Descriptive Title:

Public health facilities with “good” and “very good” transit resource scores

Geographic Unit of Analysis:

Point

Clinics and hospitals with "good" or "very good" transit resource scores*, 2012
  Total facilities # in "good" or "very good" transit resource areas % in "good" or "very good" transit resource areas
DPH Clinic 22 16 73%
Clinic (free and community) 43 36 84%
GAC Hospital 13 12 92%
Total 78 64 82%
Facility Transit Resource Score Address Type
CHINESE HOSPITAL Very Good 845 JACKSON ST. Hospital
KAISER FND HOSP - SAN FRANCISCO Very Good 2425 GEARY BLVD. Hospital
ST. FRANCIS MEMORIAL HOSPITAL Very Good 900 HYDE ST. Hospital
UCSF MEDICAL CENTER AT MOUNT ZION Very Good 1600 DIVISADERO ST. Hospital
CALIFORNIA PACIFIC MED CTR-DAVIES CAMPUS Very Good CASTRO AND DUBOCE ST. Hospital
CALIFORNIA PACIFIC MED CTR-PACIFIC CAMPUS Very Good 2333 BUCHANAN ST. Hospital
ST. MARY'S MEDICAL CENTER, SAN FRANCISCO Very Good 450 STANYAN ST. Hospital
CALIFORNIA PACIFIC MEDICAL CENTER - ST. LUKE'S CAMPUS Good 3555 CESAR CHAVEZ ST. Hospital
SAN FRANCISCO GENERAL HOSPITAL Good 1001 POTRERO AVE. Hospital
UCSF MEDICAL CENTER Good 505 PARNASSUS AVE. Hospital
CALIFORNIA PACIFIC MED CTR-CALIFORNIA EAST Good 3698 SACRAMENTO ST. Hospital
CALIFORNIA PACIFIC MED CTR-CALIFORNIA WEST Good 3700 CALIFORNIA ST. Hospital
LAGUNA HONDA HOSPITAL AND REHABILITATION CENTER Average 375 LAGUNA HONDA BLVD. Hospital
INSTITUTO FAMILIAR DE LA RAZA - OUTPATIENT Very Good 2919 MISSION ST. Clinic
MISSION NEIGHBORHOOD HEALTH CENTER Very Good 240 SHOTWELL ST. Clinic
MISSION NEIGHBORHOOD RESOURCE CENTER Very Good 165 CAPP ST Clinic
NATIVE AMERICAN HEALTH CENTER Very Good 160 CAPP ST. Clinic
NORTH EAST MEDICAL SERVICES Very Good 1520 STOCKTON ST. Clinic
ASIAN & PACIFIC ISLANDER WELLNESS CENTER Very Good 730 POLK ST. Clinic
BAART MARKET CLINIC Very Good 1111 MARKET ST., 1ST FLOOR Clinic
BAART TURK STREET CLINIC Very Good 433 TURK ST. Clinic
PLANNED PARENTHOOD GOLDEN GATE Very Good 815 EDDY ST. Clinic
HAIGHT ASHBURY INTEGRATED CARE CENTER Very Good 1735 MISSION ST Clinic
GLIDE HEALTH SERVICES Very Good 330 ELLIS ST. Clinic
SOUTH OF MARKET HEALTH CENTER Very Good 229 7TH ST. Clinic
MERRIOUNS PSYCHOLOGICAL INSTITUTE Very Good 242 MYRTLE ST. Clinic
CURRY SENIOR CENTER Very Good 333 TURK ST. Clinic
ON LOK SENIOR HEALTH SERVICES - BUSH ST Very Good 1333 BUSH ST. Clinic
ON LOK SENIOR HEALTH SERVICES - POWELL Very Good 1441 POWELL ST. Clinic
ON LOK SENIOR HEALTH SERVICES Very Good 1000 MONTGOMERY ST. Clinic
AHF HEALTHCARE CENTER - SAN FRANCISCO Very Good 1025 HOWARD ST. Clinic
ST. JAMES INFIRMARY Very Good 1372 MISSION ST. Clinic
FIRST RESORT Very Good 450 SUTTER ST., STE. 1740 Clinic
WOMAN'S COMMUNITY CLINIC/TIDES CENTER Very Good 1833 FILLMORE ST. Clinic
LYON-MARTIN WOMENS HEALTH SERVICES Very Good 1748 MARKET ST. Clinic
ST. ANTHONY MEDICAL CLINIC Very Good 150 GOLDEN GATE AVE. Clinic
MISSION NEIGHBORHOOD HEALTH CTR.-EXCELSIOR CLINIC Good 4434 MISSION ST. Clinic
MISSION NEIGHBORHOOD HEALTH CENTER - VALENCIA CLINIC Good 1647 VALENCIA ST. Clinic
PLANNED PARENTHOOD SAN FRANCISCO CENTER Good 1650 VALENCIA ST. Clinic
CHINESE HOSPITAL'S EXCELSIOR HEALTH SERVICES Good 888 PARIS ST. Clinic
LIFEWAYS PACE AT THE CORONET Good 3575 GEARY BLVD Clinic
ST. LUKE'S HEALTH CARE CENTER - ADULT CLINIC Good 1580 VALENCIA ST. Clinic
ON LOK 30TH STREET COMMUNITY CENTER Good 225 30TH ST. Clinic
ON LOK SENIOR HEALTH SERVICES-MISSION CENTER Good 4430 MISSION ST. Clinic
INSTITUTE ON AGING Good 2700 GEARY BLVD. Clinic
ST. LUKE'S HEALTH CARE CENTER - WOMEN'S CLINIC Good 1580 VALENCIA ST. Clinic
ST. LUKE'S HEALTH CARE CENTER - PEDIATRIC CLINIC Good 1580 VALENCIA ST Clinic
DRUG DETOXIFICATION, REHAB AND AFTER CARE SVS. PROG. Good 529 CLAYTON ST. Clinic
HAIGHT ASHBURY FREE MEDICAL CLINIC Good 558 CLAYTON ST. Clinic
NORTH EAST MEDICAL SERVICES - SAN BRUNO AVENUE Average 2574 SAN BRUNO AVE. Clinic
NORTH EAST MEDICAL SERVICES - NORIEGA Average 1450 NORIEGA ST. Clinic
RICHMOND MAXI-CENTER Average 3626 BALBOA ST. Clinic
SAN FRANCISCO FREE CLINIC Average 4900 CALIFORNIA ST. Clinic
NORTH EAST MEDICAL SERVICES-LELAND AVENUE Poor 82 LELAND AVE. Clinic
NORTH EAST MEDICAL SERVICES - TARAVAL Poor 2308 TARAVAL ST. Clinic
CHINESE COMMUNITY HEALTH SERVICES Poor 1800 31ST AVE. Clinic
Castro-Mission Health Center Very Good 3850 17th St. CHN
Chinatown Health Center Very Good 1490 Mason St. CHN
Maxine Hall Health Center Very Good 1301 Pierce St. CHN
Adult Immunization & Travel Clinic Very Good 101 Grove St. CHN
Breast & Cervical Cancer Services Very Good 30 Van Ness Ave. CHN
Housing and Urban Health Clinic Very Good 234 Eddy St. CHN
Tom Waddell Health Center Very Good 50 Lech Walesa CHN
Larkin Street Medical Clinic Very Good 1138 Sutter St. CHN
Mission Neighborhood Health Centers-LPC Very Good 1663 Mission St. CHN
San Francisco City Clinic Very Good 356 7th St. CHN
Children's Health Center at SFGH Good 1001 Potrero Ave. CHN
Family Health Center at SFGH Good 995 Potrero Ave. CHN
General Medical Clinic at SFGH Good 1001 Potrero Ave. CHN
Women's Health Center Good 1001 Potrero Ave. CHN
Balboa Teen Health Center Good 1000 Cayuga Ave. CHN
Cole Street Clinic Good 555 Cole St. CHN
Ocean Park Health Center Average 1351 24th Ave. CHN
Silver Avenue Family Health Center Average 1525 Silver Ave. CHN
3rd Street Youth Center & Clinic Average 5190 3rd St. CHN
Potrero Hill Health Center Average 1050 Wisconsin St. CHN
Southeast Health Center Average 2401 Keith St. CHN
Special Programs for Youth Poor 375 Woodside Ave. CHN

