Letter: Access to healthcare can improve disparities in health outcomes
Letter to the editor
As a society, we have a duty to ensure that all individuals have access to high-quality healthcare regardless of their geographic location or socioeconomic status. The County Health Rankings & Roadmaps program helps us to uphold that responsibility by individually ranking counties within each state based on their health outcomes and health factors. We define health outcomes as measurements of how long people live and how healthy they feel during their lifetime. On the other hand, health factors measure health behaviors, clinical care, social determinants, economic factors, and the physical environment. Data is collected from various sources and compiled to ultimately give each county a rank in comparison to other counties within the state.
While it sounds logical that health outcomes and health factors would proportionally align, many areas of the country do not follow this trend. To show this misalignment on a more local level, we compared two counties in Florida utilizing the County Health Rankings. The disparity in health factors and outcomes between Alachua County and Miami-Dade County portrays that a medically saturated city, like Gainesville, FL, does not necessarily translate to comparably high-ranking health outcomes. While Alachua County ranks 3rd in health factors, it falls behind in 31st place for health outcomes. In contrast, Miami-Dade County ranks 32nd in health factors but rises to 6th place for health outcomes. This begs the question: What is causing this disparity between health outcomes and health factors in these two counties? More importantly, what can we do as a society to combat this disparity?
We turned to the literature to search for information on rural-urban socioeconomic disparities, rural health behaviors, rural-urban dietary differences, diseases contributing to rural morbidity, environmental quality of Alachua County, and the rationale behind the County Health Rankings. Upon analyzing the data from the Well Florida Council Alachua County Community Health Assessment and the 2019 Community Health Assessment Miami-Dade County from the Florida Department of Health, we found that the greatest health disparity between the two counties lies in the high-poverty urban and rural populations. This suggests that socioeconomic status, location, and culture-linked behaviors are all related to health factors’ influence on health outcomes.
In Alachua compared to Miami-Dade County, lower rankings in socioeconomic status, physical environment, and health behavior factors are offset by a high prevalence of clinical care. However, this wealth of clinical care is not accessible to the entire community. By providing urban-level access to health-behavior educational resources, Alachua County could provide its geographically isolated, high-poverty communities with equitable health care. This endeavor could improve health outcomes for all of Alachua County and ultimately bring it more in line with Miami-Dade County in regard to health outcomes. We have a duty to ensure that all individuals within our communities have access to high-quality medical resources and services. We must address the underlying causes of these harmful health disparities and take action to provide all individuals–regardless of their location or socioeconomic status–with the healthcare they need to not only survive but to thrive.
Sarah Murphy, Emily Draper, Priyanka Devaguptapu, David Pfaehler, and Joseph Hartman
– MD Candidates at the University of Florida College of Medicine
The opinions expressed by letter or opinion writers are their own and do not necessarily represent the views of AlachuaChronicle.com. Letters may be submitted to info@alachuachronicle.com and are published at the discretion of the editor.
Wonder how many of the MD candidates are going to be willing to take less than the customary charge for providing care? Probably as many as the number of attorneys who are willing to provide free legal counsel to those seeking legal advice. (Without regard to the outcome of pending litigation of course)
The argument will be made that they need the fees associated with their chosen professions to pay back any loans that may have occurred. If that’s the case, shouldn’t those tuition costs be lowered to make it more conducive to helping people as so many from a particular political class claim? Which could lead to the conclusion that the institutions of higher learning are actually institutions of great hypocrisy.
Keep believing.
Some medical employers and NGOs already pay off school debts in return for working awhile for them.
Operative word being “some.”
Point is, most people who enter the legal or medical professions care more about the potential income and prestige than they do about actually helping people.
Maybe a higher health factor just does not lead to a better health outcome. The entire western medical system is broken. It’s all based on profits by masking symptoms. Perhaps the medical industry is failing as a health care system because it never addresses the underlying problems. Building more clinics and writing more scripts is not the answer!…it’s a business model to sell more products and services. This is a very odd editorial piece to say the least
*not an editorial piece*
Sorry for the typo.
op-ed is more apt
Health care is a commodity, not a right. Therefore, there will always be a profit motive in large health care settings.
Health insurers are the problem. Ask a doctor how much something costs, and they won’t be able to tell you.
Medical providers have to compete with each other by buying the latest patented technology and writing the latest non-generic drug scripts. I suggest public and private healthcare stop competing with each other. Public (Medicare, Medicaid, Obamacare, and gov’t employee/retiree health plans) use ONLY generic drugs and expired patent technology. Then private insurance plans for everybody else use newest Rx and patented high tech (if they think it’s really better) for more cost (and better outcomes?).
Umm, what about Obamacare? I thought that was the miracle, if you do tax returns anyway? Of course if you don’t bother filing a tax return you may be ineligible, is that not an incentive then? Then we won’t need 80,000 new IRS agents… 🧐🤔
“As a society, we have a duty to ensure that all individuals have access to high-quality healthcare regardless of their geographic location or socioeconomic status.”
