Access and System Navigation

Access to comprehensive, quality affordable health care is crucial for one’s health and quality of life. Access to health care must consider the cost of care such as copays, a person’s ability to navigate the public health and mental health systems, and the cultural and linguistic competency of providers. Insurance coverage helps facilitate an individual’s entry into the health care system.

Successful System Navigation affords residents greater access to primary care and specialist physicians. An ideal public health system is responsive, accessible, and accountable to the communities it services. In addition, the public health system should be one that is well connected and coordinated across various sectors.

Components of access to care include insurance coverage, availability of services, timeliness of appointments and services, and workforce.

Access to Insurance

Why is this important?

Medical costs in the United States are extremely high, so people without health insurance may not be able to afford medical treatment or prescription drugs. They are also less likely to have routine checkups and screenings, resulting in more complex and costly treatments as they delay seeking medical help.

Almost 90% of Orange County residents have health insurance, a rate consistent with the State but higher than the country.

  • Percentage of Adults (Ages 19-64) With Health Insurance

    Orange County, CA
  • 89.3%
  • 87.6%
    The United States of America

In Orange County, residents with low socioeconomic status (SES) are more likely than higher SES groups to have access-related issues, such as no health insurance, an inability to afford medications, inadequate transportation to medical appointments, and a lack of recent health screenings. According to the 2020 American Community Survey, people identifying as Hispanic/Latino, American Indian/Alaska Native, and people of other races alone had the largest uninsured population (see graph below).

Uninsured Population by Race/Ethnicity in Orange County

Delay or Difficulty With Obtaining Care

Utilizing appropriate clinical and preventative services in a timely fashion can have important implications on the progression and treatment of many diseases. Those who receive treatment earlier have greater opportunity to prevent disease or detect disease during earlier, treatable stages while a delay of necessary care can lead to an increased risk in health complications.

Between 2018-2019, the proportion of Orange County residents who experience difficulty obtaining care is 11.2% compared to 12.7% for California.

Percent of Residents Who Delayed Care or Had Difficulty Obtaining Care


Orange County



Percent of Orange County Residents Who Delayed Care or Had Difficulty Obtaining Care

People Who Delayed Care or Had Difficult Obtaining Care by Age (2019)
Orange County

Orange County residents ages 25-44 were the most likely to have difficulty obtaining care or delay care. Those under the age of 17 were the most likely to obtain care. This may be due to the fact that majority of children and youth are covered by Medi-Cal or other insurance (see below).

Children Health Insurance

Why is this important?

Health insurance for children is particularly important. To stay healthy, children require regular checkups, dental and vision care, and medical attention for illness and injury. Children with health insurance are more likely to have better health throughout their childhood and adolescence. They are more likely to receive required immunizations, fall ill less frequently, obtain necessary treatment when they do get sick, and perform better at school. Having health insurance lowers barriers to accessing care, which is likely to prevent the development of more serious illnesses. This is not only of benefit to the child but also helps lower overall family health costs.

The Healthy People 2030 national health target is to increase the proportion of children with health insurance to 100%. As of 2019, the health insurance rate for Orange County was 96.0% compared to 96.4% in California.

  • Percentage of Children (Under Age 19) in Orange County with Health Insurance

    Orange County
  • 96.4%

2022 California Children's Report Card

Health Insurance A-
Health Care Accountability D-
Health Care Access C-
Preventive Screenings D
Behavioral Health Care: Mental Health D+
Behavioral Health Care: Substance Use D-
Preventing Trauma & Supportive Healing C-
Oral Health Card C
Food Security C+
The California Children’s Report Card rates California on its ability to support better outcomes for children from prenatal to 26 years of age.

Source: Children Now

Children with Health Insurance (measurement period: 2017-2019)
Orange County

Children with Health Insurance (measurement period: 2017-2019)
Orange County

Adults Needing and Receiving Behavioral Health Services

Why is this important?

