Today’s Managing Health Care Costs Number is 4
Kaiser Health News published a series of articles earlier this week about health care and the Sandtown-Winchester – the Baltimore neighborhood where Freddie Gray was arrested before he died of a spinal chord injury in police custody, which led to a week of riots. The title is “Baltimore’s Other Divide.” Sandtown is just five blocks from the main University of Maryland hospital – but the health of the community is just awful, and the medical community struggles to offer the right care to address a series of social issues that the mainstream medical system just wasn’t designed to handle.
How awful is the health of the community?
· Average life expectancy is under 70; it is 84 in a wealthy neighborhood six miles away. (The article notes that life expectancy in this district is the same as in North Korea.)
· Lung and heart disease are twice the state average
· More babies (2/10) are born underweight than anywhere else in Maryland
· Only 37% of pregnant women get adequate prenatal care
The reporters write:
Residents of the ZIP code including Sandtown accounted for the city’s second-highest per-capita rate of diabetes-related hospital cases in 2011, the second-highest rate of psychiatric cases, the sixth-highest rate of heart and circulatory cases and the second-highest rate of injury and poisoning cases. Asthma, HIV infection and drug use are common.
In one of the federally qualified community health centers in the area,
Up to 60 percent of … patients are so poor they live a subsistence, survival-based existence, said Dr. Janice Stevenson, a staff psychologist and vice president. Some patients have never gone to the beach or even Baltimore’s famous Inner Harbor, she said.
Health care disparities are a major reason why the US underperforms most other developed countries in terms of health care quality and outcomes. It’s hard to make the “average” Americans healthy when so many live in terrible social conditions – and access to medical care is just a piece of the puzzle. The articles aren’t all about hopelessness. Hospitals are teaming up with homeless care agencies, and the health centers deploy community health workers.
These medical problems cannot be solved within the health care delivery system alone. Sustained efforts to address a cycle of financial hopelessness are necessary to achieve better health outcomes.
