The loss of Atlanta Medical Center is part of a larger pattern of urban hospital closings.


The Buffalo Urban League says the shooting was racially motivated by a white guy and a black, white, brown, and black

“In any other kind of tragedy, like a hurricane or flood, anyone offering resources would be gladly welcomed, but this was different. The president and CEO of the Buffalo Urban League said the shooting had a face and a hatred for a group of people.

The community did not feel comfortable going up the stairs to the center because they saw a lot of white people.

A White guy opened fire at a predominantly Black neighborhood grocery store on a busy Saturday in May. Black people were killed in 11 of the 13 shootings. The shooting was called racially motivated by authorities.

By Monday, the problem was addressed. She tapped her network to ensure there were more black counselors on site, as well as Black people handing out flyers on the street about available services, and that they welcomed people at the help center.

Addressing health disparities is something communities across the country are grappling with, and while the pandemic caused illness and death for millions, it also has helped spur some momentum.

Covid-19 disproportionately affected Black and brown communities there, and as a result the health outcomes of White residents and residents of color were different within Erie County.

The Buffalo Center for Health Equity reports that Black Buffalo residents have a life expectancy that is 12 years shorter than White Buffalo residents.

Source: https://www.cnn.com/2022/10/02/us/buffalo-shooting-mental-health-funding/index.html

The American Rescue Plan Health Equity Office: Opening an Office in Philadelphia, Pennsylvania, in response to the Orlando Black Hole Mass Shooting in April 2021

The American Rescue Plan gave Erie County $179 million and it allocated $1 million for the creation of the Health Equity Office. It is using the remaining funds on a variety of needs, including economic assistance for small businesses, water treatment infrastructure and restoring jobs and spending that were initially cut due to the pandemic.

The law put funding behind health equity efforts so they can work on long-term solutions. The office has nine staff members, including two epidemiologists.

“It was unlike any experience we’ve ever had,” Poloncarz added, “and I’m very grateful that we had the Office of Health Equity in place because it would have made our job a lot tougher without it.”

“Diabetes, stroke, high blood pressure: Many things are caused just from poor health-care access and low income and stress,” Kane said. “The demand (for hospitals in communities of color and low-income communities) is higher than in other communities. You have better access and you are sicker.

The group hasn’t tracked how many formal equity offices have opened, but the number is growing, Freeman said. Philadelphia hired its first chief racial equity officer this year.

High-profile killings of Black people by police, notably the murder of George Floyd in Minneapolis, gave rise to a number of communities declaring racism as a public health crisis, laying the groundwork for some of the offices opening now. In April 2021, the US Centers for Disease Control and Prevention also declared racism a serious public health threat.

She also highlighted that, in the US, race and poverty are associated with health disparities, including uneven access to high-quality doctors and care.

“You’re really trying to create the same opportunity for health for every single person in the community, no matter what their economic status is, where they live or whether they have a job,” Freeman said.

Bringing Pixie’s to the Crossroads: Exploring the Buffalo Urban League as a Community Resource Center after the Sandy Hooking

Without the supermarket, those without a car may have lacked convenient access to nutritious food. For others, it was emotionally difficult to reenter the store.

Buffalo Urban League’s Yukea Wright is a crisis counselor team leader and is working at the resource center near the Tops.

The Buffalo Urban League’s crisis counselors were already helping the community, but they wanted a new space to serve after the shooting. The group found an open space down the street that had once been a neighborhood bar known as Pixie’s and opened a resource center there within days after the tragedy. The building is built to look like a local watering hole, instead of a health institution.

The center serves as a place for people to connect with other resources that address social determinants of health, like education and employment.

The Buffalo Urban League plans to work closely with the county, especially with the new Office of Health Equity, to help drive long-term change going forward.

The county office is first working on training people in the Mental Health First Aid national program, so that the county can deploy counselors throughout the community – like at Bible studies and community centers – to meet people where they already may be. A recent nationwide study found that people of color are less likely to get mental health care, even when the share of US adults receiving treatment for mental health grows.

The office is also working on a survey that, in part, will show what problems members of the community would like addressed – it could be the high prevalence of diabetes or high blood pressure, for example.

The Legacy of Medical Debt in the Knoxville Black Business District: The Case of a Broken Medical Office Building, Freeways, and Health Insurance

Black Knoxville residents were only able to visit the basement of the hospital once Dr. H.M. Green opened his new medical office building in 1922. They were barred from the city’s other medical centers.

After the city’s Black business district was bulldozed, a number of freeways were built to replace the Green Medical Arts Building.

It’s a terrible cycle, said Berneta Haynes, a staff attorney at the National Consumer Law Center. “This legacy of segregation and structural racism underlies the racial health gap,” she said. “It impacts health outcomes and access. It has an impact on the level of medical debt.

Residents of the neighborhood are sicker than people elsewhere in the area with high levels of chronic diseases. They’re less likely to have health insurance.

Patients suffer against that backdrop. People with debt do not seek care for chronic conditions like Diabetes or Multiplesclerosis. Hospitals and doctors sometimes won’t see patients in the middle of treatment with medical debt.

