A Better St. Louis. Powered by Journalism.
  • Twitter
  • Facebook
  • Print
  • Email

Health disparities still divide city, despite progress on lead poisoning

In Health

1:20 am on Thu, 02.21.13

When Mayor Francis Slay announced plans in 2003 to tackle the scourge of lead poisoning, lots of city residents yawned, having heard that promise from previous administrations. But, thanks to Slay’s persistence, the prevalence of childhood lead poisoning in St. Louis has fallen by 80 percent on his watch. Though lead harms children across racial and economic lines, the problem is one example of a health disparity because it is more common among city residents living in older homes in black neighborhoods.

Granted, the Lead Safe St. Louis campaign got an assist from former Sen. Christopher S. Bond, R-Mo., who drummed up federal money to help finance it; and from Grace Hill Health Centers, which did some of the lead abatement work. But the mayor’s initiative is highly regarded for bringing to the table a competent city hall team and a level of success that had eluded some of his predecessors.

ASIDE

Still, his critics are asking what has the mayor done since his lead initiative.

They argue that he hasn’t put similar energy into other health inequities  concentrated more heavily in pockets of north St. Louis. The city’s director of health, Pamela Walker, responds that "we have work to do," but she adds that any city with a high concentration of poverty in one part of town is likely to have more health disparities and more difficulty reducing them.

“It’s not necessarily race related,” she says, “it’s poverty related. The mayor is really concerned about these problem. He and I talk about them nearly every day.”

Although blacks in St. Louis (and across the nation) continue to experience higher rates of death than whites from various diseases, Walker insists that the picture is improving. She reels off lots of data showing positive changes in the city’s black population between 2000 and 2009:

• Heart disease deaths decreased 23 percent.

• Stroke deaths dropped 30 percent, while diabetes deaths were 23 percent lower.

• Prostate cancer deaths dipped 12 percent, and HIV/AIDS deaths fell 34 percent.

• The death rate decreased 14 percent; teen pregnancies fell 26 percent; and gonorrhea infections dropped 53 percent. (Overlooked in her analysis of sexually transmitted infections, however, is the fact that St. Louis continues to have among the nation’s highest rates of chlamydia.)

Francis Slay
Francis Slay

Walker noted that one indication that St. Louis is doing a better job overall in addressing health needs efficiently is that emergency department services for non-emergencies have decreased 26 percent among the uninsured. That, she says, is due partly to more people having access to care at community health centers during the past 10 years.

Walker also responds to critics by noting some of the city’s health disparities will be addressed more easily if Missouri expands access to Medicaid.

“That is critical,” she says, noting that a special Medicaid pilot program, called the Gateway Health Plan, already had allowed health clinics in the city (and county) to enroll thousands of needy people in Medicaid. But without Medicaid expansion, she says, “this whole thing is in jeopardy. There is no guarantee that we are going to be able to continue the Gateway Project. That’s $23 million coming into this region. That’s also why Medicaid expansion is my No. 1 priority right now.”

Prevention as a priority

Slay has also tried to address disparities, including food deserts, by supporting neighborhood fruit and vegetable markets, such as the one in Old North St. Louis, as well as the Old North food co-op. The administration also is promoting the idea of stocking corner stores with health foods and snacks.

While the north side has more than its share of health disparities, the problems are most acute in just 17 neighborhoods in two ZIP codes -- 63106 and 63107.  They suffer a myriad of social and economic woes, including high crime, too many pregnant women getting little prenatal care, and children whose parents are behind bars.

But hope is about to bloom in those ZIP codes. Several child welfare groups are about to share in a $4.2 million federal grant awarded through the Missouri Department of Mental Health for services to help keep the estimated 1,300 youngsters in these ZIP codes out of harm’s way.

Brian Schmidt
Brian Schmidt

Reversing disparities in those neighborhoods is a big challenge, says Brian Schmidt, a researcher who heads a consulting firm called Mowonk, which is doing research for NorthSide Regeneration, part of the redevelopment proposed by developer Paul McKee. Schmidt argues that the problems in the two ZIP codes are so widespread and harmful to the city’s well-being that addressing the ailments in those two ZIP codes alone would go a long way in reshaping the picture of health disparities in the city.

