Monday, September 8, 2008

Lessons from Lackey Clinic

Attention Poverty Fighters,

The test of the Impact Humanity listserv is now complete. We apologize for the previous message, and assure you that the individual who did not understand the listserv has now been vanquished.

Today, during the meeting, we discussed our recent expedition to Lackey Free Clinic, a nonprofit health care facility that serves the underprivileged of Williamsburg and Yorktown. Beginning as a one-room clinic in a local church in 1995, Lackey Clinic now serves 5,400 patients throughout the region, filling 28,394 prescriptions and providing over $5 million worth of health care services to the area per year. Given the high cost of providing emergency care, the Lackey staff estimates a total savings of $4 million to area urgent care facilities.

We asked Mrs. Olivette Burroughs, the chief TPC (The Pharmacy Connection) staff member, "What situations or circumstances cause patients to turn to Lackey for care?" She cited numerous factors, including:
-Marital status (often, spouses who are dependents are stranded after a divorce)
-Education (many patients have less than a high school diploma, which makes it difficult to find employment)
-Language barriers (often further exacerbating the job search; many seek shelter with friends or live in homeless shelters)
-Being undocumented (also makes it difficult to find work)
-Mental illness and mental health
-Being formerly incarcerated (makes it hard to find a job-- a common theme here)
-Many work, but their employers do not provide insurance

As you can see, many of the factors that cause patients to come to Lackey for medical services also contribute to poverty in general. Although Lackey caters primarily to the "working poor," many of its patients do not work, often because they cannot find a job. We were told one story of a patient who had eight people in her family, went to Social Services for food stamps, and was turned down because her income was $2 over the limit.

We also asked, "What are the five most common diseases, illnesses, and conditions reported by patients at the clinic?" They are:
1) Acute injury
2) Asthma / COPD
3) Autoimmune disorders
4) Cardiovascular disease
5) High cholesterol

In addition, to get a sense of the epidemiological profile of Lackey's patients, we inquired, "What are the five most-commonly prescribed drugs at Lackey?" They are:
1) Protonix (ulcers, GERD)
2) Cymbalta (depression)
3) Norvasc (hyptertension)
4) Nexium (depression)
5) Lipitor (cholesterol)

Relating this local data to global health, it is evident in both cases that poverty renders people more vulnerable to health emergencies, and poor health contributes to poverty. Circumstances that hinder the flourishing health of the underpriviledged include lack of access to health care, antibiotic resistance, overcrowded living conditions, and poor nutrition (which leads to compromised immune systems). Especially damaging to underdeveloped countries is the rise of urban air pollution from economic development and a curious rise in tobacco use (smoking in general, by comparison, has tended to decrease in developed countries).

The underprivileged of developing nations face different challenges. While Lackey's patients report primarily chronic conditions (diabetes, hypertension, CVD, depression), much of the developing world confronts the threat of many infectious diseases. These include:
-Lower respiratory inflections, especially pneumonia
-Diarrhea (cholera, rotovirus, e. coli) - exacerbated by poor sanitation and contaminated drinking water
-TB (90% of cases occuring in the developing world, risk exacerbated by HIV/AIDS)
-Malaria and measles (partly responsible for high rates of infant and child mortality)
-HIV/AIDS (almost a subject unto itself)

Thus, while poverty impedes access to health care and lack of health care contributes to poverty both locally and globally, the epidemiological profile-- that is, the various diseases and conditions faced by the underprivileged, varies.

That's all for now,

UPDATE: "Two other prominent diseases are Diabetes and Hypertension. A medication associated with Diabetes is Novolin."

No comments: