Printer-friendly
Border County Health Workforce Profiles:
California
A unique characteristic of the United
States (U.S.)-Mexico Border region is
the magnitude and diversity of the human
capital residing within its boundaries.
On the U.S. side, the four Border States
were home to 65 million people in 2003,
over one-fifth (22.4 percent) of the population
of the country. About 6.9 million of
them lived in the area extending 62 miles
inland from Mexico. The Mexican side
had a similar high concentration of people,
with the larger Border cities hosting
most of the population. In addition to
the size of the population, the massive
movement of people and goods between Mexico
and the United States, combined with high
rates of poverty and lack of health insurance,
may facilitate the transmission of communicable
diseases even beyond the Border.
This report, entitled Border County
Health Workforce Profiles: California,
has companion reports for the States of
Arizona, New Mexico, Texas, and Florida.[1]
This set of reports, which will be referred
to as the “Profiles” throughout this report,
represents a ground-breaking effort to
assemble and disseminate consistent and
current information on the health workforce,
relevant population characteristics, and
basic health indicators for the U.S. Border
region. The Profiles were based on county-level
data and reported by geographic proximity
to the Border.
The great variability of health and workforce
indicators between the Border States and
between smaller regions within each State
has traditionally been hidden in the aggregate
totals and averages that have been used
to describe the Border. Recognizing and
understanding these differences is critically
important to planners, policy makers,
and program administrators who design
and target health care interventions.
While the database created for the "Profiles"
was a great improvement over existing
aggregate, fragmented and rarely comparable
information, some limitations remain.
Mostly, the limitations were the result
of using the politically defined county
boundaries as a unit of measurement rather
than the service areas within which health
care was actually delivered. Also, the
county averages may hide important differences
within a county. For example, there may
be concentrations of health professionals
in an urban area that overshadow the lack
of health professionals and extreme needs
of a large rural area, producing a better-than
average provider-to-population ratio for
the county as a whole. Given these caveats,
the data displayed in these reports provide
a solid base for future research on workforce
trends and utilization in the Border.
The contract for this study, HRSA-230-03-0017,
was awarded to the Regional Center for
Health Workforce Studies at The University
of Texas Health Science Center at San
Antonio by the U.S. Department of Health
and Human Services, Health Resources and
Services Administration, Bureau of Health
Professions (BHPr). The Evaluation and
Analysis Branch, Office of Workforce Analysis
and Quality Assurance, BHPr, HRSA was
responsible for overseeing the study.
The Border County Health Workforce Profiles
present county-level data obtained from
State health agencies and health professions
licensing boards to develop social/health
indicators and practitioner-to-population
ratios, respectively. These indicators
help describe health status and health
disparities in the U.S. regions that lie
next to Mexico as well as provide information
on the number of practitioners available
to address the health needs of the areas.
Comparable indicators and ratios were
shown in this Report for the State as
a whole, the four Border States, and the
Nation. The Profiles show that the Border
was far from being a homogeneous region.
The U.S. counties from San Diego, California,
to Brownsville, Texas, while sharing some
common cultural traits, exhibit significant
diversity in the proportion of the population
that was Hispanic/Latino(a), in socioeconomic
indicators, in health status measures
and in the supply of health professionals.
Border regions were defined by different
entities using criteria of proximity to
the Border. One definition identifies
only those counties adjacent to the U.S.-Mexico
Border as "Border Counties."
The U.S.-Mexico Border Health Commission
(USMBHC) expands that definition to include
all counties within 62 miles of the Border
excluding La Paz, Maricopa, and Pinal
Counties in Arizona and Riverside County
in California. The Texas Comptroller
of Public Accounts broadens the criteria
by adding counties considered as directly
affected by the economic impact of Border
commerce thus extending the area to approximately
100 miles from the Border in Texas. Other
definitions include larger areas. In
Arizona, totals for the following geographic
areas are included: within 62 miles of
the Border and more than 62 miles from
the Border. To satisfy as many users
as possible, the Profiles show totals
for the following geographic areas for
California, New Mexico, and Texas: within
62 miles of the Border, 62-300 miles from
the Border, and more than 300 miles from
the Border. In the Texas report, totals
for counties within 100 miles of the Border
were also included. Counties within 62
miles of the Border are also referred
to as “Border Counties” throughout
these reports using the USMBHC definition.
The Profiles were organized into three
sections:
- A summary of State highlights for
health status and the health workforce.
- Three categories of tables: Population
and health status, health professions,
and health infrastructure. Health professions
tables include physicians, dentists,
and registered nurses, non-physician
clinician providers and mental health
providers.
- A set of appendices that list counties
included in the analysis by geographic
area and a review of data sources.
These data may serve as a benchmark for
updates and for complementary data from
Mexico. It is through additional tracking
of data and summary of results for future
years, and comparison of previous findings,
that planners, policy makers, and program
administrators will be able to measure
the impact that programs may have on the
reduction of health disparities for individuals
living in the four Border States and Florida
and particularly for those citizens living
in closer proximity to the U.S.-Mexico
Border. |