Geography and Health Services in Los Angeles County
Geography and spatial analysis are increasingly useful tools for health services researchers and policy analysts. Issues in health services delivery and resource allocation that can benefit from the input of geographers include the maldistribution of healthcare providers, the definition and re-definition of medical service areas, and the differential prevalence of heath insurance coverage among subgroups of the population.
Because of the expertise of Dr. Paul Robinson (geographer) and Daniel Ryan (geographic information systems analyst), the CDU Center for Health Services Research provides timely, policy-relevant geographic and spatial analyses to researchers, government agencies, non-profit organizations, and community groups in the Los Angeles County area and beyond. Dr. Robinson is available for consultation and collaboration with community members and investigators who wish to work with geographic data.
Mapping the Geography of Health Services in Los Angeles County
The Charles Drew Medical GIS Laboratory created the following animation to illustrate racial disparities in diabetes hospitalization rates and availability of specialty care across geographically diverse communities in Los Angeles County:
Click on the thumbnail to view the animation:
Service Planning Areas and Los Angeles County Hospitals
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In 1996, eight Service Planning Areas (SPAs) were established in LA County to facilitate health services planning. Of these eight areas, SPA 6 has the highest proportion of African-American and Latino residents, as well as the highest poverty rates. The Charles Drew University is located in SPA 6 (“South”).
Existing Health Professional Shortage Areas (HPSAs), Los Angeles County 2002
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This map shows the distribution of Health Professional Shortage Areas (HPSAs) – the majority of which are in the South Central area. The Health Resources and Services Administration has developed provider shortage designation criteria to decide whether a geographic area or population group is a HPSA. HPSAs may have shortages of primary medical care, dental or mental health providers and may be urban or rural areas, population groups or medical or other public facilities.
Los Angeles County Health Facility Closures, 2002
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In June 2002, the County Board of Supervisors, voted to eliminate 12 of 14 public care centers and four school-based clinics in LA County. The community clinic closures took place during the summer of 2002. This map shows the geographic distribution of the clinic closures.
Specialty Services and Provider-to-Population Ratios, 2000 Click on thumbnail to enlarge map
This map was created from an analysis of data from the Office of Statewide Health Planning and Development (OSHPD). Wide disparities between neighborhoods in specialist availability are apparent.
Specialist-to-Population Ratios by Los Angeles County MSSAClick on thumbnail to enlarge map
This map shows the number of specialist physicians (per 100,000 population) within each Medical Service Study Area (MSSA) of Los Angeles County. An MSSA is composed of one or more complete U.S. Census Bureau census tracts, and it is the defined geographic unit of analysis for the Office of Statewide Health Planning and Development (OSHPD) in California.
HSR Publications using Geographic and Spatial Analyses
Bluthenthal RN, Brown Taylor D, Guzman-Becerra N,
Robinson PL. 2005. “
Characteristics of Malt Liquor Beer Drinkers in a Low-Income, Racial Minority Community Sample.”
Alcoholism: Clinical and Experimental Research Volume 29: Issue 3. pp 402-409.
Bluthenthal RN, Cohen DA, Farley TA, Scribner R, Beighley C, Schonlau M,
Robinson PL.
"Alcohol availability and neighborhood characteristics in Los Angeles, California and Southern Louisiana." Journal of Urban Health 2008;85:191-205.
Cohen DA, Ghosh-Dastidar B, Scribner R, Miu A, Scott M,
Robinson P, Farley TA, Bluthenthal RN, Brown-Taylor D. 2006.
Alcohol Outlets, Gonorrhea and the Los Angeles Civil Unrest: A Longitudinal Analysis. Social Science and Medicine Volume 62 Issue: 12 pp. 3062-71.
Heslin KC, Robinson PL, Baker RS, Gelberg L. "
Community characteristics and violence against homeless women in Los Angeles County". Journal of Health Care for the Poor and Underserved 2007;18(1):203-218.
Jacobson JO,
Robinson P, Bluthenthal RN 2006 “
A Multilevel Decomposition Approach to Estimate the Role of Program Location and Neighborhood Disadvantage in Racial Disparities in Alcohol Treatment Completion.” Social Science and Medicine, in press.
Jacobson JO,
Robinson P, Bluthenthal RN. “
Racial disparities in completion rates from publicly-funded alcohol treatment: Economic resources explain more than demographics and addiction severity.” Health Services Research 2007;42(2):773-94.
Relevant Links
Center for Population Health and Health Disparities RAND Health, Santa Monica
This program at RAND provides a large number of measures for a variety of substantive areas including: Cost-of-Living, Pollution, Housing Characteristics, Segregation Indices, and Street Connectivity. Data are available for various
geographic summarization levels including: census tract, county, and MSA. The data are available in several physical data
formats including: SAS, Stata, and CSV formats.
Center for Data and Geographical Information ServicesThe Center for Data and Geographical Information Services is a designated Census Information Center for the U.S. Census Bureau. Qualified staff can provide technical assistance and prepare customized tables, reports and maps. The Center has worked with numerous human and social service providers in the Los Angeles area, including community-based organizations, schools, universities and public departments.
Center for Spatially Integrated Social SciencePhysically located at the University of California Santa Barbara, the CSISS seeks to increase the appreciation of space, spatiality, location, and place in social science research.
Healthy CityHealthy City provides searchable databases and other online tools to improve the ability of low-income, underserved children, adolescents, and their families to access health and social services in Los Angeles County.
Living Independently in Los Angeles (“LILA”)LILA is a free web-based information resource created and mapped online by Los Angeles County residents with disabilities. The site’s “Map Room” is a helpful geographic tool that families, service providers, and policy makers can use to identify needed services for people with disabilities living in or visiting Los Angeles County.
Medical Geography Specialty Group This special interest group within the Association of American Geographers provides a forum for research on the spatial aspects of health care delivery and health policy.
National Center for Health Statistics: GIS and Public HealthA Web site designed to provide information on Geographic Information Systems at the National Center for Health Statistics, Centers for Disease Control and Prevention.
The following books on Geography and Health from the National Academy Press can be read entirely online:
