Researcher Reports Dire Health Conditions of Tulare County

TULARE- According to a recent report, Health in the Heartland: The Crisis Continues, San Joaquin Valley residents experience some of the worst health conditions in the state. The same report also reveals that Tulare County ranks higher than most counties in California in diabetes diagnoses, teen pregnancy, avoidable hospitalizations, and severe shortages of

health care professionals.

Based on the findings of Health in the Heartland…

• Tulare County had the highest rate of teen pregnancy in the entire state. There were 78.3 births per 1,000 females, age 15- t9, in Tulare County. Statewide there were 47.7 teen births.

• In Tulare County, 9.9% of adults”; age 18 and over, were diagnosed with diabetes. In California, only 5.9% of adults had been diagnosed with this same disease.

• The age-adjusted rate for avoidable hospitalizations in Tulare County was about 20% higher than the statewide average of California. Diagnoses related to hospitalizations were: asthma, chronic obstructive pulmonary disease, congestive heart failure, diabetes mellitus, and hypertension.

Today, Joel Diringer, lead author of Health in the Heartland: The Crisis Continues, presented specific findings from his 2004 report about the dire health conditions of the San Joaquin Valley and specific findings relating to residents in Tulare County, during a regional meeting held at the Emerton Club in Tulare from 11:30 a.m.-1:30 p.m.

Approximately 30 key health professionals attended the meeting to hear Diringer’s findings and to assist health policy researchers in identifying health policy research priorities for Tulare County residents.

Today’s meeting was the fourth of eight Valley community dissemination meetings of the Central California Health Data Information Project. The Health in the Heartland report is

one of the initial outcomes of the data project and will be utilized to meet with the San Joaquin Valley communities about the region’s current health, influence policy and promote a system of change.

The Central California Health Data Information Project is funded by The California Endowment in partnership with the Central Valley Health Policy Institute at California State University, Fresno. The Central Valley Health Policy Institute is seeking community input from the regional meetings to help shape the Institute’s research agenda.

Health in the Heartland was released at the third annual Central California Health Conference on Feb. 5th at the Fresno Convention Center. Diringer explained that the Valley’s health conditions are still in a state of crisis.

“The Valley has high rates of disease, poor community health and lacks an adequate provider network. The Valley leads the state in infant mortality, teen births and late access to prenatal care,” said Diringer.

Similar to the 1996 report of Hurting in the Heartland, Diringer’s recent report focuses on the demographics of Valley residents, economic and environmental factors, as well as health services. The report pays close attention to chronic diseases, health resources, immigrants, access to care, current health policy issues, health disparities, and health outcomes.

Over the past year, Diringer and co-authors of Health in the Heartland, Dr. Kathleen Curtis, Cheryl McKinney Paul and Danielle Deveau, studied the health conditions of the Valley’s eight counties (Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, Tulare) and the relationship among 61 community clusters in comparison to California’s health conditions as a whole.

Their report reveals that communities with poor health access are characterized by: high rates of poverty, low educational attainment, female-headed households, higher percentages of immigrants and higher percentages of non-English speaking individuals.

Tulare County leads the Valley in: highest percentage of households that speak Spanish as a dominant language at home, highest rate of child poverty, highest rate of unemployment, lowest per capita income, and highest percentage of adults over age 25 without a high school diploma.

In the Tulare County communities of Earlimart and Pixley, 74.4% of the population over age 5, did not speak English as a dominant language at home. In the same communities, 34.1% of the families were in poverty, and 41.2% of the residents were immigrants.

“The demographics of Tulare County have a significant impact on health status. Where there is higher unemployment, more people are uninsured or dependent on programs such as Medi-Cal and Healthy families,” said Curtis.

Diringer and co-authors found that approximately 80,000 children in the San Joaquin Valley region were eligible for Healthy Families or Medi-Cal but weren’t enrolled in these government

funded programs. Many of the parents of these children documented that they were fearful of jeopardizing their immigration/citizenship status, they were confused about eligibility criteria, and simply did not know about these programs.

“Even the Healthy Families program, which is designed to provide insurance coverage for the children of the working poor, requires payment of a monthly premium. Statewide, for every four persons who are enrolled in the program, three are disenrolled, about a third of those for non¬payment of the costs of the program,” said Curtis.

Large numbers of non-English speaking immigrants are an indication of the need for medical interpreters to educate non-English speaking families about these available health resources as well as health conditions and preventative services. Tulare County already experiences a short supply of health providers. In Tulare County, the number of primary care physicians, registered nurses, and dentists per 100,000 people was far below the average rates of the state. However, the number of mental health providers in Tulare County was about 37% higher than California.

Although Tulare County experiences severe health disparities, there are areas in which Tulare County has shown improvements. During the past seven years, the rate of teen pregnancy in Tulare County decreased by about 20%. Rates for coronary heart disease deaths also decreased by about 20% within the past seven years.

Advisory council members will use feedback from today’s meeting and four future meetings throughout the San Joaquin Valley to establish research priorities for the Central Valley Health Policy Institute.

“