Archives for August 2017

Adding Voices to the Numbers: Stories as Advocacy at Charlotte Community Health Clinic

Last week, the clinic that I work for, Charlotte Community Health Clinic (CCHC), participated in National Health Center Week. During this week, across the nation, Federally Qualified Health Centers (FQHCs) put on free events like pediatric immunizations and health fairs for the community. Since FQHCs differ from free clinics in that they are more dependent on federal funding, this week is also used in part to let elected officials learn more about the work health centers do. As a part of this task, we spent some time interviewing and photographing patients and staff to learn more about their stories so we could try and share them with the elected officials who attended our events. The end result was small note cards with quotes pulled from the stories of patients and staff that we put on the tables at our big celebratory breakfast.

It was a strange to see the people we had interviewed, including some patients who had talked to us for hours, whittled down to a sentence or two taken out of context. It felt like I had done our patients an injustice in not having conveyed the complexity of their stories. In describing the community we serve, our patients tend to get thrown in big categories, like “low-income,” “homeless,” “unemployed,” or “immigrant.” Yet, the first thing many of the patients I interviewed tried to do was make clear that that they didn’t fit neatly into one of those molds. From the patients who had worked as teachers or engineers for thirty-some years before being laid off, to the Pakistani immigrant who had been a US citizen for decades and paid taxes since day one, many of these patients were aware of the stereotypes that tend to be associated with those seeking low cost healthcare. For some, fighting those assumptions was why they were willing to share their stories.

The stories themselves ranged from frustrating to heartbreaking. There was the woman who searched and searched for somewhere to have a mammogram but by the time she found us and got one through our clinic she was diagnosed with Type II breast cancer and went on to have a double mastectomy. Or there was the family whose grandmother simply could not get her diabetes under control, not because she wasn’t trying, but because she had to eat whatever her neighbors were kind enough to give her. Since one son had been killed, and the other deported, she couldn’t afford to be choosy as she struggled to take care of all her grandchildren. Others were more pragmatic, describing how primary care keeps people working and keeps people away from expensive ER trips. Some stories, like the woman whose daughter had a lump in her breast but couldn’t afford the further testing to determine if it was cancerous, were almost inconceivable.

As it turns out, it’s impossible to capture the injustice of not being able to afford to find our whether your daughter is going to live or die in a sentence or two on a notecard. At the same time, it’s hard not to wonder who might be compelled to action if you could. At our National Health Center Week events, both Mayor Jennifer Roberts and Congresswoman Alma Adams made clear that there is a clear need for increased health care access in Mecklenburg County, and Congresswoman Adams acknowledged, “A medical emergency does not care if you are a Republican or Democrat.”  While that’s a hard statement to argue with, many across the country still seem to disagree about whether the care for that emergency should be a right or a privilege. For my part, I wonder how many more people would support the right to basic health care access if they had the opportunity to meet the people whose complex stories and struggles are lost behind the numbers thrown around regarding our health care system.  One challenge I look forward to as I continue my year at CCHC is figuring out how I can better amplify those voices, as I have no doubt that these are stories that deserve, and need, to be heard.

Leaving the Davidson Bubble | Starting my Davidson Impact Fellowship at Matthews Free Medical Clinic

Here’s a list of some of my biggest challenges while attending Davidson College:

  • Receiving a 45 out of 100 on my first biology exam (when the range of scores was 45-96)
  • Living with the nickname “sack of potatoes” freshman year, though that was mostly self-induced due to infrequent laundering and a lack of personal grooming enthusiasm
  • Having to attend 8:15am courses
  • Walking into a tree after staying up all night to study for an exam
  • Missing Steph Curry’s campus visit while studying abroad in Shanghai
  • Getting strep throat five times

Adversity for me was walking a few hundred feet with a fever to the College Health Center. Once there, I was able to enter without an appointment, get tested immediately, and subsequently receive medication and a goody bag of chocolate pudding and Gatorade upon diagnosis. Living in Davidson’s bubble, I didn’t think much about how privileged this was. Now having graduated and begun work at Matthews Free Medical Clinic as a Davidson Impact Fellow, I am much more aware of the reality of healthcare access in the Charlotte area, and the superficiality of my “trials and tribulations” as a Davidson College student.

North Carolina is one of the 19 states that decided against expanding Medicaid to childless adults and families with income levels up to 138% of the federal poverty level. Instead, North Carolina’s Medicaid eligibility is reserved for families with income levels at or below 45% of the federal poverty level. Though childless adults and families in North Carolina may be eligible for subsidies if their income levels are between 100-400% of the federal poverty level, there are North Carolinians left in a healthcare coverage gap because they do not qualify for Medicaid or these subsidies. Of non-elderly North Carolinians living under 200% of the federal poverty level, 29% were uninsured as of 2015 (according to Kaiser Family Foundation’s estimates based on the Census Bureau’s March Current Population Survey (CPS: Annual Social and Economic Supplements), 2014-2016)). To put this into perspective, below is the annual income of families at 200% of the federal poverty level:

200% of the Federal Poverty Level

  • Family of 1: $24,120
  • Family of 2: $32,480
  • Family of 3: $40,840
  • Family of 4: $49,200
  • Family of 5: $57,560
  • Family of 6: $65,920

Matthews Free Medical Clinic specifically focuses on this population of uninsured North Carolinians, the uninsured and non-elderly (ages 14-64) individuals of Mecklenburg and Union Counties that have family income levels at or below 200% of the federal poverty level. Our Clinic currently provides free healthcare services to over 300 active patients at any given time. The Clinic is not walk-in, and applicants must meet specific criteria to become accepted as patients.  It is important to note that although the 200% federal poverty level is representative of the Clinic’s ceiling for patient admittance, the average annual income of our patients is far below this. As of early August 2017, the average annual income of Matthews Free Medical Clinic patients was at only 79% of the federal poverty level.  These North Carolinians are financially desperate for healthcare assistance – and Matthews Free Medical Clinic serves them.

Despite being a free medical clinic, we strive to give our patients the same experiences as those received at any other medical facility. Not only does Matthews Free Medical Clinic provide primary care, but with 28 different volunteer providers, the Clinic is able to offer services ranging from cardiology and gynecology, to physical therapy and acupuncture. Patients at Matthews Free Medical Clinic are given consistent care through a permanently assigned primary care physician, who can also provide referrals to specialty and ancillary services.

Within my first two months working at the Clinic, I have analyzed demographic clinical data and presented to the Clinic’s board members, supervised and led renovations of the Clinic during Elevation Church’s Love Week, assisted in the screening process for new patient applications, updated the new patient and recertification screening sheets, assisted in the hiring of a certified medical assistant and more.

It is rewarding to know that my work is helping an organization that is making a difference in the lives of those in my own community. Access to healthcare is a real challenge for so many in the United States. It is a real challenge in North Carolina. Sometimes it takes stepping out of your own bubble to gain perspective. I am very excited about my future as a Davidson Impact Fellow and my remaining time at Matthews Free Medical Clinic.

Leaving the Davidson Bubble | Starting my Davidson Impact Fellowship at Matthews Free Medical Clinic