Central Valley residents lack doctors and other medical specialists, are more likely to die of diabetes and heart attacks, and face diminished well-being because of poverty, according to a sweeping report released Thursday.
Researchers assessed more than two dozen health care indicators, from health insurance coverage and a shortage of physicians to infants' low birth weight and rising childhood asthma rates, and compared the indicators with the state average. The findings were published in "The State of the Great Central Valley: Public Health and Access to Care."
"We're not making a lot of progress to lead healthier lives in the Central Valley, and that's disappointing," said David Hosley, president of the Great Valley Center, which published the report.
He said he hopes the findings will make Valley residents more aware of how their lifestyle choices affect their health.
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The findings were based on state and national data and the most recent data from the California Health Interview Survey (CHIS), conducted every two years since 2001.
The report offers a few bright spots in the 18 counties from Shasta to Kern: Smoking rates are down, more children are being immunized and heart disease has declined in some areas.
In the Sacramento region, the picture is better in some respects, but still uneven.
Sacramento County had the lowest rate of uninsured adults in the state, and Sacramento, Placer and Yolo counties boast the highest number of doctors per 1,000 residents in the Central Valley.
Yet despite an abundance of medical facilities and professionals, Sacramento County has the highest number in the region of infants born under 5.5 pounds and has higher heart disease and asthma rates than the state average.
In addition, the six-county region had the lowest immunization rate in the state for children under age 2.
Sacramento County Health Officer Dr. Glennah Trochet cited recent improvement in the birth weight data, but conceded there is more work to be done. "We need to do a better job of protecting the community," she said.
Sacramento was one of 13 counties where the rate of childhood asthma was higher than the state average of 16.1 percent. Other counties with that distinction were El Dorado, Yolo, Sutter and Yuba. In the Sacramento region, only Placer County was below the state average, with 14.1 percent.
Still, asthma rates were far worse in Fresno County, where more than 30 percent of children have been diagnosed with the lung disease.
While state and regional air quality officials try to cut air pollution – and associated asthma rates – in the Valley, Hosley of the Great Valley Center said residents can make their own changes.
"People in the Central Valley are making unhealthy choices," Hosley said. "We're not eating well, we don't get enough exercise, we are choosing to use alcohol or drugs to excess."
Even as the smoking rate has declined, that habit among Central Valley residents is still more prevalent than in the rest of the state. Binge drinking rates also are higher.
Trochet said obesity and smoking rates were "higher than we'd like," noting a link between smoking and the risk of heart attack.
"We can't exclude air pollution as a risk factor for heart attacks and strokes," she said.
Increasingly, health advocates and public health officials see a connection between the environment and health.
They said communities need to be designed to offer people healthier choices: fresh food and produce, access to open space, walkable, safe neighborhoods with jobs and affordable housing.
"A stable place to live improves lives of people who are there," Hosley said. "It affects how well kids do in school, how much they exercise, how well they eat. … It's all connected."
The health picture is especially dire in the San Joaquin Valley and parts of the rural North Valley, areas with a severe physician shortage.
Maria Pallavicini, professor and dean of the School of Natural Sciences at the University of California, Merced, cited California Department of Finance data from a 2005 report.
In a state with an average of 126 physicians per 100,000 people, the San Joaquin Valley has just 87. By comparison, Southern California enjoys 154 doctors per 100,000 residents and Northern California has 120 per 100,000 residents.
Access to medical specialists in the San Joaquin Valley also lags behind the rest of the state, with 43 specialists per 100,000 people compared with 107 in Northern California and 86 in Southern California.
Kings, Madera and Merced counties are especially hard hit, she said.
At the same time, the Central Valley population is projected to grow 131 percent by 2050, according to the Great Valley Center report.
Pallavicini said UC Merced is hoping to build another medical school in the region, anticipating that physicians trained there would set up their practices locally. She noted that about a third of doctors who completed training at the University of California, San Francisco – Fresno University Medical Center now practice in the Valley.
"The Valley needs and wants its own medical school to meet the needs of the community, which has different needs than those of Sacramento or Davis," she said.
Dr. Richard Pan, an associate professor in the School of Pediatrics at UC Davis, said it will be a challenge to attract physicians to areas with high rates of Medi-Cal and Medicare recipients, because of low reimbursement rates for doctors who provide that care. He said doctors will need a good balance of private and government-insured patients to make it work.
"Without good data, you don't understand what's going on," Pan said. "Data is useful to start a conversation."