MSFW Analysis - WA National Center for Farmworker Health

MSFW Analysis - WA

National Center

for Farmworker Health

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MSFW Analysis - WA

Purpose

The purpose of this presentation is

to conduct spatial data analysis of

MSFW enumeration data to enable

health planners to target limited

resources to areas of greatest

MSFW need.

MSFW Analysis - WA

Presentation Outline

Introduction

State Overview

Service Delivery Gaps

Other Data

MSFW Analysis - WA

Introduction

Acronyms MSFW Enumeration Profiles Studies Rationale for State Selections Data Sources MSFW Population Categories Rationale for MSFW Population

Categories

MSFW Analysis - WA

Acronyms

MSFW Analysis - WA

BPHC – Bureau of Primary Health Care

CHC – Community Health Center (Section 330 grantee)

HRSA – Health Resources and Services Administration

MHC – Migrant Health Center (Section 330 grantee)

MSFW – Migrant and Seasonal Farmworker

NCFH – National Center for Farmworker Health

NP – Nurse Practitioner

PA – Physician Assistant

UDS – Uniform Data System

MSFW Enumeration Profiles Studies

In 1998, the Bureau of Primary Health Care (BPHC) and the Environmental Protection Agency jointly funded a study to estimate MSFW populations at the county level, and awarded a grant to the National Center for Farmworker Health (NCFH).

NCFH subsequently contracted with Alice C. Larson, Ph.D., to research and develop state estimates for the MSFW population in ten states: Arkansas, California, Florida, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, and Texas.

MSFW Analysis - WA

Rationale for State Selections

Five states were chosen because they are home to the largest MSFW populations (California, Florida, North Carolina, Texas, and Washington).

The other five states (Arkansas, Louisiana, Maryland, Mississippi, and Oklahoma) were selected because they were states for which minimal data was available, and they appeared to provide a broad sample of MSFW employment environments.

MSFW Analysis - WA

Data Sources

• MSFW numbers are taken from the MSFW Enumeration Profiles Study - Washington, September 2000.

• MHC and CHC grantee site locations were taken from the BPHC web site (http://ask.hrsa.gov/pc/) in March 2003, and updated by the Washington Association of Community and Migrant Health Center Systems in March 2003.

• User data was provided by the Health Resources and Services Administration (HRSA) and BPHC.

MSFW Analysis - WA

MSFW Population Categories

In this analysis, there are four county MSFW population categories:

• 0 to 499

• 500 to 999

• 1,000 to 1,999

• 2,000 and over

MSFW Analysis - WA

Rationale for MSFW Population Categories

The four MSFW population categories were selected based on assumptions about deriving a potential clinic user population number from a target population estimate.

Potential clinics include existing CHC service sites or a new access point. A new access point is a new delivery site for the provision of comprehensive primary and preventive health care services. The two types of new access points are (1) new starts and (2) satellites.

We assume that a target population will produce a 75% clinic user rate and that a clinic site requires 750 to 1,500 users (based on an average ratio of 750 users per PA/NP and 1,500 per physician).

MSFW Analysis - WA

MSFW Population Category 0 - 499

Counties that have an MSFW population from

0 to 499 are assumed to have an MSFW target

population sufficient only to support a user

population that would account for less than

25% of the users of an existing CHC service

site or a new access point.

MSFW Analysis - WA

MSFW Population Category 500 - 999


500 to 999 are assumed to have an MSFW

target population sufficient to support a user

population that would account for 25% to



MSFW Analysis - WA

MSFW Population Category 1,000 – 1,999


1,000 to 1,999 are assumed to have an MSFW

target population sufficient to support a user

population that would account for 50% to



MSFW Analysis - WA

MSFW Population Category Over 2,000

Counties that have an MSFW population

over 2,000 are assumed to have an MSFW

target population sufficient to support a

user population that would justify a new

access point.

