can't stop aging or falling ill.

That reality has comforted construction companies that serve the senior-care and health care industries. Despite slowdowns in commercial and residential building, business has remained steady for several midstate firms that specialize in building structures for hospitals, retirement communities and related organizations.

"Business has not dropped off much," said David Cross, president and chief operating officer of Wagman Construction Inc. in Manchester Township, York County. "It's clearly not down in the same way residential (building) is down." 

Wagman has done projects for many retirement-community operators in the region, such as Masonic Villages, Lutheran Social Services and Bethany Village.

Many of those operators continue to build to prepare for future economic trends, Cross said. Operators want to take advantage of still relatively low interest rates, and they want to build before the cost of construction materials climbs even higher.

"(The operators) are thinking, ‘We need to do a project for when the economy comes out of its slump,'" he said.

The aging of the U.S. population means more people need medical and retirement services, said Terry Kile, vice president of sales at Horst Construction in Manheim Township, Lancaster County. The firm recently expanded several retirement communities, including Garden Spot Village in New Holland and Brandywine Assisted Living at Fenwick Island in Delaware. The company also has worked on projects for Lancaster General health system.

In addition, many people are looking for luxurious surroundings packed with amenities, Kile said. He cited Brandywine Assisted Living at Fenwick Island, which features a five-sided, four-story glass tower. A dining room occupies the first floor, with other floors providing more public spaces that overlook the landscaped grounds and fountains. The facility also has an environmentally friendly roof with a rooftop garden.

"When (a facility) decides to increase their amenities, that means they have to build stuff," Kile said. "I don't think that that trend is going away."

Although the tide of aging baby boomers looms large for senior-care and health care facilities, not all expansions are solely for older people. Lancaster General, for example, is adding on to many of its facilities because it sees an increase in demand for services across generations, said spokesman John Lines. A primary reason why the health system is building a medical-office building near its hospital on Duke Street in Lancaster is to provide more space for its family health clinic. The building is expected to be completed in December.

Lancaster General also is expanding its Womens & Babies Hospital in East Hempfield Township. The hospital has become one of the busiest maternity facilities in the state, with more than 5,000 deliveries each year.

"It had reached the point where it could no longer accommodate the additional growth," Lines said. "The growth in population and the growth in health care demand make these projects necessary."

The Hospital & Healthsystem Association of Pennsylvania, which represents hospitals statewide, does not track construction activity among its members. However, anecdotal evidence suggests that many hospitals are continuing to expand to meet demand for services and to accommodate new technology, said Tara Ramsey, communications specialist with the Swatara Township, Dauphin County-based association. Many facilities also had put off expansions and upgrades, she said.

"Pennsylvania hospitals have some of the oldest physical plants in the country," Ramsey said.

Several observers said they expect the robust activity in senior-care and health care construction to continue in the long term.

"They're still good markets," Kile said. "I don't know if they're ever going to be bad markets."