Contest Entries

Struggling for care

Entrants: Kerry Klein

Affiliation: Valley Public Radio

Health Policy (small)

Year: 2017

Place: First Place

735669_KKlein_StrugglingForCare1_20170822.mp3 (3.4 MB)
735669_KKlein_StrugglingForCare2_20170829.mp3 (5.3 MB)
735669_KKlein_StrugglingForCare3_20170905.mp3 (4.2 MB)
735669_KKlein_StrugglingForCare4_20170912.mp3 (5 MB)

List date(s) this work was published or aired.

8/22/17 8/29/17 9/5/17 9/12/17

Provide a brief synopsis of the story or stories, including any significant findings.

The San Joaquin Valley lacks doctors. For every 100,000 residents, the Valley has 39 primary care physicians-22 percent less than the state average of 64-and an even lower share of specialists. The supply is also short for health professionals who accept Medi-Cal and plans through the Affordable Care Act. Simultaneously, the Valley has an outsized need for doctors. Home to concentrated poverty and some of the most polluted air in the country, the Valley's four million residents suffer from elevated rates of asthma and obesity compared to the rest of the state. Life expectancies for poor and affluent residents can vary by as much as 20 years. "Struggling For Care" is a collection of in-depth reports, testimonials and panel discussions examining what this shortage means to residents, what some health professionals are doing about it, and why the Valley has such a tough time holding on to doctors in the first place.

Judges' comments: Much has been published about the doctor shortage in rural areas, but “Struggling for Care,” a four-part series produced by Valley Public Radio, truly elevates our understanding of the problem. Focusing on California’s agricultural San Joaquin Valley, the series takes a deep dive into history, new data, and resident’s stories, delivering a provocative analysis of causes and potential solutions. The package, which includes online discussions and postings, is smart, fresh, and moving. 

Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?

I used a wealth of data on health outcomes, Medi-Cal enrollment, medical school enrollment, and abundance of providers and international medical graduates. I also relied heavily on briefs about bills and laws, and archived footage of speeches by two U.S. presidents. All of these helped to clarify the story for me, and helped me to understand the many complicated facets of such a wide-reaching problem.

Explain types of human sources used.

I interviewed dozens of health providers, health policy analysts and experts, academics, medical education administrators, and representatives of medical societies, and I used archived audio of Presidents Clinton and Trump. We also solicited calls to a tip line, which enabled me to speak with over 30 patients with their own stories about experiencing a physician shortage. Early on in the reporting process, I also moderated a panel discussion on the topic, which informed the reporting and helped me find sources for the series.


I received an abundance of positive feedback from local providers and health policy experts from around California. The stories were ultimately picked up by Capital Public Radio, and NPR's Shots blog expressed interest. Select stories were reprinted in a newsletter with the Fresno-Madera Medical Society and the California Health Care Foundation.

Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.

I have received only positive feedback for these pieces.

Advice to other journalists planning a similar story or project.

As much as it's more work, the more sources you can interview for a big complicated health topic, the better. All of the many, many pre-interviews and background interviews I conducted for this story were absolutely invaluable.