About this dataset

Context

The dataset tabulates the population of Medicine Lake by race. It includes the population of Medicine Lake across racial categories (excluding ethnicity) as identified by the Census Bureau. The dataset can be utilized to understand the population distribution of Medicine Lake across relevant racial categories.

Key observations

The percent distribution of Medicine Lake population by race (across all racial categories recognized by the U.S. Census Bureau): 90% are white, 6.32% are American Indian and Alaska Native and 3.68% are multiracial.

Content

When available, the data consists of estimates from the U.S. Census Bureau American Community Survey (ACS) 2019-2023 5-Year Estimates.

Racial categories include:

• White
• Black or African American
• American Indian and Alaska Native
• Asian
• Native Hawaiian and Other Pacific Islander
• Some other race
• Two or more races (multiracial)

Variables / Data Columns

• Race: This column displays the racial categories (excluding ethnicity) for the Medicine Lake
• Population: The population of the racial category (excluding ethnicity) in the Medicine Lake is shown in this column.
• % of Total Population: This column displays the percentage distribution of each race as a proportion of Medicine Lake total population. Please note that the sum of all percentages may not equal one due to rounding of values.

Good to know

Margin of Error

Data in the dataset are based on the estimates and are subject to sampling variability and thus a margin of error. Neilsberg Research recommends using caution when presening these estimates in your research.

Custom data

If you do need custom data for any of your research project, report or presentation, you can contact our research staff at research@neilsberg.com for a feasibility of a custom tabulation on a fee-for-service basis.

Inspiration

Neilsberg Research Team curates, analyze and publishes demographics and economic data from a variety of public and proprietary sources, each of which often includes multiple surveys and programs. The large majority of Neilsberg Research aggregated datasets and insights is made available for free download at https://www.neilsberg.com/research/.

Recommended for further research

This dataset is a part of the main dataset for Medicine Lake Population by Race & Ethnicity. You can refer the same here

No ethnic/racial groups experienced better access to healthcare (across different access measures from health insurance to usual source of care) compared with non-Hispanic White or White people in 2017, 2018, or 2019. The exception is Asians, where they experienced better access than White population on 2 access measures (or 14 percent) but experienced worse access than White population on 4 measures (or 29 percent). The disparity was largest comparing Hispanic vs. non-Hispanic White population . This statistic depicts the percentage of healthcare access measures for which members of select ethnic groups had better or worse access to care than White population in the U.S. in 2017, 2018, or 2019.

Department of State Hospitals Patient Population Demographic (Fiscal Effective Dates: 2010-2020)

As of 2019, the distribution of selected healthcare professionals in the United State by race and ethnicity revealed deep disparities. During that year, the vast majority of healthcare workers in the US identified as white. For instance, only 11 percent of registered nurses were Black and roughly eight percent Hispanic.

In 2022, among people aged 65 years and above who had health coverage, 40.3 percent non-Hispanic White Americans had private health insurance, while a further 36 percent had Medicare Advantage. The majority of older adults in the U.S. were privately insured (with or without Medicare). This statistic illustrates the distribution of health insurance coverage among adults aged 65 and above in the U.S. in 2022, by race and coverage type.

