[Hpn] Study looks at city clinics;Baltimore Sun;7/30/01
Morgan W. Brown
Mon, 30 Jul 2001 10:04:27 -0400
Monday, July 30, 2001
The Baltimore Sun <http://www.sunspot.net>
[Baltimore, Maryland, USA]
Local News section
Study looks at city clinics
Survey finds growth in number of patients and the uninsured; 'So much need';
Eight soup kitchens, health sites examined help needy residents
By Diana K. Sugg
Originally published July 30, 2001
The lines at the community health clinics scattered around Baltimore are
getting longer. The people in them are sicker. And if the patients couldn't
get care at these free or low-cost places, many say they'd be on drugs,
homeless or dead.
The findings from a recent survey of people who use eight local health
clinics and soup kitchens reveal disturbing trends about the poor, often
sickly city residents who go to them for help.
Eighty percent of those surveyed have at least one chronic medical
condition, such as AIDS, hypertension or hepatitis. Almost half have a
mental health problem. And 60 percent have no health insurance, according to
the study from the Open Society Institute, which will be released today at a
The institute, a New York-based foundation with a Baltimore office, gives
grants to study urban issues including drug treatment, criminal justice,
health and work force development.
"We're getting more and more booked up. There's so many people and so much
need, and they just keep coming," said Dr. David Butcher, director of
research and HIV medicine at Chase Brexton Health Services on Cathedral
Street, one of the clinics surveyed. "I've noted myself the increasing
complexity of each case. People are sicker."
In the past few weeks, Butcher has seen people with serious illnesses that
hadn't been diagnosed before he saw them. One patient had cancer; another
had liver disease. Neither had health insurance. And both patients will have
a tough time getting treatment, Butcher noted, because it's become more
difficult for clinics to find specialists and hospitals that will provide
care for little money.
According to the new study, more than half the doctors surveyed said they
were less confident about getting their patients necessary health care now
than they were five years ago. Nearly 70 percent reported an increase in the
number of uninsured patients seeking health care, and substantial
difficulties getting specialized care and procedures for them.
"It's getting worse. We turn 30 to 40 people away a day," said Jeff Singer,
chief executive officer of Health Care for the Homeless, where about three
dozen people are lined up every morning before the clinic on Park Avenue
opens. "When people are living on the street, their health deteriorates."
Scattered across the city, the eight agencies studied are a sample of many
that help the vulnerable and needy in Baltimore. They range from health
clinics that also provide support services, like Health Care for the
Homeless, to Paul's Place Outreach Center in Pigtown, which does everything
from providing hot lunches to teaching people to read. Together, the eight
organizations surveyed serve about 21,800 people a year.
Dr. Tom O'Toole, an internist and researcher from Johns Hopkins Hospital who
led the study, said it was important to get a profile of these patients and
the clinics, especially as the ranks of the uninsured grow, and places like
Baltimore are facing epidemics of hepatitis, HIV infection and mental
"In the debate over health care and access to services, we often forget
about all of the different resources. These safety net groups really
represent the unsung heroes," O'Toole said. "These agencies are the glue
that's keeping people functioning and alive."
A quarter of these people were working at jobs that earned them, on average,
about $12,000 a year. About 60 percent were getting some government help,
such as food stamps or disability payments, according to the study. Forty
percent were homeless.
More than half the patients surveyed had difficulty getting medical care -
especially dental care, prescription drugs and primary care - mostly because
they had no health insurance.
Some say this shows that although the clinics are serving a need, something
must be done to get more people insured.
"This is just yet another example of the tremendous consequences that lack
of insurance has on everybody - not just patients, but taxpayers," said Dr.
Peter L. Beilenson, Baltimore's health commissioner, noting that delayed
care often means people end up sicker, in hospitals, with bigger bills. He
is leading a statewide coalition, Health Care for All, that is pushing for
universal health coverage.
In the meantime, people will rely on the clinics. According to the study,
about 40 percent of those surveyed couldn't identify anywhere else to go.
And when asked what they would do if care were not available, about a
quarter of them responded that they'd be homeless, using drugs or dead.
"For some people," said Butcher of Chase Brexton, "it's a matter of all they
can muster, just to get in the door and say, 'I need help.'"
The other agencies surveyed were New Song Ministries in Sandtown/Winchester,
Shepherd's Clinic on North Avenue, HERO on Maryland Avenue, Beans and Bread
in East Baltimore and the Mattie B. Uzzle Outreach Center in Collington
**In accordance with Title 17 U.S.C. section 107, this
material is distributed without charge or profit to
those who have expressed a prior interest in receiving
this type of information for non-profit research and
educational purposes only.**
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Morgan W. Brown
Montpelier Vermont USA
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