LIVING IN LINDEN
Exploring a neighborhood's struggles and possibilities
Linden struggles to address lack of medical access, treatment, affordability
Daniel Ferguson sat patiently as the staff on the mobile medical clinic bustled around him, tending to his clogged ear.
The doctor that the Linden resident typically sees is in Hilliard, but the Mount Carmel Health System’s mobile coach was parked conveniently outside the Clinton Township building on Cleveland Avenue. Plus, Ferguson, 61, said he can’t afford to pay a doctor right now, and the biweekly clinic is free.
Mount Carmel started bringing its Street Medicine coach to Linden in October at the urging of Clinton Township Fire Chief Rob Fraley, who has spent his five years as chief preaching about the health problems that plague Linden and the neighborhood's limited access to care.
Residents there are more likely than those in the rest of Columbus to have coronary heart disease, diabetes and arthritis. They are less likely to have health insurance. Compared with the rest of Franklin County, babies are twice as likely to die before their first birthday if they live in Linden.
The life expectancy is eight years shorter than in Franklin County as a whole.
Public health and policy experts working to improve Linden say that other factors contribute to health problems in the neighborhood. Employment, education and access to care all can affect whether someone develops a health problem and their ability to manage it, they said.
“It really all goes back to those social determinants of health,” said Dr. Mysheika Roberts, Columbus health commissioner.
Access to care in Linden also is more difficult than in other parts of the city, Roberts acknowledged. Nationwide Children’s Hospital has a primary care center there, but the city’s three hospital systems do not have a permanent outpatient presence.
Mount Carmel’s mobile clinic offers urgent care in Linden from 1 to 3 p.m. on the second and fourth Tuesday of the month at the Clinton Township firehouse, 3820 Cleveland Ave. It tries to link patients with a primary care doctor if they don’t have one and enroll them in Medicaid or Medicare if they are eligible.
The mobile clinic also has helped with a monthly produce drop where hundreds have lined up for free produce from the Mid-Ohio Food Bank. Access to healthy foods has been a problem in the neighborhood since the Kroger in the Northern Lights Shopping Center left more than a year ago, said Kristina Kowatsch-Beyer, manager of Mount Carmel’s Street Medicine program.
The owner of the Saraga International Grocery store on Morse Road plans to open another store in the former Kroger.
“We’re trying to bring as many resources into our community as we can,” Fraley said.
Linden residents also can get medical care at PrimaryOne Health, a federally qualified health center connected to St. Stephen's Community House. It expanded to a total of 15 exam rooms in 2017 to meet growing need in the neighborhood, said Charleta B. Tavares, the company’s chief executive officer.
About 30 percent of the 4,400 patients at PrimaryOne Health’s Linden facility are uninsured. About 57 percent are on Medicaid or Medicare.
Tavares said the organization expanded behavioral health services to include medication-assisted treatment for people dealing with addiction.
People in Linden are more likely to report that their mental health had not been good for 14 or more days, according to an analysis of federal Centers for Disease Control and Prevention survey data by Professor Ayaz Hyder of the Ohio State University College of Public Health.
Hyder’s analysis showed that about 42 percent of adults in Linden had high blood pressure compared to about 32 percent citywide. About 38 percent had high cholesterol compared with 32 percent in the entire city. Nearly 17 percent had diagnosed diabetes. Citywide, it’s about 11 percent.
Infant mortality is improving in Linden, but it still is significantly higher than the rest of Franklin County. From 2013 to 2017, 17.9 babies died per 1,000 live births in Linden. Countywide, the rate was 8.2. Columbus has put a focus on improving infant mortality in struggling neighborhoods.
Poorer communities, including Linden, often struggle with chronic disease as well, Roberts said.
“Those communities might not access the health care available, and if they do, they might not be able to manage their medical condition because of lack of ability to buy the drugs, follow the doctor's advice,” she said.
Tavares said employment is critical to solving those problems. And the city is working on other programs in the neighborhood, including trying to enroll more children in preschool, establishing a farmers market to improve access to fresh food, and building more sidewalks near schools to encourage safe walking. The city also is studying violent crime in the area to better understand what contributes to it.
Access to transportation also is a factor in a neighborhood's health outcomes, said Reem Aly, vice president at Health Policy Institute Ohio. Linden is a target neighborhood for improved public transportation, with Central Ohio Transit Authority's CMAX rapid transit bus line running through the neighborhood along Cleveland Avenue and transportation hubs planned for the neighborhood through Smart Columbus.
Improving access to transportation makes it easier to get to doctor appointments and to work, which leads to better health, Roberts said.
“There is no magic bullet to reducing health disparities,” Aly said. “It really is going to take a strong public-private partnership and collaboration to move the needle on all the factors that influence health.”