“These areas rank worse in the city in avoidable hospitalizations, the worst rates of cases of chlamydia and asthma,” Schmidt says. “Bringing jobs to the area is important because the area has the highest unemployment rate in the city, 22 percent. In addition, 47 percent of the residents who are 16 and older don’t own automobiles, which means they don’t always have access to transportation to get to a job.”

He says a project like McKee’s would help address the disparities by bringing jobs and other amenities to the struggling neighborhoods.

Slay's critics say he misses the big picture

Walker concedes that the administration’s work to reduce health disparities has many critics. One is Aldermanic President Lewis Reed, one of Slay's opponents in the mayoral race. Reed says Slay and the health department have been “asleep at the wheel” instead of working harder to close the gaps between the haves and have-nots in St. Louis.

Reed says boosting employment is part of the answer. “Economic development and jobs are key in any community, but this current administration is doing nothing to stimulate our job base,” he argues.

Lewis Reed
Lewis Reed

Reed says health disparities are aggravated for those lacking steady jobs. “It means families have less money to buy food and resort to buying high carb, high starch, high sugar foods because those are cheaper and more prevalent. But this consumption can also lead to health problems and end up playing a role in health disparities.”

Some of the working poor also have been hurt, says Reed, by a policy adopted during Slay’s administration to ease the city’s requirment that a portion of entry level jobs under tax increment financing projects go to city residents.

“What that means is that there are fewer jobs available to folks in our community,” Reed says. “I look at this situation as part of the rise and fall of our city. It doesn’t matter whether the health disparity involves the Hispanic population, the African-American population or the white population, we need to make sure that the disparity is addressed.”

The third Democratic mayoral candidate, former Alderman Jimmie Matthews, has criticized both Slay and Reed, saying they both cater to developers and donors who, Matthews say, don’t care about the well-being of ordinary voters.

“Any way,” Matthews adds, “the real problem in St. Louis is economics.” Take care of unemployment, and the disparities will take care of themselves, he says.

Charles Q. Troupe
Charles Q. Troupe

Alderman Charles Q. Troupe, D-1st Ward, another critic of Slay, says the administration isn't as aggressive as it should in calling attention to health issues more common among the poor.

“Some sexually transmitted diseases in this city involve children as young as 12,” he says, “but how many times do you recall anybody going to jail for statutory rape? I realize that’s the prosecutor’s job, but it’s also a public health issue, and it shows how indifferent we are to the plight of some young girls, especially on the north side.”

Troupe also called attention to a study, pushed by black aldermen, which concluded that St. Louis was falling way short in addressing health disparities on the north side. Troupe says Slay's administration had failed to carry out any of the recommendations in that report.

Some health experts have said the report was questionable because it equated some north side health conditions to those in Third World countries.  Among those who say the conclusion overstated the problem was Dr. Will Ross, an expert on health disparities, who is associate dean for diversity and an assistant professor at Washington University’s medical school.

Walker was also extremely upset by the Third World reference, saying it wasn’t worth commenting on. She added that some of Troupe’s comments had less to do with concerns about disparities than about the administration’s rejection of his request to place an urgent care center on the north side although Troupe insisted that his real beef was with the administration’s refusal to provide money to carry out some of the study's recommendations.

“There is just no indication (a center) is needed there,” Walker says. “We are not moving in that direction with funding.”

Slay’s camp says that his actions on health issues speak to his commitment to reducing disparities.

1 Comment

Join The Beacon

When you register with the Beacon, you can save your searches as news alerts, rsvp for events, manage your donations and receive news and updates from the Beacon team.

Register Now

Already a Member

Getting around the new site

Take a look at our tutorials to help you get the hang of the new site.

Most Discussed Articles By Beacon Members

Conference of American nuns will mull response to Vatican charges

In Nation

7:55 am on Fri, 08.03.12

Meeting in St. Louis next week, the Leadership Conference of Women Religious will have its first opportunity as an assembled group to consider what to do after the Vatican issued a mandate for change this spring. It calls on the conference to reorganize and more strictly observe church teachings.