Psychological distress can affect all aspects of our lives. It is important to recognize and address potential psychological issues before they become critical. Mental disorders are common across the United States, but only a fraction of those affected receive treatment. According to Sapien Lab’s report on mental health, 45% of individuals in the United States report having a clinical-level mental health problem and did not seek professional help in 2021. Persistent mental and emotional health problems should be evaluated and treated by a qualified professional.

Having and Receiving Care for Mental Health is Normal

Mental health is an important component of well-being. Just as you would see a doctor if you have pain in your arm or chest, you should see a health provider if you are experiencing symptoms of depression, anxiety, or prolonged sadness. You are not alone. An estimated 26% of Americans ages 18 and older - about one in four adults - suffers from a diagnosable mental disorder in a given year.

Prior to the COVID-19 pandemic, 12.1% of adults living in Orange County reported suffering from severe psychological distress. Approximately 19.5% of Orange County adults need help for emotional-mental and/or alcohol-drug issues. Of those who needed help, about half were not able to receive any treatment.

  • Percentage of Adults Who Need and Receive Behavioral Health Services

    Orange County
  • 54.4%

Adults Needing and Receiving Behavioral Health Care Services (measurement period: 2007-2019)
Orange County

Adults Needing and Receiving Behavioral Health Care Services by Age (2019)
Orange County

Mental Health Indicators, Adults, Ages 18 and Older

  Orange County California
Adults who likely had serious psychological distress during past year 12.1%* 12.6%
Adults who needed help for emotional-mental and/or alcohol-drug issues in past year 19.5% 21.7%
Latino 61.8% 72.8%
Asian 26.1% 36.5%
Total Adult Population 52.2% 59.6%

Other Barriers to Health Care

Barriers associated with health care access include: 1) costs, 2) availability of services, 3) navigating the health care system and 4) lack of awareness and education about resources available in the community. In the 2022 Hoag Community Needs Assessment, 39% of interviewees indicated that health care access and delivery were the greatest health needs while 19% reported health care access to be a contributing factor to poor health outcomes in their community. Components of delivery of care include quality, transparency and cultural competence.

Cultural competency in health care means “delivering effective, quality care to patients who have diverse beliefs, attitudes, values, and behaviors” (Tulane University, 2021). It is also an understanding of the impact that cultural differences can have on health care delivery. Cultural competence refers to meeting the needs of people with disabilities, individuals from diverse socioeconomic backgrounds, and members of the lesbian, gay, bisexual, transgender, queer (LGBTQ) community.

One of the sentiments shared by a community member articulated the vulnerability felt by patients who do not have access to culturally competent providers.

“…I have to consider how badly I need to go in for my annual exam. Do I want to go through this? If I feel healthy, I might be like, I don’t really want to deal with it. So, there’s a huge problem of just healthy LGBTQIA folks not getting their preventative care, because they don’t want to deal with it. So, it’s the access even though it’s accessible. I have great insurance, I have a good doctor, I have access, but it doesn't feel good. I don’t have a good rapport with my provider. So, it prevents me from going sometimes. So, there are the access problems. And I think it’s around cultural competency.”

Do We Have a Shortage of Health Care Providers in Orange County?

In Orange County, an estimated 381,543 people live in an area that has a shortage of primary care providers. Availability of primary health care providers affects access to health care in the community. Based on the 2021 County Health Rankings, Orange County ranks 17 out of 58 California counties for access to clinical care providers. When compared to California’s ratio of population to health care providers, Orange County has a good ratio of access to primary care physicians (one doctor per 1,010 residents) and dentists (one dentist per 870 residents). The ratio of population to mental health providers, however, shows that Orange County has significantly fewer mental health providers than the state ratio, making access to mental health care more difficult for those needing services.

Ratio of Population to Health Care Providers

  Orange County California
Primary Care Physicians 1,010:1 1,250:1
Dentists 870:1 1,150:1
Mental Health Providers 344:1 270:1