MSFW Analysis - WA


Introduction

State Overview


Other Data

MSFW Analysis - WA

State Overview

State Data

State Map with Counties

Perspective: Washington vs. Maryland

MSFW Population

MSFW Population – Data Map

MSFW Population – Spatial Map

MSFW Analysis - WA

Washington Data

AREA - 67,290 square miles

POPULATION (2000) – 5,987,973

TOTAL MSFW POPULATION – 289,235

COUNTIES – 39 counties (ranging in size from 55 to 5,360 square miles)

CHC/MHC SITES – 7 Grantees and 57 sites

CHC ONLY SITES – 66 Grantees and 22 sites

MSFW Analysis - WA

Washington Counties

Whatcom

Okanogan

Skagit

Asotin

Pend Orielle

Klickitat

Snohomish

King

Clallam

JeffersonFerry

Stevens

San Juan

Island

Douglas

Chelan

Kittitas

ThurstonLincoln

Grant

Walla Walla

Adams

Pierce

Wahkiakum

Cowlitz

Garfield

Columbia

FranklinWhitman

Spokane

Yakima

Benton

Lewis

Skamania

Kitsap

Clark

Mason

Grays Harbor

Pacific

MSFW Analysis - WA

Area Perspective: Washington vs. Maryland

MSFW Analysis - WA

MSFW Population

The migrant and seasonal farmworker population is estimated at 289,235. This number includes workers and their dependents.

The largest concentration of farmworkers and their families is located in the south central part of the state.

The next slide will present this data as an overlay on the county.

Data source: MSFW Enumeration Profiles Study – WA, Larson, 9/2000

MSFW Analysis - WA

MSFW Total Population - 289,235

4,904

15,190

97

257

2,210384

3

44,769

13,323

26,382

1,709

81,175

3,215

747 0188

21

344

492

200

0

6,458

1,545

1,081

2,523

2,043

1,035

28

47

364

0

9,45434,554

24,503

4,582

85765

698

938


MSFW Analysis - WA

MSFW Population

The next slide will depict the state’s counties organized into four categories, based on the county’s MSFW population.

In addition to the three categories already described, there is a category for counties with an MSFW population below 500.

MSFW Analysis - WA

MSFW Total Population - 289,235


MSFW Analysis - WA


Introduction

State Overview


Other Data

MSFW Analysis - WA


Analysis ProcessMHC GranteesCHC GranteesGrantee Delivery Area vs MSFW PopulationCounty Analysis by MSFW Population Category

MSFW Analysis - WA

Analysis Process

Service potential will be evaluated in the following order:

• MHC grantee in county

• CHC grantee in county

• MHC grantee in adjoining county

• CHC grantee in adjoining county

MSFW Analysis - WA

MHC Grantees

There are seven Migrant Health

Center grantees in the state. These

grantees provide services at 57 sites in

16 counties in Washington and 3 sites

in Oregon.

Data source: BPHC web site, 3/2003

MSFW Analysis - WA

MHC Grantee Sites and Service Counties


MSFW Analysis - WA

MHC Delivery Sites Coverage


MSFW Analysis - WA

Analysis of Counties with >2,000 MSFW Population

There are three counties that have

MSFW populations in excess of

2,000 that do not have an MHC

grantee delivery site in the county.

MSFW Analysis - WA

MSFW Population > 2,000

4,904

6,458

15,190

26,382

13,323

44,7692,043

2,210

3,2159,454

34,554

81,175

2,523

4,582

24,503


MSFW Analysis - WA

MHC Grantee Delivery Sites


MSFW Analysis - WA

County Service Area with no MHC

Douglas

Lewis

Klickitat


MSFW Analysis - WA

Douglas County

MSFW Population 13,3231

Douglas County adjoins three counties that have MHC grantees2, and three grantee sites are close enough to provide services to a portion of the MSFW population of the county.

Douglas

1 MSFW Enumeration Profiles Study – WA, Larson, 9/2000 2 BPHC Web Site, 3/2003

MSFW Analysis - WA

Lewis County


Lewis County adjoins two counties that have MHC grantees2, but the nearest healthcare delivery site is almost 20 miles from the county line, not close enough to provide services to most of the MSFW population of the county.

Lewis


MSFW Analysis - WA

Klickitat County


Klickitat County adjoins three counties (one in Oregon) that have MHC grantees2, but only one site provides umbrella coverage in the county. There are limited services available to the MSFW population of the county.

