(Anniston Star) — Randall Pringle knows where to take a sick cow, but he’s not so sure about where he’d go if he got injured on the job.
“I guess I’d go to Montgomery,” said Pringle, who owns a farm near Hayneville and travels to other ranches as a working cowboy. “There’s a hospital there. But I try to just stay safe.”
Pringle is one of about 11,000 people who live in Lowndes County, where there’s no hospital and, as residents are quick to point out, only one doctor. Rural and poor, this Black Belt community ranks near the bottom, statewide, in most measures of public health.
11,000 people live in Lowndes County, with no hospital and only one doctor
Communities like Lowndes County may soon get a closer look from state government. In his State of the State address, Gov. Robert Bentley announced that he plans to appoint a Health Care Improvement Task Force to create a plan to “improve the quality, affordability and accessibility of health care.”
The governor said in remarks on Tuesday that he’d announce the appointment of a 37-member panel this week.
“We want to bring everyone together,” Bentley said. “We’re asking people to leave their turf at the door, and we’re asking people to talk about real solutions for health care in the state of Alabama.”
Travel for care
For most Alabamians, it’s no secret that the state is sicker than most of America. By most counts, Alabama ranks among the top 10 states for obesity and physical inactivity. In a regular survey by the Centers for Disease Control, one Alabamian in nine said they’d been diagnosed with some form of diabetes. Life expectancy for a child born in the state is 75.4 years, according to the Kaiser Family Foundation — 3.5 years below the national average. Mississippi is the only state where the expected lifespan is shorter.
For public health experts, it’s a complex problem. For people in Hayneville, seat of the county without a hospital, the solutions are simple.
“A place where people could get dialysis would be great,” said Ethel Seals, a retired medical technician who lives in Hayneville. “We have a lot of diabetics here. They shouldn’t have to go to Montgomery.”
Seals was among more than a dozen people who were socializing at Hayneville’s senior center Tuesday morning. Many of them arrived on a bus run by the senior center. Seals said that in a poor community, even people who have health insurance have to travel to Selma or Montgomery — both about a half-hour drive — for a problem that requires a hospital.
“All of us wear glasses,” Seals said, referring to the crowd at the senior center. “We have to go to Montgomery for that, too.”
Lowndes County ranked 66th out of 67 Alabama counties in health care outcomes in a study released last month by the Robert Wood Johnson Foundation. Thirty-six percent of the county’s residents reported they were in fair or poor health, compared to about one in four statewide. Forty-four percent of county residents were obese. The ratio of residents to primary care doctors was 10,857 to 1, a far cry from the roughly 1,000-to-1 ratio the foundation found in the nation’s healthiest communities.
Sanders for Medicaid
Even without a hospital, health care seems to make up a significant portion of Hayneville’s economy. Stores are few — Family Dollar, Dollar General, Hayneville Associated Groceries — along Alabama 21, the main street. But there’s a drug store on the town square, the medical clinic and the health department. A sign planted along the highway urges residents to enroll in Obamacare. Nearby, another sign reads “Keep the Rock — Vote Sanders.”
Sen. Hank Sanders, D-Selma, has been one of the state’s most vocal proponents of expansion of Medicaid under the Affordable Care Act, something Bentley has said he won’t do. Like other Democrats, Sanders has argued that expansion would help not only health care, but the economy.
“If we expanded Medicaid, it would help everybody, but it would help poor counties like Lowndes disproportionately,” Sanders said. “We don’t need another study to tell us that.”
In Alabama’s worst-ranked county for health outcomes, things look a little different.
Walker County, with a population of just under 66,000, has its own hospital, and is next door to Jefferson County, home to some of the South’s best medical centers.Yet it ranks below Lowndes in the Robert Wood Johnson Foundation study, with similar rates of premature death and people reporting they were in ill health.
“Oh, it’s terrible,” said Sen. Greg Reed, R-Jasper, who represents the area. “The numbers are awful.”
Poor nutrition, little exercise
Assistant state health officer Karen Landers, who doubles as director of Walker County’s health department, said that despite the presence of a hospital, making health care accessible to people in the rural part of the county has been a challenge.
Obesity, though, is a bigger problem for the county, she said. A lack of grocery stores with healthy options — and a lack of places to exercise — has been a problem for people in rural parts of the county, she said.
“I don’t want to say that this is the only issue,” Landers said. “But it’s the most important issue that we can turn around in order to change the health care situation as a whole.”
Jim Carnes, policy director for the group Alabama Arise, has served on health care task forces for Bentley in the past. He says the state’s biggest health care problems are already well documented.
“We’re all accustomed to ranking in the high 40s and sometimes 50th on major health statistics,” he said. “It’s easy to become cynical.”
Carnes said that to address its residents’ chronic health problems, the state will almost certainly have to address a lack of access to doctors. He said he expected the task force to look at ways to train more doctors and get them into rural communities, as well as “scope-of-practice” issues that would get more nurse practitioners or other professionals into those areas.
“Closing the insurance coverage gap would help with that,” he said. “But I wouldn’t exactly call that low-hanging fruit,” he said.
By Tim Lockette, Source