County Project: ORANGE 1

California State University, Long Beach

County Project: Orange

Lisa Tran

016448456

HCA 300 Tuesday 9:30- 10:45

November 2, 2018

Word Count: 1,584

County Project: ORANGE 2

Abstract

This paper will explore the assessment and analysis of health care in Orange County. This paper

will also develop a health profile, regarding health care needs and resources. The research will

comprise of the general information concerning the current health care in Orange County.

Through the usage of the available government data, the research will focus on the cost, access,

and quality in health care. The research will also identify the most crucial healthcare problems

prominent in Orange County and discuss the consequences of these problems. Lastly, discussion

of what has been done to address the problems and recommendations on how to address the

problems will be presented.

Keywords:​ Orange County health statistics and ranking, county-level data.

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The County of Orange is the third most populated in California. According to the United

States Census Bureau in 2017, the estimated ​total population​​ is 3,190,400 people in Orange

County within 39,536,653 people in California. The economic and social makeup of Orange

County’s population is composed of 22% under the age of 18 and 14.3% over the age of 65.

Moreover, the ​ethnic composition of Orange County​​ is made up of 40% Whites. The rest of

the population is composed of 2.1% Blacks, 1% American Indians and Alaska Natives, 21%

Asians, 0.4% Native Hawaiians and Pacific Islanders, and 34.2% Hispanics or Latinos. The

majority of the population’s ethnicity in Orange County is made up of Whites and Hispanics or

Latinos (“United States Census Bureau” 2018).

According to data collected from Orange County Register in 2018, the number of people

in Orange County who lives below the poverty line is 11.1%, which is much lower compared to

California’s average of 14% in​ poverty rate​​. However, the demographic of children living in

poverty is 1.2% higher than the state’s. Data shows the ​child poverty rates​​ in Orange County is

24%, whereas the state’s average is 22.8% (Orange County Register, 2018).

The UCLA Center of Health Policy Research (2005) categorizes ​health coverage rates

according to age groups. Of the children between the ages of 0 to 18 that reside in the county,

12% are uninsured, 55.4% are employment-based, 24.5% are on Medical, and 8.1% are private

or insured under other types of insurances. Adults from the age of 19 to 64 are 25.6% uninsured,

57.4% are employment-based, 5.9% are on Medical, and 11.1% are private or insured under

other types of insurances (UCLA Center of Health Policy Research, 2005).

Medi-Cal​​ provides high quality, accessible, and cost-effective healthcare through the

delivery of primary and preventive care. Medi-Cal beneficiaries in California receive health care
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through three models of managed care: Two-Plan Model, County Organized Health System, and

Geographic Managed Care. The Geographic Managed Care allows beneficiaries to have more

options within a designated region. Under the Two-Plan Model, beneficiaries have the option to

choose between a Local ​Initiative or a Commercial ​Plan. Under the County Organized Health

System, beneficiaries are all under the same managed care plan operated by the government. The

managed care model in Orange County is the County Organized Health System, which provides

medically necessary services. CalOptima, Orange County’s largest health insurer, provides

quality health care services to low income families, children, seniors, and the disabled. However,

some services under the County Organized Health System plan, including dental services and

optometry services are provided on a fee-for-service basis instead.

There are ​46 hospitals in Orange County​​, which include Kindred Hospital, Kaiser

Foundation Hospital, St. Joseph Hospital, St. Jude Medical Center, and UCI Medical Center.

There is 61 hospital beds per 1,000 population (​Dartmouth Atlas of HealthCare​, 2018​).

According to the Dartmouth Institute for Health Policy and Clinical Practice (2018), there are

about 52 primary care physicians per 100,000 population and 108.4 special care physicians per

100,000 population. The major driving force of imbalance between specialty care physicians and

primary care physicians is because of ​rapid advances in technology. As medical technology

advances, specialty care physicians can provide patients with more diagnostic options. They also

provide patients with the most up-to-date treatment, thus, there is a more demand for specialty

care physicians.

The ​role of Public Health Services​​ is to monitor health related factors in the community,

prevent, and improve the health of residents in Orange County. According to the Public Health
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Strategic Plan 2018-2020, the five focus areas includes: Maternal and Infant Health, Healthy

Weight and Fitness, Chronic Disease Prevention and Management, STDs and HIV, and Alcohol,

Tobacco, and Other drugs. Furthermore, the behavioral health services provide the public with

alcohol and drug abuse services and ​mental health services​​ for uninsured populations.

Uninsured and low-income adults who do not qualify for Medi-Cal and needs necessary medical

service can be eligible in the Medical Services for Indigents Program (MSI). There are a total of

27 medical service locations in the county, however, this program is limited to seriously ill

patients only.

The ​California County Scorecard​​ (2016-2017) is used to determine the education,

health, and economic well-being of children in Orange County compared to other countries in

California. In education, there is a 3% increase of 12th grade students graduating on time

(California County Scorecard, 2016-2017). In health, the percentage of women who receive early

prenatal care went from 90% in 2014 to 86% in 2016 (California County Scorecard, 2016-2017).

The California County Scorecard indicates that the economic well-being of children in Orange

County is not so great. For example, children in the child welfare system who have had a

medical exam in the last year decreased from 93% in 2014 to 78% in 2016.

