April 23, 2024 by Isha Misra

Welcome to Healthcare for Change!

Welcome to Healthcare for Change!

When I started medical school 10 years ago, I was naïve and idealistic and had no idea just how broken the US healthcare system was. Over the course of my medical career, I have cared for some of the most vulnerable patients in the DMV and the Philadelphia Tristate regions. I have had patients who are undocumented, uninsured, unemployed, incarcerated, or homeless. I have also coordinated care for patients who have low health literacy, are experiencing food insecurity, or lack access to reliable transportation. I will never forget the patients who traveled hours on buses to get to their appointments, the young man with a traumatic brain injury whose family walked for miles from their small village in Honduras to discuss his plan of care, the single mother coming to the emergency room after a night shift only to learn that her son had been shot and killed earlier that evening, or the elderly couple who shared their prescriptions due to an inability to afford medications. My experiences have shaped me as a physician and have shown me the many ways in which socioeconomic and environmental factors can affect the health status and health outcomes of patient populations. This led to the creation of Healthcare for Change.

The US spends more on healthcare than any other developed country, but this has not resulted in better health outcomes. Why? Because there are so many factors that impact a patient’s health outcomes, and we aren’t spending money on what is truly important. How can a person who is experiencing food insecurity manage chronic conditions like diabetes and heart failure, when they don’t know where they will get their next meal? What if they can’t reach a food pantry or a food distribution center because they have limited mobility and there is no one to drive them? How can someone pay for their medications when they are worried about making rent?

Currently, I live and work in Montgomery County, Maryland, which is one of the healthiest counties in the state as per the 2023 County Health Rankings. Montgomery County is educated (with the highest percentage of residents over 25 years of age who hold post graduate degrees) and wealthy with a median household income of $111,812. It is also one of the most ethnically and culturally diverse counties in the US. Yet significant disparities still exist.

• About 9% of residents lack a high school diploma.

• Less education is linked to a lower socioeconomic status, which in turn is linked to poor health. High school graduation is also linked to lower risk of incarceration.

• 45% of households have an income of less than $100,000.

• The self-sufficiency standard for a family of four in the county is about $99,756. This is the income needed to meet basic needs without public subsidies or private/informal assistance.

• Almost 8% of residents do not own a motor vehicle.

• More than 30% live in a cost burdened home (a home that exceeds 30% of income). For those residents who do not own a home, Montgomery County has the 8th highest rent in the US.

• 7% of residents are uninsured.

• Many individuals have limited access to outpatient primary care services, which results in increased visits to the ER and further drives up healthcare costs.

• 32% of residents are of foreign birth and about 16% speak English less than very well, which affects access to care, communication with healthcare providers, and health literacy.

• White males live about 3.6 years longer than black males.

• Black women have the highest pregnancy related maternal mortality rate.

• Black infants have the highest mortality rate.

My hope is that Healthcare for Change can address some of these widespread disparities and health inequities because quality healthcare should be a right for all and not a privilege for some.

If you are interested in learning more about us, please reach out to us on our contact page.