Report on Capacity, Quality, and Accessibility of Veteran Affairs Clinics in Southern California

This is a version of the github repository found here: https://github.com/Derreckadam/Takano_fellowship. The final report is labeled Takano_Final_Jan 27.docx the code can be found in the markdown file, vet-data.Rmd This report describes Southern California veterans, and their needs with regard to Veteran Affairs Health Facilities. US Census Bureau Data including veteran age, disability status, income level, and race is documented. To analyze the quality and ratings of health care, physical addresses were accessed using data from the US Department of Veteran Affairs (VA). Transportation routes, drive-time, and accessibility to these facilities were analyzed using traffic reports and map data from ArcGIS, as well as bus stops from the Riverside Transit Authority. In general, this report finds that, despite having the largest veteran population of any state, California does not have A) high quality medical centers and B) clinics that are easily accessible by much of the population, and that C) this impacts some veteran groups much more than others. VA (SAIL) internal evaluations composed of 25 different metrics, show that the best California facilities have only 3, 2 or 1-star facilities. This is in contrast to the 5-star quality seen on the east coast. An additional issue identified is the need for improved accessibility. Metrics not evaluated by SAIL such as demographics, income, and disabilities clearly show important physical locations where additional facilities should exist to serve these populations. One such location is Congressional District 41. Access to other clinics requires high drive times to clinics (30 minutes) and bus routes are exceptionally long (1 hour). This significantly impacts disadvantaged populations in this district especially senior citizens, disabled veterans, and impoverished veterans who need to use these facilities. There is clear evidence there is a strong need for improved health services for Veterans, that CD 41 is a prime location for a new Veteran Affairs Health Facility and Touchpoints, or urgent care centers run by the VA likely to be effective