Our Region

The Regional Primary Care Coalition covers a region that is over2,300 square miles, and has a population of almost 4.7 million people. It encompasses Washington, DC, two counties in Suburban Maryland (Montgomery and Prince George’s) and the five health districts of Northern Virginia (Alexandria, Arlington, Fairfax, Loudoun, and Prince William), an area that includes more than 20 distinct counties and cities. Yet, from the standpoint of residents, the boundaries are porous - people often live in one jurisdiction, work in another, and may go to yet another to get their health care.

Just over one half of the region’s population is White (50.2%), over one quarter is African American (27.6%) and just over one tenth is Asian (10.6%). Over one eighth of the overall population identify as being of Hispanic or Latino ethnicity (15.3%) regardless of race (2010 U.S. Census). There are also growing numbers of immigrants from Africa throughout the region. The remainder of the population are of other races, or are of two or more races. Interestingly, the region has the seventh highest number of foreign-born residents among all metropolitan areas in the U.S. (Demographic and Economic Trends Report, 2009).

Almost 2/3 of the population is between 20 and 64 years of age, and over a quarter of the population is 19 years old or younger (2010 U.S. Census). Just over one quarter of the region’s population that is over 5 years old speaks languages other than, or in addition to, English in the home. In four jurisdictions, more than 30% of the population over age 5 speaks a language other than English, and over 10% of the population say that they do not speak English very well. (Note: Language data is from 2010 ACS 1-year estimates, which do not include Fairfax City, Falls Church City, Manassas City, or Manassas Park City.)

As a whole, the region is relatively prosperous, with the median household income and per capita income in all jurisdictions exceeding that of the United States. The region is also well educated, with a higher percentage of adults over age 25 with a bachelor’s degree than the nation as a whole. Yet, the demographic and socioeconomic characteristics of the region’s jurisdictions vary widely as do its health status indicators and its approaches to delivering and financing health services for the low income and uninsured populations.


Socio-Economic Characteristics and Health Indicators

Longevity, economic well-being and overall health vary by where one lives. Depending on where a person lives in our region, there is:

  • Almost a 10 year difference in life expectancy;
  • Over a 95% difference in median household income;
  • More than a three fold difference in the infant morality rate per 1,000 births;
  • More than a two fold difference in the rate of deaths from coronary heart disease;
  • More than a three fold difference in the rate of deaths from stroke, colon cancer and lung cancer;
  • Almost a three fold difference in the rate of deaths from breast cancer;
  • About a four fold difference in the percentage of the population under age 65 who have no health insurance.

There are disparities by race/ethnicity as well. For example, infant mortality rates for births to African-American women are higher than for other races/ethnicities in all jurisdictions. Data for coronary heart disease, stroke, colon cancer, lung cancer, and breast cancer mortality data was drawn from the 2009 Community Health Status Indicators. Life expectancy data was drawn from the 2008 Community Health Status reports. Infant mortality data was taken from the Annie E. Casey Foundation, KIDS Count Data Center, State and Community Profiles. Insurance data was taken from the 2006 Small Area Health Insurance Estimates from the US Census Bureau. Income data was taken from the 2010 ACS 1-year estimates.


Health Services for Low Income and Uninsured Populations

The financing, organization and delivery of primary care services for low income and uninsured populations vary widely across the region.

The primary care associations that are a part of RPCC represent some 40 clinics that serve the region’s low income, uninsured (go to www.dcpca.org for a list of safety net clinics that are part of DCPCA; www.primarycarecoalition.org for a list of clinics that are part of Montgomery Cares in Montgomery County; and www.gbms.org for information on the Federally qualified health center in Prince George’s County). These clinics include non-profit private clinics, federally qualified health centers, free clinics, hospital-affiliated clinics, and clinics run by local governments.

Medicaid and the State Children’s Health Insurance Program cover some services for some people, but eligibility requirements and benefits vary greatly (see http://www.statehealthfacts.org/ for details). Additionally, a number of local jurisdictions provide funding to support their own health coverage programs, clinics and/or service delivery systems. For example,

  • The DC Healthcare Alliance, funded by the District of Columbia, provides health coverage to DC residents with incomes up to 200% of poverty and who are not eligible for Medicaid. Alliance members get care at community health centers and other participating providers in the District of Columbia.
  • Montgomery Cares, funded in part by Montgomery County and administered by the Primary Care Coalition of Montgomery County (PCC), provides primary health care to approximately 21,000 medically uninsured, low-income adult county residents up to 250% of poverty through a network of independent nonprofit clinics known as the Community HealthLink Clinics (for more information see: Montgomery Cares Program).
  • Care for Kids (CFK), funded by Montgomery County and administered by the PCC, provides health care to approximately 3,600 uninsured low-income children up to age 19 who are not eligible for other state or federal health programs
  • In Fairfax County, VA, the Community Health Care Network provides primary health care to approximately 26,000 adult County residents with incomes up to 200% of poverty through a network of clinics funded by the County government.
  • The Alexandria Health Department at Casey Clinic provides prenatal care, post-partum care and Ryan White case management services to people living with HIV/AIDS, connecting them to medical care and social services. The Alexandria Health Department at King Street provides child health services, family planning clinics, immunizations, TB clinic, STI clinic and WIC services as well as dental care for children and adults. Alexandria Neighborhood Health Services, Inc. provides primary medical care for adults, including dental care, pharmacy, oncology, chronic illness management, Ryan White medical care services to those with HIV/AIDS, pharmacy, and referral to specialty care.