It makes it harder for black patients to enroll in health insurance even if they need it. Someone knows someone who is getting sued for medical bills. They stay away from medical centers.

Source: https://www.npr.org/sections/health-shots/2022/10/27/1131984451/medical-debt-racial-inequities

The Beginnings of Black History: The Impact of Jim Crow Repression and Innocence on The Bottom, the Heart of Knoxville’s Black Community

Burns helped the woman find an oncologist to treat what turned out to be cancer. There was a cost to waiting so long, though. Because the cancer was so advanced, the friend had to undergo chemotherapy and have both breasts removed.

It could have been a lot worse. “What if she didn’t know me? What if she kept on leaking her breast? And it was necrotic? Burns said. But, she added, if her friend hadn’t been so worried about going into debt, she would have gone to the doctor sooner.

Just outside downtown, below refurbished office buildings and former warehouses, is an area once called The Bottom, long the heart of the Black community.

Jim Crow segregation and violence were the factors that kept this area going. In 1919, mobs of whites rioted, attacking Black-owned stores and shooting residents after a young Black man was accused of killing a white woman.

Beginning in the late 1950s, the city systematically wiped out The Bottom and surrounding neighborhoods in an urban renewal and highway-building campaign. More than 500 homes, 15 churches, and 100 Blackowned businesses were demolished by officials.

There are more than 2,500 displaced families. Many ended up in public housing. Others left the area. Businesses never reopened. “It changed the whole landscape,” said the Rev. Reneé Kesler, director of the Beck Cultural Exchange Center, a nonprofit that preserves Knoxville’s Black history. Generations won’t recover from that.

A tiny fraction of residents are homeowners. Blocks are filled with boarded-up buildings and overgrown lots. Down the street from Knoxville’s oldest Black cemetery, a Dollar General recently closed — one of the few stores around that sold groceries.

Source: https://www.npr.org/sections/health-shots/2022/10/27/1131984451/medical-debt-racial-inequities

Managing Debt: The Wealth of the First Black Family in Knoxville, SC: A Case Study of Black Poverty and Economic Uncertainty

It’s not difficult to understand the difference, said Eboni Winford, a clinical psychologist at Cherokee Health Systems, a network of clinics that serve low-income patients. Black people don’t have as much wealth as they should to pass on, so we can’t use it for medical bills.

According to the Federal Reserve Bank of St. Louis, the median white family in the country has about 184,000 in assets, including homes, savings, and retirement accounts. The assets of the median Black family total just $23,000.

“What happened is we concentrated Black poverty,” said Gwen McKenzie, a Knoxville City Council member who grew up not far from The Bottom. “From there, that’s where it became generational.”

She considers herself luckier than most. Born in Knoxville and raised by a single mother, Reed became the first in her family to own a home, a small house built after the city demolished The Bottom. For the past 15 years, she’s worked for a faith-based nonprofit that assists low-income residents of Knoxville.

” It has been hard.” said Reed, who just turned 60. Her son was raised by herself. And though she’s always worked, her modest salary made saving difficult. “I just tried to live a frugal kind of life,” she said. “And by the grace of God, I didn’t become homeless.”

She couldn’t escape medical debt, though. Reed was diagnosed with cancer five years ago. She was unable to afford medical bills because she had health insurance at work.

She has been pursued and taken to court by debt collectors. Reed had to make difficult choices due to that. “There’s always a sacrifice,” she said. “You don’t do things to pay other things.”

“I was so upset, I didn’t even find out how much I owed,” Reed said. “I mean, I wasn’t calling about a little toothache. This is a problem that affects someone’s life.

Source: https://www.npr.org/sections/health-shots/2022/10/27/1131984451/medical-debt-racial-inequities

The Impact of Medicaid Expansion on the Health and Wealth of Low-Income People: A Case Study in East Knoxville, Tennessee

The expansion of Medicaid, in particular, has brought new financial security to millions of low-income Americans. In a recent analysis of credit bureau and census data, researchers estimated that Medicaid expansion helped enrollees avoid more than $1,200 in medical debt.

Eight of the 12 are Southern states with large Black populations. The decision not to expand has disproportionately affected communities like East Knoxville that are already contending with deep racial disparities in health and wealth.

Of the roughly 2.2 million people locked out of health coverage because these states rejected Medicaid expansion, nearly 60% are people of color, according to a KFF analysis. A quarter are black.

Cynthia said she has worked to improve the health of the city’s Black community and many people try to keep their insurance until they are eligible for Medicare. She said that people pray that they don’t get sick before they are 65.

At the courthouse in downtown Knoxville, the dockets are filled with debt collection lawsuits filed by some of the region’s largest hospitals: Fort Sanders Regional Medical Center, East Tennessee Children’s Hospital, and Parkwest Medical Center.

Source: https://www.npr.org/sections/health-shots/2022/10/27/1131984451/medical-debt-racial-inequities

The Atlanta Medical Center Closures: “It’s Breaking My Heart,” Rejoind Bethe Ansell, and the National Association for Community Health Equity

Reflecting on her experience with medical debt, Reed said she tries to stay upbeat. “I don’t sweat the small stuff,” she said. “What am I going to do against this hospital?”

