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Better by : Hannah Truempi | ULSTL Mobile Health Unit Intern
Health
Prior to her first screening on the Urban League ’ s Mobile Health Van , Laura Johnson was breaking her costly blood pressure pills in half to make them last as long as possible . “ I knew it was bad to take just half a pill ,” states Ms . Johnson , “ but I was unemployed , uninsured , and unable to afford all of my medications .”
Fortunately , Ms . Johnson is not alone in the battle against rising healthcare costs . Forty-five percent of African American St . Louis residents are uninsured , compared to 18 percent in their white counterparts , and this disparity is on the rise . In addition to having a greater percentage of uninsured individuals , the African American population of St . Louis is plagued with deep health disparities . These disparities are strongly linked to the social determinants of health — the idea that where you live , work , and grow-up has the greatest impact on your health than any other factor . The distribution of money , power , and access to resources like healthy foods and green spaces all play a role in determining the health of a population . These systemic differences , with clear geographic divisions , are exacerbated in St . Louis , the sixth most segregated city in the United States .
In St . Louis City , mere miles determine differences in life expectancy of up to 20 years . A child born in the Jeff-Vander- Lou neighborhood , where 95 percent of residents are African American , can expect to live 18 years less than a child born in Clayton , where 80 percent of residents are white . In this case , five miles is all it takes to separate a life expectancy well above today ’ s national average and one that was the national average in 1950 . These low life expectancies in predominantly African American neighborhoods are rooted in governmental and school board policies that have systematically put the interests of White communities over those of Black communities , resulting in large ramifications on the education , income , and health status of African American St . Louis residents . Although individual lifestyle choices and personal responsibility are important in achieving better health , the context in which those choices are made has a great impact on their feasibility . For many African American St . Louis residents , making healthy decisions goes beyond personal choice .
While St . Louis has a long way to go to achieving health equity for all , the Urban League of Metropolitan St . Louis ’ Mobile Health Program is making large strides of progress . After receiving a $ 500,000 grant from the Missouri Foundation for Health in 2013 , the program ’ s mobile health van , a clinic on wheels , has travelled to 10 + zip codes where documented health disparities persist each month to give free health screenings on blood pressure , blood sugar , and cholesterol levels , as well as flu shot vaccinations . Parked outside of local grocery stores , places of worship , and community centers , the mobile clinic makes preventive services accessible to those who typically go without them .
For Timothy Jones , a St . Louis resident , the mobile clinic has changed his life . Before his first visit to the mobile clinic , Mr . Jones was unaware that he had very high blood pressure . After being advised to visit his primary care physician by one of the van ’ s nurses , Mr . Jones was put on medication for the rest of his life . “ If this wasn ’ t caught sooner , I ’ m sure it would have resulted in a costly trip to the emergency room ,” he states . Now , Mr . Jones is a regular on the van . “ I make sure to get the van schedule each month and visit it at least every two weeks to check my levels ,” he says . “ The convenience and friendliness of the van has made it easy for me to stay on top of my health . In the past 6 months I have seen my blood pressure , blood sugar , and cholesterol levels decrease and I have more energy than I ’ ve had in years ,” he adds .
In addition to offering free health screenings , case managers within the Mobile Health Program follow up with clients with elevated levels and those who report experiencing barriers to healthcare in an effort to connect them to the services they need . This “ bridge to care ” ensures that not only are clients aware of their health , but that they make appointments with their primary care physicians if their levels are high . The program provides financial assistance to those who need help covering the costs of co-payments , medications , or transportation to and from appointments . Case managers also connect clients to other safety-net programs and make referrals to free or reduced services offered by healthcare organizations in metropolitan St . Louis .
African Americans in St . Louis face several barriers to making healthy decisions . One of these barriers is the lack of primary care and prevention services in predominantly Black communities . In north St . Louis City , there are 25 physicians for every 10,000 residents , a number that is 70 percent less than the rest of St . Louis City . Those without a usual source of care typically utilize emergency rooms at higher rates . As a result , hospital charges for heart disease , cancer , and diabetes in St . Louis come to upwards of $ 1.1 billion annually . Reducing the disparities in these three diseases through increased preventive health interventions within African American communities could lead to a savings of $ 65 million per year .
For St . Louis resident Cornelia Jackson , this assistance allowed her to get the care that she needed , but could not afford . Earlier in 2016 , Ms . Jackson was struggling to pay for high healthcare bills that were not covered by her insurance program . “ I was in debt to my doctor ,” explains Ms . Jackson , “ And because of this , I was not able to go to appointments as necessary or cover my medication costs .” Since stepping on the van in July of 2016 , Ms . Jackson has been assisted with both co-payment and prescription costs , both of which have allowed her to live a happier , healthier life . “ Health is important to me because I want to live independently and help other people for as long as I can ,” states Ms . Jackson . CONTINUED >
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