Health Assessment Glosses Over Needs

* So it’s true. Orange County really is the happiest place on earth. Orange County’s Health Care Agency tells us that according to the state’s morbidity and mortality statistics, we are the second-healthiest of California’s largest counties (Jan. 12).

Len Foster, acting public health director, explains that “Orange County is a wealthy community and, as a rule, poverty is associated with adverse health status.” In other words, the rich get good health care. This is news?

What does the HCA report tell us about those residents who fall outside the parameters of “those with insurance (or) others in emergency events (for whom) the excellent health infrastructure . . . provides good access to health care.”?

What does it tell us about the 20% of Orange County children without health care coverage, despite the availability of CalOPTIMA and the Healthy Start program?

Or the thousands of uninsured and underinsured county residents who must access emergency room care for conditions which only attain emergency status for lack of adequate access to affordable health care?


Pamela Austin, project director of the Orange County Health Needs Assessment, states that a key factor in the county’s high ratings is the “unique way the county’s Medi-Cal population is handled”; i.e., that CalOPTIMA provides greater access to health care for the county’s publicly insured.

We look forward to her statement being borne out by a statistically significant assessment of a complete cross-section of Orange County’s population, incorporating CalOPTIMA’s documented evidence, in the report due out in the next few months.

We must comment on the article’s implication that the quality of health in Orange County is dependent upon the racial makeup of its residents.

Although we are certain that Foster’s comment that the county “would have had a higher infant mortality if we had a greater number of African Americans because African Americans have an infant mortality rate twice that of the (general) population” was not intended to offend, it is unfortunate that the article failed to clarify that it is poverty and the concomitant lack of resources, rather than skin color, which determines access to health care and the consequent morbidity and mortality rates.

Like its homeless, Orange County’s underinsured and uninsured populations are a reality. We ignore their needs at our peril; in terms of both the potential public health repercussions and the diminishing of our own humanity.


Executive Director

and General Counsel

Public Law Center


Directing Attorney

Health Issues Project

Public Law Center

* While it is great news to learn that Orange County residents are living healthy lives, it is a tragedy that the health of residents in neighboring Los Angeles County is so precarious.

Our destinies are linked; if Orange County has “more doctors, more hospitals . . . " then somewhere has less. Health care services, like any other economic resource, come in fixed quantities.

Unfortunately, communicable diseases defy conventional economics; they are no respecter of persons, no matter how much they earn or where they live.