In Fairmount Heights, a diabetic senior fainted on her front lawn because she had no doctor to prescribe medicine. Without readily accessible dental care, children suffer too long with rotten teeth. When they get sick, parents pray they can get them to a doctor in time because the nearest clinic is always booked.
In a virtual health-care desert, resident Daisy Capers shakes her head as she describes countless preventable predicaments. In medical parlance, a severely underserved community has one physician for every 3,500 residents. In her Prince George’s County Zip code, 20743, there is one for about every 7,000.
At the same time, residents have the county’s highest rates of hospital admissions because of preventable diseases, such as high blood pressure, angina and long-term diabetes. According to county health statistics, a Fairmount Heights resident would be four times more likely to be hospitalized because of diabetes than a resident of Laurel. Life expectancy is 72 years, seven years fewer than the state average.
“I see so many people in need,’’ said Capers, who has lived in Fairmount Heights for 18 years and considers herself one of the needy, with poor vision and a husband with disabilities. “In other places, health-care facilities are able to provide some structure to communities. They make it better. We don’t have that.”
There are many ways to combat poverty, but Maryland is the first state in the nation to try an approach focused solely on health care. Taking a page from tax-incentive programs that have spurred businesses in troubled corridors, the state has designated the Zip code one of five “health enterprise zones” in hopes of luring more medical resources to the community.
The designation entitles the area to $1.1 million in state funding that can be used to help pay off loans for recent medical school grads, purchase discount medical equipment or provide security at clinics. Those perks are intended to be enough to lure five clinics to set up shop over the next three years and recruit 11 full-time primary-care physicians, two dentists and five nurse practitioners to staff them.
Located outside the District’s southeastern border, the Zip code includes Seat Pleasant, Capitol Heights and Fairmount Heights and has 40,000 residents. One in eight residents lives in poverty, statistics show. One in 10 is unemployed. Immigrants from Africa and Latin America have been moving into the neighborhood over the past decade, changing the makeup of a community that prided itself on being one of the first municipalities in Maryland incorporated by blacks.
Lost in the town’s demographic changes and wilted prosperity are memories of more stable times, when the idea of a local doctor didn’t seem like an urban myth.
“When did that clinic close?” said Jacqueline Wood-Dodson, 63, a Fairmount Heights council member who grew up in the area. “I suppose it’s been 40 years since we last had a clinic here. A place that we could actually walk to. No one can remember it anymore.”
That’s a particularly jarring statement in Maryland, which data from the United Health Foundation’s annual rankings show has a higher proportion of doctors than any state except Massachusetts. But those doctors aren’t evenly distributed. More so than in 35 states across the country, access to a doctor depends on where you live.
Communities without doctors have disproportionately high rates of crime and unemployment, said Lt. Gov. Anthony G. Brown (D), who pushed for the creation of the health enterprise zone program. This means that the zone could improve social and economic well-being as well as residents’ physical health.
“There’s a compelling case that we need to expel health-care disparities,’’ said Brown, adding that the reliance on emergency rooms is driving up costs for taxpayers. “And if you don’t believe in this from an economic standpoint, then from a moral standpoint, it’s something you need to address.”
In May, the state began distributing $4.4 million between the five zones, which also include downtown Annapolis, Lexington Park, Dorchester County and West Baltimore. The West Baltimore and Prince George’s Zip codes got the biggest shares of the money — $1.1 million each.
With the new state money, county Deputy Health Officer Ernest Carter said, residents’ health should improve almost immediately.
“Doctors don’t mind working with underserved communities,’’ Carter said. But physicians often hesitate to move to poor neighborhoods because it’s difficult to support a practice when so many patients are uninsured, he said. “So they opt not to go.”
Residents such as Wood-Dodson have grown used to few, if any, options.
Residents are accustomed to sharing prescriptions and rushing to the emergency room when pain becomes unbearable. Some of the new immigrants, Wood-Dodson said, crowd in a van and go to a clinic in Cheverly together.
There are no on-call bus services, such as Access-A-Ride, to take seniors to the Capitol Heights branch of Greater Baden Medical Services, the only place in the Zip code that allows patients to pay on a sliding scale. From Fairmount Heights, the trip can take more than an hour on public transportation — requiring a walk, rides on public buses and the Metro. The trip presents an even greater obstacle for those in ill health.
“It’s a deterrent,’’ said LaDonna Smith, 39, who just moved back to her home town. Self-employed and without a car, Smith said she has resorted to borrowing her neighbors’ vehicle for health care. “It’s hard to want to do all that work for a checkup, if you know you need a checkup. And a lot of people here don’t know.”
Even with the restrictions to access, the Greater Baden clinic remains “booked solid,” said Colenthia Malloy, its executive director.
With 6,000 clients, Malloy acknowledges that there are tens of thousands not being served. “Believe me, there’s enough work to go around,’’ she said. “One thing we have to work hard to ensure is that one player isn’t getting all of the patients who are uninsured. For [this] program to sustain itself, everyone has to have the right mix.”
But for Capers, there’s a simple strength in knowing help is nearby. Her husband, William, is wheelchair-bound and has renal failure. For years, she has struggled to get him to dialysis in Greenbelt, a trip that can take as long as an hour in traffic.
Nearly a month ago, her husband went into a coma. She recently agreed to place him in hospice care.
Capers prays he’ll make it, but the truth is she wonders how the back-and-forth affected his health.
“It has never been an easy road for us to get what we need,’’ she said. “More doctors would be such a blessing.”