California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

Lack of Services in Calif. Communities Associated With Public Health Risks

Hundreds of unincorporated California communities lack basic services such as adequate sewer systems and clean drinking water, which can cause public health issues, California Watch reports.

Public Health Issues

About 1.8 million low-income state residents -- many of whom are Spanish-speaking -- live in unincorporated communities, according to research and advocacy group PolicyLink. The communities typically are located on county land and lack infrastructure that can help reduce gastrointestinal illness, respiratory disease symptoms and other public health and safety risks.

Raul Ruiz, an emergency department physician and founder of the Coachella Valley Healthcare Initiative, said patients living in unincorporated communities experience high rates of chronic diseases, such as:

  • Diabetes;
  • Hypertension;
  • Obesity; and
  • Stroke.

According to Ruiz, poor infrastructure exacerbates health conditions. For example, he said, drinking water tainted with arsenic can lead to learning disabilities in children.

In addition, he noted that unincorporated communities tend to have a shortage of physicians to manage residents' health conditions. He said that his organization found that in the Eastern Coachella Valley, there is one physician for every 8,407 residents. HHS considers an area where there is one physician for every 3,500 patients to be medically underserved.

Seeking Improvements

According to California Watch, language barriers, legal status and a lack of political knowledge have made it difficult for residents to seek aid from the government for improving public health and safety.

Assembly member Henry T. Perea (D-Fresno) said, "You're looking at very small communities that are impoverished, and in many cases, (residents are) undocumented, and that puts them at a severe disadvantage."

Residents of unincorporated communities have led efforts to push for improvement, but they have had limited success with lobbying the government, filing lawsuits and organizing neighbors.

However, residents have succeeded in taking steps to develop infrastructure in certain communities.

Residents of an unincorporated area near Tulare known as the Matheny Tract received aid from California Rural Legal Assistance -- an advocacy group that provides free legal services in low-income communities -- and have made demands at local government meetings. The city of Tulare and Tulare County have signed a memorandum of understanding to consider connecting Matheny Tract to the city's sewer system, which would cost about $5.5 million.

Lawmakers this year have introduced legislation (SB 1498) that would allow cities and service districts to extend services to unincorporated communities. In addition, Gov. Jerry Brown (D) in October 2011 signed a law requiring state officials to consider nearby low-income unincorporated areas in city planning efforts (Yeung, California Watch, 4/6).

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