Access important for health care

Editor’s note: This is the fourth in a series of articles breaking down the recently-released Western Upper Peninsula Health Department study of the health status of residents in its coverage area of Baraga, Gogebic, Houghton, Keweenaw and Ontonagon counties.

HANCOCK – Having access to adequate health care is significantly related to income, and officials with the Western Upper Peninsula Health Department are concerned lack of access for lower income residents negatively affects their health outcomes.

Dr. Teresa Frankovich, health department medical director, said one of the categories of the health status survey for residents in the health department’s coverage area of Baraga, Gogebic, Houghton, Keweenaw and Ontonagon counties is access to adequate health care.

Although there have been many national studies showing disparities in access to health care regarding race and gender, as well as income, Frankovich said for the health department coverage area the disparities are more limited.

“What we can see in our own local data, it primarily points out the impact of income,” she said. “It’s poverty.”

Ray Sharp, health department community planning and preparedness manager, said the health status survey showed income levels are a factor in all the categories of the survey.

“That was one of the strongest findings that ran through our whole assessment,” he said. “(In) lower-income households, their family members were less likely to visit a doctor, less likely to have health insurance, less likely to get routine health screening. Dental (care) access is definitely a need that came out of our assessment.”

According to the survey, Sharp said 60 percent of low-income adults and one third of low-income children did not see a dentist in the past year.

It’s not just physical health problems affecting lower-income residents, Sharp said.

“The same pattern is observed in mental health,” he said.

Sharp said according to the survey, 20 percent of low-income adults reported 14 or more days of poor mental health in the previous 30 days since they answered the survey questions.

“That’s a much higher rate than the higher-income groups,” he said.

Sharp said adults with incomes below $25,000 per year reported poorer health at a rate more than twice those residents with incomes above $50,000.

As an example of that disparity, Frankovich said the rate of diabetes in the health department coverage area is 12.2 percent.

“That’s higher than the national average (of 10 percent),” she said.

Frankovich said about 20 percent of residents in the health department coverage area are without the ability to pay for health care.

“One in five of western U.P. adults aged 19 to 64 have no health insurance,” she said. “If you look at lower-income populations, that’s nearly a third (who don’t have health insurance).”

Another barrier to getting adequate health care for lower-income residents is they may not have access to transportation to get to health care providers, which may be a long distance away from where they live, Sharp said.

Sharp said other factors are related to low income and poorer health, such as lack of nutritious food.

“These are multi-faceted problems,” he said. Although the access to health care issue is complex, Frankovich said it may be possible for some low-income residents to get limited care through the Western U.P. Health Access Coalition located in the health department headquarters building in Hancock. The coalition telephone number is 482-7122.

Frankovich said the results of the health status survey, including lack of access to adequate health care, can be used by health care providers and policy makers to possible reduce the negative outcomes. “It allows us to see the impact on our population and sets the stage for us to look at solutions,” she said.

The 262-page Western Upper Peninsula 2012 Regional Community Health Assessment can be seen at

The final article in this series will examine what is being done to address various poor health issues.