1. HEALTH FACTORS AND ACCESS TO CARE IN CALIFORNIA’S COUNTIES Prepared by: Stella Kim

2. Hospital Location Implications for Health  Hospitals are entries to health care access  “Access to health services means the timely use of personal health services to achieve the best health outcomes”¹  California has 535 licensed acute care hospitals² 1.Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Millman M, editor. Washington: National Academies Press; 1993. 2.Office of Statewide Health Planning and Development http://www.oshpd.ca.gov/HID/Products/FacilityList/HospitalListing_ June2012.pdf Source: http://www.doh.state.fl.us/pl anning_eval/vital_statistics/ Physician_Information_main_ page.html

3.  Hospitals are heavily clustered in wealthier counties  Median income varied from $36k in Modoc County to $94k in Marin County  Los Angeles County on the higher side of median income at $58,611 Skills: Geoprocessing (clipping) and Geocoding, Inset Map, Select by Attribute – “Highest Income Counties” was derived by Querying “Median Income” for “medincome.> 75000 and exporting data to a new layer. Map Prepared by Stella Kim Income and Hospital Location Variation Map Prepared by Stella Kim

4. Population Clusters and Hospital Location Skills: Geocoding, Geoprocessing (clipping), Point Graduated Symbol Map Prepared by Stella Kim CA Geographic Terrain and Hospital Location Skills: Geocoding, Geoprocessing (clipping) Map Prepared by Stella Kim Sources: California Public Health Department, ARCGIS Online Basemap

5.  In densely populated counties, most can access hospitals coverage of the entire county is generally within 10 miles  Rural counties have less hospitals and their ranges don’t meet Source: US Census, California Department of Public Health Skills: Geoprocessing (clipping), Geocoding, Buffering Map Prepared by Stella Kim 10 Mile Radius of Hospitals Within Counties

6. Health Risks: Diabetes Incidence and Uninsured Populations  The CDC estimates that in the US, 8.3% of the population is currently diabetic¹  In California the diabetic rate ranges from 8% to 10%  National uninsured rate was 15.7% in 2011 of 311 million people according to the US Census ²  California’s counties ranged from 12% in Marin County to 25% in Los Angeles County 1.Center for Disease Control and Prevention http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf 2.Kaiser Health NewsKaiser Health News http://www.kaiserhealthnews.org/stories/2012/september/12/census-number-of- uninsured-drops.aspx

7. California Counties Above National Average Percent of Uninsured Populations California Counties Above National Average Percent of Diabetic Incidence Sources: US Census, County Health Rankings Project Map Prepared by Stella Kim

8. Methodology: County Health Rankings  County Health Ranking Project funded by the Robert Wood Johnson Foundation ¹  Ranks counties based on Health Factors, tobacco usage, sex, diet, access to care, quality of care, income, employment, education and environment  Also ranks counties based on health outcomes including morbidity, mortality, health behaviors, clinical care. 1.County Health Rankings http://www.countyhealthrankings.org/http://www.countyhealthrankings.org/

9. County Health Rankings Highest to Lowest Skills: Geoprocessing (clipping), Geocoding Map Prepared by Stella Kim

10. LA County: A Closer Look

11. FINDINGS & NEXT STEPS  FINDINGS:  Median Income breakdown of counties are very similar to County Health Rankings with wealthier and higher ranked counties having the most hospitals and access of care  Counties with high incidence of diabetes, and uninsured populations are lacking in hospital service.  Additional variables and data must be examined to better compare LA County’s health status and hospital utilization as a possible factor for the final

12. SKILLS UTILIZED  Inset Map  Geocoding  Geoprocessing  Point symbol  Buffering  Attribute sub-set selections

13. Challenges  CHALLENGES: GIS steep learning curve, DATA DATA DATA, finding it and manipulating it. Lack of actual hospital utilization data put further query at a standstill  FURTHER QUERIES: Thorough examination and hunting of original data for an innovative project

14. Sources  US Census  California Department of Public Health  County Health Ranking Project  Kaiser Health News  Center for Disease Control  Office of Statewide Health Planning and Development  Institute of Medicine