Medical Service Study Areas (MSSAs)As defined by California's Office of Statewide Health Planning and Development (OSHPD) in 2013, "MSSAs are sub-city and sub-county geographical units used to organize and display population, demographic and physician data" (Source). Each census tract in CA is assigned to a given MSSA. The most recent MSSA dataset (2014) was used. Spatial data are available via OSHPD at the California Open Data Portal. This information may be useful in studying health equity.Definitions:Race/Ethnicity: Race/ethnicity is categorized as: All races/ethnicities, Non-Hispanic (NH) White, NH Black, Asian/Pacific Islander, or Hispanic. "All races" includes all of the above, as well as other and unknown race/ethnicity and American Indian/Alaska Native. The latter two groups are not reported separately due to small numbers for many cancer sites.Racial/Ethnic Composition: Distribution of residents' race/ethnicity (e.g., % Hispanic, % non-Hispanic White, % non-Hispanic Black, % non-Hispanic Asian/Pacific Islander). (Source: US Census, 2010.)Rural: Percent of residents who reside in blocks that are designated as rural. (Source: US Census, 2010.)Foreign Born: Percent of residents who were born outside the United States. (Source: American Community Survey, 2008-2012.)Socioeconomic Status (Neighborhood Level): A composite measure of seven indicator variables created by principal component analysis; indicators include: education, blue-collar job, unemployment, household income, poverty, rent, and house value. Quintiles based on state distribution, with quintile 1 being the lowest SES and 5 being the highest. (Source: American Community Survey, 2008-2012.)Spatial extent: CaliforniaSpatial Unit: MSSACreated: n/aUpdated: n/aSource: California Health MapsContact Email: gbacr@ucsf.eduSource Link: https://www.californiahealthmaps.org/?areatype=mssa&address=&sex=Both&site=AllSite&race=&year=05yr&overlays=none&choropleth=Obesity

The population share of the Latino/Hispanic ethnic group in the United States was 19 percent, whereas they accounted for 32 percent of health center patients. Health center had a disproportionally high amount of patients of ethnic minorities. This statistic depicts the share of ethnic minorities in health centers compared to the share in the overall U.S. population as of 2022.

About this dataset

Context

The dataset tabulates the population of Medicine Lodge by race. It includes the population of Medicine Lodge across racial categories (excluding ethnicity) as identified by the Census Bureau. The dataset can be utilized to understand the population distribution of Medicine Lodge across relevant racial categories.

Key observations

The percent distribution of Medicine Lodge population by race (across all racial categories recognized by the U.S. Census Bureau): 91.77% are white, 1.84% are American Indian and Alaska Native, 1.38% are Asian, 0.20% are some other race and 4.81% are multiracial.

Content

When available, the data consists of estimates from the U.S. Census Bureau American Community Survey (ACS) 2019-2023 5-Year Estimates.

Racial categories include:

• White
• Black or African American
• American Indian and Alaska Native
• Asian
• Native Hawaiian and Other Pacific Islander
• Some other race
• Two or more races (multiracial)

Variables / Data Columns

• Race: This column displays the racial categories (excluding ethnicity) for the Medicine Lodge
• Population: The population of the racial category (excluding ethnicity) in the Medicine Lodge is shown in this column.
• % of Total Population: This column displays the percentage distribution of each race as a proportion of Medicine Lodge total population. Please note that the sum of all percentages may not equal one due to rounding of values.

Good to know

Margin of Error

Data in the dataset are based on the estimates and are subject to sampling variability and thus a margin of error. Neilsberg Research recommends using caution when presening these estimates in your research.

Custom data

If you do need custom data for any of your research project, report or presentation, you can contact our research staff at research@neilsberg.com for a feasibility of a custom tabulation on a fee-for-service basis.

Inspiration

Neilsberg Research Team curates, analyze and publishes demographics and economic data from a variety of public and proprietary sources, each of which often includes multiple surveys and programs. The large majority of Neilsberg Research aggregated datasets and insights is made available for free download at https://www.neilsberg.com/research/.

Recommended for further research

This dataset is a part of the main dataset for Medicine Lodge Population by Race & Ethnicity. You can refer the same here