The 'free' Zoo

In Commentary

7:51 am on Tue, 05.22.12

When a family of four goes to the St. Louis Zoo, they can be forgiven for not knowing it will cost them $60, $72 if they park. If they can't pay, the alternative is to tell the kids they can't do what kids do at the zoo.

Featured Articles

House sends Boeing incentive bill to Nixon

In Economy

12:55 pm on Fri, 12.06.13

The Missouri House easily passed legislation aimed at attracting production of the 777x, a move that wraps up a legislative special session that saw little suspense and few surprises. The bill now goes to Gov. Jay Nixon, who has strongly supported the legislation.

Gandhi inspired Mandela on South Africa's 'Long Road to Freedom'

In World

10:10 am on Fri, 12.06.13

Nelson Mandela, who died Thursday at the age of 95, was a towering moral figure of the 20th century -- along with Mahatma Gandhi. It was no coincidence that Gandhi and Mandela, whose paths never crossed directly, both embarked on their campaigns against discrimination in South Africa. It was when Mandela won election as South Africa’s first black president that Gandhi's influence became apparent.

Featured Articles

Regina Carter brings jazz and therapy to Children's Hospital

6:36 am on Mon, 12.09.13

One night, the violinist is taking bows before a standing ovation at Jazz at the Bistro. The next afternoon, some of her audience may have trouble standing, but the kids in the playroom at Children's Hospital were no less appreciative. “Jazz is medicine personified," according to a doctor who brings in the jazz musicians.

Encore: Dead before death

In Performing Arts

12:58 am on Fri, 12.06.13

For years , the author was certain he would never come to appreciate The Grateful Dead, let alone be a Deadhead. But little by little, he's come around. He talks about his conversion and relates a real evolution: by a musician who went on to play with the Schwag, a Dead cover band.

Featured Articles

Schlichter honored with St. Louis Award

In Region

4:57 pm on Tue, 12.03.13

The attorney has founded Arch Grants, which brings together nonprofit philanthropy and commercially viable opportunitiesto fund new business startups, and Mentor St. Louis, which finds adult mentors for elementary students in the St. Louis Public School System. He was the driving force behind the state's historic tax credit program.

BioGenerator sets open house to celebrate new digs for entrepreneurs-in-residence

In InnovationSTL

12:29 pm on Tue, 11.12.13

BioSTL's BioGenerator organization is on the move as its entrepreneurs-in-residence find a new home in 4,300 square feet of office and conference space in an old automobile factory. The blossoming program, which helps BioGenerator's portfolio companies to get off the ground, continues to pay dividends within the growing biotech community.

Ambassadors aim to soften rough landing for St. Louis immigrants

In InnovationSTL

6:34 am on Fri, 11.08.13

The St. Louis Mosaic Project is set to hold an orientation for its new ambassadors -- dozens of foreign and native-born volunteers who aim to help make the community a more welcoming place for those from other nations. Participants will be expected to do everything from visiting local restaurants serving international cuisine to having dinner with an immigrant to the area.

Recent Articles

More Articles

Innovation and entrepreneurial activity are on the rise in St. Louis, especially in bioscience, technology and alternative energy. The Beacon's InnovationSTL section focuses on the people who are part of this wave, what they're doing and how this is shaping our future. To many St. Louisans, this wave is not yet visible. InnovationSTL aims to change that. We welcome you to share your knowledge, learn more about this vibrant trend and discuss its impact.

Featured Articles

Regina Carter brings jazz and therapy to Children's Hospital

6:36 am on Mon, 12.09.13

One night, the violinist is taking bows before a standing ovation at Jazz at the Bistro. The next afternoon, some of her audience may have trouble standing, but the kids in the playroom at Children's Hospital were no less appreciative. “Jazz is medicine personified," according to a doctor who brings in the jazz musicians.

Featured Articles

Featured Events:

More About The Beacon Home