The health system is not broken, it works as expected

ByShannon J. Cortes

May 9, 2022

“Access Denied” is the perfect name for San Antonio Express-News reporter Laura Garcia’s ongoing series on health disparities in the county’s southernmost third.

The area encompasses what we consider the south side of the city, the historic west side, and parts of the east side, where Mexican Americans make up a large portion of the population.

What they also have in common is poverty, poor school performance, lower income levels and lack of transportation.

Fewer have insurance coverage, so are unaccustomed to the ridiculous complexities of the country’s healthcare system.

They lacked good coronavirus information in English and Spanish, weren’t tested or vaccinated as quickly, and couldn’t help flatten the curve.

More of these residents were on the front line and unable to work remotely. They were exposed to the virus and suffered more than residents of the county’s wealthier northern sectors.

Garcia’s investigative journalism has had an impact.

Bexar County, for example, uses maps created for the series to change its approach.

“To me, these two maps are kind of a visual mission statement for this new department that I’m forming,” Bexar County Executive David Smith said last week when he announced an initiative to revamp health care in outlying areas. “It’s about trying to spread these health care outcomes more evenly across our community.”

Bexar County will revamp about 16 health-related county functions, consolidate them into a single structure, and hire a county director of public health for a new initiative that will cost $2 million a year in disaster relief funds. pandemic.

Garcia’s first article was published on April 24, the second Sunday. A third and final installment will be released on May 22.

Born in Pearsall, because her hometown of Cotulla had no hospital, Garcia grew up in southwest San Antonio, trained by San Antonio College’s powerful journalism department, and eventually graduated from the Texas State University, another big producer of Texas journalists.

She collaborated with data journalist Libby Seline, with support from the Annenberg Center for Health Journalism at the University of Southern California, where Garcia was a 2021 National Fellow.

USC will be partnering with an “Access Denied” community engagement health fair from 9 a.m. to 1 p.m. May 28 at the Wesley Health and Wellness Center, 1406 Fitch St.

“Access Denied” describes an inadequate and failing health care system that has ravaged areas where poor people of color were already suffering from chronic illnesses exacerbated by COVID, including obesity, diabetes and heart disease.

In a south-side postcode, “Access Denied” found a 16 times higher death rate compared to a north-side postcode.

Garcia told the Texas Standard that the COVID death rate in parts of the South Side is double that of Bexar County, the state of Texas and the nation.

Mass vaccination sites have been set up downtown and on the north side – none on the south end of the county. One of Garcia’s most powerful phrases: “It doesn’t matter if they’re free.”

Today, in a north-side zip code, 99% of its eligible residents are fully vaccinated against COVID-19 compared to south-side zip codes, where approximately 50% of residents are fully vaccinated against the virus.

This is no accident, but the result of over a century of segregation followed by decades of redlining.

Many politicians, civil servants and medical experts have called the healthcare system failing and said the pandemic has brought these issues to light.

At the time, I agreed that the seizure had added to an existing one and, as one doctor put it, “worsened a failing system.”

But if there is an epilogue to this series, it is this one:

The health system is not broken. It works exactly as expected, said political scientist Alicia Reyes-Barrientez, assistant professor in the Department of Social Sciences at Texas A&M University-San Antonio.

“It was not designed to cure the sickest or the poorest,” she said. “The health care system was designed to provide optimal care for certain people. It is a racialized institution. We need to think about the health care system this way.

“Money and connections,” plus health insurance, “is what gives you the best chance of getting optimal health care in this country. Years of research show that,” Reyes-said Barrientz.

It is therefore not a question of reforming the health system, although those who are part of it may protest.

“Health care needs to be completely redone,” she said. “He never cared about blacks and browns.”

It’s part of a much larger system that we live in, and that’s why the president changes but the status quo remains.

“That’s why so many frustrated people don’t vote,” Reyes-Barrientez said. “They don’t believe voting will change anything.

“Do I vote?” she says. “Religiously. Do I think voting will create the radical change we need? Absolutely not.”

At least 5,320 people in Bexar County have died from COVID-19. In the United States, the death toll recently reached 1 million.

Each death is estimated to have affected nine close relatives, the Washington Post reported, or 9 million mourners.

That’s a terribly conservative number.

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