NOTE: This dataset has been retired and marked as historical-only. The recommended dataset to use in its place is https://data.cityofchicago.org/Health-Human-Services/COVID-19-Vaccination-Coverage-Region-HCEZ-/5sc6-ey97. COVID-19 vaccinations administered to Chicago residents by Healthy Chicago Equity Zones (HCEZ) based on the reported address, race-ethnicity, and age group of the person vaccinated, as provided by the medical provider in the Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE). Healthy Chicago Equity Zones is an initiative of the Chicago Department of Public Health to organize and support hyperlocal, community-led efforts that promote health and racial equity. Chicago is divided into six HCEZs. Combinations of Chicago’s 77 community areas make up each HCEZ, based on geography. For more information about HCEZs including which community areas are in each zone see: https://data.cityofchicago.org/Health-Human-Services/Healthy-Chicago-Equity-Zones/nk2j-663f Vaccination Status Definitions: ·People with at least one vaccine dose: Number of people who have received at least one dose of any COVID-19 vaccine, including the single-dose Johnson & Johnson COVID-19 vaccine. ·People with a completed vaccine series: Number of people who have completed a primary COVID-19 vaccine series. Requirements vary depending on age and type of primary vaccine series received. ·People with a bivalent dose: Number of people who received a bivalent (updated) dose of vaccine. Updated, bivalent doses became available in Fall 2022 and were created with the original strain of COVID-19 and newer Omicron variant strains. Weekly cumulative totals by vaccination status are shown for each combination of race-ethnicity and age group within an HCEZ. Note that each HCEZ has a row where HCEZ is “Citywide” and each HCEZ has a row where age is "All" so care should be taken when summing rows. Vaccinations are counted based on the date on which they were administered. Weekly cumulative totals are reported from the week ending Saturday, December 19, 2020 onward (after December 15, when vaccines were first administered in Chicago) through the Saturday prior to the dataset being updated. Population counts are from the U.S. Census Bureau American Community Survey (ACS) 2017-2021 5-year estimates. Coverage percentages are calculated based on the cumulative number of people in each population subgroup (age group by race-ethnicity within an HCEZ) who have each vaccination status as of the date, divided by the estimated number of people in that subgroup. Actual counts may exceed population estimates and lead to >100% coverage, especially in small race-ethnicity subgroups of each age group within an HCEZ. All coverage percentages are capped at 99%. All data are provisional and subject to change. Information is updated as additional details are received and it is, in fact, very common for recent dates to be incomplete and to be updated as time goes on. At any given time, this dataset reflects data currently known to CDPH. Numbers in this dataset may differ from other public sources due to when data are reported and how City of Chicago boundaries are defined. CDPH uses the most complete data available to estimate COVID-19 vaccination coverage among Chicagoans, but there are several limitations that impact its estimates. Data reported in I-CARE only includes doses administered in Illinois and some doses administered outside of Illinois reported historically by Illinois providers. Doses administered by the federal Bureau of Prisons and Department of Defense are also not currently reported in I-CARE. The Veterans Health Administration began reporting doses in I-CARE beginning September 2022. Due to people receiving vaccinations that are not recorded in I-CARE that can be linked to their record, such as someone receiving a vaccine dose in another state, the number of people with a completed series or a booster dose is underesti

In 2023, four in ten Black adults in the U.S. who experienced discrimination by health care providers mentioned that they trust health providers all or most of the time to do what is right for them and their community. In general, U.S. adults across all racial groups, who had been treated unfairly or disrespected, were less likely to trust health care providers to do what is right for them and the community.

Graph and download economic data for Expenditures: Healthcare by Race: Asian (CXUHEALTHLB0904M) from 2003 to 2023 about healthcare, health, asian, expenditures, and USA.

As of 2023, across 70 measures assessing health and healthcare in the U.S., the Black, AI/AN, and Hispanic populations fare worse than the White population. The racial/ethnic disparity was largest comparing Black and White populations. The Black population fared worse than the White population across 55 health and healthcare measures, while they only fared better than the White population for 12 of them.

On the other hand, the Asian population did not fare worse than White people across most examined measures. Nonetheless, these measures cover aspects of health coverage, access, and use; health status, outcomes, and behaviors; and social determinants of health, yet more is needed to provide the full scope of healthcare disparities.

The dataset contains estimates for the number of healthcare professionals in 15 different healthcare categories (e.g., Registered Nurse, Dentist, License Clinical Social Worker, etc.) based on completion of license renewal by Race/Ethnicity. There are two timeframes: all current licenses and recent licenses (since 2017). California population estimates are also included to provide a marker for each Race/Ethnicity. Each healthcare professional category can be compared across Race/Ethnicity groups and compared to statewide population estimates, so Race/Ethnicity shortages can be identified for each healthcare professional category. For instance, a notable difference between healthcare professional category and statewide population would indicate either underrepresentation or overrepresentation for that Race/Ethnicity, depending on the direction of the difference.

