UC Merced Magazine | Volume XIX, Issue VII

They have given their lives and bodies to ensure the rest of us have food on our tables. — Professor Nancy Burke

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Beyond direct health care services, she said creating environments that promote healthy living can make a substantial difference. “We want to keep people healthy before they even need a doctor,” Sullivan said. “That means making it easier for people to exercise, access healthy food and feel safe in their communities.” Addressing the Physician Shortage Despite being California’s fastest-growing region, the San Joaquin Valley has the lowest physician-to-resident ratio in the state — 39 doctors per 100,000 people, 22% below the state average, according to the California Health Care Foundation. To help address the shortage, the San Joaquin Valley PRIME+ program, a partnership between UC Merced, UCSF and UC San Francisco’s Fresno campus, offers students a path to medical school. Last fall, the university welcomed the second cohort of students in the B.S.-to-M.D. pathway. “Many of our program applicants talk about having to serve as interpreters for their families in health care settings,” Burke said. “They’ve seen the problems with access to care first hand.” UC Health offers a Health Scholars program that provides specialized resources and peer support for students interested in health careers. Health Scholars get access to hands-on learning, focused pre-health courses and career advising. The university offers degrees in public health and human biology and many other majors that can lead to medical school or training for other health care-related careers. The goal is to create a workforce that understands and is invested in the region’s unique circumstances. Many aspiring health care professionals in the region have first-hand experience with the barriers their communities face. “The challenges are big, but so are the opportunities,” Sullivan said. “We have a chance to rethink how we deliver health care in rural California and build a system that truly serves everyone.”

Lessons from the Pandemic During the pandemic, federal, state and local governments rushed to send resources to remote and underserved populations. “For those of us who have been studying these health inequities, there were no surprises,” Burke said. “Finally, people started paying attention.” Mobile health clinics and telehealth services, once rare, have become crucial tools. Though emergency funding has since dried up, Sullivan said it is important to continue building on those alternative methods of care to address rural health care disparities. “The idea of a brick-and-mortar office with a mid-level professional who can help with blood pressure, temperature and lung assessments while a telehealth provider interprets the data is a creative way to extend care,” Sullivan said. “We can leverage lower-level practitioners in ways that expand access.” Shifting Focus to Preventive Care Health experts agree that preventive care is the best way to improve health outcomes. Sullivan pointed out that the debate around universal health care often overlooks a key fact: Emergency rooms already provide universal access — but in the least efficient way. “Anyone can walk into any ER and receive care, regardless of their ability to pay,” Sullivan said. “But the emergency department is the most expensive way to deliver health care.” She advocates redirecting public resources toward preventive care, which would improve quality of life while reducing health care costs in the long run. She said many people facing financial hardship make strategic decisions about their health care, often delaying visits to a primary care provider because of work obligations. “If I take a day off to see my doctor, I lose a whole day’s wages and might not make rent,” Sullivan said. “But if I go to the ER after hours, I may wait six hours, but I’ll still get seen.”

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