Reform LA Health System

10,044,458

Current Estimated Population of Los Angeles County

3,702,746

Estimate of people in LA county in areas with a shortage of doctors

Major Medical Schools (in Los Angeles County)

Los Angeles County

VS

o Los Angeles County: 10 million: 2 major medical schools

o Costa Rica: 4.25 million: 7 medical schools
o Nicaragua: 6.5 million: 6 medical schools
o Cuba: 11.4 million: 14 medical schools
o Sweden: 10.2 million: 8 medical school
o Illinois: 12.7 million: 8 medical schools
o Michigan: 9.9 million: 6 medical school
o Ohio: 11.6 million: 7 medical schools
o Pennsylvania: 12.8 million: 7 medical schools
o Massachusetts: 6.9 million: 4 medical schools

The issues facing the LA County Health System

The disparity in access to care in communities of low socioeconomic status has significantly impacted the quality of health and has led to higher infant and maternal mortality rates, chronic diseases, and reduced life span. The disproportionate impact of Covid-19 on these vulnerable communities has provided a sense of urgency to review the Los Angeles county public health policies

Black Californians have higher mortality rates for four leading cancers (breast, prostate, lung, and colorectal) as compared with other races/ethnicities in California

In affluent communities such as Beverly Hills, Santa Monica, and Westwood, the average life expectancy is approximately 90 years whereas, in Compton, Carson, Sun Valley, and the residents of Southeast L.A., the average life expectancy drops to approximately 75 years.

The ratio of primary care physicians in Los Angeles county was 56 per 100,000 population, far below the recommendation of 60-80 physicians per 100,000

In Compton, the infant mortality rate is 7.0 per 1,000 live births as compared to infant mortality rate of 2.1 per 1,000 live births in more affluent communities of Bel Air, Encino, and Westwood.

Infant mortality rate for black infants in Los Angeles county in 2016 was 10.4 per 1,000 live births, three times higher than the rate of 3.2 per 1,000 live births for white newborns.

Children with severe emotional disturbances come from low-socioeconomic families with 10% of all California children who live below the poverty line suffer from a severe emotional disturbance.

For every 100,000 children in the state, California currently has only 13 practicing board certified child and adolescent psychiatrists.

Since 1946, when the second of the two major medical schools was founded, the population of Los Angeles county has doubled to more than 10 million and no new major medical schools have been established.

PROPOSAL

The proposal calls to establish an independently run new medical school at the current location of Harbor-UCLA Medical Center in the city of Torrance with an incoming enrollment of 150 to 175 students per year. The specific mission of this community-based medical school will be to train a diverse physician workforce to deliver medical and mental health care to the communities facing critical doctor shortages, and to perform population medicine and public health research to identify and address the needs of the communities of low-socioeconomic status.

Prospective students will be selected based on their scholastic achievement and their ties to their communities where they grew up. The emphasis of the medical school will be in the areas of preventive and primary care including General Internal Medicine, Pediatrics, General Surgery, Family Medicine, OB/GYN, Emergency Medicine and Psychiatry and other short-supply specialties such as ophthalmology, etc. Financial incentives and full scholarship will be awarded to those graduating physicians who commit to serve in areas with a shortage of physicians. The recipients of the awards will have to commit to serving in the underserved communities for five years following the completion of their residency training. Failure to meet their obligation will lead to an automatic conversion of the financial awards into a loan with a pre-determined interest rate which must be repaid within a specified time period.

This proposal is a viable, permanent solution to the chronic undersupply of physicians in marginalized communities and ultimately will address the disparity in access to health care that saves lives. The proposal to open a new medical school has been designed to ensure that the graduating physicians will have to serve the communities with Medi-Cal health insurance. Similar programs have proven successful in other parts of the country and also in Riverside county.

Impacts of Physician Shortages

The number of physicians in many low socioeconomic communities in LA county is below the recommended ratio.

The communities with severe shortage of doctors and lack access to care were disproportionately affected by the Coronavirus. Health inequities has led to higher morbidity/mortality rates amongst African Americans, Latinx, and other low-income communities making them more vulnerable to infections, cancer, diabetes, heart disease, and higher infant/maternal mortality rates. They face significant disadvantage for early detection, delay in care and live a shorter life span (75 yrs) as compared to residents of affluent communities (90 yrs). An estimated 3,702,746 people in the county live in areas with shortage of doctors.

L.A. County with a population of more than 10 million has only two major medical schools whereas Costa Rica with a population of 4.25 million has 7 medical schools.

LA County should establish a new medical school to train the much-needed physicians and waive tuition for graduating doctors who commit to serve in areas with shortage of physicians. This will present a viable solution to shortage of physicians and improves access to care in low socioeconomic communities and ultimately will save lives.

Given the current healthcare crisis, while the time has come to address the inefficiencies of the LA County Department of Health Services, there is greater need for a better and stronger healthcare system across the county. Now is the time to act, and please join us in making this more widely known.