Health Care Access

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RATE OF UNINSURED REMAINS CONSTANT 

Individuals who have health insurance and a usual source of care are more likely to seek routine health care and take advantage of preventative health screening services than those without such coverage.[1] The result is a healthier population and more cost-effective health care. Delaying or not receiving needed medical care may result in more serious illness, increased complications, and longer hospital stays.[2] This indicator measures the percentage of residents without health insurance coverage, the number of residents per primary care physician, whether residents have a usual source of care or delayed care, and Medi-Cal enrollment.  

TREND

Long-term, the rate of uninsured has declined as the rate of Medi-Cal enrollment has increased. In 2023, 8.1% of San Bernardino County residents were uninsured, the same proportion as in 2022. The long-term trend, however, is toward fewer uninsured, with a drop of almost 6 percentage points from 2014, when 13.8% of residents were uninsured. 

PROPORTION UNINSURED REMAINS STEADY
Uninsured in San Bernardino County, 2014-2023

Note: 2020 ACS 1-year data not available.

Source: U.S. Census Bureau, American Community Survey, 1-Year Estimates, Table S2702

Medi-Cal enrollment fell 2% between 2023 and 2024, from 873,933 people enrolled to 856,910. During the 10-year period between 2015 and 2024, Medi-Cal enrollment increased 19%. This growth likely contributes to the falling rate of uninsured in the county.  

MEDI-CAL ENROLLMENT GROWS ALMOST 20% OVER 10-YEAR PERIOD
Enrollment in Medi-Cal in San Bernardino County, 2015-2024

Source: San Bernardino County Human Services

RACE/ETHNICITY DETAIL

Residents who identify as “some other race” comprised 45% of the uninsured population in San Bernardino County, followed by 21% who identified as two or more races. In terms of ethnicity, 73% of the uninsured population is Latino, though Latinos make up 56% of the total population. In the accompanying charts, the distribution of San Bernardino County population by race and ethnicity is provided for context.  

RESIDENTS IDENTIFYING AS "OTHER" COMPRISE PLURALITY OF UNINSURED
Distribution of Uninsured and Total Population by Race in San Bernardino County, 2023
LATINOS COMPRISE MAJORITY OF UNINSURED POPULATION
Distribution of Uninsured and Total Population by Ethnicity in San Bernardino County, 2023

Note: The Census asks respondents to report both their race (or races) and their ethnicity (Hispanic or not Hispanic). Because race and ethnicity are collected as separate, overlapping categories, they are presented separately. Race categories include people of any ethnicity, and the Hispanic category includes people of any race. To understand health insurance coverage by race or ethnicity, the charts display the number of individuals from each racial or ethnic group that are uninsured expressed as a percent of all people who are uninsured, compared to each group’s percentage of the overall population. For example, if 100 people are uninsured, and 73 of those people identify as Latino, then 73% of the people who are uninsured are Latino. This can be compared to the proportion of the population that identifies as Latino. For example, if 73% of people who are uninsured are Latino and 56% of the overall population is Latino, then it suggests Latino individuals are overrepresented among people without health insurance coverage. 

Source: U.S. Census Bureau, American Community Survey, 1-Year Estimates, Table S2702 

SOCIOECONOMIC DETAIL

When broken out by household annual income, those with incomes in the lowest range (less than $25,000) were the most likely to be uninsured (11.4%). Regarding education level, 16.1% of those with less than a high school diploma were uninsured, compared with 3.9% of those with a college degree. At 12.2%, young adults (ages 19- 25 years old) were the age group most likely to be uninsured, while only 3.0% of children under age six were uninsured.   

RESIDENTS WITHOUT A HIGH SCHOOL DIPLOMA ARE MOST LIKELY TO BE UNINSURED
Uninsured by Income, Education, and Age in San Bernardino County, 2023

Source: U.S. Census Bureau, American Community Survey, 1-Year Estimates, Table S2702

GEOGRAPHIC COMPARISON

The San Bernardino County rate of uninsured (8.1%) is slightly higher than the United States rate (7.9%) and substantially higher than the California rate (6.4%). It is in the mid-range among all peer counties compared.  

SAN BERNARDINO’S RATE OF UNINSURED IS IN THE MIDDLE AMONG COUNTIES COMPARED
County Comparison of Uninsured, 2023

Source: U.S. Census Bureau, American Community Survey, 1-Year Estimates, Table S2702

In terms of access to health care, according to the 2023 California Health Interview Survey (CHIS), 75.6% of people under age 65 had a usual place to go to when they were sick or needed health advice, a lower proportion than California and all neighboring counties except Los Angeles. In addition, 16.6% of San Bernardino County residents under age 65 delayed or did not get the medical care that they needed. 

SAN BERNARDINO COUNTY HAS LOWER RATE OF HAVING USUAL PLACE TO GO FOR HEALTH CARE
County Comparison of Health Care Access (Under Age 65), 2023

Source: California Health Interview Survey

There are 1,679 people for each primary care physician (PCP) in San Bernardino County, which is a less favorable ratio than the state and all neighboring counties compared, except Clark County and Riverside County. The national target ratio (consisting of “top performers” falling in the 90th percentile of all counties) is 1,030 for each primary care physician.[3] 

COUNTY HAS LESS FAVORABLE RATIO OF RESIDENTS TO PRIMARY CARE PHYSICIANS
County Comparison of the Number of Residents per Primary Care Physician, 2023

Source: County Health Rankings and Roadmaps (www.countyhealthrankings.org)

Hospitals and Medical Facilities

There are 26 hospitals and eight county-run mental health clinics serving residents and visitors in San Bernardino County, including two trauma centers: Loma Linda University Medical Center and Arrowhead Regional Medical Center (ARMC). ARMC is a county-owned facility that provides comprehensive services for cardiac care, neurosciences and neuro critical care, behavioral health and adolescent behavioral health care, cancer care, orthopedics, and mobile and level 1 trauma services. ARMC operates three community Family Health Centers (FHCs) for primary care, an on-site primary care clinic, and the only burn center serving San Bernardino, Riverside, Inyo and Mono counties. ARMC also has a state-of-the-art electronic health record system to better serve San Bernardino County residents. In addition, the San Bernardino County Department of Public Health operates four Federally Qualified Health Centers providing primary, pediatric, dental, immunization and reproductive care services.

Source: San Bernardino County Human Services


[1] U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Healthy People 2030, https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-primary-care (accessed April 6, 2025)

[2] Diamant AL, et al. Delays and Unmet Need for Health Care Among Adult Primary Care, American Journal of Public Health (2004), 94 (5) 783-789

[3] Primary care physicians include practicing physicians under age 75 specializing in general practice medicine, family medicine, internal medicine, and pediatrics.

1Primary care physicians include practicing physicians under age 75 specializing in general practice medicine, family medicine, internal medicine, and pediatrics.