Editorial: Addressing massive disparities in primary care

The reopening of Primary Care at Valeo will help one of our most underserved populations

Frank Henderson, chair of the Valeo Behavioral Health Care, cut the ribbon Wednesday to celebrate the reopening of Primary Care at Valeo. The lack of financial funding had forced the closure of the clinic earlier this year. (Thad Allton/The Capital-Journal)

Last month, we celebrated the opening of the Pine Ridge Family Health Center — a primary care clinic that serves Pine Ridge Manor, the largest public housing site overseen by the Topeka Housing Authority. For low-income Americans, a lack of access to primary health care can be disastrous. They suffer from untreated conditions because they can’t afford a visit to the doctor, and often end up paying exorbitant emergency room bills anyway. They neglect chronic health problems that get worse and more expensive over time. And many of them die far too young.

 

As Harvard public health professor Ichiro Kawachi explained in a February 2016 article in the Harvard Gazette, “There are huge inequalities in this country that often get overlooked … If you want to observe the problems of poverty and inequality, you don’t need to travel all the way to Malawi. You can go to a rural house in America.” Or a house in certain parts of Topeka. According to a 2014 report commissioned by Shawnee County, there are 21,000 uninsured residents in our community and 16,000 people with “unmet primary care need.”

Race is a significant predictor of insufficient primary care. A 2016 Kaiser Family Foundation analysis found that 21 percent of black Americans and almost a quarter of Hispanics didn’t receive or had to delay health care in 2014. The proportion was only 14 percent for whites. A 2012 study in Health Services Research reports that, while 13.2 percent of white Americans live in “zip codes with few or no primary care physicians,” this proportion increases to 24.3 percent for Hispanics and 25.6 percent for blacks.

A lack of primary care can be particularly debilitating for Americans who suffer from mental illness. Not only are they disproportionately likely to be impoverished, but mental illness can also exacerbate existing inequalities. For example, a 2001 report from the U.S. Department of Health and Human Services highlights the racial disparities associated with mental health treatment: “Racial and ethnic minorities have less access to mental health services than do whites. They are less likely to receive needed care. When they receive care, it is more likely to be poor in quality.”

These are all reasons why the reopening of Primary Care at Valeo — which shut down earlier this year when St. Francis was up for sale — is a major boon for the health of our community. A $250,000 gift from the St. Francis Foundation allowed the clinic to start seeing patients again in October. Valeo Behavioral Health Care CEO Bill Persinger says the donation will fund the clinic for two years: “We’ll combine that with other revenue, like we’ll bill Medicaid or Medicare and people will pay what they can out of their own pockets.”

According to a 2016 study conducted by two MIT researchers, the richest 1 percent of American men can expect to live 14.6 years longer than the poorest 1 percent — a gap the drops to 10.1 years for women. Persinger points to the staggering discrepancy between average Americans and those with severe mental illnesses: “We have discovered through research nationally that people who have a severe mental illness like schizophrenia have a life expectancy about 25 years less than the normal population.”

These are numbers that should horrify every American, and we hope the reopening of Primary Care at Valeo will bring them down in our community.

Members of The Capital-Journal’s editorial advisory board are Zach Ahrens, Matt Johnson, Ray Beers Jr., Laura Burton, Garry Cushinberry, Mike Hall, Jessica Lucas, Veronica Padilla and John Stauffer.

 

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