Shasta and Lassen Counties — Regional Market Report 2025

Introduction

Shasta and Lassen Counties face some of California’s most pressing health care challenges. Residents experience high death rates from chronic disease, suicide, and drug overdoses — while a severe workforce shortage limits access to care. About 180,000 of the region’s nearly 210,000 residents live in Shasta County, where political polarization has created additional barriers to county health services and recruiting health professionals.

Shasta and Lassen Counties make up one of seven markets included in the 2025 Regional Market Reports, which focus on gaining key insights into the organization, financing, and delivery of care in communities across California and over time.

How Are Local Health Care Leaders Responding?

Despite these obstacles, health care leaders in Shasta and Lassen Counties are working to maximize services and maintain financial sustainability. Priorities include reducing health care workforce shortages and building new behavioral health care infrastructure.

Although some providers in the region are thriving, others remain financially vulnerable — particularly as they navigate state and federal policies that often fail to recognize the distinctive needs of rural health care delivery.

What’s at Stake: Federal Policy and Medi-Cal in Shasta and Lassen Counties

Federal cuts under House Resolution 1 (H.R. 1), also known as the “One Big Beautiful Bill Act of 2025,” threaten Medi-Cal coverage for thousands of Shasta and Lassen residents. These cuts could also jeopardize the financial viability of essential rural health care providers serving the region.

Five Key Factors Shaping Health Care in Shasta and Lassen Counties

1. Severe Health Care Workforce Shortage Limits Access to Care

Access to care is a major problem in Shasta and Lassen Counties. The region faces a severe shortage of both primary care providers and specialists, leading to long waits for patients trying to establish a primary care relationship and significant difficulty accessing specialty care.

Who is most affected?

• Medicare patients and those with commercial insurance face the greatest access challenges.
• Medi-Cal enrollees may also experience barriers, though the region’s community health centers (CHCs) prioritize serving Medi-Cal patients and uninsured residents.

Despite considerable efforts on workforce development, recruitment, and retention — including many creative local approaches — significant gaps remain.

2. Federal and State Budget Cuts Threaten Rural Provider Survival

Although some health care providers in Shasta and Lassen Counties are financially stable, others face serious threats from federal funding cuts and California state budget constraints.

Key facts:

• 3 in 5 residents in Shasta and Lassen Counties are covered by Medi-Cal or Medicare — higher than the statewide average.
• Federal cuts under H.R. 1 threaten Medi-Cal coverage and could reduce access to care across the region, regardless of insurance status.
• In many remote communities, a single CHC or critical access hospital is the only source of care.

Health care leaders in the region are resourceful and resilient, but operating without economies of scale and navigating statewide policies designed for urban settings creates ongoing challenges to rural sustainability.

3. High Mortality Rates and “Deaths of Despair” in Rural Northeastern California

Residents of Shasta and Lassen Counties experience significantly higher death rates than Californians overall:

• Shasta County: The all-cause death rate is almost 60% higher than statewide.
• Lassen County: The all-cause death rate is 31% higher than statewide.

Contributing factors include high rates of death related to:

• Chronic disease
• Suicide
• Firearms
• Alcohol and drug use

These “deaths of despair” reflect broader challenges with behavioral health access, substance use treatment, and social conditions in the region.

4. Political Polarization Affects Public Health and Provider Recruitment

In Shasta County, local politics and divisiveness mirror national patterns — with direct implications for health care. Political polarization has affected:

• Access to behavioral health services
• County health department functions
• Recruitment of health professionals to the area

This politicization of public health creates additional barriers in a region already struggling with workforce shortages and limited resources.

5. Community Collaboration to Build Behavioral Health Infrastructure

Despite challenges, community organizations in Shasta County have joined together to address critical behavioral health infrastructure needs. A new treatment facility offering a continuum of crisis stabilization services has been identified as the region’s highest priority.

Proposed facility components:

• Medical detox services
• 16-bed psychiatric health facility
• Youth crisis services

The Shasta Health Assessment and Redesign Collaborative (SHARC), a long-standing multistakeholder group, is partnering with a local nonprofit and a behavioral health care company to secure state funding for this new infrastructure. However, a letter of opposition from Shasta County submitted just days before the application deadline could jeopardize the effort.