Klickitat


MSFW Analysis - WA

Analysis of Counties with 1,000-1,999 MSFW Population

Of the four counties that have

MSFW populations ranging from

1,000 to 1,999, only one does not

have an MHC grantee delivery site

in the county.

MSFW Analysis - WA

MSFW Population 1,000 – 1,999

1,545

1,081

1,709

1,035


MSFW Analysis - WA


Kittitas


MSFW Analysis - WA

Kittitas County


Kittitas County is almost completely surrounded by counties that have MHC grantees, and some healthcare delivery sites are close enough to provide services to a portion of the MSFW population of the county.

Kittitas


MSFW Analysis - WA

Analysis of Counties500-999 MSFW Population

Of the four counties that have MSFW populations ranging from 500 to 999, one has an MHC grantee delivery site in the county, and the other three adjoin counties with MHC delivery sites. However, these delivery sites are too distant to provide adequate services to the MSFW population.

MSFW Analysis - WA

MSFW Population500 – 1,000

747

765

698

938


MSFW Analysis - WA


Grays Harbor

Whitman

Columbia


MSFW Analysis - WA

MHC Coverage

Grays Harbor

Whitman

Columbia


MSFW Analysis - WA

Potential MSFW Providers

***

***

*

** *

*

A CHC is a potential service provider to the MSFW population

of one county that has no MHC grantee

MSFW Analysis - WA

CHC Grantees

There are nineteen Community Health Center grantees in the state. All seven of the MHC grantees are also CHC grantees.

The twelve additional CHC grantees provide health services at 66 sites in 22 counties.


MSFW Analysis - WA

CHC Grantee Delivery Areas


MSFW Analysis - WA

CHC Grantee Delivery Areas


MSFW Analysis - WA

CHC Serviced County

Of the seven counties discussed that do not

have an MHC grantee delivery site in the

county, one of them has a CHC grantee in

the county.

MSFW Analysis - WA

Grays Harbor County

Grays Harbor


MSFW Analysis - WA

Isolated Counties

There are six counties that do not have an

MHC grantee delivery site in the county.

Although these counties adjoin counties with

MHC or CHC delivery sites, in most cases

these delivery sites are too distant to provide

adequate services to the MSFW population.

MSFW Analysis - WA

Isolated Counties

Columbia

Whitman

Kittitas

Klickitat

Lewis

Douglas

MSFW Analysis - WA

Isolated CountiesMHC/CHC Coverage

Columbia

Whitman

Kittitas

Klickitat

Lewis

Douglas

MSFW Analysis - WA


Introduction

State Overview


Other Data

MSFW Analysis - WA

Other Data

MHC Grantee Service Penetration

CHC Grantee Service to MSFW Population

MHC/CHC Service Penetration – Spatial Analysis

Percent Minority Population

Uninsured Population Below 100% Poverty

Percent Uninsured Population Below 100% Poverty

Percent Total Uninsured and Below 100% Poverty

MSFW Analysis - WA

MHC Grantee Service Penetration

The seven MHC grantees provided services to 88,723 users1 during 2001, which represents over 30% of the estimated statewide MSFW population.

The estimated MSFW population in the counties where the grantees provided health services is 260,0492. The reported users represent over 34% penetration of this population.

1 UDS Reports - 2001, BPHC

2 MSFW Enumeration Profiles Study – WA, Larson, 9/2000

MSFW Analysis - WA

CHC Grantee Service to MSFW Population

In addition to the services provided to the MSFW population by the MHC grantees, CHC grantees provided services to 1,255 farmworkers and their families1.

The resulting statewide service penetration rate for the MSFW population2 is 31.43%.

