National Rural Health Day was created to recognize rural health workers for their efforts and the collaborations that address the unique challenges faced in rural communities.
Why is this opinion column appearing in The Sun?
Did you know a large part of Alachua County is rural including towns such as High Springs, Micanopy, Hawthorne, Newberry, Archer, Waldo and La Crosse, as well as the farms, state parks and unincorporated areas in between? And these areas often have a much higher poverty rate than Gainesville? For example, in the northeastern portion of the county, the percentage of residents living in poverty is 58 percent and 43 percent of residents have less than a high school education. We are surrounded by rural counties where many of our fellow Gainesville employees live.
Did you know that there are significant health disparities in Alachua County? In rural areas, residents often have higher rates of health risk factors such as smoking, obesity and physical inactivity as well as poorer health outcomes. In the counties directly north of Alachua County (their data as proxy for the rural portions of Alachua County), preventable hospitalization rates and premature deaths are among the highest in the state!
Why does that matter? There are numerous reasons — but the two I'd like to focus on are economics and health equity.
It is no mystery that people without affordable access to health care are sicker, miss work more often or are not able to work, have poorer long-term health outcomes, live shorter lives and often have a diminished quality of life. Uninsured people seek health care services in emergency rooms, when they are forced to address an immediate health concern. This is a hugely expensive and inappropriate use of taxpayer dollars. Not only is emergency care the most expensive place to get primary health care, but these patients do not receive help managing their health conditions over the long-term.
Healthy People 2020 defines health equity as "attainment of the highest level of health for all people." One barrier to affordable health services is having insurance. In our county, the rural area directly north of Gainesville, including Monteocha, has higher than 20 percent and sometimes 30 percent uninsured residents versus under 10 percent for the heart of Gainesville. An example of health disparities is that we find higher death rates in rural areas from cancer and often it is detected much later in the disease process.
Of course, you can't separate health outcomes from social determinants including social and economic environments, the physical environment, and individual characteristics and behaviors. By the way, these determinants are often linked to many other outcomes such as educational attainment, income and earning potential, abuse and neglect rates, incarceration, etc. The Gainesville For All initiative led by Sun columnist James Lawrence is doing an excellent job of identifying social determinants' action steps in our community.
I want to raise up the good things being done in area to improve rural health care access and quality in Alachua County — and how you can help.
Alachua County has a strong and very collaborative health care safety net. The backbone is provided by UF Health Shands, which serves the highest percentage of our uninsured patients. There are also local providers who accept Medicaid or provide discounted care for uninsured patients.
Three rural health clinics in our county provide comprehensive medical and/or dental home health care with affordable sliding scale fees: ACORN Clinic in the north part of the county (medical and dental, social service referrals: ACORNclinic.org), Archer Family Health Care in the south (medical and mental health: https://ufhealth.org/archer-family-health-care) and Palms Medical Group's High Springs branch (medical: palmsmg.org).
The Alachua County health care safety net is supported by the We Care Physician Referral Network. We Care uses free volunteer services of Alachua County physicians and our area hospitals, dentists, mental health care providers, and 2 medical and dental laboratories, as well as other ancillary service providers such as home health care agencies and physical therapists. Since 1990 the program has provided more than $90 million in health care service to our uninsured and low-income residents!
No matter what transpires with private or government-supported health insurance, there will always be people who fall through the cracks. These local clinics help form the "safety net of the safety net." They are here for you, your family, friends, neighbors and acquaintances. Check out their websites so you can refer people to them. They all need your time, talent and/or treasure to sustain them in their crucial roles in our rural communities.