The Issue at hand!
The Issue
Reform LA Health is an attempt to highlight and address the deficiencies facing the Los Angeles county public 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 system’s policies. Since 1946, when the second of the two major medical schools was founded in Los Angeles, the population has doubled to more than 10 million and no new major medical schools have been established. Data has revealed that approximately 3,702,746 people in Los Angeles County live in areas that has a shortage of primary care providers.
What are the deficiencies?
- 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.
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
Our Solution
Reform LA Health suggests steps to reform the deficiencies in Los Angeles county by establishing a new medical school to train not only residents in various specialties, but also prepare a new generation of students and to address the looming shortage of physicians. The tuition for those graduates who commit to servicing in communities with a shortage of physicians will be waived. The current fragmented system which is divided between the two university partners will be merged, creating the largest consolidated general hospital in the country. This will provide a strong, unified, and cost-effective healthcare system integrated with the new medical school.
The current system has failed to meet the demand of many inner communities that are more vulnerable and are primarily dependent on the Department of Health Services for their health care. The fact that the county does not even have the means of performing demographics and population medicine studies on the communities that they serve clearly proves how inefficient they are. The proposal to reform the system will create the largest consolidated general hospital in the country, which is not only cost effective, but also provides uniformity in public health delivery. It will create a strong, unified, and efficient system all staffed with physicians operated by a much needed new medical school. The new medical school will train not only residents in various specialties, but also provides education for medical students to address the shortage of physicians. If the graduating physicians commit to serve in the communities with a shortage of physicians, then their tuition will be waived. It will also establish a school of public health that studies demographics to collect and analyze relevant data regarding the health needs of the population in which they serve. The present system was put together decades ago and is now in dire need of change to meet the challenges of current and future demands.