# Elk Grove In National Context

## Headline

When you scale the hospital comparison from California to the full United States, Elk Grove still stands out.

Using the Census Bureau's **2024 incorporated-place population estimates** and a national public hospital layer with a **last edit date of December 14, 2020**, Elk Grove appears to be the **138th-largest incorporated place in the country** and one of only **four incorporated places with 150,000+ residents that match to zero open general acute care hospitals inside city limits**.

Those four are:

1. Santa Clarita, California
2. Peoria, Arizona
3. Elk Grove, California
4. Sunnyvale, California

That makes Elk Grove unusual not just in California, but nationally.

## Why this is still a fair claim

The national hospital layer is older than the California-specific hospital dataset used in the earlier California memo, so this national comparison should be treated as **directional rather than perfect**.

Still, the main Elk Grove result is reinforced by the fresher California-only check:

- The national file also shows Elk Grove at `0` in-city general acute care hospitals.
- The California-specific 2026-era hospital layer also showed Elk Grove at `0`.

So the outlier status is not coming from a single stale source.

## Closest national peers

Among the closest U.S. population peers, Elk Grove is the only city in this immediate cluster with zero matched general acute care hospitals.

| Place | 2024 population | Open general acute care hospitals |
| --- | ---: | ---: |
| Glendale, CA | 187,823 | 3 |
| Clarksville, TN | 185,690 | 1 |
| Ontario, CA | 185,285 | 2 |
| Newport News, VA | 183,056 | 2 |
| Elk Grove, CA | 182,797 | 0 |
| Cary, NC | 182,659 | 1 |
| Aurora, IL | 180,710 | 2 |
| Salem, OR | 180,406 | 1 |
| Pembroke Pines, FL | 179,326 | 2 |
| Eugene, OR | 178,786 | 1 |
| Santa Rosa, CA | 177,524 | 4 |
| Rancho Cucamonga, CA | 176,675 | 1 |

## Chart pack

![Largest zero-hospital cities](/Users/alexbonnifield/Documents/Hospital%20Analysis/outputs/chart_largest_zero_hospital_cities.svg)

![Elk Grove peer comparison](/Users/alexbonnifield/Documents/Hospital%20Analysis/outputs/chart_elk_grove_peer_hospitals.svg)

![Population versus hospitals](/Users/alexbonnifield/Documents/Hospital%20Analysis/outputs/chart_population_vs_hospitals.svg)

## Files generated locally

- `outputs/us_large_cities_hospital_comparison.csv`
- `outputs/us_large_cities_without_general_acute_hospital.csv`
- `outputs/elk_grove_us_closest_peers.csv`
- `outputs/chart_largest_zero_hospital_cities.svg`
- `outputs/chart_elk_grove_peer_hospitals.svg`
- `outputs/chart_population_vs_hospitals.svg`
- `scripts/analyze_us_hospital_access.py`

## Sources

- U.S. Census Bureau incorporated-place population estimates: <https://www2.census.gov/programs-surveys/popest/datasets/2020-2024/cities/totals/sub-est2024.csv>
- National hospital layer metadata and fields: <https://services1-nocdn.arcgis.com/0MSEUqKaxRlEPj5g/ArcGIS/rest/services/Hospitals_WFL1/FeatureServer/0?f=json>
- National hospital layer paged query endpoint: <https://services1-nocdn.arcgis.com/0MSEUqKaxRlEPj5g/ArcGIS/rest/services/Hospitals_WFL1/FeatureServer/0/query?where=1%3D1&outFields=NAME,CITY,STATE,STATUS,TYPE,BEDS,SOURCEDATE&returnGeometry=false&resultOffset=0&resultRecordCount=2000&f=json>