Key Data on Shasta and Lassen Counties

Health Insurance Coverage

Where do Shasta and Lassen residents get their health coverage?

Roughly a third of residents are Medi-Cal members, on par with the state overall. About one in five residents relies on Medicare, exceeding the state average, while enrollment in commercial insurance, at 40%, is lower than the state. 

Sources: MA State/County Penetration (July 2019 and July 2023), US Centers for Medicare & Medicaid Services; MA State/County Penetration (July 2019 and July 2023), US Centers for Medicare & Medicaid Services; “By Medicare Dual Status, Certified Eligibles,” California Department of Health Care Services; Katherine Wilson, California Health Insurers, Enrollment Almanac — 2025 Edition, California Health Care Foundation, February 2025

Population and Economic Context

How does the Shasta/Lassen region compare to California overall?

Drug-related overdose deaths in Shasta and Lassen are about 70% higher than statewide. The region’s rate of drug-related emergency department visits also exceeds the state and is the highest rate of any other region in the Regional Market Report study.  

Sources: Annual Estimates of the Resident Population for Counties in the United States: April 1, 2020 to July 1, 2024 (CO-EST2024-POP); Annual Estimates of the Resident Population for Counties in the United States: April 1, 2010 to July 1, 2019 (CO-EST2019-ANNRES-06); “American Community Survey 5-Year Estimates Subject Tables, S1901, Income in the Past 12 Months (in 2023 Inflation-Adjusted Dollars), 2023,” US Census Bureau; “Current Industry Employment and Unemployment Rates for Counties,” California Employment Development Department; “California Employment Development Department; and “Housing Affordability Index – Traditional – Historical Data Series (Q2 2024),” California Association of Realtors; “Healthcare Payments Data Measures Data (2018–2023)”; “Infant Mortality,” California Department of Public Health (CDPH); “California Overdose Surveillance Dashboard,” CDPH, last updated May 19, 2025.; “American Community Survey, 2023 5-Year Estimates, S1810, Disability Characteristics,” US Census Bureau

Hospital Landscape

Which hospitals serve Shasta and Lassen?

Of the four acute care hospitals in Shasta and Lassen, two are in Redding: Mercy Medical Center and Shasta Regional Medical Center. The other two are critical access hospitals, Mayers Memorial in Fall River Mills (Shasta) and Banner Lassen in Susanville (Lassen), offering 24-hour emergency services and a small number of acute care beds in rural areas.  While the four hospitals collectively have a higher net income margin than hospitals statewide, there is wide variation in net income margins among the hospitals. 

Source: 2023 Pivot Table – Hospital Annual Selected File, California Department of Health Care Access and Information.

Community Health Centers

What are the main community health centers in Shasta and Lassen?

Community health centers (CHCs) are often the main — sometimes the only — care providers in many parts of the region. Opened in 1987, Shasta Community Health Center is the largest CHC in the region by a wide margin. 

Unlike CHCs in many urban areas, CHCs in Shasta and Lassen are more likely to serve those with Medicare and commercial insurance (not just the uninsured or those with Medi-Cal). This results in a smaller share of Shasta and Lassen CHC patients with household incomes under 100% of the federal poverty level. It also means that CHCs in the region generate a smaller share of net patient revenue from Medi-Cal.

Source: 2023 Primary Care Clinic Annual Utilization Data (November 2024), California Department of Health Care Access and Information, last updated October 31, 2024.

Health Care Workforce

How do Shasta and Lassen compare to California?

The region faces a severe physician shortage, with only two-thirds the number of physicians per 100,000 population as are available statewide. The picture is much more positive for advanced practice providers and nurses, with higher per capita supply compared to the state overall. The well-established statewide shortage of behavioral health workers is especially severe in Shasta and Lassen. (Of note, statewide figures are not a recommended benchmark but rather a baseline for comparison on regional disparities in supply.)

Source: “2024 License Renewal Survey Data, Representing Active Licenses as of December 3, 2024,” custom data request, HCAI, received April 14, 2025.