This dataset comprises physician-level entries from the 1906 American Medical Directory, the first in a series of semi-annual directories of all practicing physicians published by the American Medical Association [1]. Physicians are consistently listed by city, county, and state. Most records also include details about the place and date of medical training. From 1906-1940, Directories also identified the race of black physicians [2].This dataset comprises physician entries for a subset of US states and the District of Columbia, including all of the South and several adjacent states (Alabama, Arkansas, Delaware, Florida, Georgia, Kansas, Kentucky, Louisiana, Maryland, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia). Records were extracted via manual double-entry by professional data management company [3], and place names were matched to latitude/longitude coordinates. The main source for geolocating physician entries was the US Census. Historical Census records were sourced from IPUMS National Historical Geographic Information System [4]. Additionally, a public database of historical US Post Office locations was used to match locations that could not be found using Census records [5]. Fuzzy matching algorithms were also used to match misspelled place or county names [6].The source of geocoding match is described in the “match.source” field (Type of spatial match (census_YEAR = match to NHGIS census place-county-state for given year; census_fuzzy_YEAR = matched to NHGIS place-county-state with fuzzy matching algorithm; dc = matched to centroid for Washington, DC; post_places = place-county-state matched to Blevins & Helbock's post office dataset; post_fuzzy = matched to post office dataset with fuzzy matching algorithm; post_simp = place/state matched to post office dataset; post_confimed_missing = post office dataset confirms place and county, but could not find coordinates; osm = matched using Open Street Map geocoder; hand-match = matched by research assistants reviewing web archival sources; unmatched/hand_match_missing = place coordinates could not be found). For records where place names could not be matched, but county names could, coordinates for county centroids were used. Overall, 40,964 records were matched to places (match.type=place_point) and 931 to county centroids ( match.type=county_centroid); 76 records could not be matched (match.type=NA).Most records include information about the physician’s medical training, including the year of graduation and a code linking to a school. A key to these codes is given on Directory pages 26-27, and at the beginning of each state’s section [1]. The OSM geocoder was used to assign coordinates to each school by its listed location. Straight-line distances between physicians’ place of training and practice were calculated using the sf package in R [7], and are given in the “school.dist.km” field. Additionally, the Directory identified a handful of schools that were “fraudulent” (school.fraudulent=1), and institutions set up to train black physicians (school.black=1).AMA identified black physicians in the directory with the signifier “(col.)” following the physician’s name (race.black=1). Additionally, a number of physicians attended schools identified by AMA as serving black students, but were not otherwise identified as black; thus an expanded racial identifier was generated to identify black physicians (race.black.prob=1), including physicians who attended these schools and those directly identified (race.black=1).Approximately 10% of dataset entries were audited by trained research assistants, in addition to 100% of black physician entries. These audits demonstrated a high degree of accuracy between the original Directory and extracted records. Still, given the complexity of matching across multiple archival sources, it is possible that some errors remain; any identified errors will be periodically rectified in the dataset, with a log kept of these updates.For further information about this dataset, or to report errors, please contact Dr Ben Chrisinger (Benjamin.Chrisinger@tufts.edu). Future updates to this dataset, including additional states and Directory years, will be posted here: https://dataverse.harvard.edu/dataverse/amd.References:1. American Medical Association, 1906. American Medical Directory. American Medical Association, Chicago. Retrieved from: https://catalog.hathitrust.org/Record/000543547.2. Baker, Robert B., Harriet A. Washington, Ololade Olakanmi, Todd L. Savitt, Elizabeth A. Jacobs, Eddie Hoover, and Matthew K. Wynia. "African American physicians and organized medicine, 1846-1968: origins of a racial divide." JAMA 300, no. 3 (2008): 306-313. doi:10.1001/jama.300.3.306.3. GABS Research Consult Limited Company, https://www.gabsrcl.com.4. Steven Manson, Jonathan Schroeder, David Van Riper, Tracy Kugler, and Steven Ruggles. IPUMS National Historical Geographic Information System: Version 17.0 [GNIS, TIGER/Line & Census Maps for US Places and Counties: 1900, 1910, 1920, 1930, 1940, 1950; 1910_cPHA: ds37]. Minneapolis, MN: IPUMS. 2022. http://doi.org/10.18128/D050.V17.05. Blevins, Cameron; Helbock, Richard W., 2021, "US Post Offices", https://doi.org/10.7910/DVN/NUKCNA, Harvard Dataverse, V1, UNF:6:8ROmiI5/4qA8jHrt62PpyA== [fileUNF]6. fedmatch: Fast, Flexible, and User-Friendly Record Linkage Methods. https://cran.r-project.org/web/packages/fedmatch/index.html7. sf: Simple Features for R. https://cran.r-project.org/web/packages/sf/index.html

