With Health Insurance Drying Up, Rural Georgia Fights To Stay In Shape
at the Andrew Young School of Policy Studies

Access Georgia Rural Health Initiative Is Building
A Critical Health Care Network Across Georgia

CONTACT: Tina Anderson Smith, 404-651-0929

ATLANTA, March 3 -- It's commonly called "the diabetes belt," and it's a region of Georgia that least needs or desires the designation.

That's because it already suffers from widespread and deep poverty, has limited prospects for a substantial economic jump-start, and is home to a rural population which averages a 9th grade level of education. And although it sits within a geographic triangle anchored by Augusta, Savannah and Macon, it is well removed from the relative prosperity of those cities.

The region is east central Georgia, bounded roughly by Interstate 20 on the north, the Oconee River on the west, U.S 25 on the east and Interstate 16 on the south. For generations home to vast cotton fields and timber, the area today is so sparsely inhabited that industries struggle to find skilled workers and are less inclined to set up shop there. Barely eight percent of Georgia's residents live there -- although the 11 counties encompass more than 4,000 square miles.

And many who live there are not healthy. To complicate their situation, thousands lack health insurance, with limited prospects of having it anytime soon. For an area whose notoriety lies in its high incidence of diabetes, the news about the high cost of health care has not been welcome.

According to Tina Anderson Smith, who heads the rural health program at the Georgia Health Policy Center, this problem is growing and is most apparent in rural Georgia.

"When you leave the major urban areas, you enter a part of Georgia where the health care system and its basic infrastructure have been in danger for some time," said Ms. Smith. "Georgians who live in some rural areas have watched their local hospitals and clinics close or reduce services. The bottom line is that the Georgians who most need health care live in areas where health care services are the most limited."

Part of the solution is being driven by the Access Georgia Rural Health Initiative, a state program directed by the Georgia Health Policy Center (an affiliate of the Andrew Young School of Policy Studies at Georgia State University). This program tackles the burgeoning challenges of rural health care by assuring Georgians access to primary health care services where they live.

The Georgia Health Policy Center provides to Access Georgia a wide range of expertise in the areas of community development, clinical medicine, hospital financing, strategic planning, economics, managed care and organizational development.

"The correlation between uninsured rural Georgians and their physical and emotional health is striking," said Ms. Smith. "As a rule, people without adequate health insurance become sicker and die at younger ages than people with adequate health coverage. Uninsured women who develop breast cancer, for example, are twice as likely to die than insured women with the same diagnosis."

And uninsured children who need medical or surgical care are four times more likely to go without care than insured children with the same needs, and are far more likely to be missing some or all of their immunizations, Ms. Smith added. "Families with uninsured children are rolling the dice that their children will somehow stay healthy, even in rural Georgia where chronic diseases like diabetes, hypertension and asthma are so prevalent."

Part of the Access Georgia effort, the East Georgia Health Cooperative serves the area known as "the diabetes belt:" Emanuel, Glascock, Hancock, Jefferson, Jenkins, Johnson, Taliaferro, Tattnall, Treutlen, Warren and Washington counties. "Fortunately, this region was blessed with very dedicated health care professionals when we established our goals and objectives," said Mr. Bill Baker, the cooperative's executive director. "With four hospitals and 60 primary care physicians, our opportunity was to combine and coordinate, rather than to create or recruit entirely new services."

Mr. Baker said that the cooperative is a liaison among the health care providers, and "reaches out to regional, state and federal partnerships that can strengthen those providers."

"Our hospital administrators are all members of the Georgia Hospital Association and other rural councils, but we had never worked together," said Rita Culvern, chief executive officer of Jefferson Hospital in Louisville, Georgia. "We knew each other's names but viewed one another as competitors. Now we are networking, sharing resources, and asking one another's advice on establishing programs."

In addition to the East Georgia Health Cooperative, there are eight Access Georgia networks that reach uninsured Georgians in a total of 39 counties. These counties generally are rural and poor. The networks operate numerous health care and wellness programs that are tailored specifically to the needs of rural Georgia. Some examples:

• The development of a patient database and a unified transportation service in Greene, Morgan and Putnam counties, where more than 6,000 ninsured men, women and children live. This program is called the "Greene-Morgan-Putnam Health Network."
• The integration of health and human services in a seven-county Central Georgia region where more than 45,000 uninsured people live -- its success is being judged with an emphasis on preventable, treatable or controllable health conditions such as heart disease, diabetes, hypertension and depression. This program is called "Community Health Works," and it covers Bibb, Crawford, Houston, Jones, Monroe, Peach and Twiggs counties.
• The enhancement of health care access for the growing Hispanic population, largely uninsured, in the carpet belt of Northwest Georgia, with programs designed to provide direct medical and dental services as well as to educate Hispanic children about communicable diseases and teen pregnancy. This program is called the "Northwest Georgia Healthcare Partnership" and covers Murray and Whitfield counties.
• And, the design of a multi-faceted "system" in three coastal counties that accelerates access to prescription drugs and existing medical services, making health care far more effective for the area's 22,000 uninsured residents. This program is called the "Coastal Medical Access Project," and it covers Camden, Glynn and McIntosh counties.

"In the worst cases, manageable chronic conditions, such as diabetes, spiral into expensive, acute crises – with all the financial and human costs that implies – primarily because people did not receive timely and consistent care," said Ms. Smith of the Georgia Health Policy Center. "We think the Access Georgia program provides the right framework for better health care management by rural communities, and for better preventive health care by Georgia's rural citizens."

Access Georgia works in collaboration with the Georgia Department of Community Health's Office of Rural Health Services to produce stable community health care systems. The shared goal is to deliver a set of "clinically relevant" services that match the health care needs of rural communities and are of the same or better quality than services available outside of those communities. The nine networks in Georgia work through partnerships in the local communities -- partnerships that include hospitals, clinics, physicians, nurses, pharmacies, educational institutions, business organizations, religious groups and citizen volunteers.

Funding for Access Georgia has totaled more than $1.7 million and has been secured through a matching grants effort. This effort, spearheaded by the Philanthropic Collaborative for a Healthy Georgia, brought together public and private institutions throughout Georgia -- including the Department of Community Health and the Robert Wood Johnson Foundation.

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CONTACT: Tina Anderson Smith, 404-651-0929
Georgia Health Policy Center

Frequently Asked Questions About Georgia's Uninsured Rural Citizens