Originally created 06/29/02

Two work to reform health for minorities

It might not be a surprise to Isiah Lineberry and the Rev. Lester Smalls that minorities in poor rural counties have less access to health care.

That doesn't mean they have to accept it.

Mr. Lineberry, the executive director for the Office of Rural Health Services in the Georgia Department of Community Health, and the Rev. Smalls, the chairman of the board of directors of the Margaret J. Weston Medical Center in Clearwater, are working in different ways to change the rural health landscape outlined in a recent report.

The South Carolina Rural Health Research Center painted a grim picture of the prospects for minorities in rural counties:

  • In South Carolina, the 12 counties with the highest black population include the 10 poorest in the state; in Georgia, the top 17 include the nine poorest.
  • More than 80 percent of majority-black rural counties are considered Health Profession Shortage Areas because they lack health care providers.
  • About 12 percent of rural blacks live in a county with no hospital.
  • About seven of 10 rural blacks living in poverty are concentrated in six Southern states, which include Georgia and South Carolina.
  • More than a third of rural blacks live in poverty, compared with 13 percent of rural whites.
  • On average, a majority-black county has a total income that is 66 percent of the average county's. The lack of individual and community resources is a double whammy on those who live there, said Jan Probst, the deputy director of the research center.

    "It's hard to bootstrap (up) when your bootstraps are two-thirds as long," Dr. Probst said. Ironically, these counties do not receive the same economic development assistance from the federal government as their urban counterparts. One of the recommendations in the report is to provide grant-writing assistance so the counties can compete, Dr. Probst said.

    The lack of health care access probably takes a toll. In future studies, researchers would like to examine disease rates and health outcomes for those counties, Dr. Probst said.

    The report also recommends the increase of federal programs such as the Community Health Centers, which provide funding for primary care and preventative services. The need is certainly out there, the Rev. Smalls said.

    There is a link between health care access and poverty in that those without access may be more likely to be sick and less able to work, he said.

    "If you're sick, you're not motivated to do it," the Rev. Smalls said.

    The Office of Rural Health coordinates the Community Health Centers and other programs to bring health care and providers to those counties, and to keep rural hospitals open. By becoming a critical access hospital, as Wills Memorial Hospital in Washington did, the hospital limits its inpatient beds in return for higher reimbursement, Mr. Lineberry said. That has a direct impact both on health care and economics.

    "In many rural counties, the hospital may be one of the highest employers for the county," Mr. Lineberry said. His office also promotes rural counties working together to find regional solutions.

    Reach Tom Corwin at (706) 823-3213 or tomc@augustachronicle.com.


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