Integrating Care in South Los Angeles
We are the safety net of the safety net.
– John Merryman, South Bay Family Health Care
In a 2000 report, “The Health Care Safety Net: A Fragile Patchwork of Providers,” Laura Tobler defined the safety net as a loosely connected system of:
community health centers, local health departments, rural and specialty clinics and public hospitals . . .’ that ‘ . . . millions of Americans with no health insurance and no money to pay for care out of pocket and millions more who depend on Medicaid’ go to for health care.1
Health care safety net providers share a common focus: to provide care, regardless of a person’s ability to pay.
In 1995, Los Angeles County created the “Public Private Partnership” program, which contracted with community clinics to provide primary care for residents who earn less than 133 1/3 percent of the Federal Poverty Level (FPL).
About 7.6 million Californians rely on safety net clinics for regular health services. A national study of community health clinics found that our patients are nearly three times more likely to be low income (live below 200% of the federal poverty level (FPL)), three times more likely to be on Medicaid, and 2.5 times more likely to be uninsured than the rest of the population.2
South Los Angeles is one of the most disadvantaged and underserved communities in the United States.
In SPA 6:
- More people die of lung cancer, stroke, diabetes, and heart disease than in any other place in Los Angeles County.
- Diabetes rates are 44 percent higher than the nation’s average.
- Hypertension rates are 24 percent higher.
- HIV/AIDS rates are 38 percent higher.
- Asthma rates are 11 percent higher.
- Homicides account for 76 percent of the deaths of people between the ages of 15 and 34 in South Los Angeles. The homicide rate in South Los Angeles is 200 percent higher than the rest of Los Angeles County.3
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By comparison, the resources to address these needs fall short of those available in other communities:
- SPA 6 had the lowest number of emergency department treatment stations (59) per 100,000 residents when compared to Los Angeles County and other geographic areas.
- SPA 6 had only half as many acute care hospitals per 100,000 patients as the rest of Los Angeles County.
- SPA 6 residents are forced to travel longer and farther to receive emergency room care at hospitals in neighboring communities, thereby placing significant pressure on ER rooms that are already overcrowded.
- Residents in SPA 6 were the highest users of inpatient services when compared with Los Angeles County and California (107 discharges/1,000 vs. 101 discharges/1,000 in California). But SPA 6 residents have limited access to inpatient services.
- Based on current utilization patterns, SPA 6 needs an estimated 2,000 hospital beds. Prior to the closure of King/Harbor, there were approximately 1,000 existing beds, and since the closure, there are approximately 700 beds. In terms of hospital beds per 1,000 residents, SPA 6 ranks among the lowest regions in the country. Nationally, the average is about 3 beds per 1,000 residents; California has an average of 2; West Los Angeles has about 4, while South Los Angeles has about 1 bed per 1,000 residents.
- SPA 6 had only half the licensed available bed supply per 1,000 population that the rest of the county did.4
- SPA 6 residents are routinely forced to wait longer than other Los Angeles County residents to get an appointment for care at a doctor’s office or clinic. The wait times for receiving specialty care at county facilities can be six months to one year.
- SPA 6 continues to have the highest percentage of adults unable to receive dental care.
- There is also a shortage of prenatal, mental health, rehabilitation, and elder care services in SPA 6 when compared with the rest of the county.
- SPA 6 also had the highest mortality rates for cardiovascular disease, diabetes, and stroke among the eight SPAs in Los Angeles County.5
When Martin Luther King Hospital was closed in 2007, it became the fifteenth acute-care facility to close in Los Angeles County since 2000. About half of these hospitals served residents south of the 10 Freeway, South Los Angeles.6
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The Southside Coalition Story
The People We Serve
A View of the People Our Members Serve
1Laura Tobler. 2000 (July 17).
2Helen Lee et al. 2012 (Oct.).
4Annie Park et al. 2008 (Dec.).
5Lee et al.
6Merdies Hayes. 2012 (Nov. 22).