Entry to healthcare isn’t sufficient, we should construct neighborhood belief


In June, a new report from the Centers for Diseases Control on access to Covid-19 therapies revealed a gaping hole in our nation’s healthcare system. Despite having established nearly 40,000 dispensing sites – particularly in high-vulnerability neighborhoods – those areas had the lowest rates of distribution. In short, lifesaving treatments are available, but the people who need them the most aren’t getting them.

Why? Because making more medicine available doesn’t address the underlying systemic problems that lead to health inequities.

For the affluent, our nation’s healthcare system works well – or well enough. But for people in underserved communities, both urban and rural, the existing system isn’t delivering the right care and resources, at the right time, to the people who need it most. Increasing the availability of quality healthcare doesn’t address the obstacles that prevent patients from receiving that care.

For example, most people are paid only for the hours they work. Two-thirds of low-wage workers don’t get paid sick days, and they simply can’t sacrifice hours of income to get healthcare. And according to the American Hospital Association, millions of Americans don’t seek care because they don’t have access to safe and reliable transportation.

Securing childcare is also out of reach for many families, which is why parents, especially mothers, often skip the care that could help them. A recent study found that 2 out of 3 low-income parents skipped medical care – even though over 48% suffer from at least one chronic condition.

The problem goes deeper than accessing care during an illness. Sometimes, more importantly, preventive medicine doesn’t occur, ensuring poor health outcomes down the road. Ongoing management of conditions like addiction or diabetes, gets disrupted or ignored, and conditions that can be detected and treated early, like cancer or heart disease, get pushed off to some time in the future. Studies have shown, for example, that women with lower incomes are much less likely to get regular mammograms.

It’s a vicious cycle because poor health outcomes contribute to poor employment outcomes too – meaning an increased risk of poverty, stress and homelessness. Children suffer alongside their parents which perpetuates the cycle. For example, children from low-income families are diagnosed with autism about eight months later than those from wealthier families – one reason being that they are less likely to receive regular well-child visits.

So, where do we go from here?

As that CDC report illustrates, flooding a community with “resources” isn’t enough. The missing piece is connecting those resources to the people who need them. This is where mobile health clinics can make a difference. Mobile clinics mean that patients in underserved communities have to jump through far fewer hoops to secure high-quality care. Multiple studies have shown that mobile health clinics are particularly effective in facilitating access to health care for marginalized groups, including people of color, immigrants, and LGBTQ+ populations. Not only do they advance health equity, but they also complement other objectives of health care organizations, such as building trust and expanding community reach.

Around the country, there are more than two thousand mobile health clinics that provide customized and critical services to communities that are in some way detached from the traditional healthcare system. Currently, these clinics serve about seven million Americans, but the need is much greater.

These clinics provide a wide variety of services ranging from cancer screenings and STD tests to birth control and other pregnancy-related services. They also provide preventive care, health and wellness counseling, and referrals to employment, housing and food resources. Patients don’t have to come to us; we go to them.

Longstanding inefficiencies up and down the healthcare delivery chain have created effectively invisible barriers to much-needed healthcare. By working closely with the community to reach those most in need and build trusting relationships, we can deliver high-quality care in a way that addresses the needs of the whole person, no matter who they are or where they live.

Photo: Nina Shatirishvili, Getty Images



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