Alford, 65, said that she suffers from asthma, diabetes and high blood pressure, and that there were times when the Atlanta Medical Center’s (AMC) downtown hospital, formerly known as Georgia Baptist Hospital, would keep her overnight for monitoring.

Greene said that several AMC medical offices – including family medicine, neurosurgery and orthopedic practices – must either close or relocate. And some are moving out of the city altogether, to Whiter and wealthier Cobb County.

Staff and residents were shocked by the decision to close the hospital, as reported by the Atlanta Journal-Constitution. The pending closing was reported by the newspaper on August 31.

“Wellstar has operated AMC since 2016, investing more than $350 million in capital improvements and to support sustained operating losses. That includes $107 million in losses in just the last 12 months, amid decreasing revenue and increasing costs for staff and supplies due to soaring inflation. The pandemic and the intense financial headwinds straining healthcare organizations right now have only made matters worse at AMC,” the nonprofit said in a statement.

Richard Rose, the president of the NAACP’s Atlanta chapter, told CNN that urban hospital closures are an issue of “racial inequality.” The state and hospital officials have not provided enough resources to save the hospitals that have mostly served Black and low-income residents.

“We’ve had three hospital closures in the last year or so, all of them Black neighborhoods,” David Ansell, the senior vice president for community health equity at Rush University Medical Center in Chicago, told Kaiser Health News in 2020, adding that choosing to shut down those hospitals was “really criminal” in his mind, “because people will die as a result.”

“We have already seen an influx of patients in our emergency department and an increase in our trauma volumes. We have taken actions to help absorb the increased volume. The need for trauma surgeons and primary care physicians in our neighborhood health centers has increased as we have hired former Atlanta Medical Center surgeons. Additional doctors have been added to the ER waiting room. We have added 41 new inpatient beds, and more are forthcoming,” Grady Health said in a statement.

In an October open letter to community members, he said that his hospital would be able to add 185 beds thanks to funds from the American Rescue Plan.

Nancy Kane is a professor at the Harvard University. The precarious state of access to care in Atlanta was summarized by the school.

“When a hospital leaves, the whole network starts to collapse,” she told CNN. The trauma and maternity services are not the only ones. The whole care continuum starts to be affected.”

Per Wellstar figures cited by the Atlanta Journal-Constitution, of the nearly 4,300 emergency room patients the two AMC locations saw in 2019, north of two-thirds (67.3%) were Black, and more than half (51.5%) were Medicaid and Medicare recipients.

A number of families in south Fulton County are without a full-service hospital less than 7 miles away because of the closing of AMC South.

And while Google Maps estimates a 15-minute drive from AMC South to Grady, that commute could be many leagues worse during peak traffic hours in the bustling metropolis.

Source: https://www.cnn.com/2022/11/12/us/hospital-closures-race-deconstructed-newsletter-reaj/index.html

The Baltimore-Aid Fix and the Duke University Health System: Is Your Healthcare System Anarchic? A comment on Phillip Lee, a DC resident, who lived in DC for 12 years

Rose referred to Kemp’s pledge to fund more beds at Grady as a “Band-Aid fix on an open wound,” and explained that the closures jeopardize the health of residents who live near shuttered facilities.

If you happen to be living in a low income neighborhood, the distance to care will be greater. She said that it was a big issue if you didn’t have a car.

In emergency cases where there is a heart attack or a gunshot wound, it has been documented that people who live in low-income neighborhoods are more likely to die.

Just two months earlier, the chief teaching hospital affiliated with the Duke University College of Medicine announced that it would be closing its doors.

AlanSager, a professor of health policy and management at the Boston University School of Public Health who has documented hospital closings for the past 12 years, characterized the US’s health-care system as “anarchic.”

You are hurting people. You’re really hurting people. You’re messing with people’s lives, and you can’t do that. Phillip Lee, a lifelong DC resident, told WUSA that he couldn’t do that.

Source: https://www.cnn.com/2022/11/12/us/hospital-closures-race-deconstructed-newsletter-reaj/index.html

What’s happening in the space of doctors and hospitals? The “problem” that is going to happen is happening in a large chain of hospitals

It is not an event that comes from Mars. She said it came from under-investment in the facility. That is part of the problem. People are not saying, “Let’s not go there anymore.” They decide to go somewhere else because they can not get in or the services they need are not there anymore.

There are big chains buying hospitals across the country. They might have more than 100 hospitals. The location of the headquarters is St. Louis. The chains might have hospitals in nine or 10 states. Kane said that the chains lost a sense of commitment to the local community. If you have a lot of Medicaid patients or uninsured patients, or a hospital that does not get a lot of government support, you can end up being a poor performer in a portfolio.

Chains might not have a commitment to the community or state governments might not be demanding that they pay attention.

Many residents will struggle to secure appointments because of the lack of a robust transit system in metro Atlanta.

“They’re putting profits over people,” he told CNN. Black people suffer from chronic illnesses at a higher rate, and have a lower life expectancy. It’s going to be very difficult for those people to access basic services.”