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Business
Journal Health Care Quarterly The findings of a report to assess the health of the community in Santa Clara County confirmed what many in the industry already know--there is a widening and evident disparity between groups that correlates with income and ethnicity. The report is required every three years for nonprofit hospitals as a condition of their tax-exempt status (SB697). This is the second report that has been done since the law passed in 1994. Each hospital can do the report individually but in Santa Clara County, the nonprofit hospitals joined forces and invited community organizations to participate in the process. The group, the Community Benefits Coalition, also worked with a similar group in San Mateo County to develop a survey that they both used this year. "We now have a tool to use in future evaluations that will allow us to track and compare changes in the Bay Area," said Sharon Keating Beauregard of Kaiser Permanente, who co-chaired the coalition. With the exception of a few areas, the findings showed that Santa Clara County as a whole is doing well. The county compared favorably in many areas with the Healthy 2000 goals previously set by the Department of Health and Human Services as a benchmark for evaluating health outcomes. The areas where Santa Clara County fell short were in the percentages of children receiving immunizations and the rates of sexually transmitted diseases and tuberculosis. There were significantly higher rates of infant mortality, juvenile and domestic violence, teen pregnancy, sexually transmitted diseases, alcohol and drug abuse, and mental health problems for Hispanics, African Americans and low-income groups. "We live in a highly resourceful area," said Todd Hansen, senior vice president and general counsel for The Health Trust, a community member of the coalition. "But the affluence only exacerbates the problems of the poor. Health access was shown to be directly correlated to income level." The Health Trust was formed from the proceeds of the sale of Good Samaritan Health System to Columbia/HCA in 1996. "It's really a tale of two cities," said Don Bolce, executive director of Joing Venture: Silicon Valley Network, another coalition member. The results parallel those of a broader study done by Joint Venture annually that looks at multiple indicators to identify Silicon Valley trends. Apparently the income gap has created significant difference not only in housing and education, but in health outcomes as well. In addition, 13.1 percent of residents in Santa Clara County are uninsured, a troubling statistic that concerns all segments of the health care industry. The uninsured have poor access to services and poorer health outcomes due to limited treatment and a lack of early intervention and preventive care. "While there is a lot of attention on health care quality these days, there is little being done to address the problem of the uninsured. All of the legislative efforts are aimed at improving health care benefits for those who already have insurance," said Mr. Bolce. "This only drives up the costs of insurance and makes health care insurance even more out of reach for those who don't have it." Contrary to what many may think, the uninsured generally do not include the chronically unemployed, who qualify for government programs such as Medi-Cal. The uninsured consist primarily of individuals who work in industries that typically don't provide the employer-sponsored health benefits; those who work for small businesses and the self-employed; and part time, temporary workers and independent contractors. With health premium costs rising again, many fear that some employers who currently provide benefits for employees may choose to stop, or may require additional contributions from employees. The Community Benefits Coalition will be meeting this week to begin planning next steps. As a result of the previous assessment, the group provided funding for "The Community Diabetes Project. These funds were used to help develop a curriculum and training for lay persons to teach diabetics how to manage their condition. The project has provided diabetic screenings for over 200 individuals. Individual members of the council also will be taking the report back to their respective organizations as a resource for strategic planning. In addition, the report will be used to drive policy and funding decisions for both public and private agencies. "Since lifestyle factors account for over 50 percent of health outcomes, the findings make a good case for increasing prevention efforts especially targeting high risk populations," said Guadalupe Olivas, public health director for Santa Clara County. The full report is available online at http://www.jointventure.org/initiatives/health/hospital.pdf Community Benefits Coalition Members include:
Cindy Ling is a freelance writer based in San Jose.
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