Safety and Injury
Direct care physician to population ratio
Easy and fast access to physician services is required for residents to utilize services needed at the time of injury. Injury care is not always an emergency, but prompt care helps promote a timely recovery. In 2004, there were 2,748 direct care physicians in Bexar County and the ratio of direct care physician to the population per 100,000 is 184. The trend data shows that this rate is constant over the last 12 years for the state and for the Harris and Bexar Counties. The distribution of physicians within Bexar County is skewed to the sectors in the north of the county, 72 percent of physicians in Bexar County practice in the north, one half of these are located near the South Texas Medical Center in the East Northwest area. An additional 16 percent have offices in the central (downtown) area. The remaining 12 percent of physicians practice in the southern part of the county. Health insurance coverage helps provide access to health care services. An estimated 24.6 percent of the Texas population, or 5.4 million persons, were uninsured in 2004. In San Antonio it is estimated that 24.3 percent or 363,033 residents of the county are uninsured.34 The disparity in the distribution of physicians may result in the inability of many residents in the southern areas of the county to have access to urgent care providers in a timely fashion when needed.
Hospitalization rate for unintentional injury
In 2004, in Bexar County there were 5,530 hospitalizations for unintentional injuries. This is 35 hospitalizations per 10,000 population. Rates across the sectors of the county are all lower than the state and Harris County rates. The rates vary from 29 to 30 hospitalizations per 10,000 people in the Northeast sector, West, and South sectors to 36 to 40 in the East, Northwest and North Central sectors.
Age-adjusted mortality for unintentional injury
The number of deaths due to unintentional injury per 100,000 people is has been gradually rising in Bexar County. The increase has occurred across the State. In 1992, the death rate due to injuries was 28 deaths per 100,000 population, this has increased to 44 deaths per 100,000 in 2004. The 2004 age-adjusted injury mortality rates mark for the first time, since prior to 1992, the Bexar County age-adjusted injury death rate exceeding the statewide rate.
In contrast to hospitalization rates, the 2004 age-adjusted morality rates for unintentional injuries within Bexar County do suggest a geographic pattern. Rates are highest in the southern part of the county. The West and East sectors have the highest rates at 56 and 55 per 100,000. The South sector has the third highest injury mortality rate (48 per 100,000) followed by the North Central sector. The Northwest and Northeast sector each have rates of 38 injury deaths per 100,000 residents living in the area.
Both social and environmental factors contribute to injury deaths. It is likely that the conditions that contribute to injury may be different depending on the social conditions in which one lives. People doing manual labor are more often exposed to hazards than those working in offices. Poor quality roadways are likely to result in more automobile crashes. Variations in the quality of the streets and highways occur according to the tax and voter base in different areas of the county.
Years of potential life lost (YPLL) due to unintentional injury
In 2004, there were 379 premature deaths in Bexar County caused by unintentional injuries. This resulted in the loss of 11,444 years of life to those less than 65 years of age who died. On average, people who died from unintentional injury lost 29 years of life. This is 2 to 2.5 times as many years of life lost for chronic conditions such as heart disease, diabetes, and cancer. The YPLL was 831 per 100,000 people in 2004 for Bexar County. In the last 12 years, Bexar County experienced an increase of twenty percent in the YPLL rate. Texas and Harris, on the other hand, have experienced a slow decline in premature mortality due to unintentional injury.
Years of potential life lost rates for the unintentional injury are approximately 65 percent higher the southern sectors when compared to the sectors in the north. East and West sectors have rates that are considerably higher than in the north sectors at 1,113 and 1,215 per 100,000 people respectively. In the north sectors, YPLL rates range form 594 to 753. The higher proportion of years of life lost suggests that people living in the southern sectors are at greater risk of injury than people living in the north.
34) Texas Hospital Association, FAST FACTS: The Uninsured in Texas, 2006 www.thaonline.org/Issues1/Uninsured/UninsuredFastFacts.pdf, accessed May 15 2006.