Access to Health Care in California

Access to insurance coverage and the availability of primary care clinics help draw a full picture of what access to health care for low-income communities of color in California looks like.

Insurance coverage is the first step towards having access to healthcare services. Studies have shown that uninsured people are less likely to receive preventive care and regular care for chronic diseases than those with insurance. In 2014, 27% of uninsured adults went without needed medical care due to financial burden.

Primary care clinics play a critical role in serving low-income communities. One out of every 14 people in the U.S. now relies on a federally-funded clinic for primary care.

The indices below provide a pre-ACA snapshot of the health landscape in California. This tool can arm advocates and key decision-makers with the information necessary to strengthen the safety net for those unable or ineligible to access health care.

As efforts continue to expand access to health coverage through ACA implementation and other policy levers, future iterations of the indices will incorporate updated data to evaluate progress in ensuring health care coverage and access to all Californians.


The Access to Health Coverage Need Index measures the relative level of need for health coverage in California counties. A higher index score corresponds to a higher need for health coverage in a county. Counties are ranked and classified into five categories (Lowest, Low, Moderate, High, and Highest) based on the distance of their index scores from the average.

Counties are grouped into Urban, Semi-Urban, and Non-Urban County categories to calculate the relative need. This is to reflect that counties with different geographic characteristics and population densities face different challenges. Please note that the distribution of resources in these counties is not necessarily proportionate to their total populations.

Seven indicators were selected to calculate the Access to Health Coverage Need Index. An extensive literature review and correlation analysis were completed to identify which variables would most likely reflect populations at-risk of being left out of the health care system. The following indicators are:

  • Remaining Uninsured Population: The number of uninsured population ages under 65
  • Undocumented Immigrants: The percentage of undocumented immigrants
  • Communities of Color: The percentage of people from communities of color
  • Mothers with Late or No Prenatal Care: The percentage of mothers receiving late or no prenatal care
  • Parole and Probation Population per 1,000 Adults: The rate of adults on parole or probation per 1,000 adults
  • Low-Income Population: The percentage of people with incomes below 150% of the Census Poverty Threshold
  • Clinics per 10,000 Persons: The rate of Federally Qualified Health Clinics and look-alikes, known as community clinics

Findings

Counties such as Los Angeles, San Bernardino, Imperial, Glenn, and San Benito have a higher need for health coverage for their residents.

Although counties such as Alameda, Shasta, and El Dorado may have an overall lower need for health coverage compared to other similar counties, they do have specific populations within their counties that could require special attention or support.

  • Alameda County has a high percentage of communities of color that traditionally have had issues accessing health coverage
  • Shasta County has a high percentage of mothers who received late or no prenatal care
  • El Dorado County has a high number of uninsured populations

To learn about our Access to Health Coverage Need Index, download the fact sheet here.

The Access to Clinics Index measures the relative level of need for primary care clinics in California counties. Primary care clinics include free and community clinics offering primary care services to the uninsured and underinsured populations. A higher index score corresponds to a higher need for primary care clinics in a county. Counties are ranked and classified into five categories (Lowest, Low, Moderate, High, and Highest) based on the distance of their index scores from the average.

Counties are grouped into Urban, Semi-Urban, and Non-Urban County categories to calculate the relative need. This is to reflect that counties with different geographic characteristics and population densities face different challenges. Please note that the distribution of resources in these counties is not necessarily proportionate to their total populations.

Seven indicators were selected to calculate the Access to Clinics Need Index. An extensive literature review and correlation analysis were completed to identify which variables would most likely reflect populations at-risk of being left out of the health care system. The following indicators are:

  • Language Other than English: The number of persons speaking a language other than English at home
  • Clinics per 10,000 Persons: The rate of Federally Qualified Health Clinics and look-alikes, known as community clinics
  • Patients Served by Clinics per 1,000 Persons: The rate of patients served by community clinics per 1,000 persons
  • Delayed or Did Not Get Care:The percentage of adults who delayed or did not get needed medical care in the last year
  • Emergency Department Visits per 100 Persons: The percentage of Emergency Department Visits per 100 persons
  • Preventable Hospitalizations per 1,000 Adults: The rate of avoidable hospitalizations for persons ages 18 and over
  • Undocumented Immigrants: The percentage of undocumented immigrants

Findings

Counties such as Los Angeles, Yuba, Butte, and Lake have the highest need for primary care clinics.

Although counties such as San Francisco, Santa Cruz, and Calaveras have an overall lower need for primary care clinics compared to other similar counties, they do have specific populations within their counties that could require special attention or support.

  • San Francisco County has a high rate of patients served by community clinics
  • Santa Cruz County has a high percentage of adults who delayed or did not get needed medical care in the last year
  • Calaveras County has a high rate of avoidable hospitalizations for adults

As efforts continue to expand access to health coverage through ACA implementation and other policy levers that strengthen the safety net, it will be important to ensure that there is a sufficient supply of health care resources to meet the demand of those seeking services.


To learn about our Access to Clinics Need Index, download the fact sheet here.


Source:

Zooming In

The county-level need index does not reflect varying levels of need that exists within that area. In addition to the county-level indices, there is local level data available to evaluate how a community (e.g. ZIP Code, Census Tract) fares within a county, region, or California. To learn more about what the health care needs are in a particular region, please select one below.

Zoom into:


A Closer Look

Source:

Mix & Match Indicators

With the increasing complexity of understanding the many factors related to one’s health condition, an index is a useful tool in summarizing multiple factors into one measure or value.

Below is an opportunity for you to develop your own index (with the indicators utilized above) and strengthen your ability to visualize how multiple factors can be combined into one measure. Enjoy!


Make Your Own Index

Urban Semi-Urban Non-Urban

Learn more about indexing


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