Dataset Information

Assessing emergency healthcare accessibility in the Salton Sea region of Imperial County, California.

ABSTRACT: The area surrounding California's Salton Sea, which lies within Riverside and Imperial counties, has particularly negative health outcomes. Imperial County, a primarily rural region that encompasses the lake, has pediatric asthma-related emergency healthcare visits that double the state average. This paper seeks to assess the level of emergency healthcare access in the Salton Sea region of Imperial County, drawing from spatial science methods. For this study, the "Salton Sea region" is defined as all Imperial County census tracts that include the Salton Sea within its boundaries. To measure "access," this study calculated driving travel times from census tracts to hospitals within Imperial County rather than Euclidean distance to account for geography and urban infrastructures such as road networks and traffic conditions. This study also used the Rational Agent Access Model, or RAAM, to assess access. RAAM scores account for the supply and demand for hospitals in addition to travel times. Results showed that the average travel time for Salton Sea region residents to drive to Imperial County emergency healthcare facilities ranged from 50-61 minutes, compared to 14-20 minutes for other Imperial County tracts. RAAM scores, compared to other Imperial County tracts, were about 30% higher in the Salton Sea region, meaning that healthcare supply is limited in the region. State and county policy should account for spatial inaccessibility to healthcare institutions in order to address emergency healthcare access.

SUBMITTER: Juturu P

PROVIDER: S-EPMC8244845 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe Salton Sea (SS) is the largest inland body of water in California: surface area 980 km2, volume 7.3 million acre-feet, 58 km long, 14-22 km wide, maximum depth 15 m. Located in the southeastern Sonoran desert of California, it is 85 m below sea level at its lowest point. It was formed between 1905 and 1907 from heavy river flows of the Colorado River. Since its formation, it has attracted both people and wildlife, including flocks of migratory birds that have made the Salton Sea a critical stopover on the Pacific flyway. Over the past 15 years wintering populations of eared grebe (Podiceps nigricollis) at the Salton Sea, have experienced over 200,000 mortalities. The cause of these large die-offs remains unknown. The unique environmental conditions of the Salton Sea, including salinities from brackish freshwater at river inlets to hypersaline conditions, extreme daily summer temperatures (>38 degrees C), and high nutrient loading from rivers and agricultural drainage favor eutrophic conditions that encourage algal blooms throughout the year. A significant component of these algal blooms are the prokaryotic group - the Cyanophyta or blue-green algae (also called Cyanobacteria). Since many Cyanobacteria produce toxins (the cyanotoxins) it became important to evaluate their presence and to determine if they are a contributing factor in eared-grebe mortalities at the Salton Sea.ResultsFrom November 1999 to April 2001, 247 water and sediment samples were received for phytoplankton identification and cyanotoxin analyses. Immunoassay (ELISA) screening of these samples found that eighty five percent of all water samples contained low but detectable levels of the potent cyclic peptide liver toxin called microcystins. Isolation and identification of cyanobacteria isolates showed that the picoplanktonic Synechococcus and the benthic filamentous Oscillatoria were dominant. Both organisms were found to produce microcystins dominated by microcystin-LR and YR. A laboratory strain of Synechococcus was identified by PCR as being closest to known marine forms of this genus. Analyses of affected grebe livers found microcystins at levels that may account for some of the acute mortalities.ConclusionThe production of microcystins by a marine Synechococcus indicates that microcystins may be a more common occurrence in marine environments - a finding not recognized before this work. Further research should be done to define the distribution of microcystin producing marine cyanobacteria and to determine exposure/response effects of microcystins and possibly other cyanotoxins in the Salton Sea. Future efforts to reduce avian mortalities and remediate the Salton Sea should evaluate vectors by which microcystins enter avian species and ways to control and mitigate toxic cyanobacteria waterblooms at the Salton Sea.

Project description:Accessibility to trauma centers is vital for the patients of severe motor vehicle crashes. Many vehicle crash fatalities failed to reach the proper emergency medical services since the accident location was far away from trauma centers. The spatial discordance between the service coverage area of trauma centers and actual locations of motor vehicle accidents delays the definitive medical care and results in death or disability. Many fatalities would have been prevented if the patients had a chance to get proper treatment in time at Southeastern region of the U.S. Also, the accessibility to trauma centers from the actual locations of motor vehicle accidents is different in the Southeastern region. This research aimed to facilitate the accessibility to trauma centers for severe motor vehicle crash patients in the Southeastern region. The analyses are conducted to assess current trauma center accessibility and suggest the optimal locations of future trauma centers using the Anti-covering location model for trauma centers (TraCt model). This study found that existing trauma centers failed to serve many demands, and the actual coverages of the current locations of trauma centers over potential demands are highly different in each Southeastern state. TraCt model is applied to each Southeastern state, and its solutions provide better coverage for demand locations. However, the TraCt model for each state tends to choose too many facilities, with excessively supplied facilities across the Southeastern region. The excessive service supply issue is addressed by applying the TraCt Model to a broader spatial extent. TraCt model applied to the entire Southeastern region and most of the demand, over 98% covered by the service coverage of optimal facility locations with 15 additional facilities. This research proves that the GIS and TraCt model applied to the broader spatial extent works well with increasing trauma medical service beneficiaries while providing a minimum number of additional facilities.

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Assessing emergency healthcare accessibility in the Salton Sea region of Imperial County, California.

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