In general, Orange County is healthier than most countries. As of 2017, Orange County

ranked the 7th healthiest in California (OC Health Care Agency, 2017). Additionally, Orange

County was ranked 6th out of 57 countries in ​California Health Outcomes​​. According to

County Health Ratings, Orange County ranked 5th in length of life and 13th in quality of life.

There are a 6% low birthweight and 4,100 premature deaths in Orange County, whereas a total of

5,300 premature deaths and 7% of low birthweight in California. Moreover, Orange County
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ranked 6th in health factors, including 4th in health behaviors, 21st in clinical care, 6th in social

and economic factors, and 38th in physical factors. Health behaviors include 19% adult obesity,

16% physical inactivity, 17% excessive drinking, and 28% alcohol- impaired driving deaths

(​“Orange County Health Rankings” 2018). There are 359.8 people who have sexually

transmitted infections and 17 teens gave birth. As for Clinical Care, there is a total of 10% of

uninsured people, 83% diabetes screening, and 64% mammography screening. In Social and

Economic Factors, there is a total 15% of children are in poverty, including 18% Blacks, 26%

Hispanic, and 7% Whites. The unemployment rate is 4% in Orange County ​ (​“Orange County

Health Rankings” 2018).

Although Orange County is healthier than most counties, there are still ​health disparities

that exist in the county. Some unmet health needs in Orange County includes diabetes, obesity,

Alzheimer’s disease, and mental health (Community Health Needs Assessment, 2016). The

leading factors that contribute to these health problems in Orange County is associated with

unhealthy eating and physical inactivity. According to Orange County Health Agency (2018),

type 2 diabetes is the 8th leading cause of death in the county. The adult obesity rate is 23% with

certain populations, such as Latinos representing a significantly higher proportion of 39%

(Orange County Health Care Agency (2018). Moreover, the rate of overweight children has

increased from 14.8% to 18.84% and the percentage of physically inactive youths is 15.3%

(Kaiser Permanente Community Health Needs Assessment, 2016). ​Some strategies taken place

to improve these health problems ​include promoting diabetes prevention, improving diabetes

screening, and expanding programs that is accessible to all populations. The 2nd major leading

cause of death is suicides (Orange County Health Agency, 2018). Of the patients who were
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admitted into hospitals for self-inflicted injuries, 87% of them were diagnosed with mental

illness (Kaiser Permanente Community Health Needs Assessment, 2016). Despite these high

rates, there is a lack of beds for youth with mental illness (Kaiser Permanente Community Health

Needs Assessment, 2016).

​A strategy to prevent these health issues in the county​​ could be to educate the

population the importance of healthy eating habits and regular physical activity. For example,

Orange County can work together with school educators to expand health education programs.

As a community, people can promote healthy eating and expands effort in building more

recreational centers. Moreover, a strategy to help those with mental health issues could be to

implement mobile crisis services. As individuals, people can take the Assessing and Managing

Suicide Risks (ASMR) workshop, which is a one-day training program that teaches you how to

deal with someone at risk of committing suicide.

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References:

California County Scoreboard (2016-2017). ​Orange County.​ Retrieved on November 2, 2018

from http://pub.childrennow.org/2016/credits/

County Health Rankings and Roadmaps (2018). University of Wisconsin Population Health

Institute and Robert Wood Johnson Foundation. Retrieved on November 2, 2018 from

http://www.countyhealthrankings.org/app/california/2018/rankings/orange/county/outco

mes/overall/snapshot

Gaines, Robbin (2018). “ California Maps: How Many Primary Care and Specialist Physicians

Are in Your Country?” ​California HealthCare Foundation.​ Retrieved on November 2,

2018 from https://www.chcf.org/publication/california-maps-how-many-primary-care-

and-specialist-physicians-are-in-your-county/

HPSA by State and County (2018). ​Health Resources and Service Administration.​ Retrieved on

November 2, 2018 from https://data.hrsa.gov/tools/shortage-area/hpsa-find

Kelch R., Deborah (2015). “ Locally Sourced: The Crucial Role of Countries in the Health of

Californians.”​ California HealthCare Foundation. ​Retrieved on November 2, 2018 from

https://www.chcf.org/wp-content/uploads/2017/12/PDF-LocallySourcedCrucialRoleCoun

ties.pdf

MUA by State and County (2018). Health Resources and Service Administration. Retrieved on

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Office of Statewide Health Planning and Development (2018). “ OSHPD Facilities”. Retrieved

on November 2, 2018 from https://geo.oshpd.ca.gov/oshpd-facilities.

Parsley Keith (2018). “Medi-Cal Managed Care”. Retrieved November 2, 2018 from
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https://www.dhcs.ca.gov/services/Pages/Medi-CalManagedCare.aspx

Roosevelt, Margot. (2018, July 24). Orange County portrait: Low wages, child poverty, costly

housing. ​The Orange County Register.​ Retrieved November 2 from ​https://www.oc

register.com/2018/07/24/orange-county-portrait-low-wages-child-poverty-costly-housing

University of California Los Angeles, Center for Health Policy Research (2007). “Health

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​ etrieved November 2, 2018 from http://healthpolicy

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.ucla.edu/publications/Documents/PDF/SHIC%20Fact%20Sheets/shic07_orange.pdf

United States Census Bureau (2017). “Orange County Quickfacts from the US Census Bureau.”

State and County Quickfacts.​ Retrieved November 2, 2018, https://www.census.gov/

quickfacts/fact/table/orangecountycalifornia/SEX255217#viewtop