James Gocke, a family nurse practitioner, takes notes during Regina Tate's… (Gary Friedman, Los Angeles…)
Life is shorter for African Americans in the High Desert.
Antelope Valley residents of all races face higher mortality rates than in the rest of Los Angeles County, but the rates for black residents are even more pronounced. African Americans in the region die four years sooner than black residents elsewhere in the county and 10 years earlier than county residents in general, according to the most recent health statistics.
As the number of African Americans living in cities like Palmdale and Lancaster continues to grow, county officials acknowledge that they have yet to investigate the causes and consequences of lowered life expectancy.
But healthcare providers and African American patients suggest that limited access to medical care may play a role. Patients who cannot visit general practitioners or specialists are likely to forgo treatment or wait until illnesses become so severe that they must go to the emergency room. Health statistics show that black residents in the Antelope Valley who have coronary heart disease, diabetes or renal failure will probably die sooner than similar patients elsewhere in the county.
The problem is especially acute for the area's 87,000 uninsured residents, they say.
"It's hard to see doctors, period," said Vicki Harris, 56, who moved to Lancaster in 1988 after she was injured in a drive-by shooting near her L.A. home. She contracted hepatitis C through a blood transfusion, and she has high blood pressure, among other ailments. "No one really wants to take your plan," she said.
At the Antelope Valley Community Clinic in Lancaster, Chief Executive James A. Cook said his facility was expecting some 70,000 patient visits this year, more than triple the 22,000 in 2010. "Neither the county nor other community providers … can keep pace with the huge demand for primary care services for the uninsured," Cook said.
Health advocates say the High Desert is particularly lacking in medical specialists: dermatologists, cardiologists, rheumatologists, ophthalmologists and gastroenterologists. Psychiatric access is "almost nonexistent" and the county-funded Antelope Valley Community Clinic is one of the only facilities to provide dental care for uninsured adults, according to Cook.
L.A. County health officials say they have a strong commitment to providing adequate and quality health services to low-income High Desert residents.
Christina Ghaly, deputy director of strategic planning at the county Department of Health Services, said that all patients on the county's low-income Healthy Way LA program are assigned a primary care provider, and the cost of necessary medical services is not capped. The county funds five private nonprofit clinics in the Antelope Valley that last year had about 140,000 patient visits for primary and specialty care, officials said. A new multi-service ambulatory center is set to open in Lancaster in July 2014, Ghaly said. The county also operates one health center in the High Desert that provides free and low-cost services, such as immunizations and communicable disease testing and treatment.
Although county health authorities have not studied why black residents die earlier in the Antelope Valley, Steven Teutsch, chief science officer at the county's Department of Public Health, pointed to several possible factors. These include social environment, such as level of education and jobs; health behaviors, including diet and obesity; physical milieu, such as walkability of the community; and access to healthcare and the quality of that care.
In 2007, the latest year for which the county has statistics, blacks were living until about age 70 in the High Desert compared to age 74 elsewhere in the county. By comparison, life expectancy in general for county residents was almost 81.
Antelope Valley African Americans who suffer serious illnesses also die sooner than other county residents who suffer from the same illnesses.
According to age-adjusted county Health Department statistics, blacks died from coronary heart disease at a rate of 281 per 100,000 people, compared with 211 elsewhere in the county. And High Desert blacks suffering from diabetes died at a rate of 98 per 100,000 people, compared with the rate of 38 for those elsewhere in the county. (Age-adjusted mortality rates are calculated to account for differing age distributions in various populations.)
An estimated 32% of patients treated at the Antelope Valley Community Clinic in Lancaster are African American, and the majority have a combination of heart disease, diabetes, obesity and high blood pressure, Cook said.