This booming California empire is on its way to a public health crisis

The Inland Empire is growing, and there aren’t enough doctors to catch up. Inland Southern California is experiencing a surge in its economy and population, but its ratio of physicians to population is still one of the lowest in the state.

The supply of physicians in the region, which includes the San Bernardino-Riverside-Ontario metropolitan areas as well as much of San Bernardino and Riverside counties, is well below the state average: the California Health Care Foundation found that there were 120 physicians per 100,000 people in the region in 2016, compared to the state average of 194 per 100,000.

Already one of the state’s poorer regions, the Inland Empire is on its way to a public health crisis caused by a severe physician shortage.

The socioeconomic factors behind the shortage are complex, but there are a few major forces behind it: a tendency for locally trained physicians to leave the area for better salaries, a lower regional income than neighboring counties like Los Angeles and Orange, and a diverse population that doesn’t always see itself reflected in the physicians that we have.

The physician shortage issue is one that affects the entire state, but it’s going to hit the Inland Empire especially hard. The region is one of the poorest in the state, and those that can’t afford health coverage now are only going to struggle more as the problem worsens. Many doctors already in the area do not accept patients who are uninsured or covered by Medicaid, meaning the region’s high percentage of low-income, homeless and immigrant residents will bear the brunt of the shortage.

The Inland Empire’s severe physician shortage will be the subject of my 2018 California Fellowship with USC Annenberg’s Center for Health Journalism. I’ll delve deeper into the reasons for the shortage, its effects on underserved communities, and the individuals and institutions that are taking steps to address it.

There are several local programs that are taking steps to bring more doctors to the area, or retain the ones that are being educated here. I’ll examine an effort by Loma Linda University to train San Bernardino County residents in nursing and other health professions by opening an occupational training center in downtown San Bernardino.

Another story will be on an initiative by the University of California, Riverside to offer tuition waivers to medical students who practice medicine in the area, in an effort to both train and retain young health workers.

Another segment will cover a program at the University of California, Los Angeles that trains immigrant doctors to serve underserved communities. Such a program could be especially helpful in increasing the ability of immigrant communities in the Inland Empire to access health care.

I’ll also examine the rarity of mental health professionals in the Inland Empire. Based on a report put out by UCSF’s Healthforce Center, the Inland Empire and San Joaquin Valley have the lowest ratio of mental health professionals to population size in the state. I’ll also examine how the report’s suggestions — increasing supply of mental health professionals, increasing their racial and ethnic diversity, and improving data collection — could be implemented in this region.

[Photo: Matthew Ornelas/KVCR]