1 UDS Reports - 2001, BPHC

2 MSFW Enumeration Profiles Study – WA, Larson, 9/2000

MSFW Analysis - WA

MHC/CHC Service Penetration

*

*

*

*

*

**

*

* *

**

**

* MULTIPLE COUNTY AVERAGE

Statewide Penetration Rate 31.43%

UDS Reports - 2001, BPHC

MSFW Enumeration Profiles Study – WA, Larson, 9/2000

MSFW Analysis - WA

% Minority Population

Data source: US Census 2000

MSFW Analysis - WA

Uninsured Population < 100% Poverty

Data source: REACH 2000, NACHC

MSFW Analysis - WA

% Uninsured Population< 100% Poverty


MSFW Analysis - WA

% Total Uninsured and % <100% Poverty


MSFW Analysis - WA

MSFW Analysis - WA

National Center

for Farmworker Health

Washington Counties

Whatcom

Okanogan

Skagit

Asotin

Pend Orielle

Klickitat

Snohomish

King

Clallam

JeffersonFerry

Stevens

San Juan

Island

Douglas

Chelan

Kittitas

ThurstonLincoln

Grant

Walla Walla

Adams

Pierce

Wahkiakum

Cowlitz

Garfield

Columbia

FranklinWhitman

Spokane

Yakima

Benton

Lewis

Skamania

Kitsap

Clark

Mason

Grays Harbor

Pacific

MSFW Analysis - WA

NAME MHC Penetration

Adams 15.07%AsotinBenton 31.90%Chelan 20.86%ClallamClarkColumbiaCowlitzDouglasFerryFranklin 31.90%GarfieldGrant 7.28%Grays HarborIslandJeffersonKingKitsapKittitasKlickitatLewisLincolnMasonOkanogan 35.33%PacificPend OreillePierce 49.79%San JuanSkagit 49.79%SkamaniaSnohomish 49.79%Spokane 31.86%StevensThurston 49.79%WahkiakumWalla Walla 31.86%Whatcom 49.79%WhitmanYakima 31.86%

STATE 31.43%

MSFW Analysis - WA

NAME MSFW Total Population

Migrant Farmworker

Seasonal Farmworker

Adjusted Farmworker

Total

Migrant Farmworker

Family Members

Seasonal Farmworker

Family Members

Adams 4,582 1,031 1,931 2,962 265 1,355Asotin 97 22 41 63 6 29Benton 34,554 7,773 14,564 22,338 1,995 10,222Chelan 26,382 5,935 11,120 17,055 1,523 7,804Clallam 257 58 108 166 15 76Clark 2,210 497 931 1,428 128 654Columbia 938 211 396 607 54 278Cowlitz 492 111 208 318 28 146Douglas 13,323 2,997 5,615 8,612 769 3,941Ferry 21 5 9 13 1 6Franklin 24,503 5,512 10,328 15,840 1,415 7,248Garfield 0 0 0 0 0 0Grant 44,769 10,071 18,870 28,941 2,585 13,243Grays Harbor 747 168 315 483 43 221Island 47 11 20 31 3 14Jefferson 3 1 1 2 0 1King 1,081 243 456 699 62 320Kitsap 364 82 153 235 21 108Kittitas 1,709 384 720 1,105 99 506Klickitat 3,215 723 1,355 2,079 186 951Lewis 2,043 460 861 1,320 118 604Lincoln 85 19 36 55 5 25Mason 344 77 145 222 20 102Okanogan 15,190 3,417 6,403 9,820 877 4,494Pacific 200 45 84 129 12 59Pend Oreille 0 0 0 0 0 0Pierce 2,523 568 1,063 1,631 146 746San Juan 28 6 12 18 2 8Skagit 6,458 1,453 2,722 4,175 373 1,910Skamania 384 86 162 248 22 113Snohomish 1,545 348 651 999 89 457Spokane 765 172 323 495 44 226Stevens 188 42 79 122 11 56Thurston 1,035 233 436 669 60 306Wahkiakum 0 0 0 0 0 0Walla Walla 9,454 2,127 3,985 6,111 546 2,797Whatcom 4,904 1,103 2,067 3,170 283 1,451Whitman 698 157 294 451 40 206Yakima 81,175 18,262 34,214 52,476 4,687 24,013


MSFW Analysis - WA


County Uninsured Total % Uninsured Uninsured Total Uninsured Total Uninsured Total % Uninsured <100% Poverty

