May 25, 2001

UCLA Report of Uninsured Californians by Legislative Districts Shows 75% With Uninsured Rate Above National Average

Three-quarters of California's legislative districts have higher uninsured rates among the nonelderly (ages 0-64) than the national average of 17 percent, according to the first report to break down health coverage rates by the state's legislative districts.

The study —Uninsured Californians in Assembly and Senate Districts, 2000— conducted by the UCLA Center for Health Policy Research and funded by The California Endowment, reports that more than 6.8 million Californians, or 22 percent, lacked health insurance in 1999, the fourth highest uninsured rate among 50 states.

Assembly District 46 had the highest uninsured rate among the state's legislative jurisdictions, with 44 percent of the nonelderly lacking health coverage. The district is one of the most ethnically diverse areas of California and includes the communities of Temple-Beaudry, Koreatown, Boyle Heights, Little Tokyo, Wilshire Center, Westlake; and portions of Chinatown and East Los Angeles. In contrast, Assembly District 24 had the lowest rate, with just 10 percent of the nonelderly lacking coverage. Located in the heart of the Silicon Valley, this district includes Cupertino, Saratoga, Los Gatos, Campbell and the southern part of San Jose.

Highlights of the report include the following findings:

Among California's 80 Assembly districts, 60 have uninsured rates for the nonelderly (ages 0-64) above the national average of 17 percent; 55 have rates for children (ages 0-18) above the national average of 14 percent; and 57 have rates nonelderly adults (ages 19-64) above the national average of 19 percent.

Among California's 40 Senate districts, 29 have uninsured rates for the nonelderly above the national average; 26 have rates for children above the national average, and 29 have rates for nonelderly adults above the national average.

Although nearly all of California's elderly adults (ages 65 and up) are covered at least by Medicare, about 2 percent were uninsured in 1999. Legislative districts with elderly uninsured rates exceeding 5 percent are located primarily in Los Angeles County.

Legislative districts with higher uninsured rates have higher percentages of populations of color. For example, the 10 Assembly districts with the highest uninsured rates among nonelderly adults also have the highest percentages of ethnic minority residents, primarily Latino.

Legislative districts with higher uninsured rates also have higher percentage of residents living in or near poverty. For example, four out of five Senate districts with the highest uninsured rates also have the highest percentages of residents living in or near poverty.

"Lack of health insurance is a serious problem for all Californians, not just for legislative districts with high uninsured rates, said E. Richard Brown, PhD, a UCLA public health professor and director of the UCLA Center for Health Policy Research. "The state needs to expand the Medi-Cal and Healthy Families programs to include more uninsured residents and to encourage employers to help pay for coverage of their employees and their families."

"In districts with high concentrations of uninsured residents, these individuals do not receive important preventive care and are less likely to effectively manage chronic illnesses such as diabetes, asthma and high blood pressure," Brown said. "As a result, there is a very high fiscal cost to the public —at least $4 billion in California over the past year— in providing even minimal health care to these residents. We hope that this date will help local county and regional efforts in the development of programs that will encourage eligible families to enroll."

More than two-thirds of California's 1.85 million uninsured children (ages 0-18) are eligible for, but not enrolled in, Medi-Cal or Healthy Families. An estimated 685,000 non-elderly adults (ages 19-64) are uninsured but eligible for Medi-Cal coverage, about 14 percent of California's nearly 5 million uninsured adults.

The California Endowment has been working to improve access to health care for underserved communities, especially children. Since its inception, The Endowment has invested approximately $20 million in community-based, multicultural approaches to assess the health coverage gaps and to determine the barriers the insured face in enrolling in exiting public health coverage programs.

"It is unconscionable that so many of our children are not receiving critical health care services, yet are eligible for program like Health Families," said Robert K. Ross, MD, president and CEO of The California Endowment. "The Medi-Cal and Healthy Families programs should be expanded to include more parents. Evidence has shown that when parents are insured, the likelihood of their children being insured increases." Dr. Ross went on to say that The Endowment is hoping to work in partnership with state and local communities to consolidate the Healthy Families, Medi-Cal and other programs to create a seamless enrollment system for families.

The Center for Health Policy Research, jointly sponsored by the UCLA School of Public Health and the UCLA School Public Policy and Social Research, conducts research on national, state and local health policy issues, provides public service to policy makers and community leaders, and offers educational opportunities for graduate students and post-doctoral fellow fellows.

The California Endowment, the state's largest health foundation, was established in 1996 to expand access to affordable, quality health care for under-served individuals and communities, and to promote fundamental improvements in the health status of all Californians. The Endowment has regional offices in Los Angeles, San Francisco, Sacramento, Fresno and San Diego with program staff working throughout the state. The Endowment makes grants to organizations and institutions that directly benefit the health and well being of the people of California.

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