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Virus Threatens Rural Areas
AGING POPULATION LACKS ADEQUATE HEALTH CARE
By Charlie Hayslett
Editor's Note: Charlie Hayslett is retired from
a career in journalism (he started out in
Athens) and still keeps his hand in public
relations. He puts his knowledge of our state
on display from time to time in his blog,
Trouble in God’s Country, at troubleingod-
scountry.com. This one went online Mar. 22.
Last Thursday, I posted a piece suggesting
that COVID-19 might constitute a perfect
storm for rural Georgia—that old age and
poor health status could combine with a
frail health care delivery system to put rural
areas in particular jeopardy. Since then, a
couple of reports have come out that sup
port that view and bring certain health care
and political realities into sharp focus.
First was a report Saturday from Kaiser
Health News that documented the number
of ICU beds available in virtually every U.S.
county and compared those numbers with
Overall, the situation here in Georgia is
a microcosm of the national picture Bump
found—and, if the primary goal in this situ
ation is to try to meet the health care needs
of the entire state, state politics, as always,
hovers not very far in the background and
imposes a set of difficult strictures on the
process.
In the 2018 gubernatorial election,
Brian Kemp, the Republican nominee who
ultimately won and is now governor, largely
swept rural Georgia, carrying 130 counties.
Of those, 83 don’t have a single ICU bed
(indeed, most don’t even have hospitals).
Combined, those counties have a popula
tion of 1.7 million, more than 380,000 of
whom (22%) are over 60. So far, only 47 of
the state’s 600 confirmed COVID-19 cases
hail from those counties, but it seems likely
those numbers will rise as testing becomes
more available in rural areas.
Category
Total No.
ICU Beds
Total
Population 60+
No. People 60+
per ICU Bed
No. Positive
COVID-19 Tests
as of 3/22/20
Kemp Counties (130)
797
968,496
1,215.18
210
Abrams Counties (29)
1711
894,658
522.89
352
Statewide (159)
2508
1,863,154
742.88
562
the population of people 60 and older in
each of those counties. That’s not a perfect
measure of an older person’s access to crit
ical care, of course; just because there’s not
an ICU bed in your home county doesn’t
mean there’s not one in the next county or
a nearby city. But it’s not a bad measure of
the magnitude of the healthcare challenge
taking shape.
The second was a report in today’s
Washington Post. Philip Bump, one of the
nation’s top data journalists, took the KHN
data and laid it over county-level data from
the 2016 presidential election between
Donald Trump and Hillary Clinton.
“Comparing the county-level data from
Kaiser Health News to 2016 presidential
election data,” Bump wrote, “we discovered
a remarkable bit of data: About 8.3 million
people who voted for Trump in 2016 live in
counties where there are no ICU beds or no
hospitals. That amounts to about 13% of
the total votes Trump earned in that elec
tion, or one out of every eight votes.
“Those counties are also home to about
3.8 million people who voted for Hillary
Clinton, a figure which makes up only about
5% of her total. Most of the counties voted
for Trump by wide margins; he won them
by an average of 41 points. He won 10
times as many counties with no ICU beds as
did Clinton.”
This afternoon, I pulled Kaiser’s Georgia
data and combined it with data from Geor
gia’s 2018 gubernatorial election and today’s
Georgia Department of Public Health report
on the number of people in the state who
have tested positive for COVID-19. (As of
midday today, that number was up to 600
people from 59 counties; 38 of the positives
were from unknown counties.)
In contrast, the Democratic nominee,
Stacey Abrams, dominated the state’s urban
areas, which have a much younger popu
lation and much more robust health care
delivery systems. Twelve of the 29 counties
she carried were indeed rural (including
a half-dozen southwest Georgia counties
that are now in the orbit of the COVID-19
hotspot erupting in and around Albany)
and also boast no ICU beds of their own.
But the overwhelming majority of her sup
port came from urban and suburban areas
that are home to large health care systems
with a good number of ICU beds.
The 130 counties Kemp carried are home
to right at 52% of the state’s 60-plus pop
ulation but have fewer than a third of the
state’s ICU beds.
To use Philip Bump’s Washington Post
framework, more than half a million
Georgians who voted for Kemp— about
25% of his total—reside in counties with
out a single ICU bed. That’s true of only
about 10% of Abrams voters.
Again, rural Georgians who fall victim
to COVID-19 may well be able to get access
to an ICU bed in metro Atlanta or another
major city if they need it, but the current
pandemic does seem to put a sharp new
focus on a problem that has bedeviled the
state’s Republicans since they took power
at the turn of the century: how to provide
health care to rural areas that constitute
their political base.
For a decade now, the state’s GOP
leaders have steadfastly refused to take
advantage of billions of dollars in Medicaid
expansion funds and presided over a steady
stream of rural hospital failures. The chick
ens may be coming home to roost, infected
by viruses. ©
Willson Center Micro-Fellowships
in the Arts and Humanities
The University of Georgia Willson Center for
Humanities and Arts invites proposals for Shelter
Projects, a micro-fellowship program to support
graduate students and community-based artists and
practitioners in the creation of shareable reflections
on their experience of the current pandemic through
the arts and humanities.
Projects may include:
■ a poem
■ a song
■ a journal
■ a short film
■ a sculpture
■ a drawing
■ a painting
■ a set of observations of the natural world
■ some other artistic or humanistic form
Shelter Projects are a partnership of the UGA
Graduate School, the UGA Arts Council, the Franklin
College of Arts and Sciences, Flagpole, and the
Willson Center through the UGA Office of Research.
Micro-fellowships are $500 each and will be
available on a rolling basis as funding allows.
To apply or to learn how you can support
Shelter Projects, visit
WILLSON.UGA.EDU
APRIL 1, 2020 | FLAGPOLE.COM
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