Adams 1,350 2,832 47.67% 1,232 4,530 1,023 7,766 3,605 15,128 23.83% 18.72%

Asotin 727 2,751 26.43% 774 4,794 1,005 14,003 2,506 21,548 11.63% 12.77%

Benton 4,686 13,146 35.65% 4,675 21,898 9,497 104,660 18,858 139,704 13.50% 9.41%

Chelan 2,460 6,878 35.77% 2,690 13,331 3,591 41,244 8,741 61,453 14.22% 11.19%

Clallam 2,116 7,891 26.82% 2,525 14,957 3,079 42,006 7,720 64,854 11.90% 12.17%

Clark 8,338 28,205 29.56% 9,889 51,415 19,734 243,364 37,960 322,984 11.75% 8.73%

Columbia 237 644 36.80% 214 1,067 227 2,647 679 4,358 15.58% 14.78%

Cow litz 3,048 10,943 27.85% 3,283 18,741 4,709 61,934 11,040 91,618 12.05% 11.94%

Douglas 1,583 4,300 36.81% 1,739 8,260 1,948 21,627 5,269 34,187 15.41% 12.58%

Ferry 391 1,382 28.29% 382 1,826 364 4,170 1,137 7,378 15.41% 18.73%

Franklin 5,381 11,586 46.44% 3,270 11,682 3,170 23,927 11,820 47,195 25.05% 24.55%

Garfield 75 320 23.44% 83 607 88 1,385 246 2,312 10.64% 13.84%

Grant 4,426 10,789 41.02% 4,289 18,298 4,292 41,784 13,007 70,871 18.35% 15.22%

Grays Harbor 2,954 10,902 27.10% 3,065 17,725 3,002 39,988 9,021 68,615 13.15% 15.89%

Island 1,782 5,907 30.17% 2,869 14,275 4,237 50,839 8,887 71,021 12.51% 8.32%

Jefferson 764 2,968 25.74% 947 5,970 1,234 17,696 2,945 26,634 11.06% 11.14%

King 29,763 92,960 32.02% 42,694 175,790 129,743 1,372,250 202,199 1,641,000 12.32% 5.66%

Kitsap 7,327 23,815 30.77% 9,174 43,215 15,049 173,592 31,550 240,622 13.11% 9.90%

Kittitas 1,553 5,158 30.11% 1,465 7,498 1,555 19,267 4,573 31,923 14.33% 16.16%

Klickitat 954 3,051 31.27% 942 4,983 887 10,942 2,784 18,976 14.67% 16.08%

Lew is 2,614 9,596 27.24% 2,683 16,274 3,115 42,718 8,412 68,588 12.26% 13.99%

Lincoln 287 1,165 24.64% 320 2,192 427 6,390 1,034 9,747 10.61% 11.95%

Mason 1,862 6,676 27.89% 2,096 11,753 2,482 32,561 6,441 50,990 12.63% 13.09%

Okanogan 2,378 7,060 33.68% 2,244 10,700 1,915 21,573 6,538 39,333 16.62% 17.95%

Pacif ic 1,003 3,785 26.50% 970 5,976 845 11,827 2,818 21,588 13.05% 17.53%

Pend Oreille 532 2,030 26.21% 528 3,286 463 6,450 1,522 11,766 12.94% 17.25%

Pierce 21,172 67,475 31.38% 27,486 116,432 44,498 486,679 93,156 670,586 13.89% 10.06%

San Juan 210 818 25.67% 331 2,204 639 9,496 1,180 12,518 9.43% 6.53%

Skagit 3,163 9,784 32.33% 3,734 19,606 5,687 69,676 12,584 99,066 12.70% 9.88%

Skamania 326 1,146 28.45% 371 2,077 499 6,446 1,196 9,669 12.37% 11.85%

Snohomish 11,229 37,324 30.09% 15,649 77,273 37,809 448,446 64,687 563,043 11.49% 6.63%

Spokane 14,063 49,581 28.36% 15,010 80,410 22,235 282,680 51,308 412,671 12.43% 12.01%