Why Is This An Indicator Of Health and Sustainability?

The availability of public transportation to community health facilities is one factor among many that affect access to good quality, affordable, reliable health care. Studies in the Bay Area have shown that a quarter of patients who missed medical appointments cited lack of transportation as the cause.a While Medi-Cal requires managed care programs to be no more than a 30 minutes travel time or 10 miles from a member’s home, a distance of more than 7 miles in San Francisco can often take over an hour to travel by transit.

San Francisco’s hospitals are among the largest employers in the city. By locating health facilities near transit and encouraging employees to use public transportation rather than personal vehicles to get to work, thereby reducing vehicle congestion around the facilities, there would be benefits to air quality, community noise, and injuries.

Interpretation and Geographic Equity Analysis

The majority of San Francisco’s hospitals and clinics are within areas that have “good” or “very good” transit resources, as defined by the Transit Resource Score (see: indicator TR.1.f ).  73% of Department of Public Health Managed clinics fell within area with good or very good transit resources. Only one facility, Special Programs for Youth, which operates out of the San Francisco Youth Guidance Center, was deemed to be in an area with “poor” transit access. 84% of free and community primary care clinics were near good or very good transit access, with only North East Medical Services (Leland Ave. and Taraval) and Chinese Community Health Services being in areas with poor transit resources. All hospitals except for Laguna Honda have good or very good transit resources.


