Low-cost health care centers are lacking in parts of the St. Louis region with the greatest medical need, according to a report from the St. Louis Regional Health Commission.
The growing need reflects the changing demographics of the region, Robert Fruend, the commission’s CEO said. North St. Louis was long considered the neediest part of the city. As a result, majority of the region’s low-cost health clinics are there. But “over time, over the last 20 to 30 years, that node of this concentrated circle of poverty and need that we had in our region has migrated outwards,” Fruend said.
For example, the report found that the south St. Louis neighborhoods of Bevo Mill and Gravois Park have some of the highest numbers of uninsured residents who don’t receive primary care. North St. Louis County residents also have some of the highest rates of poverty and lowest rates of insurance coverage. However, there are few federally qualified or county-run centers in these areas.
“What we’ve also seen is as poverty has migrated over time across our region, our primary care infrastructure hasn’t necessarily kept up,” Fruend said.
The report also identified the north St. Louis County cities of Overland, Jennings and Florissant as among those with the highest primary care gaps in the region.
There are 17 primary care centers in the area; they provide a range of services from chronic disease management to dental care. Health experts emphasize the importance of this routine, ongoing treatment in what’s referred to as a “medical home,” but barriers such as cost and transportation often keep the poor and uninsured from accessing such care.
“There’s no substitute for a medical visit,” Fruend said. “And until we get to the day when docs are making house calls again — and I think we’re far from that day — having as many accessible sites as we can is important.”
The report also examined health disparities and emergency room use across the region’s zip codes.
Despite the large number of primary care sites in the north part of the St. Louis, many of those neighborhoods had the highest emergency room usage.
Fruend emphasized that access to care was only one part overall public health. Many people in the north St. Louis are still the poorest and the sickest in the region, he said.
He said the information could drive future decisions about where to locate primary care sites.
“We have this concentrated area of wealth in our community, starting at the Arch and going straight west on (Highway) 40, almost straight to Columbia, but either side of that golden rectangle you have high areas of need, and increasingly so,” Fruend said.
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