The Times West Virginian

September 19, 2013

Report: State lagging on health care for poor

By John Raby
Associated Press

CHARLESTON — West Virginia isn’t doing a good job of delivering health care services for low-income residents, according to a private foundation’s report released Wednesday that even looked at the risk of tooth decay among the state’s poor.

The Commonwealth Fund report ranked West Virginia tied with Nevada for 41st among the states and the District of Columbia.

The report, titled “Health Care in the Two Americas,” found big gaps between the lowest- and highest-performing states. For instance, low-income adults in West Virginia are far more likely to lose six or more teeth to decay or disease compared to Connecticut, Hawaii and Utah.

The New York and Washington, D.C.-based organization that supports independent research on health policy looked at 30 different indicators in four categories.

While West Virginia ranked 20th in providing appropriate preventive care screenings and treatment for low-income residents, it ranked 28th in health-care access and affordability, 46th in potentially avoidable hospital use and 50th in promoting healthy lifestyles.

The report also ranked West Virginia at the bottom for the number of hospital admissions and return trips and potentially avoidable emergency room visits among Medicare patients.

“We found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives,” said Cathy Schoen, a Commonwealth Fund senior vice president and the report’s lead author. “These are more than numbers. We are talking about people’s lives, health, and well-being.”

Nine of the bottom 10 states were in the South.

The report used the most current data available, generally from 2010-2011. The goal is to prompt state policymakers and health care leaders to use the data to target resources for improvements for low-income residents.

West Virginia is already taking steps to do that.

While the report noted one-third of West Virginia’s low-income population was uninsured, Gov. Earl Ray Tomblin announced in May the state would extend Medicaid coverage to an estimated 91,500 uninsured low-income residents under the federal health care overhaul starting in January.

The report placed West Virginia among the top five states for having lower rates of uninsured children and those without a personal doctor or nurse.

The report noted poor marks for the state in adult obesity, smoking, lack of exercise, and those reporting poor to fair health or mental health issues. About 32 percent of West Virginia adults, one-fourth of state second graders and about 28 percent of fifth graders are obese.

Last year, a statewide coalition unveiled a program pushing residents to live more active lifestyles. The plan seeks to build partnerships between schools, communities and park systems.

And the public-private Reconnecting McDowell partnership launched in 2012 is working to improve life in McDowell County, which is plagued with poor academic performance, drug abuse and poverty.

The report defines “low income” as under 200 percent of the federal poverty level. That’s about $23,000 annual income for an individual or about $47,000 for a family of four.

U.S. Census Bureau figures show about 18 percent of West Virginia residents are living in poverty, including one-fourth of children.

State Department of Health and Human Resources Secretary Karen L. Bowling said the state also is working with six others to improve services for those who frequently use the emergency room or other high-cost forms of health care instead of coordinated, lower-cost programs.

West Virginia also is working to reduce preterm births and infant mortality, and to provide dental services to those who can’t afford it, she said.

“We have made progress, but have much work ahead of us,” Bowling said.