April 2014 Report

Roots That Run Deep: Barriers to Healthcare for Crossroad Patients

If I have gained any insight from my time volunteering at Crossroad Health Center, it would be this: healthcare, like many things in life, becomes not simpler but more complex the more you learn about it. The social issues surrounding healthcare in underserved communities cannot truly be understood at a distance; rather, they must be experienced firsthand and engaged with an open mind and an open heart.

Over-the-Rhine is a complex, dynamic, and diverse community, and as such, the barriers to healthcare in OTR and surrounding neighborhoods are not simply reducible to poverty. We cannot simply throw more money into the system and expect health outcomes to improve. Rather, there are a whole host of social and environmental factors that come into play when considering the issue. From my time observing and talking with providers at Crossroad, here are a few of the more notable barriers to healthcare:

1)    Finances. Somewhat obviously, this is one of the major impediments to receiving proper care for the residents of an impoverished neighborhood such as OTR. Other issues such as lack of insurance or poor access to transportation stem from financial difficulties.

2)    Insufficient providers. Quite simply, there are not enough healthcare providers in OTR, and so naturally that results in a lower quality of care for the neighborhood as a whole. Moreover, very few providers are actually from the neighborhood itself, resulting in possible cultural disconnects or a lack of trust between patient and provider.

3)    Geographical location. An inner-city neighborhood is not exactly an ideal environment for good health. As an example, the high lead levels in the soil and older buildings is a constant concern for pediatric health in the community.

4)    Medical illiteracy. There is a great need for outreach programs in OTR and similar neighborhoods to increase overall medical literacy in the patient population. 

5)    Language. Very often a language barrier exists between provider and patient, resulting in less effective communication and poorer outcomes. For example, many of Crossroad’s patients only speak Spanish.

6)    Family situations. Broken and dysfunctional families are by no means unique to OTR, but they certainly can be a factor in such a population. Insufficient parental oversight is a common concern, leading to fewer office visits and follow-ups and less concern for the general health of children.

7)    Toxic charity. It is often tempting to think we can rush in and “save” a neighborhood like OTR. Throw enough money and medication at the problem, and health will improve. In reality, a lot of well-intentioned charitable work can actually undermine the establishment of sustainable healthcare structures by promoting dependency or even distrust of one-time initiatives.

There are numerous other factors in play. The point to be made here is that these issues are complicated, and require that we take the time to truly educate ourselves on the situation before taking action. Only in that way can we be assured that our action will be efficacious. Time spent at Crossroad is invaluable in this respect, as it is both an opportunity to serve and to learn.

- Michael Petrany