It is no doubt a valuable study, underlining the connections between family finances and health habits and ultimately, good health itself. But most medical school and hospital administrators, and of course doctors, could have outlined the findings of a study from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute even before they were released.
The gist of those findings: In North Carolina, and undoubtedly everywhere else, people who are more affluent, and who live in urban areas (two things that tend to go together) typically enjoy better health than those in rural areas.
For one thing, they have more money and are insured at higher levels, and yes, in the crazy quilt system that guides the health care delivered to Americans, money counts.
And that affluence typically reflects a higher educational level in a family. More education – perhaps because of more awareness of the need to monitor one’s health – usually means people are better off physically, and that they’re aware of the need for their children to have checkups.
In urban areas where those better-educated and more affluent folks live, there typically are more readily available doctors and specialists.
So the essence of the study is that education usually means higher earnings and better insurance for families and better access.
The poor? They get poorer in every way.
Yes, there’s Medicaid, but then there are the people for whom poverty has been a generation-to-generation legacy. They haven’t monitored their health, they eat poorly, they don’t train their children to be healthier because no one helped them, and absent insurance (perhaps they’re not aware of the Medicaid option, or don’t quite qualify) they don’t go to the doctor until an illness hits them hard, when they go, finally, to an emergency room.
“There’s this trait of not addressing health problems until they’re right on top of you,” said Tom Vitaglione, a senior fellow at Action for Children NC.
The North Carolina statistics provided by the recently released study ought to guide state leaders in their decisions about how and where to invest public health dollars. Consider: Urban and wealthier counties such as Wake and Mecklenburg lead the state in life expectancy and quality of life. But the stats aren’t so good in Columbus County, Robeson, Halifax, Bladen and Edgecombe.
Those are poor places and the measurements of the quality of personal health are far more dismal. And yes, all those counties have more unemployment and poverty problems than urban ones.
With the U.S. Supreme Court reviewing challenges to President Obama’s health care reform plan, these statistics are timely in this inevitable sense: A system that helps the affluent stay healthy and fails or excludes those who are, for example, unemployed and without insurance or unable to afford it because of pre-existing medical conditions isn’t working as well as the advocates of the status quo would like to believe.
In North Carolina, and elsewhere, a family’s means should make no difference in the quality of health care or health itself. A naive and idealistic dream? Perhaps. But what exactly is wrong with it?