About this dataset

Context

The dataset tabulates the Non-Hispanic population of Medical Lake by race. It includes the distribution of the Non-Hispanic population of Medical Lake across various race categories as identified by the Census Bureau. The dataset can be utilized to understand the Non-Hispanic population distribution of Medical Lake across relevant racial categories.

Key observations

Of the Non-Hispanic population in Medical Lake, the largest racial group is White alone with a population of 4,343 (92.96% of the total Non-Hispanic population).

Content

When available, the data consists of estimates from the U.S. Census Bureau American Community Survey (ACS) 2019-2023 5-Year Estimates.

Racial categories include:

• White
• Black or African American
• American Indian and Alaska Native
• Asian
• Native Hawaiian and Other Pacific Islander
• Some other race
• Two or more races (multiracial)

Variables / Data Columns

• Race: This column displays the racial categories (for Non-Hispanic) for the Medical Lake
• Population: The population of the racial category (for Non-Hispanic) in the Medical Lake is shown in this column.
• % of Total Population: This column displays the percentage distribution of each race as a proportion of Medical Lake total Non-Hispanic population. Please note that the sum of all percentages may not equal one due to rounding of values.

Good to know

Margin of Error

Data in the dataset are based on the estimates and are subject to sampling variability and thus a margin of error. Neilsberg Research recommends using caution when presening these estimates in your research.

Custom data

If you do need custom data for any of your research project, report or presentation, you can contact our research staff at research@neilsberg.com for a feasibility of a custom tabulation on a fee-for-service basis.

Inspiration

Neilsberg Research Team curates, analyze and publishes demographics and economic data from a variety of public and proprietary sources, each of which often includes multiple surveys and programs. The large majority of Neilsberg Research aggregated datasets and insights is made available for free download at https://www.neilsberg.com/research/.

Recommended for further research

This dataset is a part of the main dataset for Medical Lake Population by Race & Ethnicity. You can refer the same here

As of 2023, more than ********* of Black women in the United States reported to have been treated unfairly or with disrespect in the last three years by a health care provider or staff because of their racial background. Subsequently, Black men were the second most discriminated against group in the healthcare sector, with ** percent experiencing unfair or disrespectful treatment in the last three years.

In 2023, approximately ******** percent of the Hispanic population in the United States did not have health insurance, a historical low since 2010. In 2023, the national average was *** percent. White Americans had a below-average rate of just *** percent, whereas *** percent of Black Americans had no health insurance.Impact of the Affordable Care ActThe Affordable Care Act (ACA), also known as Obamacare, was enacted in March 2010, which expanded the Medicaid program, made affordable health insurance available to more people and aimed to lower health care costs by supporting innovative medical care delivery methods. Though it was enacted in 2010, the full effects of it weren’t seen until 2013, when government-run insurance marketplaces such as HealthCare.gov were opened. The number of Americans without health insurance fell significantly between 2010 and 2015, but began to rise again after 2016. What caused the change?The Tax Cuts and Jobs Act of 2017 has played a role in decreasing the number of Americans with health insurance, because the individual mandate was repealed. The aim of the individual mandate (part of the ACA) was to ensure that all Americans had health coverage and thus spread the costs over the young, old, sick and healthy by imposing a large tax fine on those without coverage.

