For Appointments Call 619-779-7900
Patient Profiles
La Maestra has been providing services and programs
available to all low-income residents in the community
it serves. Many of its patients are immigrants and
refugees, many of whom are in the country legally and
were forced to leave their native countries due to
conflict or other upheaval. La Maestra also places a
high value on the support of the family and provides
comprehensive programs that strengthen both the children
and adults. Many other patients are second or third
generation families from the communities they serve.
Most are struggling to survive but are learning to build
their knowledge of the community and its resources to
become more self-sufficient. All of these residents rely
heavily on La Maestra Community Health Centers not only
for their health care but for their non-medical needs as
well.
Annual State and Federal reports provide excellent data
on the characteristics of La Maestra patients at all
locations: 64% are women (83% of those are of child
bearing age). 96% are non-white and 80% say they prefer
to be served in a language other than English. An
astounding 98% of them are below the Federal definition
of poverty (double that of all of San Diego County, the
state of California and the United States as a whole).
The vast majority (92%) are either uninsured or rely on
public insurance programs for partial coverage. The City
Heights, a part of the Central Region of San Diego is a
federally designated MUA/MUP- Medically Underserved Area
/ Medically Underserved Population.
The community serves as a microcosm of inner city
challenges of poverty, unemployment, and poor access to
health care or social services. Linguistic and cultural
barriers compound these problems.
There are no County hospitals in San Diego and the small
network of community clinics, like La Maestra, provides
the only existing safety net. County statistics for the
region report startling problems: a poverty rate of
19.22% (200% above the countywide average), highest teen
birth rate, lowest prenatal care utilization rates,
lowest health insurance coverage rates, and highest
rates of reported child abuse. El Cajon City in East San
Diego County, although in a more rural desert setting,
experiences similar problems to those of City Heights.
In El Cajon, the majority of the population is Latino
although “official” census numbers report only 26%.
Because of the high cost of housing in coastal areas,
there is a migration of middle income, working people
buying homes in El Cajon and commuting west.
From outward appearances household incomes seem to be
rising. This development masks the fact that there is
still high local unemployment, underemployment and
poverty. Many Hispanic refugees and Chaldean immigrants,
who escaped from Iraq, live in El Cajon and struggle
with linguistic and cultural barriers that continue to
exist. The problem is so well recognized that the
Medical Director from La Maestra (who is Chaldean
himself) was asked to establish the El Cajon Center.
Although many of the patients being served at the main
clinic in City Heights walk and push their strollers to
the clinic (an informal study showed 62%), there are
over 37 separate census tracts served by this
overburdened facility on Fairmount. The primary service
area has a population of 199,230. City Heights is a
small part of a larger extended area that includes the
entire Central Region of San Diego County with a
population of approximately 488,205. Similarly, the El
Cajon facility is easily accessible by public
transportation and is available to over 29 different
census tracts with a total population of 118,902
(according to the 2002 Census). All of the East Region
of San Diego County has a slightly less dense population
of approximately 448,750.
Commented Dr. Almansour, “Our patients experience
lack of access to appropriate medical care. They have no
insurance coverage from their minimum wage job
employers. They do not know where or how to shop, they
practice unhealthy behaviors (smoking, drinking alcohol
and soda) encouraged by marketing, stress and culture
and they therefore suffer from their poor diet/nutrition
and lack of adequate physical activity and substance
abuse. Frequently we see escalated rates of chronic
disease and mental health problems. We have learned that
women typically seek medical and dental services for
their children. Men are more likely to come for enabling
services like housing assistance, and job
training/placement programs. For many reasons, these
adults often fail to recognize or acknowledge their own
health problems and obtain care only in later stages of
illness or disease. Co-morbidities and symptoms are
oftentimes identified when individuals come to the
Center for unrelated assistance and timely referrals are
made”
