This is the approximate population of Juneau, Alaska. It is also one-third the number of people who can sit in Sanford Stadium on game day. More shockingly, this is the number of people who currently live without health insurance in Athens-Clarke County.
1. The underserved includes individuals who are uninsured.
In 2010, 22.8% of Athens-Clarke residents were uninsured (1). This is a gigantic proportion of the community, especially considering that only 16% of the entire US population is uninsured (2). The median household income is $34,000, and 33.3% of the county lives at or below the federal poverty level (1). The rate of unemployment in Athens is 7.5%.
Based on these statistics, one might make the following assumption: underserved = low-income people who cannot afford health insurance. However, this is not always the case. In fact, according to the Kaiser Family Foundation, only four in ten uninsured individuals earn incomes less than the federal poverty level (3).
So. Who exactly are the uninsured?
Health insurance coverage is oftentimes tied to employment in the US. As a result, people who are uninsured tend to lack coverage because they are either unemployed or do not receive health benefits from their employers. Given this fact, neither work status or education level accurately reflects an individual's insurance status. People from any background can be uninsured, although minorities and low-wage employees are disproportionately effected.
2. The underserved includes individuals who, for whatever reason, are unable to access medical care.
http://www.veraquestresearch.com/veraspectives/ill-go-to-the-doctor-tomorrow/
Access to health insurance does not equal access to affordable, quality health care. Other structural barriers prevent people from receiving health services in Athens, Georgia. Below are examples of possible barriers to health care access.
Inadequate physical infrastructure: 8% of households in Athens do not have access to a vehicle (1). As a result, some Athens patients depend on public transportation in order to attend medical appointments. Public transportation can be unreliable, expensive, and inconvenient. As a result, patients forgo medical care because they cannot get to the clinic on time.
Demand>>Supply: The shortage of physicians and medical clinics contribute to the underserved's inability to access health services. Currently, medical centers such as Mercy Health Center, Athens Nurses Clinic, and the Athens Neighborhood Health Network (more on these later) are unable to meet patient demand in terms of sheer numbers. Although hundreds of people request new patient status at Mercy Health Center every week, the clinic is only able to add ten patients per week due to limited resources (4).
Low willingness to accept Medicaid: Medical providers may be hesitant to accept Medicaid patients because of low reimbursement rates. Medicaid is a joint state-federal health insurance program that provides long-term care and covers many low-income families.
Other barriers include an unwillingness to seek care due to cultural/linguistic barriers, a lack of access to care because of immigration status, and a low level of awareness for the value of preventative and follow up care. Overall, the underserved includes a diverse group of individuals who face a common challenge to access health services. Athens has made progress in removing some of these barriers by investing in free clinics and developing alternative models of care provision. However, we still have a long way to go. Next week, I will write about free/government-funded health clinics and examine how they function as a safety net for the Athens community.
P.S. Since this is a global health class, I will end the entry with an interesting map that compares the number of patients per physician between different countries. The US is doing relatively well, and we do have much to be thankful for in our communities.
http://strangemaps.files.wordpress.com/2007/10/276540-poster594x420mm_eng.jpg
Endnotes:
1. http://www.georgiastats.uga.edu/counties/059.pdf
2. http://www.statehealthfacts.org/comparetable.jsp?ind=125&cat=3
3. http://www.kaiseredu.org/Issue-Modules/The-Uninsured/Background-Brief.aspx
4. http://athens.patch.com/articles/demand-for-free-health-care-growing-in-athens-ga?ncid=newsltuspatc00000001#photo-13454753
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