RATE OF UNINSURED REMAINS RELATIVELY STEADY
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. 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. With the implementation of the Affordable Care Act (ACA), more people are receiving access to health care; however, a regional shortage of doctors, particularly primary care physicians, may restrict timely access to care. This indicator measures the percentage of residents without health insurance coverage, the number of residents per primary care physician, and whether residents have a usual source of care or delayed care and Medi-Cal enrollment.
TREND
In 2021, 8.9% of San Bernardino County residents were uninsured, a slight decrease from 2019 when 9.1% of residents were uninsured. The long-term trend is downward with a drop of almost 12 percentage points from 2012, when 20.6% of residents were uninsured.
PROPORTION UNINSURED IS NEARLY 12 PERCENTAGE POINTS LOWER THAN 10 YEARS AGO
Uninsured in San Bernardino County, 2012-2021
In the 10-year period between 2013 and 2022, Medi-Cal enrollment increased 86%, largely owing to the roll out of the Affordable Care Act, which expanded eligibility. Another factor contributing to the increase is the federal public health emergency (PHE) due to the COVID-19 pandemic, which prevents states from disenrolling people while the federal PHE was in effect unless they specifically request it. Consequently, there was a 7% increase in Medi-Cal enrollment between 2021 and 2022.
MEDI-CAL ENROLLMENT CONTINUES TO GROW
Enrollment in Medi-Cal in San Bernardino County, 2013-2022
RACE/ETHNICITY DETAIL
At 15.6%, Pacific Islander residents are the racial or ethnic group most likely to be uninsured. This is followed by Native American residents (12.6%). Only 4.9% of White residents in San Bernardino County are uninsured. This variation in rates by race/ethnicity contributes to an Equity Gap Score of 3.2, signaling that the group with the lowest proportion uninsured (White) is over three times lower than the group with the highest proportion uninsured (Pacific Islander residents).
PACIFIC ISLANDER RESIDENTS HAVE HIGHEST PROPORTION UNINSURED
Uninsured by Race/Ethnicity in San Bernardino County, 2021
| Race/Ethnicity | Percent Uninsured |
|---|---|
| White | 4.9% |
| Asian | 5.2% |
| Black | 5.4% |
| Average | 8.9% |
| Two+ | 9.1% |
| Latino | 11.8% |
| Native American | 12.6% |
| Pacific Islander | 15.6% |
SOCIOECONOMIC DETAIL
When broken out by household income, those with incomes in the lowest ranges (less than $25,000 and $25,000-$34,000) were the most likely to be uninsured (12.0% and 11.9%, respectively). Regarding education level, 17.6% of those with less than a high school diploma were uninsured, compared with 4.2% of those with a college degree. At 12.6%, adults (ages 26-64 years old) were the age group most likely to be uninsured, while only 3.5% of children under age six were uninsured.
NEARLY 1-IN-5 RESIDENTS WITHOUT A HIGH SCHOOL DIPLOMA ARE UNINSURED
Uninsured by Income, Education and Age in San Bernardino County, 2021
GEOGRAPHIC DETAIL
The San Bernardino County rate of uninsured (8.9%) is higher than the United States (8.6%) and California (7.0%). 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, 2021
In terms of access to health care, according to the 2021 California Health Interview Survey (CHIS), 79.2% of San Bernardino County residents 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. Conversely, 15.2% of San Bernardino County residents under age 65 delayed or did not get the medical care that they needed, which is a rate lower than all neighboring counties compared and California (18.0%).
SAN BERNARDINO COUNTY HAS LOWEST RATE OF DELAYING CARE
County Comparison of Health Care Access (Under Age 65), 2021
There are 1,701 people for each primary care physician in San Bernardino County, which is a less favorable ratio than the state and all neighboring counties compared, except Riverside County. The national target ratio (consisting of “top performers” in the top 10%) is 1,030 for each primary care physician.[1]
COUNTY HAS LESS FAVORABLE RATIO OF RESIDENTS TO PRIMARY CARE PHYSICIANS
County Comparison of the Number of Residents per Primary Care Physician, 2022
Hospitals and Medical Facilities
There are 26 hospitals 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 recently implemented a new 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, reproductive, maternal, and HIV care services.
[1] Primary care physicians include practicing physicians under age 75 specializing in general practice medicine, family medicine, internal medicine, and pediatrics.