25/02/2016
One more reason why we need to continue to support our Free Peoples Clinics
of Herbalists Without Borders...
Poor Health: Poverty and scarce resources...
Patients wait in line at a monthly clinic at City on a Hill, which is in one of Milwaukee's poorest neighborhoods.
Locally, in the distressed community of Braddock, residents fought a long battle against the closure of their local hospital. UPMC shut down the Braddock facility in 2010 and protesters gathered in the street as the building was razed months later, tolling a bell for the 104-year-old institution.
Hospitals and family doctors, the mainstays of health care, are pulling out of poor city neighborhoods, where the sickest populations live.
A Pittsburgh Post-Gazette/Milwaukee Journal Sentinel analysis of data from the largest U.S. metropolitan areas shows that people in poor neighborhoods are less healthy than their more affluent neighbors but more likely to live in areas with physician shortages and closed hospitals.
At a time when research shows that being poor is highly correlated with poor health, hospitals and doctors are following privately insured patients to more affluent areas rather than remaining anchored in communities with the greatest health care needs.
The Post-Gazette/Journal Sentinel analysis shows that nearly two-thirds of the roughly 230 hospitals opened since 2000 are in wealthier, mostly suburban areas.
As health systems open those facilities, they have been closing their urban counterparts. The number of hospitals in 52 major cities in the United States has fallen from its peak of 781 in 1970 to 426 in 2010, a drop of 46 percent.
Most of the facilities closed were small to mid-size community hospitals in poor urban neighborhoods and public hospitals, leaving many low-income neighborhoods with no safety-net hospital.
New York City's boroughs have lost more than 20 hospitals since 1990. Detroit has gone from dozens in the 1960s to four.
Locally, in the distressed community of Braddock, residents fought a long battle against the closure of their community's hospital. UPMC shut down the Braddock facility and razed the building in 2010 as protesters gathered in the street, tolling a bell for the 104-year-old institution.
Since 1988, Milwaukee County has lost its public hospital and five city hospitals.
One of those is the former Milwaukee Hospital. A small nonprofit called City on a Hill now operates in a wing of the large complex, which overlooks one of Milwaukee's poorest neighborhoods. Once a month, when the agency hosts a free clinic on a Saturday, a line forms more than an hour early and stretches down the block.
The closures have been going on for decades.
Between 1990 and 2010 alone, 148 nonprofit hospitals closed in the largest American cities, along with 53 for-profit hospitals.
In addition, five public hospitals closed, according to Alan Sager of Boston University, who has tracked and studied hospital closures in the United States. His research shows it's not just poor-performing hospitals being closed; the ones that shut down often are rated as being more efficient than those that remain.
"In a competitive free market, efficient hospitals would be likelier to survive," he wrote in a paper summarizing some of his research results. "That hasn't happened, providing evidence that no such market is present."
When communities lose hospitals, they lose doctors, too.
The newspapers' data analysis shows that doctors are scarcer in poor neighborhoods: Fifty-eight percent of the nation's 5,800 federally designated "primary care shortage areas" fall in census tracts of highest poverty in the 52 major metropolitan areas. In the 52 metro areas, at least one in five people live in a shortage area. Those areas also tend to have higher than average populations of people with disabilities.
These are typically neighborhoods where people are isolated by poverty. They are less likely to have jobs, less likely to have vehicles and access to healthy food, and more likely to face violence in and outside their homes.
As the presence of health care providers in low-income neighborhoods decreases, a growing body of evidence shows that poor people are more likely to be in poor health – indeed, poverty itself can make people sick. Excerpt from writer, Lillian Thomas
