Public Health & Risk

California County Primary-Care Access & Health-Burden Scorecard

Name: California County Primary-Care Access & Health-Burden Scorecard
Creator: KYFEX

A county-level targeting index for California, fusing adult chronic-disease and social-risk prevalence (CDC PLACES) with federally designated primary-care provider shortages (HRSA). Ranks all 58 counties by combined need so a health department or rural-health office can see where high burden and thin provider supply overlap.

KYFEX·May 31, 2026

Key findings

1
58 of California's 58 counties (100%) fall within a federally designated primary-care Health Professional Shortage Area.
2
Adult diagnosed-diabetes prevalence ranges from 9.3% in Yolo County to 15.9% in Trinity County, a 6.6-point spread within a single state.
3
Imperial County carries the highest combined targeting-priority index (77.9/100), led by its access & sdoh barriers score.
4
The median county uninsured rate (adults 18-64) is 8.8%, and the median adult diabetes prevalence is 12.0%.

How it is built

A Health-Burden axis is built from CDC PLACES crude adult prevalence (diagnosed diabetes, obesity, high blood pressure, coronary heart disease, fair or poor self-rated health, frequent physical distress). An Access & SDOH barriers axis combines uninsured (adults 18-64), lack of reliable transportation, food insecurity, housing insecurity, below poverty (acs), households without a vehicle (acs) (Census ACS measures join CDC PLACES here). Each measure is min-max normalized across the state's counties to 0-100, then averaged within its axis. A Provider-Shortage axis scales each county's worst designated primary-care HPSA score against the HRSA 0-26 severity scale. The combined Targeting-Priority Index is the equal-weighted mean of the three axes. PLACES values are model-based estimates with confidence intervals (carried per county), not direct counts. Scores are relative WITHIN California: a 100 marks the worst county in the state on that axis, not a national benchmark.

Health-burden axis

Diagnosed diabetesObesityHigh blood pressureCoronary heart diseaseFair or poor self-rated healthFrequent physical distress

Access & SDOH barriers axis

Uninsured (adults 18-64)Lack of reliable transportationFood insecurityHousing insecurityBelow poverty (ACS)Households without a vehicle (ACS)

Top 50 counties by targeting priority

Higher scores mean greater relative need within California. Showing the 50 highest-priority of 58 counties; the full ranking is below as CSV or JSON.