According to a survey from 2018, around 86 percent of African American women working in health care believed race was "very much" a barrier to their career advancement, compared to just 9 percent of white women. This statistic shows the percentage of survey respondents who reported race was "very much" a barrier to career advancement for females in the U.S. health care industry 2018.

Note: DPH is updating and streamlining the COVID-19 cases, deaths, and testing data. As of 6/27/2022, the data will be published in four tables instead of twelve. The COVID-19 Cases, Deaths, and Tests by Day dataset contains cases and test data by date of sample submission. The death data are by date of death. This dataset is updated daily and contains information back to the beginning of the pandemic. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Cases-Deaths-and-Tests-by-Day/g9vi-2ahj. The COVID-19 State Metrics dataset contains over 93 columns of data. This dataset is updated daily and currently contains information starting June 21, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-State-Level-Data/qmgw-5kp6 . The COVID-19 County Metrics dataset contains 25 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-County-Level-Data/ujiq-dy22 . The COVID-19 Town Metrics dataset contains 16 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Town-Level-Data/icxw-cada . To protect confidentiality, if a town has fewer than 5 cases or positive NAAT tests over the past 7 days, those data will be suppressed. COVID-19 cases and associated deaths that have been reported among Connecticut residents, broken down by race and ethnicity. All data in this report are preliminary; data for previous dates will be updated as new reports are received and data errors are corrected. Deaths reported to the either the Office of the Chief Medical Examiner (OCME) or Department of Public Health (DPH) are included in the COVID-19 update. The following data show the number of COVID-19 cases and associated deaths per 100,000 population by race and ethnicity. Crude rates represent the total cases or deaths per 100,000 people. Age-adjusted rates consider the age of the person at diagnosis or death when estimating the rate and use a standardized population to provide a fair comparison between population groups with different age distributions. Age-adjustment is important in Connecticut as the median age of among the non-Hispanic white population is 47 years, whereas it is 34 years among non-Hispanic blacks, and 29 years among Hispanics. Because most non-Hispanic white residents who died were over 75 years of age, the age-adjusted rates are lower than the unadjusted rates. In contrast, Hispanic residents who died tend to be younger than 75 years of age which results in higher age-adjusted rates. The population data used to calculate rates is based on the CT DPH population statistics for 2019, which is available online here: https://portal.ct.gov/DPH/Health-Information-Systems--Reporting/Population/Population-Statistics. Prior to 5/10/2021, the population estimates from 2018 were used. Rates are standardized to the 2000 US Millions Standard population (data available here: https://seer.cancer.gov/stdpopulations/). Standardization was done using 19 age groups (0, 1-4, 5-9, 10-14, ..., 80-84, 85 years and older). More information about direct standardization for age adjustment is available here: https://www.cdc.gov/nchs/data/statnt/statnt06rv.pdf Categories are mutually exclusive. The category “multiracial” includes people who answered ‘yes’ to more than one race category. Counts may not add up to total case counts as data on race and ethnicity may be missing. Age adjusted rates calculated only for groups with more than 20 deaths. Abbreviation: NH=Non-Hispanic. Data on Connecticut deaths were obtained from the Connecticut Deaths Registry maintained by the DPH Office of Vital Records. Cause of death was determined by a death certifier (e.g., physician, APRN, medical