Wow, this op-ed starts off like a steaming pile of dung still on fire. We have no such duty.
Maybe the authors should ask themselves if a ‘medically saturated’ community actually results in worse health care outcomes? A community full of doctors pumping their patients full of pills as directed by Big Pharma; a community full of doctors telling their patients to wear a mask and stay indoors for 2.5 years b/c old and fat people are dying…you mean to tell me that community might have worse health outcomes than a city that largely ignored these overeducated dorks? Until medical education is stripped on its over-reliance on Big Pharma and Big Agriculture, you can expect to see the continued assault on American health outcomes.
Authors are spot-on.
Value-based care, study that concept.
And it’s not “medically-saturated” if all don’t have access.
Congrats to our future healthcare providers for a great editorial!
This comes from the UF medical school that was found doing CRT teaching. With Obamacare and Uncle Joe there should be no one without healthcare. Insurance companies are a big part of differing health care options but doctors also have the obligation to inform a patient of all available treatments irregardless of whether they can afford it. It seems that Big Pharma influences doctors on what to tell patients to make the biggest profit.
Typical “get off my yard” response from commenters here.
Yeah, in a civilized society, citizens should have access to good health care, and the rest of the civilized world doesn’t have a big problem with that. In fact, we have the most expensive system in the world and are the only one in a developed country without universal coverage. Those other countries do this with differing combinations of government and private coverage, so ideological responses to this are nonsense. There are differing ways to achieve this civilized goal. At this point someone will bring up medical tourism and how the US is a destination for wealthy patients. Keep in mind that greater numbers of Americans leave to go places were they can afford treatment.
As to comments about how bad our medical system is, maybe we can agree that it is too expensive and the problem lies there. But as to the effectiveness of modern health care – and as someone healthy enough now to hike 4 miles or bike 10 miles any day, and over 70, but who has had 3 serious health problems which could have killed me – we have the good fortune to benefit from the advanced science and medicine of today, which continues to exponentially improve. And by the way, that included the development of Covid vaccines in less than year which saved millions of lives. What do you think those who lived and died during the Bubonic plague of 1250 would have given to have a vaccine?
Talk about spoiled, most of you seem to think we are going backward and you’re paying too much. Well, given examples from elsewhere in the world, also using the advanced medical abilities we share, we are paying too much. But that is fixable. The continued advances happening at places like UF are cause for celebration and pride, at least equal to whatever the Gators pull off in football season.
I commend the authors of this letter for their goal and dedication.
Figured you would toot their horns.
People have access to healthcare…is it affordable? That depends on who you ask. Why not ask these MD candidates how willing they’ll be to set up their clinic over on the east side of Alachua County.
What’s their goal? How can you determine what their dedication is to?
It’s easy to know who you’re dedicated to. Glad there’s enough of you to share and the Poes and Wards don’t mind sharing.
I may print your comment out. It’s perfect. In three paragraphs you’ve managed to capture the ethos of a generation. Completely out of touch Boomer who inherited the richest country known to man and pissed it away on feel good platitudes.
Newsflash, you confuse a paltry, domesticated society for a civilized one. Our health outcomes are terrible because people stuff their fat faces with crap food, sit around and watch TV all day and then pray at the alter of Science to fix all of the negative consequences.
Anyone continuing to advocate for the efficacy of the Covid vaccine is delusional…or a victim of 50 years of non-stop propaganda. Maybe there’s no distinction to be made.
https://ourworldindata.org/grapher/united-states-rates-of-covid-19-deaths-by-vaccination-status
We have a choice about what we eat.
Science doesn’t need an alter. It flies planes, cures the sick, and multiplies loaves. If God could do that on his own, he wouldn’t keep losing market share.
Science can’t fix stupid.
That’s a choice people make…you should make a different one.
Yes very convincing data. The foxes are telling the hens not to worry. Carry on hens!
If we have a choice about what we eat, what does that say about the average American who eats terribly? A civilized society would shame these people into being thin and healthy, not indulge them and offer them a new and improved pill with side effects a mile long.
Science does not, in fact, fly planes, cure the sick nor multiply loaves. Men do that. They do it by wielding science and submitting it to their will. When their will becomes decadent, rotten and misguided, science becomes decadent, rotten and misguided. How else to explain surgically castrating young children, insane rates of anti-social and psychological issues, and an ever increasing desire to subvert the natural order?
The gods are not losing market share, they’re just on vacation until we stop acting like buffoons.
This data?
https://ourworldindata.org/grapher/united-states-rates-of-covid-19-deaths-by-vaccination-status
Sure, it’s all a big conspiracy involving tens of thousands of doctors and scientists, including 2 of my clients, one an ER doc, the other an ICU doc, who personally related to me the sad deaths from Covid they attended, almost all of whom were unvaxxed. One patient dying before his wife could get there, told the doc, “Tell my wife I love her, she’s still the most beautiful women I ever met, and get vaccinated.” There were an estimated 300k needless deaths in the US by people who refused to get vaccinated.
