Poverty In The Suburbs

a home with under forclosure

Our service area is suburban. We know from the AP article (see below for a link) and other publications, as well as our own experience serving a rapidly expanding patient population of financially stressed individuals and families that our community is no exception to this demographic shift in poverty.

Some surprising facts about the suburban population that accesses care at TCHC:

  • Ninety-eight percent of our patients are 200% below the Federal Poverty level
  • 70% of our patients subsist at 100% of the federal poverty level
  • 52% of our patients come to us without private insurance (employer based) or publicly funded health care coverage (e.g. Medi-Cal)

A study published in the Journal of the American Medical Association (2007) points to a seemingly unanticipated side effect of this shift. There is evidence to suggest that a disconnect exists between where suburban residents live and where they can find safety-net health care. Safety-net service providers are often underfunded or non-existent in suburban areas relative to their urban counterparts.1

This is certainly the case for southern Alameda County residents – from central Fremont the closest County Hospital is 23 miles and up to 3 hours by public transportation. As a case in point to this disconnect, in the past 10 years there has been a notable convergence in certain key health indicators for the urban Oakland and suburban Tri-Cities populations of Alameda County.2  While Oakland area specific health outcomes appear to be improving, for example, many Tri-Cities area health outcomes are on the decline.3  In fact, according to the most recent Select Health Indicators for Cities in Alameda County 2007, rates of diabetes illness, hospitalization and mortality in Union City and Newark have now grown to be higher than the rates found in the more urbanized cities to the north (such as San Leandro, Oakland, Emeryville, Berkeley).

Now, Newark and Union City are the first and third most impacted cities in the county in terms of diabetes disease burden. The rate of teen pregnancy in the community of Newark is also higher than most other areas of the county, as is childhood obesity and rates of certain types of cancer. The mortality rate from coronary heart disease (CHD) in Hayward exceeds the county level rate, and many of the neighboring cities. Hayward has the fourth highest mortality rate in the county due to CHD, followed by Fremont, Union City, and Newark that round out the top ten.4

To see the Associated Press (AP) article "Poverty follows families to the suburbs - Suburban poor outnumber their inner-city counterparts for the first time" found on MSNBC in December, 2006 , click here

1
Kuehn, B.M. (2007). Poverty Shift May Burden Health System. JAMA , 297(10), 1047-1048.
2
Alameda County Public Health Department Community Assessment, Planning, and Education Unit (CAPE)(2007, August). Select Health Indicators for Cities in Alameda County, 2007—Prepared for the Hospital Council of Northern and Central California. Retrieved December 17, 2007, from http://www.acphd.org/
3
Ibid
4
Ibid