When we talk about disparities in health care, there are many: access to care; the costs of care; the quality of care; and of course, the outcomes of our crazy, ill-designed, patchwork health care “system.”
Perhaps no disparity is more stark than that revealed by a regional analysis of how long people live on average, compiled by ZIP code. Our life spans, after all, are a complicated product of our health, determined as much (more!) by societal and economic forces as well as health care.
A decade ago in Tulsa county, we found that the life expectancy of people born in ZIP code 74126 was on average 14 years less than those born in ZIP code 74137.
This is not unique to Oklahoma. The Robert Wood Johnson Foundation conducted similar analyses for other metro areas and found gaps of 14 years in Kansas City, and an astonishing 25 years in New Orleans.
Knowing what we now know about the importance of early childhood in brain development, educational attainment, and health outcomes, many think that improving this fundamental disparity will take generations.
Some good news, then: the Tulsa Health Department re-did the analysis-by-zip-code and found that the gap had diminished–by 3 years!
The analysis only reports the outcome of a reduced life-expectancy gap. As to the reasons why, we can only speculate.
One editorialist looks at the community's openness about its failings and its collective investment: $46 million over the last decade from public and private sources to build infrastructure (clinics, offices, etc.) and bring health care professionals to areas that lacked them.
This is pretty heady stuff, to be honest. It shows that collective action in pursuit of a complicated goal has to be pursued on many fronts. And most importantly, that we still have a long way to go.
This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.