Impoverished Areas Have Low Access to Occupational Medicine Services

Article ID: 510420

Released: 11-Mar-2005 3:20 PM EST

Source Newsroom: Wolters Kluwer Health: Lippincott Williams and Wilkins

Newswise — High-poverty counties in the Southeastern United States have limited access to physicians and clinics specializing in occupational and environmental medicine (OEM), reports a study in the March Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

Dr. Elizabeth S. Safran and colleagues of Morehouse School of Medicine, Atlanta, examined access to physicians and clinics specializing in OEM four Southeastern states: South Carolina, Georgia, Alabama, and Mississippi. The researchers focused on the availability of OEM services to minority and low-income groups, who tend to have higher exposure to environmental pollutants and hazardous substances.

The results showed low access to OEM services for people living in impoverished areas. Of counties where at least 15 percent of residents were below poverty level, 95 percent were more than 100 miles from the nearest OEM specialty clinic. Just 17 percent of these impoverished counties had even one physician who was board-certified in the practice of OEM.

Counties with a higher percentage of African-American or other minority residents were also more likely to be more than 100 miles from the nearest OEM clinic. However, counties with a high percentage of minorities or African-Americans were not necessarily less likely to have a board-certified OEM specialist. This may have reflected the high percentage of minorities and African-Americans living in urban areas, or the fact that a growing percentage of the minority population in the Southeast does not live under the poverty line.

Census maps used for the study suggested remnants of two historically important industries in the Southeastern United States: cotton and coal mining. The areas with the highest concentrations of poverty and African-American population cut a path from the Mississippi Delta across central Alabama, Georgia, and South Carolina—the so-called Cotton Belt. In Eastern Kentucky, similarly high poverty rates were noted in a region of high white population, reflecting the influence of the coal mining industry. Dr. Safran and colleagues write, "Perhaps, it is the legacy of these historical events which contribute to the distribution of these economic and racial disparities in the Southeastern United States today."

The study highlights "the significant shortage of board-certified OEM physicians and OEM clinics"¦for disadvantaged populations in some areas." The authors suggest some possible solutions, including creating more residency programs to train qualified OEM physicians, along with programs and incentives to place OEM physicians and clinics in underserved areas.ACOEM, an international society of 6,000 occupational physicians and other healthcare professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.


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