Introduction: The County’s General Information
Lake County, the poorest in the state, is situated in the northwest of California, and Lakeport is the County seat. The county, created on May 20, 1861, has a total population of 64,386 as of 2019 (United States Census Bureau, 2019). It covers an area of 3,442 square kilometers, which is approximately 1,329 square miles. Of this acreage, 3,250 square kilometers is an island, while the rest is land. There are 15 cities in Lake County, including Lowe Lake, Middletown, Upper Lake, Spring Valley, Nice, and Hidden Valley Lake. However, the major ones are Lakeport and Clearlake, with the latter being the largest.
County Health Rankings and Roadmaps
The health of a population is a result of a number of factors. The County Health Rankings and Roadmaps (2021) states health is influenced by income, education, quality of life, housing, and the neighborhood’s safety. These aspects significantly affect the health outcomes of the residents of a given area. According to the County Health Rankings & Roadmaps (2021), Lake County was ranked last (58th) in health outcomes and 52nd in health factors. These rankings are important as they help policymakers understand the county’s overall health and the element in play for the situation. From this data, Lake County is trailing in terms of the various health indicators, and it is witnessing the worst health outcomes in the entire state.
When compared with the national averages, California is slightly better positioned in terms of health rankings. For example, the proportion of premature deaths is 17% which equals the national average. Similarly, nationally, 3.8% of people report fair or poor health compared with 3.5% in California, while the percentage of low birth weight was 8% and 7% in the nation and state, respectively (United States Census Bureau, 2019). Moreover, as of 2020, California’s high school graduation rate was 83%, which was lower than the national average of 85% (United States Census Bureau, 2019). Also, adult smoking, obesity, and physical inactivity were lower in the state than in the country, but in Lake County, adult smoking is more prevalent than in other levels.
Population: General Demographics
A region’s demographics are essential as it shows the distribution of a population by age, gender, race, and disability. These are indicators that health experts use to devise their targeted interventions to address the health needs of specific age groups. The portion of the population under age 5 is 5.9%, while those below 18 accounts for 21.2% of the population. On the other hand, the older adults, 65 years and over, are 23.1%, explaining the county’s low median income.
When compared to the statewide data, Lake County almost depicts a similar pattern. People below age 5 in California account for 6%, while those under 18 are 22.5%. However, there is a significant difference in the number of elderly between the county and the state. In 2010, the total population was 64,665, and in 2019, it was 64,662, representing a decrease of 0.4%, while in the entire state, there was a 6.1% increase. In Lake County, 23.1% of people are aged 65 years and over, while in California, they account only for 14.8%. This data indicates a high dependency ratio in the county than the state, owing to the high proportion of the aging population.
Table 1: Age and Sex in Lake County versus California.
The percentage of race and Hispanic origin is also an essential indicator of the health of the population. According to the 2019 Census, in Lake County, whites alone make up the highest proportion at 68.9% compared with the state’s 71.9%. African Americans are 2.1% in the county and 6.5% in California. Additionally, American Indians and Alaska Native are 4.5%, Asian alone 1.4%, Native Hawaiian 0.3%, two or more races 4.7%, and Hispanic or Latino 22%. This data indicates that the dominant race in Lake County is white alone, accounting for 71.9% of the total population, and there is a similar pattern in the state. African Americans are second in both the county and state, and this is important information because this race usually presents many health challenges because of their socioeconomic status.
Population: Socioeconomic Status
The socioeconomic status is indicated by several factors, including median income, poverty level, education, and occupation, determining access to health. The California State Council on Developmental Disabilities (2021) defines poverty as when 20% or more of the population lives below the poverty line. In Lake County, 24% of people are poor, and it is the state with the highest prevalence of poverty in the whole of California, and it has 17% of children in this category. The median household income in the county is $47,040, and it has increased from the last half a decade. Since there are many poor people in the county, access to quality healthcare is a significant challenge.
Chronic Condition
In Lake County, cirrhosis and chronic liver diseases have been the leading cause of death among adults. As of 2019, the county’s mortality rate from these illnesses is double the state and national averages. Males were most affected because of the prevalent tobacco, alcohol, and drug use in the county. For example, the prevalence of alcohol abuse in the county is 3.29, while the national average is 2.15% and 2.08% nationally (Centers for Medicare and Medicaid Services, 2021). This explains the high chronic liver-related mortality in Lake County, California.
Health Insurance
It is vital for every person to have a medical cover. However, some people in the United States are not insured for various reasons, but the leading one is low financial ability. In Lake County, 10% of the population does not have health insurance, which equals the state’s rate and slightly lower than the 10.6% national average. Health insurance is an essential indicator of people’s access to health. With the passing of the Affordable Care Act, most people have been able to afford quality medical care. For children aged below five years, only 1.5% are uninsured (Kids Data, 2021). This explains the low prevalence of pediatric health problems in Lake County.
Medi-Cal Managed Care
California has been among the leading states in health reforms and managing care. Through managed care delivery systems, Medi-Cal Managed Care ensures health care that is high-quality, cost-effective, and accessible (California Department of Health Care Services, 2021). In Lake County, the people with Medi-Cal are assigned of these two managed care plans: either Two-Plan or County Organized Health Systems. In the former, there are two options; a prepaid health plan, the Local Initiative, organized by the county, and a commercial plan. As for County Organized Health Systems (COHS), the county runs this Medi-Cal managed care health plan, and it is the only one serving the entire population.
