There are so many people here working to see that the poor get the physical and mental health care they need. But are they approaching that daunting task as effectively as they can? Are they reaching the people they need to reach?
Last weekend, more than 60 health and social-service advocates and professionals gathered on Manchester University's Fort Wayne campus to talk about working together to meet the needs of vulnerable populations.
“We have tremendous generosity, huge hearts, great philanthropy – everything,” said Ahmed Abdelmageed, one of the organizers of the conference. “But we're not talking to each other.
“It's not a selfish thing,” said Abdelmageed, the assistant dean of alumni and community engagement at Manchester. “We are so passionate, we become so consumed by the work that we do, that we don't look outside of the box.”
Economic disparity is much discussed these days. The closely linked problem of health disparity is less understood. But the toll exacted by unhealthy living conditions and unmet needs for care is very real.
Census-tract data from the National Center for Health Statistics shows life expectancy may vary widely among neighborhoods only blocks apart. Countywide life expectancy here, for instance, is 78.3 years – just under the national average of 78.6 years. But Dr. Brad Isbister, medical director of the Matthew 25 Health and Dental Clinic, turned those findings into estimates that show startling variations within Allen County – from less than 73 years in some urban ZIP codes to well past 80 years in some areas outside the city.
Conference-goers were also reminded that in a state with one of the nation's highest infant-mortality rates, some areas of Allen County have among the Indiana's highest infant-mortality rates for African Americans. Isbister stressed the need for policies to encourage health professionals and others to get the flu vaccine and to get employers to appreciate the link between access to health care and the productivity of their employees.
In many cases, conference-goers were told, access to health care may be part of a larger struggle. “Vulnerability,” Isbister said, “is risk of crisis.” He told of a patient who missed two of her appointments because she'd been in jail for driving with a suspended license. That, he said, led to her losing her job and custody of her children.
It all stemmed from her lack of “30 to 50 bucks three months ago” to pay for her license renewal, Isbister said. “Money is what insulates ourselves from the consequences of our actions. For folks where 50 cents or a buck is a big deal, there's no margin for error. The consequences are disproportionate, they're unfair.”
Fort Wayne's low wage structure drags everyone down, said Rachel Blakeman, director of the Community Research Institute, warning that a recession will aggravate the problem. “We know the people who are most vulnerable in a recession are the unskilled workers,” she said. An answer, Blakeman said, is raising educational levels and thus, raising wages.
Organizers hope the conference will become a semi-annual or annual event, drawing not just the health community, but business leaders, educators and political leaders as well.
“Where are the people who don't serve the vulnerable?” a participant challenged the group.
“How do we get them here?”