While health and well-being are inextricably linked to housing quality, food security, neighborhood safety, education and other social determinants of health, any strategy to improve health outcomes must address patient needs and the healthcare system directly.
The American Academy of Family Physicians has recognzied the U.S. health care delivery system has historically engaged in the systematic segregation and discrimination of patients based on race and ethnicity. These issues result in inequities in access to and quality of health care and are major contributors to racial and ethnic health disparities. While segregation and discrimination based on race and ethnicity is no longer legal today, AAFP notes, some organizations continue to discriminate based on insurance status, which also disproportionately impacts non-white populations.
The federal Affordable Care Act and state Medicaid expansion have made insurance more available for many low and moderate income citizens and legal immigrants. Yet cost of care and insurance coverage remains a barrier for many Trenton residents.
In 2017, it was estimated that 16.8% of Trenton residents lacked health insurance (including Medicaid, Medicare, or private insurance)–nearly double the national rate of 10.2% and the New Jersey rate of 8.9%.
Those without health coverage are more likely to use the emergency room to address chronic illnesses and are more likely to be hospitalized for avoidable health problems. But chronic conditions require consistent monitoring and an ongoing relationship with the patient to manage the illness and reduce the likelihood of complications.
When patients visit multiple emergency rooms and receive treatment from different clinicians, they receive fragmented and sometimes repetitive or contradictory treatment that is aimed at temporarily solving the problem rather than managing conditions over the long term.
Such unmanaged chronic conditions lead to true medical emergencies, a dangerous and costly alternative compared to prevention and ongoing management.
Increasing access to quality healthcare for all while also building health literacy, including knowledge about prevention and opportunities for healthy lifestyle choices, is the best way to improve outcomes for the community as a whole.