This is the current Medical Service Study Area. California Medical Service Study Areas are created by the California Department of Health Care Access and Information (HCAI).Check the Data Dictionary for field descriptions.Search for the Medical Service Study Area data on the CHHS Open Data Portal.Checkout the California Healthcare Atlas for more Medical Service Study Area information.This is an update to the MSSA geometries and demographics to reflect the new 2020 Census tract data. The Medical Service Study Area (MSSA) polygon layer represents the best fit mapping of all new 2020 California census tract boundaries to the original 2010 census tract boundaries used in the construction of the original 2010 MSSA file. Each of the state's new 9,129 census tracts was assigned to one of the previously established medical service study areas (excluding tracts with no land area), as identified in this data layer. The MSSA Census tract data is aggregated by HCAI, to create this MSSA data layer. This represents the final re-mapping of 2020 Census tracts to the original 2010 MSSA geometries. The 2010 MSSA were based on U.S. Census 2010 data and public meetings held throughout California.Source of update: American Community Survey 5-year 2006-2010 data for poverty. For source tables refer to InfoUSA update procedural documentation. The 2010 MSSA Detail layer was developed to update fields affected by population change. The American Community Survey 5-year 2006-2010 population data pertaining to total, in households, race, ethnicity, age, and poverty was used in the update. The 2010 MSSA Census Tract Detail map layer was developed to support geographic information systems (GIS) applications, representing 2010 census tract geography that is the foundation of 2010 medical service study area (MSSA) boundaries. ***This version is the finalized MSSA reconfiguration boundaries based on the US Census Bureau 2010 Census. In 1976 Garamendi Rural Health Services Act, required the development of a geographic framework for determining which parts of the state were rural and which were urban, and for determining which parts of counties and cities had adequate health care resources and which were "medically underserved". Thus, sub-city and sub-county geographic units called "medical service study areas [MSSAs]" were developed, using combinations of census-defined geographic units, established following General Rules promulgated by a statutory commission. After each subsequent census the MSSAs were revised. In the scheduled revisions that followed the 1990 census, community meetings of stakeholders (including county officials, and representatives of hospitals and community health centers) were held in larger metropolitan areas. The meetings were designed to develop consensus as how to draw the sub-city units so as to best display health care disparities. The importance of involving stakeholders was heightened in 1992 when the United States Department of Health and Human Services' Health and Resources Administration entered a formal agreement to recognize the state-determined MSSAs as "rational service areas" for federal recognition of "health professional shortage areas" and "medically underserved areas". After the 2000 census, two innovations transformed the process, and set the stage for GIS to emerge as a major factor in health care resource planning in California. First, the Office of Statewide Health Planning and Development [OSHPD], which organizes the community stakeholder meetings and provides the staff to administer the MSSAs, entered into an Enterprise GIS contract. Second, OSHPD authorized at least one community meeting to be held in each of the 58 counties, a significant number of which were wholly rural or frontier counties. For populous Los Angeles County, 11 community meetings were held. As a result, health resource data in California are collected and organized by 541 geographic units. The boundaries of these units were established by community healthcare experts, with the objective of maximizing their usefulness for needs assessment purposes. The most dramatic consequence was introducing a data simultaneously displayed in a GIS format. A two-person team, incorporating healthcare policy and GIS expertise, conducted the series of meetings, and supervised the development of the 2000-census configuration of the MSSAs.MSSA Configuration Guidelines (General Rules):- Each MSSA is composed of one or more complete census tracts.- As a general rule, MSSAs are deemed to be "rational service areas [RSAs]" for purposes of designating health professional shortage areas [HPSAs], medically underserved areas [MUAs] or medically underserved populations [MUPs].- MSSAs will not cross county lines.- To the extent practicable, all census-defined places within the MSSA are within 30 minutes travel time to the largest population center within the MSSA, except in those circumstances where meeting this criterion would require splitting a census tract.- To the extent practicable, areas that, standing alone, would meet both the definition of an MSSA and a Rural MSSA, should not be a part of an Urban MSSA.- Any Urban MSSA whose population exceeds 200,000 shall be divided into two or more Urban MSSA Subdivisions.- Urban MSSA Subdivisions should be within a population range of 75,000 to 125,000, but may not be smaller than five square miles in area. If removing any census tract on the perimeter of the Urban MSSA Subdivision would cause the area to fall below five square miles in area, then the population of the Urban MSSA may exceed 125,000. - To the extent practicable, Urban MSSA Subdivisions should reflect recognized community and neighborhood boundaries and take into account such demographic information as income level and ethnicity. Rural Definitions: A rural MSSA is an MSSA adopted by the Commission, which has a population density of less than 250 persons per square mile, and which has no census defined place within the area with a population in excess of 50,000. Only the population that is located within the MSSA is counted in determining the population of the census defined place. A frontier MSSA is a rural MSSA adopted by the Commission which has a population density of less than 11 persons per square mile. Any MSSA which is not a rural or frontier MSSA is an urban MSSA. Last updated December 6th 2024.