While it is useful to site large health care facilities in areas with rich transit resources, clinics in areas with less robust transit resources are important assets for nearby residents. 

Methods

To calculate the Transit Resource Scores, the distance from each residential intersection (intersections within 100 meters of residential lots) to each transit route stop (multiple route stops can be found at one location when multiple transit routes share stop or station) within 1 mile of the intersection was calculated. A distance of < 0.25 miles was given a score of 1, while distances between 0.25-0.49 miles were given a score of 0.9 and distances between 0.5-1.0 miles were given a score of 0.75.

Route stops were gathered by using General Transit Feed Specification (GTFS) data from Muni, Bart, Caltrain, the Bay Ferries, and AC Transit. The frequency that each route ran through each stop during a seven day week was attached to each route stop. Route and stop data for samTrans and Golden Gate Transit was taken from the Metropolitan Transportation Commission Transit Geodatabase (2008) and seven day route frequency was manually attached.

For each intersection the distance scores were multiplied by the seven day frequency for each route stop within 1 mile of the intersection. All of the products of the seven day route frequency and of the distance score were then summed for all of the route stops within 1 mile of the intersection. This number was normalized to a score of 100 to derive the final intersection Transit Resource Score. Intersection scores were then interpolated over the surface of San Francisco using inverse distance weighting to create a raster file.

This list of facilities includes all known public health facilities that provide primary care in San Francisco. This list was created by combining health care clinics and hospitals included in San Francisco's Community Health Network (CHN) and the list of facilities licensed by the California Department of Health Services, Office of Statewide Health Planning and Development (OSHPD). Consolidated hospital licenses (i.e., CA Pacific Medical Center) are listed as separate locations (i.e., East Campus, Davies Campus, Pacific Campus and West Campus) when there are distinct facilities.

The types of facilities include:

GAC -- General Acute Care Hospital

CHN -- Primary Care Clinic in the SF Community Health Network

COMM -- OSHPD Licensed, Community-Based Primary Care Clinic

FREE -- OSHPD Licensed, Free Primary Care Clinic

Clinics included on the OSHPD list include facilities that are licensed under Section 1204 of the Health and Safety Code (indicating that they are a 501c3 non-profit organization and operate as a primary care clinic). OSHPD criteria exclude tribal facilities located on tribal land (not applicable in San Francisco), county facilities and non 501c3 (or for-profit) health facilities. Although county facilities are excluded on the OSHPD lists, San Francisco County public health facilities were included on our list of facilities providing primary health care.

The following facilities were not included on the list: home health agencies, hospices, private doctors' offices, specialty clinics, intermediate care facilities for the developmentally disabled, referral agencies, skilled nursing facilities, chemical dependency recovery hospitals, alternative birthing centers, psychiatric health facilities, and certified but not licensed facilities. Additionally the American College of Traditional Chinese Medicine and other traditional Chinese and alternative medicine providers are not included. In some cases, multiple clinics may be located at the same address.

Scores for facilities were assessed by using the “extract values to point” tool in ArcGIS. Scores were classified as “very good,” “good,” “average,” “poor,” and “very poor” based on the quintile distribution of the pixel values in the original Transit Resource Score raster file. 

Limitations

This analysis does not capture other factors that impact on transit access and use, including cost, time and distance and number of transfers to destination, accessibility for people of different abilities and ages, perceived and actual safety, weather, availability of bicycle racks, hours of operation, and availability of travel stipends/incentives/discounts provided by work or to low income families. Individuals may live far from their health facility of choice and direct transit routes may not exist from a person’s residence to the facility, resulting in long transit travel times. 

Data Source

CA Office of Statewide Health Planning and Development, Healthcare Facilities Listings. Accessed on June 2012: http://www.oshpd.ca.gov/HID/Products/Listings.html#PC

San Francisco Department of Public Health, Community Health Network Centers. Accessed on June 2012: http://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/default.asp

Routes, stops, and route frequencies for Muni, BART, Caltrain, and all SF Bay ferry operators (2012) gathered through GTFS feeds: http://code.google.com/p/googletransitdatafeed/wiki/PublicFeeds; stops and routes for Golden Gate Transit, WestCat, and samTrans retrieved from MTC Bay Area Transit Geodatabase (2008) and route frequencies retrieved through transit operator websites (2012).

Map and table prepared by City and County of San Francisco, Department of Public Health, Environmental Health Section using ArcGIS 10.0 software, February 2012.

Detailed information regarding census data, geographic units of analysis, their definitions, and their boundaries can be found in the Indicator Project at the following links:

Geographic_Units_of_Analysis

Technical Notes

  1. Hobson J, Quiroz-Martinez J. Roadblocks to Health: Transportation Barriers to Healthy Communities. Transportation and Land Use Coalition (TALC). 2002.