Hospitals, Community Clinics, and Physicians
The number and type of hospitals in a place determine the residents’ access to health care. There are only two hospitals in Lake County; Adventist Health in Clearlake and Sutter Lakeside Hospital in Lakeport. Adventist Health is a faith-based facility based on Seventh-day Adventist heritage and values and serves over 80 million patients through its many branches across California and beyond. It provides care through joint retirement centers, home cares, clinics, and hospice agencies, and it has 25 beds (Kaiser Family Foundation, 2021). On the other hand, Sutter Lakeside Hospital is affiliated with the non-profit Sutter Health, and it serves residents of Lakeport. It is a medical-surgical acute care facility and a teaching hospital with 30 beds (Kaiser Family Foundation, 2021). These two hospitals and their branches and agencies across Lake County help address the residents’ health problems.
Moreover, there are two community clinics in Lake County; Hospice Services of Lake County and Lake County Tribal Health Consortium (California’s Office of Statewide Health Planning and Development, 2021). The former is a private facility specializing in hospice services, and it offers accessible or affordable services to the needy and uninsured residents of the county. Similarly, Lake County Tribal Health Consortium usually serves the rural populations helping reduce alcohol and drug abuse prevalent in the county.
The number of physicians has been rising in California, and their demand is expected to increase because of the aging population. In Lake County, the number of patient care physicians per 1000 population is 41.8 while that of specialists is 60.8, and their number is 27 and 39 respectively(California Health Care Foundation, 2019). The county does not have aerospace medicine and allergy and immunology specialists.
Public and Mental Health Services
There are many behavioral and public health services in Lake County. The focus of mental and behavioral health services in the county include rehabilitation, counseling, and coping, which are offered to the drug and alcohol users in the county. The community clinics provide outpatient therapy and behavioral and psychiatric counseling. These services aim to enhance is to help counter the effects of the prevalent drug and alcohol abuse.
A Major Health Problem in Lake County
One of the leading health issues in the county is cirrhosis and lung-related diseases, including cancer. The leading cause of liver cirrhosis is chronic alcoholism, which is very prevalent in the county, and its incidence is higher than both the state and national averages (Centers for Medicare and Medicaid Services, 2021). Other risk factors for lung-related illnesses include tobacco smoking and hepatitis (Naghavi, 2019). According to the Centers for Medicare and Medicaid Services (2021), 47.9% and 25.9% of deaths in Lake Count are a result of cirrhosis. One of the significant factors contributing to this death toll is a lack of sufficient physicians and specialists in lung-related conditions.
Actions Taken in the County to Address the Problem
The government has endeavored to ensure a large proportion of the population is insured, and the present number of uninsured in Lake County is below 10% (County Health Rankings & Roadmaps, 2021). Moreover, there are active behavioral programs and services aimed at countering the prevalent alcoholism in the county (California State Association of Counties, 2021). Additionally, the government has offered a free outpatient substance abuse program to help in addiction treatment to tackle alcoholism. Nevertheless, the problem still remains and new suggestions need to be considered.
Recommendations
On top of these actions by the government, there is a need for more interventions to help reduce cirrhosis and lung-related mortality due to chronic alcoholism. The first solution is to promote preventive health care, mainly because most people are below the poverty line. The available clinics need to be spread across the county because, currently, some cities are not well covered. The second recommendation is to develop or strengthen intersectoral and comprehensive national policies to create awareness about the dangers of alcoholism. The government can also, directly and indirectly, increase the capacity of health systems to deliver treatment and prevention services to alcohol-use disorders and comorbid conditions and disorders. Third, there is a need for community action through local initiatives empowered by the government. Properly executed community programs can effectively prevent and reduce chronic alcoholism.
Conclusion
To conclude, Lake County is ranked among the least healthy counties in California and the United States at large. It lags in most health indicators such as poverty, income, housing, access to health, and the number of uninsured. The heath of its people could be adversely impacted by these factors coupled with alcohol and drug abuse. Moreover, for overall health, Lake County has been in the bottom five counties of the state for over half a decade ago.
There are significant health gaps in the health of the population because of the high poverty rate in the county since over 20% are poor. The primary health concern in the county is cirrhosis and lung-related mortality, whose rate is higher than the state and nation. Although many actions have been taken, the community and government should take initiatives to reduce alcoholism and drug abuse, which have been identified as the main causes of liver diseases.
References
California Department of Health Care Services. (2021). Medi-Cal managed care. DHCS. Web.
California Health Care Foundation. (2019). California maps: How many primary care and specialist physicians are in your County? Web.
California’s Office of Statewide Health Planning and Development. (2021). Lake County Community Clinics. OSHPD. Web.
California State Association of Counties. (2021). Lake County. Web.
California State Council on Developmental Disabilities. (2021). California poverty levels by county. Web.
Centers for Medicare and Medicaid Services. (2021). Story map series: Chronic conditions prevalence, state/county 2018. Web.
County Health Rankings & Roadmaps. (2021). How healthy is your County? | County health rankings. Web.
Kaiser Family Foundation. (2021). Hospital beds per 1,000 population by ownership type. KFF. Web.
Kids Data. (2021). Health insurance coverage (Regions of 65,000 residents or more), by age group. Kidsdata. Web.
Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the global burden of disease study 2016. BMJ, 364(194), 1-11. Web.
United States Census Bureau. (2019). QuickFacts Lake County, California. Web.