Of course science, like any knowledge and technology, can be used for ill. That doesn’t denigrate science, though those using it for ill are sometimes just uninformed.
You can wait for the gods to wake up, but the rest of us are too busy trying to take responsibility for our own lives and those of our countrymen and fellow humans.
Jazzman, your plea for universal care, claiming all the other developed countries have it, misses some unpleasant but important facts. One is we are the only country in the world that 1/2 the population is supported by the government. Another is that ALL of the population of those countries pay 40-60% of every penny they acquire, earned or unearned, in taxes to the government. The last to consider is the wait times for services and procedures (unacceptably long to us) and lack of services and operations if the budget has run out for the year. Elective surgery is limited as well.
“According to the Social Security Administration, the number of people on welfare in 2021 was around 65 million…”
You’re confusing the top tax rates with what average Europeans pay.
The US does not rank high in patient satisfaction compared to other developed countries. https://www.statista.com/statistics/1109036/satisfaction-health-system-worldwide-by-country/
Utter woke nonsense, by all means, let’s give the folks who produce nothing but criminals more stuff. Try not plowing through a bag of chips and washing it down with a sugary soda in front of the TV, and take a walk once in a while for goodness sake!
Most of the people pouring our concrete, nailing down shingles in the Florida sun, or mowing your lawn don’t have health insurance. They might buy a bag of chips on the way home, so I get your point.
And I’m sure you set the bar high by paying your common laborers wages well above minimum as well as their medical insurance premiums.
Probably a clothing and car allowance as well.
Sure you did.
You progressive liberals, you’re all the same.
I pay pretty well, long ago learning that keeping good people has a high value. But, I work in a market where I have to compete, and health insurance is not the standard in construction jobs and is expensive, so no, I don’t provide it. I wish it was mandated or provided by other means – there are many drawbacks to employer provided health plans – and the field would then be level and include health insurance for construction workers.
So you wanted government to mandate something that you could have provided for your “highly valued” employees. I guess you were the beneficiary of the value they brought to your business.
Thanks for being honest about that. Contradicts many of your comments about caring for those less fortunate…that’s referred to as hypocrisy.
Has anybody heard of the VA? This is socialized health care. The more money put into system but care remains the same. Have these future M.D.’s ever been to other countries and seen how much taxes are spent on health care. Looks good from the outside until you pay for it with high taxes.
But now for possible solutions we have the largest amount of our national budget for defense. Why because “Who is the world going to call when help is needed, THE USA”? Other countries use their budget for social programs. They should be paying us for defense since we provide their protection. Look at Canada, if it were not for the U.S. they would be speaking Russian.
National health care only works if at local level. Small businesses and individuals should be allowed to join County insurance, paying premiums.
Lastly, everyone should pay something. Nothing in this world is “FREE”.
Oh, yeah “Big Pharma” takes big gambles to develop medication.
Does anyone think that these future M.D.’s will be invested in pharmaceuticals?
I have exactly zero solutions to offer on this issue, but I would like to note two points:
First, these opinion pieces by medical school students have been appearing in local papers for the past couple of years. Why? Are you all taking a class which requires you to do this? And is it a requirement that all of these pieces come from a left-leaning world view? Because they do.
Second, I have helped many people through the years who have been independently employed, hard-working people who simply could not afford private insurance. Then they got sick and had to be hospitalized. Then they recovered. Then the hospital collection team came after them and they faced losing most of what they had earned honestly throughout their career. That result cannot be right. Again, I’m not saying how to fix it, I’m just saying it happens. And it happens more than you’d like to think.
Low pricing or high profits – depending on competition in a market – are subsidized by those who work without health insurance. As you note, sometimes they end up being literally billed for that subsidy. Those of us who have it through our work should reflect on the fact that their product price and market pay for this benefit as it is unlikely they would be paid more if suddenly it were dropped.
Not sure what the point of this letter was (five authors for four boxes of liberal word salad?), reads like these kids are just checking a box as part of their graduation requirements. No solutions or insight provided.
“As a society, we have a duty to ensure that all individuals have access to high-quality healthcare”
Convenient that this “duty” will coincidentally make the authors quite wealthy. Everyone already has access, but whether they can afford it is a different story. I don’t see any mass movement by doctors to dedicate their lives to providing free or affordable care.
On the contrary, doctors expect to be extremely well compensated for their role as drug dealers and gatekeepers for the insurance companies.
Sad that you don’t understand the point of the article. Healthcare is a right in this county. Unfortunately not all are able to access. We need to do a better job as humans to support each other.
People go into healthcare not for the money but because they want to make the world a better place. Just look at the number of free clinics in communities across the U.S (one example). The UF College of Medicine is to be commended for educating our future (both students and the general public).
Additionally, value-based healthcare prioritizes health outcomes, not payment. This model is trending upward and will continue to help us reach the most vulnerable with needed care. It will not however, make healthcare providers “rich” but improve the world in which we live.
Thank you to those who dedicate their lives towards making the world a better place.
LMAO! Lay off the painkillers.