Economic hard times' toll shows in Roxboro clinic

Editor's note: This fall, The N&O is talking to people about the nation's health-care system: what works, what doesn't and what should be done to fix it.

Blood pressure is a great measure of how efficiently the heart pumps vital fluid through the body, but at the Person Family Medical and Dental Center in Roxboro, it has also served as a gauge for economic health.

Before last fall, most patients at the clinic had pretty good blood-pressure readings. As the unemployment rate rose, though, so did blood pressure.

"It has a lot to do with losing health coverage," says Jean Davison, a nurse practitioner at the busy practice north of Durham. "People were not able to get their prescriptions filled; they waited to come in to the clinic. And it's stressful being unemployed."

Davison, 53, who also teaches nursing at UNC-Chapel Hill, says that as a front-line caregiver, she sees a need to eliminate one of the most pressing worries that face people who lose their jobs: How they'll get health care.

Davison says she wants legislators debating health-care reform in Washington to include some form of universal coverage that patients could count on no matter if they lose their jobs.

"People are feeling broken," she says, noting that the unemployment rate in Person County hit 12 percent this summer, higher than the North Carolina and national averages. "They thought they would always have a job and always have health insurance."

And when the two huge stresses combine, she says, health takes a hit.

At the clinic in Roxboro, which is federally funded because it provides care to a large number of low-income people, patients were fairly representative of others in rural parts of the state. On average, they tend to have more heart disease, stroke and cancer than the statewide average, but the clinic's doctor and nurses had joined a community partnership last year to work on those problems.

They looked at blood-pressure measurements for patients who had visited the officeover the previous two years to get a sense of where they stood before starting the new health push. They found that nearly 70 percent of patients had satisfactory blood-pressure readings. That was last fall, before the economy tanked.

Then layoffs began mounting. Blood-pressure readings of patients spiked. In January, only 47 percent of patients coming into the clinic had satisfactory readings.

"The numbers were pretty staggering," she said, noting that some of the higher readings may have been attributed to inconsistencies in how the measurement was taken. But the numbers should have improved, considering Davison and her colleagues were intervening with counseling and other efforts.

"We were trying to prevent bad health outcomes, and our patients were focused on survival," Davison says.

In the end, Davison says, the costs for bad health are borne by society. Taxpayers pick up the bill for larger Medicaid rolls, and people who have health insurance pay through higher premiums.

Davison says additional health coverage and prevention efforts should be paid for with a tax on sugary beverages or snack foods.

"People don't realize they're paying for it anyway," she says. "You can pay the tax directly, or indirectly."

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