#	County	Priority	Burden	Access	Shortage	Diabetes	Uninsured	Top driver
1	Imperial	77.9	72.0	84.8	76.9	15.0%	22.1%	Access & SDOH barriers
2	Fresno	70.3	56.6	61.9	92.3	12.7%	14.6%	Provider shortage
3	Kern	70.2	59.7	70.1	80.8	13.3%	16.7%	Provider shortage
4	Tulare	70.1	59.6	70.0	80.8	13.1%	18.2%	Provider shortage
5	Merced	69.5	57.3	74.3	76.9	13.0%	18.2%	Provider shortage
6	Madera	67.4	67.9	72.9	61.5	13.5%	17.9%	Access & SDOH barriers
7	Kings	64.4	51.6	68.5	73.1	12.1%	17.6%	Provider shortage
8	Trinity	63.3	91.2	33.4	65.4	15.9%	7.0%	Health burden
9	Modoc	60.9	79.6	37.8	65.4	14.9%	8.6%	Health burden
10	Lake	60.7	73.3	39.7	69.2	14.1%	10.1%	Health burden
11	Monterey	58.1	48.6	48.9	76.9	12.5%	15.9%	Provider shortage
12	Siskiyou	57.9	69.9	30.7	73.1	13.9%	7.6%	Provider shortage
13	Lassen	57.6	53.6	42.2	76.9	11.5%	12.0%	Provider shortage
14	Colusa	57.5	61.0	53.9	57.7	13.4%	17.6%	Health burden
15	San Bernardino	56.9	46.9	50.6	73.1	12.1%	14.3%	Provider shortage
16	Sierra	56.7	83.4	25.1	61.5	15.3%	7.5%	Health burden
17	Tehama	56.3	62.7	40.9	65.4	13.0%	10.8%	Provider shortage
18	Mendocino	56.1	64.4	38.4	65.4	13.7%	10.3%	Provider shortage
19	Del Norte	55.7	57.2	33.1	76.9	12.5%	9.7%	Provider shortage
20	Riverside	55.4	52.2	40.9	73.1	12.4%	12.7%	Provider shortage
21	Sutter	55.0	51.6	44.3	69.2	12.8%	11.9%	Provider shortage
22	Los Angeles	54.5	38.1	44.7	80.8	12.6%	11.7%	Provider shortage
23	Glenn	54.4	54.7	43.0	65.4	12.6%	13.7%	Provider shortage
24	Stanislaus	53.6	52.2	47.2	61.5	11.9%	14.0%	Provider shortage
25	Humboldt	53.5	45.9	37.6	76.9	11.4%	7.5%	Provider shortage
26	San Joaquin	53.0	42.3	43.7	73.1	12.3%	12.8%	Provider shortage
27	Mariposa	52.9	63.3	22.4	73.1	13.5%	7.3%	Provider shortage
28	Yuba	52.3	42.2	45.5	69.2	11.3%	11.0%	Provider shortage
29	Plumas	52.0	64.8	14.3	76.9	13.5%	6.4%	Provider shortage
30	San Benito	49.1	36.9	33.5	76.9	11.3%	13.9%	Provider shortage
31	Calaveras	48.2	59.9	19.2	65.4	13.2%	7.1%	Provider shortage
32	Shasta	47.2	48.2	24.2	69.2	11.7%	7.1%	Provider shortage
33	Butte	46.7	37.9	36.8	65.4	10.7%	8.3%	Provider shortage
34	Sacramento	46.7	35.6	31.4	73.1	11.2%	8.7%	Provider shortage
35	Solano	46.7	40.2	26.8	73.1	12.1%	9.1%	Provider shortage
36	Santa Barbara	46.6	32.8	37.7	69.2	10.8%	11.7%	Provider shortage
37	Inyo	45.9	48.1	20.5	69.2	12.4%	7.9%	Provider shortage
38	Tuolumne	45.3	50.1	16.6	69.2	12.1%	7.0%	Provider shortage
39	Napa	43.3	37.0	19.8	73.1	11.4%	9.7%	Provider shortage
40	Amador	42.0	49.0	11.7	65.4	11.8%	7.5%	Provider shortage
41	Ventura	41.8	32.1	24.2	69.2	11.4%	10.3%	Provider shortage
42	Contra Costa	41.7	27.8	16.6	80.8	11.3%	7.8%	Provider shortage
43	Nevada	41.0	44.3	9.6	69.2	11.5%	5.6%	Provider shortage
44	Sonoma	40.8	29.8	15.8	76.9	10.7%	8.4%	Provider shortage
45	Yolo	40.3	15.9	35.8	69.2	9.3%	8.9%	Provider shortage
46	San Diego	40.2	19.0	24.6	76.9	10.0%	8.7%	Provider shortage
47	Orange	40.1	25.9	21.4	73.1	11.5%	8.9%	Provider shortage
48	El Dorado	39.1	33.8	6.7	76.9	10.8%	5.7%	Provider shortage
49	Alameda	38.0	16.7	20.3	76.9	11.0%	7.1%	Provider shortage
50	San Luis Obispo	37.7	27.9	19.7	65.4	10.0%	7.5%	Provider shortage

All 58 counties, ranked:CSV JSON

Limitations

Scores are intra-state relative, not absolute or cross-state comparable.
PLACES values are small-area model-based estimates with confidence intervals, not direct counts.
HPSA aggregation takes the worst designated primary-care score per county; geographic, population-group, and facility designations are pooled.
Equal axis weighting is a transparent default, not a calibrated policy model.
Socioeconomic measures are ACS 2019-2023 5-year estimates; ACS estimates carry margins of error not reflected in the composite.
This is informational analysis of public data, not clinical, individual, or actuarial advice.

Sources

CDC PLACES — Local Data for Better Health (County Data)
PLACES: Local Data for Better Health, County Data, 2025 release (measure year 2023) · accessed 2026-06-01
HRSA — Primary Care Health Professional Shortage Areas
Shortage Area HPSA detail (Primary Care discipline, designated) · accessed 2026-06-01
U.S. Census Bureau — American Community Survey (5-year)
ACS 2019-2023 5-year estimates · accessed 2026-06-01

Frequently asked questions

What does the California county health-access scorecard measure?

It ranks all 58 California counties by a combined Targeting-Priority Index that fuses adult chronic-disease and social-risk prevalence from CDC PLACES with federally designated primary-care provider shortages from HRSA, highlighting where health need and thin provider supply overlap.

Which public datasets is it built from?

CDC PLACES county estimates (PLACES: Local Data for Better Health, County Data, 2025 release, measure year 2023) and the HRSA Primary Care Health Professional Shortage Area detail file, both fully open federal sources accessed 2026-06-01.

How should the Targeting-Priority Index be used?

As a transparent first-pass screen for where to focus outreach, workforce, or program resources. Scores are relative within the state and equal-weighted by default; a real engagement would calibrate weights to a program's goals and add socioeconomic and utilization layers.