Originally published here
Understanding health care access by wards
As nationwide awareness of racial health disparities increases, it is important to understand these disparities specific to Washington, DC. As the following mapped results and discussion shows, wards 7 and 8 residents are being drastically affected by the lack of health care in their own wards. Clearly, the Mayor’s office is aware of the health disparities in wards 7 and 8. In 2017, Mayor Muriel Bowser issued a report addressing how far outside of their neighborhoods people must travel to access health care. For Medicaid patients living east of the river, less than 25% see a primary care doctor in their zip code. Additionally, from DC Hunger, 58% of Washington DC’s COVID-19 related deaths have been Black residents. These rates are also concerning for children, given that Black children are more than four times more likely to die from asthma than white children, and as we know COVID-19 attacks the raspatory system.
The following maps are included below to illustrate these disparities: the amount of positive COVID-19 cases by ward, and the location of hospitals, primary care facilities, and mental health treatment.
Paralleling the map provided by DC.gov, the above map displays the amount of positive COVID-19 test results by wards. Noticeably, the highest amount of positive test results are in Wards 4 (1,999), 5 (1,447), and 8 (1,402). With the highest number of positive tests, ward 4 has 1,999 cases and fewest in wards 3 (446) and 2 (533).
An ongoing discussion around COVID-19 is the lack of access to medical care. Importantly, ward 7 does not have any hospitals and the median household income is just below 40K. With 1,371 positive cases of COVID-19 in ward 7, the lack of hospitals in the ward is incredibly concerning.
While there are no hospitals in ward 4, it is important to acknowledge the average median income by ward that can offset this. From DC Economic Strategy, the median household income in wards 1–6 are all above 60K, while those in wards 7 and 8, the median household income is below $40K. Ward 3, with three hospitals, has the average median household of over 120K. It is important to note that wards 7 and 8 have close to the same number of residents as wards 2 and 3.
Leah Potter detailed the efforts of the DC Health Justice Coalition calling for a full-service hospital to serve wards 7 and 8. The following specialty services have been called for: neurology, kidney care, and HIV screening and treatment. The United Medical Center (UMC) located on Southern Avenue SE is considered to be the only hospital in wards 7 and 8, with the imminent closing in 2023. The leader of the DC Nurses Association unit for UMC employees, there has been a lack of funding and investment in the hospital, which pushes staff to ration resources and supplies. These practices are simply not happening West of the river. Additionally, as a result of such few hospital options in wards 7 and 8, wait times can be three days. Three days.
As Street Sense Media’s Leah Potter explained, the burden of necessary healthcare falls to local facilities, displayed above as primary care centers and intermediate care facilities. Noticeably, there are over 25 intermediate care facilities and 5 primary care centers in ward 7, which provide health care due to the lack of a hospital in this ward.
While the growing awareness of racial health disparities is an improvement, there needs to be an increase in dialogue surrounding the access to mental health providers. The decrease in human interaction and contact has left people alone more than usual, and at an increased risk of mental health concerns. A qualitative pilot study by Ganz and colleagues published in 2018 detail the barriers to mental health treatment utilization in wards 7 and 8. Utilizing semi-structured, in-depth interviews with five informants from wards 7 and 8, their findings detail just how many barriers truly exist. These barriers exist at multiple social-ecological levels: individual/interpersonal, provider/mental health system, lack of social support, the model of mental healthcare, lack of patient-centered care, limited access to mental health services, the stigma of mental illness and mental health treatment, and poverty (Ganz et al., 2018). Their recommendation, in addition to future studies, is funding dedicated to efforts increasing mental health treatment utilization.
