By every measure, Georgia is failing to meet the health and health care needs of its citizens. Not only are our health outcomes poor, they are declining relative to the rest of the country. Despite political rhetoric that lauds the health and prosperity of our state, objective data tell a very different story. Through a health lens, our state is going from bad to worse, a trend that will continue without a change in course.
Georgia ranked 45th out of 50 states and the District of Columbia in the Commonwealth Fund’s 2014 state health rankings, down from 36th in the fund’s 2009 report across dimensions ranging from access and affordability to healthy lives and equity. Today, Georgia has the third-highest rate of uninsured persons in the country.
We are among the worst states in the country for low birth-weight babies, obesity and diabetes, and both racial/ethnic and rural disparities in health status. These are not trends that align with health and prosperity.
Despite compelling data that Medicaid expansion would improve access to care for low-income Georgians, grow jobs, and support rural hospitals and the communities they serve, our state Legislature has chosen inaction. Actually, worse than inaction, they passed two bills that created additional barriers to access to health care for low-income Georgians — a glaring example of failed state leadership.
But health is much more than health care.
Socioeconomic status, level of education, and the social and environmental context in which people live, learn, work, and play are now understood to be the strongest drivers of health. Unfortunately, we are failing here as well.
Almost 1 in 5 Georgians lives at or below the poverty level, a number that is higher for rural Georgians and children, where it is more than 1 in 4. Georgia’s unemployment rate is the highest in the country, even surpassing Mississippi. Our high school graduation rate ranks 45th in the country. We recently received a grade of “F” for food insecurity and food deserts — communities without affordable access to healthy foods.
These are not statistics that reflect prosperity or conditions that support good health. These are statistics reflecting conditions that predictably lead to worse health.
Through the lens of health and prosperity, our state leadership is failing, and all Georgians, but especially the most vulnerable Georgians, are paying the price. State leadership that fails to adequately prioritize and fund education, fails to adequately manage and staff food assistance programs (jeopardizing federal funding) and child protective services (jeopardizing the welfare of our most vulnerable children), and fails to take action to provide affordable access to health care for low-income Georgians, is not the leadership we need.
Georgia needs and deserves leadership and a proactive policy agenda that is truly aligned with the health and prosperity of our state. Georgia needs leaders who are prepared to take action to both ensure access to affordable, quality health care for all Georgians and to align policies across all sectors that advance the health and prosperity of our state. The status quo is unacceptable. Rhetoric in the face of failing policies and failing metrics is no longer acceptable. Our children, our communities and our state deserve better.
Harry J. Heiman, MD, MPH, is director of health policy for the Satcher Health Leadership Institute at the Morehouse School of Medicine. He is active in Georgians for a Healthy Future and the Georgia Academy of Family Physicians.