Identifying Clinic Facility needs in Los Angeles SPAs and MSSAs Brenda Pérez UP 206A Winter 2011

 LA County community clinics and health centers (clinics) target communities where care is needed but scarce and improve access to care for nearly a million individuals regardless of their insurance status or ability to pay.  However, data suggests there is still a high unmet demand for services and that it will remain high after health reform implementation.

 MUA: Medically Underserved Area  MUP: Medically Underserved Population  Approximately one third of Californians live in a designated HPSA, MUP or MUA.¹ ¹ CA Office of Statewide Planning and Development (OSHPD)

 Service Planning Areas (SPAs): Eight in LA County for health care planning purposes.  Each SPA is responsible for planning public health and clinical services according to the health needs of local communities:¹ Assess health needs of local communities Provide services through clinics and community partners Promote health & prevent disease Note: The eight SPAs were derived by selecting SPAs in the view from LA County and converting to shapefile ¹ Los Angeles County Department of Public Health

POPULATION DENSITY UNDER 5 POPULATION DENSITY OVER 65

100% BELOW FPL200% BELOW FPL

 LA County has the largest total number of uninsured residents in California, with 2.2 million nonelderly adults and children (24% of the total population) experiencing some period without health insurance in ¹  Clinics are a key source of care for these medically disenfranchised people. ¹ In LA County, 61% of all clinic patients are uninsured and 54% of health center patients are insured About 56% of clinic visits are by uninsured patients. ¹ California Health Interview Survey, 2009

 Health Care Facilities in LA: ¹ All: 2,155 Community Clinics: 275 Free Clinics:14 ¹ CA Office of Statewide Planning and Development (OSHPD)

 Need analyzed by: Population Density Population Below 100% FPL Population Below 200% FPL Population over 65 Population under 5 Population on Medicare Population Uninsured Community Health Clinic Locations Free Clinic Locations

 Average Nearest Neighbor H 0: Clinic need is randomly distributed Ratio: 2.04 Z-Score: 5.64 P-Value:.001  High/Low Clustering H 0: There is no spatial clustering of clinic need Z-Score: 7.44 P-Value:.001

 Inset Map  Chart  Geoprocessing Clipping  Boundary Sub- Selections  Point Graduated Symbols  Hotspot Analysis  Metadata  Modeling Automate Race/Ethnicity graphics  Original Data Insurance Status layers derived from CHIS source and rendered to shp files  Measurement Tool Average Nearest Neighbor High/Low Clustering