Stevens 1,916 7,135 26.85% 1,793 10,276 1,764 23,192 5,473 40,603 13.48% 17.57%

Thurston 5,578 18,310 30.46% 7,119 34,993 12,761 151,677 25,458 204,980 12.42% 8.93%

Wahkiakum 163 620 26.29% 156 1,006 157 2,262 476 3,888 12.24% 15.95%

Walla Walla 2,450 6,686 36.64% 2,531 11,640 3,301 35,989 8,281 54,315 15.25% 12.31%

Whatcom 5,268 17,356 30.35% 5,802 29,380 9,199 111,264 20,270 158,000 12.83% 10.98%

Whitman 1,783 5,644 31.59% 1,821 7,734 2,409 26,211 6,013 39,589 15.19% 14.26%

Yakima 20,398 45,903 44.44% 13,353 51,742 14,642 124,774 48,393 222,419 21.76% 20.64%

Below 100% Poverty Total100-200% Poverty Above 200% Poverty Total Population

MSFW Analysis - WA

Data source: 2000 Census

County Total Minority Hispanic Wh, NonHisp % Min % Hisp

Adams 16,428 8,062 7,732 8,366 49.07% 47.07%

Asotin 20,551 1,125 401 19,426 5.47% 1.95%

Benton 142,475 26,018 17,806 116,457 18.26% 12.50%

Chelan 66,616 15,026 12,831 51,590 22.56% 19.26%

Clallam 64,525 8,112 2,203 56,413 12.57% 3.41%

Clark 345,238 46,104 16,248 299,134 13.35% 4.71%

Columbia 4,064 379 258 3,685 9.33% 6.35%

Cowlitz 92,948 9,377 4,231 83,571 10.09% 4.55%

Douglas 32,603 7,424 6,433 25,179 22.77% 19.73%

Ferry 7,260 1,821 205 5,439 25.08% 2.82%

Franklin 49,347 25,877 23,032 23,470 52.44% 46.67%

Garfield 2,397 93 47 2,304 3.88% 1.96%

Grant 74,698 25,815 22,476 48,883 34.56% 30.09%

Grays 67,194 9,082 3,258 58,112 13.52% 4.85%

Island 71,558 10,629 2,843 60,929 14.85% 3.97%

Jefferson 25,953 2,325 535 23,628 8.96% 2.06%

King 1,737,034 461,907 95,242 1,275,127 26.59% 5.48%

Kitsap 231,969 41,218 9,609 190,751 17.77% 4.14%

Kittitas 33,362 3,537 1,668 29,825 10.60% 5.00%

Klickitat 19,161 2,832 1,496 16,329 14.78% 7.81%

Lewis 68,600 6,426 3,684 62,174 9.37% 5.37%

Lincoln 10,184 552 191 9,632 5.42% 1.88%

Mason 49,405 6,769 2,361 42,636 13.70% 4.78%

Okanogan 39,564 11,202 5,688 28,362 28.31% 14.38%

Pacific 20,984 2,522 1,052 18,462 12.02% 5.01%

Pend 11,732 911 241 10,821 7.77% 2.05%

Pierce 700,820 167,886 38,621 532,934 23.96% 5.51%

San 14,077 890 338 13,187 6.32% 2.40%

Skagit 102,979 17,483 11,536 85,496 16.98% 11.20%

Skamania 9,872 950 398 8,922 9.62% 4.03%

Snohomish 606,024 100,826 28,590 505,198 16.64% 4.72%

Spokane 417,939 42,512 11,561 375,427 10.17% 2.77%

Stevens 40,066 4,348 739 35,718 10.85% 1.84%

Thurston 207,355 34,392 9,392 172,963 16.59% 4.53%

Wahkiakum 3,824 278 98 3,546 7.27% 2.56%

Walla 55,180 11,678 8,654 43,502 21.16% 15.68%

Whatcom 166,814 22,972 8,687 143,842 13.77% 5.21%

Whitman 40,740 5,423 1,219 35,317 13.31% 2.99%

Yakima 222,581 96,848 79,905 125,733 43.51% 35.90%

MSFW Analysis - WA

Documents

MSFW Analysis - WA National Center for Farmworker Health