New Appalachia

The San Joaquin Valley consists of the southern half of the Central Valley, between the Sacramento-San Joaquin River Delta in the north and the Tehachapi Mountains in the south.

Insufficient access to medicine in the United States, in particular prenatal and preventive care, is typified by both rural and inner city communities. Early and adequate access to prenatal care is important to maternal and child health and is another comparative indicator of community health. According to the California Department of Health Services, 37% of births in Merced County occurred with no or late prenatal care and the San Joaquin Valley average was 19.5% of births with no or late prenatal care. By comparison, the California average was 13.6% of births and the national average was 10% of births[3]

Likewise, the counties of the San Joaquin Valley have relatively high ratios of population to physicians, suggesting relatively low access, with the highest in Kings County at 1,027 patients per a physician, the San Joaquin Valley average at approximately 671 patients per a physician and the California average of 400 patients per a physician.[4] Another measure of access is licensed acute care hospital beds per thousand population, where the Kings County average of 1.1 beds per a thousand and the San Joaquin Valley average of 1.8 beds per a thousand were again less than the state average of 2.1 bed per a thousand.[5] Consequently, the age adjusted death rate is significantly higher than the rest of California.

Moreover, the poverty rate for persons under the age of 18 was as high as 32% in Tulare County and 25.6% in the San Joaquin Valley, compared to 19% in California as a whole.

In 2011 Forbes, after taking the fluctuation of median home values, five of the top twenty "most miserable cities" were located in the San Joaquin Valley.[6] Aside from the collapse of median home values, persistent crime, unemployment and poverty were common factors between Bakersfield, Fresno, Merced, Modesto and Stockton; every major city of the San Joaquin Valley.

In response the University of California with the University of California, Merced is exploring opening a research medical school specializing in rural care, in hopes that some graduates will settle in the San Joaquin Valley and provide better healthcare[7]