The Problems Community Health Centers Address

There is not a health center that was created in Washington or in a state capital. Every single health center in America grew out of a felt need from a local community that said, ‘We need health care.’ – Dan Hawkins, Director of Policy for NACHC1

Local solutions to meet local health care needs. That is the essence of the work of the community health center.

Community health centers (CHCs) tailor their services to tackle the health care problems that are most associated with their local populations. We focus on preventive, primary, and managed care services for a reason. This full-service focus improves both short-term and long-term health outcomes for our patients. Studies show that greater use of the type of evidence-based preventive services employed in CHCs would save lives and billions of health care dollars.2

Patients in South Los Angeles experience higher rates of

  • Chronic disease
  • Breast cancer
  • Low birth weight babies
  • HIV/AIDS detection

These are exactly the types of health challenges that CHCs have proved most effective in addressing. We ensure access to care for patients who otherwise would be without it. This is the work of the member clinics of the Southside Coalition.

Problems CHCs Address At A Glance
Access to Care
27.9% Women in LA County who have difficulty accessing health care
39% Women in South LA who have difficulty accessing health care


Chronic Disease Management
70% Deaths each year from chronic diseases
75% Health care costs from treating chronic diseases
25% Patient visit to CHCs for a chronic illness
8% Americans diagnosed with diabetes
12% South LA residents diagnosed with diabetes


Breast Cancer
Most common cancer among all women in LA County
Leading cause of death among Latinas in LA County
SPA 6: Highest rate


Low Birth Weights
SPA6: Highest in LA County


Infant Mortality Among African Americans
SPA 6: Significantly lower than LA County or US rates


HIV/AIDS
50,000 new cases nationally each year
800,000 HIV tests by CHCs each year

CHCs Increase Access to Primary Care
CHCs Improve Chronic Disease Management
CHCs Promote Early Breast Cancer Detection
CHCs Reduce Low Birth Weight and Infant Mortality Rates
CHCs Target HIV Prevention, Diagnoses, and Treatment

CHCs Increase Access to Primary Care

A study by the Los Angeles County Affiliate of Susan G. Komen for the Cure® found that 27.9 percent of women in Los Angeles County have difficulty accessing health care. Latinas are the highest percentage of uninsured women in Los Angeles County. The study also found that 39 percent of women in SPA 6, South Los Angeles, have difficulty accessing health care. This is the highest percentage in Los Angeles County.3

Residents who lack insurance and live in communities where there are fewer health care facilities and professionals often delay seeking treatment. Overwhelmed providers tend to spend less time with individual patients and, in many cases, stop accepting new patients. Many also will not accept uninsured or Medi-Cal patients. Residents in these areas resort to ER visits to take care of their health needs, driving up the cost of health care in that community.

Southside Coalition members and other community health centers increase access to preventive and primary care and reduce reliance on emergency departments at local hospitals. According to a study released by the California Primary Care Association, FQHC patients were less likely to require an emergency room visit, an inpatient stay, or a 30-day readmission to the hospital.4

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CHCs Improve Chronic Disease Management

According to the Centers for Disease Control, 7 out of 10 deaths among Americans each year are from chronic diseases. Further, almost every adult suffers from at least one chronic illness.5 It should come as no surprise that 75 percent of health care costs arise from treating chronic diseases.6

One in four visitors to a community health center is there to care for a chronic illness. Studies reveal that community health centers score higher than private practices in treating chronic illnesses among uninsured, Medicaid, Hispanic, and African American patients.7 The reason lies in our focus on preventive care, including screenings, diagnoses, and treatment. Community health centers are more likely to follow care guidelines in treating patients. All Southside Coalition member clinics provide chronic disease management services.

