DURHAM – Durham has an adequate number of doctors and other health-care providers but the overall health of its residents has a lot of room for improvement, according to participants in the Community Leadership Breakfast hosted by the Lincoln Community Health Center on Wednesday.
“We are the City of Medicine but not the community of health,” said Durham County Health Department Director Gayle Harris, a panelist for the event. Referring to data presented at the event, Harris noted that Durham residents have great disparities in health depending on race and income.
“The number one thing you can do to impact health lies in addressing socioeconomic factors –poverty, education, housing,” Harris said.
Lack of health insurance is a key part of the problem, according to another panelist, Benjamin Money Jr., president and chief executive officer of the N.C. Community Health Center Association. One solution is Community Health Centers like the Lincoln Community Health Center, but CHCs are facing significant funding challenges, Money noted.
“Only two out of 10 Lincoln patients are insured, but as a community health center, Lincoln provides high-quality care to all regardless of their ability to pay,” he said. “That is analogous to a restaurant that is always open and always serves good wholesome food. Everyone comes in, has their fill, but only 2 out of 10 can pay for the meal. How long can that business survive?”
The third panelist was Gina Upchurch, Executive Director of Senior PHARMAssist Program in Durham County.
The Community Leadership Breakfast came during Community Health Center Week (Aug. 7-13), an annual event designed to highlight the contribution of these centers to the nation’s health-care system. The centers are located in areas of high need – where poverty levels and infant mortality are high and where there are few practicing physicians.
Among the attendees at the event were Durham Mayor Bill Bell, Durham City Manager Tom Bonfield, Durham City Council Member J. Michael Woodard, state representatives Mickey Michaux, Winkie Wilkins and Paul Luebke, and staff members from the offices of U.S. Sen. Richard Burr and U.S. Rep. David Price.
Community Health Center week is especially meaningful this year because of funding cutbacks the centers are facing or already have sustained, organizers said.
According to a white paper released this week by the North Carolina Community Health Center Association, budget cuts are putting the future of CHCs at risk. The white paper notes that earlier this year Congress voted to cut Fiscal Year 2011 Health Center Program funding by $600 million. “Not only will this $600 million cut impact access to care for America’s most underserved communities, but the budget cut also halts the planned health center expansion that was to fund 350 new health centers across the country,” the white paper stated.
CHCs are also facing proposed funding cuts at both the state and federal level, said Dr. Evelyn Schmidt, Chief Executive Officer for the Lincoln Community Health Center.
“We’re fighting just to get back to the level of funding that we had last year,” Dr. Schmidt said. “And this is despite the fact that community health centers provide health care at significant cost savings for the health-care system.”
Dr. Schmidt noted that another report released this week by the Geiger Gibson Program in Community Health Policy at the School of Public Health and Health Services at The George Washington University found that CHCs provide the most efficient form of health care. The report concluded: “On average, total annual health care spending for North Carolina patients served by health centers was 62 percent less than for those patients with similar health status and demographic characteristics served in other ambulatory care settings.”
At the breakfast, Mel Downey-Piper, coordinator of Partnership for a Healthy Durham, presented data showing areas of significant strength and disparities among Durham County residents. The county has one primary care provider for every 352 residents, a figure well above the national benchmark of one per 631 residents, Downey-Piper said. Overall, Durham is the ninth healthiest among North Carolina’s 100 counties, she said.
But those figures mask significant disparities, according to date she presented. For instance:
- The pregnancy rate among Black and Hispanic teens, aged 15 to 19, in 2009 was 85 and 180 per 1,000 residents, respectively, which far exceeds the rate for whites, about 50 per 1,000.
- Depression among Hispanic high school students was almost twice the rate for white high school students.
And despite overall health, there were significant areas for concern, Downey-Piper reported. For example:
- Almost a third (29.3 percent) of adults were obese, according to the county’s 2010 health report.
- The county’s rate for sexually transmitted infections of 551 per 100,000 residents is well above the national benchmark of 83.
- One in five residents is uninsured.
If state and federal lawmakers do not provide sufficient funding for community health centers, the entire heath-care system will suffer, Money stated. He noted that Lincoln serves 44 percent of Durham’s uninsured. The center serves only 8 percent of Durham’s Medicaid patients but Money said that number could increase if $356 million in proposed cuts to the Medicaid program go through because private providers might stop accepting Medicaid.
“At what point will for-profit providers drop Medicaid?” Money said. “Then what happens? They come to Lincoln, which is already overcrowded with the uninsured. What happens when they can’t get an appointment? They go the hospital emergency room where the average cost is $570 for a visit vs. $123 for a community health center. Who pays for that? We all do in higher health care costs.”
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