CNA Presents New Data on Sutter's Medical Redlining: St. Luke's Closure to Have Disproportionate Impact On Latinos, Other Medically Underserved Groups

Sutter Health's planned closure of St. Luke's Hospital in San Francisco will have a particularly adverse impact on the city's Latino community, as evidenced by new state data released today by the California Nurses Association/National Nurses Organizing Committee. CNA/NNOC presented the data at a San Francisco press conference opposing Sutter's plans to end all hospital services at St. Luke's by 2009.

Sutter plans to transfer much of the current in-patient hospital care to another facility across town, California Pacific Medical Center. That process gets underway as of November 11 when Sutter will close newborn intensive care and children's facilities at St. Luke's.

"Latinos and other medically underserved populations will suffer an inordinate, disproportionate, and discriminatory impact from this unnecessary closure," said Bonnie Castillo, RN, CNA/NNOC's Sutter division director. "Sutter has made it apparent that it would prefer to have a more high income patient base, and is slamming the doors on a community that desperately needs this hospital. Medical redlining should have no place in San Francisco."

A CNA/NNOC analysis of state data, from the Office of Statewide Health Planning and Development, shows a huge disparity between the demographics of patients served by St. Luke's and CPMC.

40 percent of in-patient hospital discharges at St. Luke's are Hispanic patients - compared to just 1 percent of CPMC discharges.
54 percent of emergency room visits at St. Luke's are Hispanic or African-American patients - compared to just 8 percent of ER visits at CPMC.

The state data also demonstrates a stark divergence in income levels.

42 percent of ER visits at St. Luke's are billed to Medi-Cal - compared to just 6% at CPMC.
40 percent of in-patient hospital expected payments at St. Luke's are Medi-Cal - compared to just 7 percent at CPMC.
51 percent of St. Luke's patient discharges come from just three zip codes adjacent to the hospital - compared to 22 percent of CPMC's hospital patients, an indication that St. Luke's patient base is drawn heavily from surrounding neighborhoods.
From one-fourth to nearly half of St. Luke's patients from five zip codes that account for 63 percent of all the hospital's discharge have incomes under 200 percent of the poverty level. For the five top zip codes for CPMC patients, the comparable income levels range from 8 percent to 28 percent.

"There can be no mistaking this data," says Castillo. "St. Luke's serves a far greater percentage of Latino and African-American patients than CPMC who will be unfairly harmed by the closure."

"The data also demonstrates the impact on low-income neighborhoods, who are already medically underserved, and who typically have a much harder time traveling to medical facilities away from their neighborhoods," said Castillo.

A report in the October 24/31 issue of JAMA, the Journal of the American Medical Association documents the health consequences of declining income levels in the U.S. One of its points is that for lower income Americans, "traveling across town to access better resources or health care facilities is often beyond their means."

"All San Franciscans will be harmed by the closure of St. Luke's and the unwarranted loss of hospital and emergency care services. It stresses the entire medical safety net of the city, which is especially dangerous in the advent of an emergency, from earthquakes to fires to major traffic gridlock," said Castillo.

"But some communities will endure greater harm than others. Sutter's desire to re-apportion its patient base to higher income residents is disgraceful, and should be stopped," she said.

Read the "Medical Redlining" flyer