Merced County's Health Status Shows Little improvement

MERCED- 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 Merced County ranks higher than most counties in California in late prenatal care, teen pregnancy, syphilis diagnoses, cancer deaths, and severe shortages of health care professionals.

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 Merced County, during a regional meeting held at the Merced County Health Department from 10:00- 12:00 noon.

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 Merced County residents.

In order to help identify these priorities, John Volanti, director of the Merced County Health

Department, highlighted some of the leading health concerns of the Merced region.

Volanti also serves on the regional advisory council of the new Central Valley Health Policy Institute at California State University, Fresno. His role involves identifying and carrying North Valley concerns to the policy institute advisory council during its quarterly meetings.

Based on the findings of Health in the Heartland…

• Merced County has the third highest rate of late prenatal care among the state. In Merced County, 38.8% of women received late prenatal care after their first trimester, compared to an average of 15.5% of women in California. Merced County ranked 56 in terms of highest percentages of late prenatal care among 58 California c3nties.

• Atwater and Merced, communities within the County of Merced, had the highest rate of late prenatal care in the county, with 42.6% of women receiving care after their first trimester.

• Merced County’s rate of teen pregnancy is about 27% higher than that of the state, placing Merced County at 52′ out of 58 counties in California. There were 66 births per 1,000 females aged 15-19 in Merced County, compared to the statewide average of 48.

Even though Merced County still experiences a high rate of teen pregnancy, the percentage of births to teenage mothers has actually decreased by about 30% within the past seven years. Statewide rates showed a 28% improvement during the same period.

Merced County shows little improvement in the following health conditions…

• The rate of syphilis in Merced County per 100,000 persons increased dramatically from 0.3 cases to 2.5 cases within a seven-year period. Merced County ranked 57th (second highest among the entire state) out of 58 counties in California.

• Age adjusted rates for cancer deaths were also high and above the average rate of California, with 185.4 deaths per 100,000 people in Merced County. California’s statewide percentage was 176.1 deaths.

• Merced County had the highest rate of deaths due to breast cancer, among the San Joaquin Valley. There were 28 deaths per 100,000 females, compared to the state average of 24.5 deaths.

Today’s meeting was the second 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.

• Unemployment rates for Merced County were more than two times the overall rate for California. In Merced County, the unemployment rate was 14.4%, compared to the statewide average of 6.7%.

• One in five adults (21.7%) residing in Merced County had less than a ninth grade education, and 36.4% of residents, age 25 and over, did not have a high school diploma. California’s rate of adults, age 25 and older, without a high school diploma was 23.2%.

• North Merced and Livingston, communities within Merced County, ranked among the highest percentages of immigrants in the Valley. Almost 34% of residents in these communities were immigrants.

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.

“Full enrollment in these programs would provide improved access to care for this vulnerable population, and replace local dollars now being spent on uninsured children with state and federal funds,” said Diringer.

Health in the Heartland reveals that …

• Over the past three decades, more than 100,000 Southeast Asians have fled their homeland to reside in the San Joaquin Valley. Those of the Hmong race, have settled primarily in Merced and Fresno counties. It’s documented that the Southeast Asians who migrated to the Valley, had limited English proficiency and a majority of healthcare professionals were not and still aren’t familiar with the Southeast Asian languages.

As documented in the well-known book, The Spirit Catches You and You Fall Down, tragedy can be the result of language and cultural barriers.

Large numbers of immigrants indicate the need for medical interpreters to educate non-English speaking families about available health resources, health conditions, and preventative services. Merced County already experiences a short supply of health providers. During 2000-2001…

• Merced County had approximately 30% fewer primary care physicians than the California average. There were 67.4 primary care physicians per 100,000 persons in California, compared to 46.6 in Merced County.

• An even larger disparity exists among specialists in Merced County. California’s average percentage of specialists was more than two times the amount in Merced County. Statewide there were 122.2 specialists per 100,000 persons, compared to 48.6 in Merced County.

• Merced County had approximately 38% fewer nurses than did California. California’s statewide average was 729.9 nurses per 100,000 people, compared to 448.4 in Merced County.

• California had two times as many dentists than did Merced County. Statewide there were 79.9 dentists per 100,000 persons, compared to 39.5 in Merced County.

• California had ten times the rate of psychologists to the population existing in Merced County. In California, there were 40 psychologists per 100,000 persons, compared to only 3.8 in Merced County.

“It’s important to note that collectively, our health in many areas is not getting worse- there is no change and/or improvements. We do see we have failed to keep pace with the improvements of the rest of the state. The bottom line is that we have health disparities that we have recognized, that are unacceptable in one of the richest agricultural valleys in the world,” said Curtis.

Health in the Heartland highlights the areas in which Merced County has improved its health status. For example…

• Within a period of eight years, Merced County’s infant mortality rate dropped by 32%, from 7.4 infant deaths per 1,000 live births to 5 deaths.

• Merced County had a higher rate of kindergarten immunizations, compared to the state average of 92.3%. In Merced County, 95.7% of kindergarteners received immunizations.

• Merced County’s percentage of deaths due to coronary heart disease based on 100,000 persons was 138.3, compared to 166 in California.

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

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