Diabetes is one of the most prevalent chronic diseases among health center patients. It is one of the five leading causes of death for residents of South Los Angeles. The disease affects about 8 percent of all Americans but more than 12 percent of South Los Angeles residents. Medical expenses for people with diabetes are more than twice those for people without diabetes.8 Health centers’ use of education and outreach services helps reduce the complications associated with diabetes9 and the health care costs of diabetes-related illnesses.10

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CHCs Promote Early Breast Cancer Detection

Breast cancer is the most common cancer among all women in Los Angeles County.11 It is the leading cause of death among Latinas in Los Angeles County and the second leading cause of death for white, African American, and Asian and Pacific Islander women. The highest rate is found in SPA 6.12 SPA 6 also had the highest percentage of women diagnosed with a later stage of invasive breast cancer.13

A Susan B. Komen resources map identified SPA 6 as the Los Angeles County area lacking the most breast health resources, including the fewest hospitals that provide cancer services.14

This is critical because studies show clearly that timely screenings can reduce the rate of breast cancer deaths.

According to the National Association of Community Health Centers (NACHC), in 2011, nationally, community health centers provided 334,591 mammograms to 314,776 patients.

California’s breast cancer incidence rate (44.60 per 100,000) for women between the ages of 18–44 is the fourth highest in the United States.15 California also was one of the top five states for breast cancer screenings of patients at community health centers (the others were New York, Texas, West Virginia, and Massachusetts).16 Several Southside Coalition member clinics provide breast cancer detection screenings.

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CHCs Reduce Low Birth Weight and Infant Mortality Rates

Low Birth Weight (LBW) has a high correlation with infant mortality. It can also lead to lifelong disabilities for children, including developmental, vision, and hearing problems.17 South Los Angeles residents have the highest incidence of low birth weights in Los Angeles County.

Despite treating many of the patients who are at highest risk for LBW deliveries, health centers have lower rates of LBW than private practices among mothers who receive prenatal care.18 Community health centers also reduce LBW rates among African Americans, who experience the highest rates, by more than 17,000 annually.19 Health centers have reduced infant mortality by as much as 40 percent in some communities. The infant mortality rate among African Americans in SPA 6 is significantly lower than the averages in both Los Angeles County and nationally.20

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CHCs Target HIV Prevention, Diagnoses, and Treatment

Health centers are a major source of HIV prevention, care, and treatment in America’s safety net. Community health centers provided HIV testing to nearly 800,000 patients in 2010.

HIV is a leading cause of death for African American men and women and Latinas, in the 35–44 age group.21 Too many are diagnosed late in their infection and consequently fail to benefit from early treatment and prevention that can delay diagnosis of or death from AIDS.22 Even with diagnosis, many of these patients are less likely to be on antiretroviral therapy because they often lack adequate insurance.23

More than 50,000 new cases of HIV are diagnosed each year. Primary care providers in Southside Coalition clinics are frontline sources of care for HIV and AIDS patients. We are in a unique position to promote prevention, identify new cases, and help deliver life-saving treatment to patients who might otherwise go untreated.

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Next: How Well Do Community Health Centers Work?

Related:
The Southside Coalition Story
Community Health Centers: Better Care, For Less
Patient-Centered Medical Homes
The South Los Angeles Safety Net: Filling the Gaps
How the Southside Coalition Is Strengthening the Local Safety Net

Notes:
1Dan Hawkins. “New Study Highlights Critical Role of CHCs in Health Care System,” AAFP.
2Michael V. Maciosek et al. 2010.
3Los Angeles County Affiliate of Susan G. Komen for the Cure. 2012; LADPH (2007). Los Angeles County Health Survey.
4California Primary Care Association. 2012.
5US Department of Health and Human Services. 2011(Feb. 9). Building Healthier Communities.
6CDC. 2009 (Dec. 17). Chronic Disease Prevention.
7Leiyu Shi et al. 2012.
8American Diabetes Association. 2007.
9Marshall H. Chin. 2010.
10Elbert S. Huang et al. 2007.
11-15Los Angeles County Affiliate of Susan G. Komen for the Cure. 2012. pp. 7–38.
16NACHC. 2012 (Sept. 27).
17HRSA. 2009. Child Health USA 2008–2009.
18Leiyu Shi, Gregory D. Stevens, John T. Wulu et al. 2004.
19Ibid.
20LADPH. 2013 (March). Key Indicators of Health by Service Planning Area, p. 24.
21CDC. 2011 (Aug.). HIV in the United States.
22Ibid.
23Marsha Lillie-Blanton et al. 2010 (Aug.).