Tuberculosis And Rural Healthcare In America


With guest host Jessica Yellin.

Alabama’s tuberculosis epidemic and what it shows us about rural healthcare in America.

Two residents cross one of the main streets in downtown Marion, Ala., Wednesday, Aug. 24, 2016. Stretching from east Texas to southern Virginia, the impoverished area known as the Black Belt is heavily populated by blacks. (AP Photo/Brynn Anderson)

In most places tuberculosis is a disease from the past. But in the small county of Perry, Alabama it’s a near outbreak. Even more unusual? The infected ignored health official’s pleas to seek treatment. It was so bad, the county finally paid residents to get tested. It all comes down to racial divides. Historic abuses by the medical system. And a tragic shortage of local doctors. This hour On Point, a snapshot of health care in rural America. — Jessica Yellin


Helen Ouyang, author of recent Harper’s Magazine piece headlined “Where Healthcare Won’t Go: A Tuberculosis Crisis In The Black Belt.” Physician and assistant professor of medicine at Columbia University. (@DrHelenOuyang)

Shane Lee, town doctor in Marion, Alabama. He founded the Marion Clinic in 1990 and discovered the community’s first severe case of tuberculosis.

John Wheat, professor of community and rural medicine and internal medicine at the University of Alabama in Tuscaloosa.

Noam Levey, national healthcare reporter for the Los Angeles Times. (@NoamLevey)

From The Reading List

Harper’s Magazine: Where Health Care Won’t Go: A Tuberculosis Crisis In The Black Belt — “Marion, a town of 3,500 and the seat of Perry County, has been grappling with a historic outbreak of a disease that has vanished from worry in much of the United States. Thirty-four active cases have been found; if that doesn’t seem like a lot, consider that the rate of infection — what the World Health Organization uses to determine severity — is almost a hundred times the national average, and higher than the rates in India, Kenya, and Haiti. Nearly 200 more in Marion were discovered to have latent tuberculosis, meaning that they were infected but had not developed active symptoms — which include bloody coughing, shortness of breath, night sweats, and weight loss.”

NPR: Small Alabama County Offers Cash Amid Struggle To Stop Tuberculosis Spread — “There’s only one health department in Alabama where people can go to be tested for tuberculosis. That’s in Perry County, where an outbreak claimed three lives in 2015. For every 100,000 people there, 253 would be infected; normally in Alabama it’s only 2.5. Now, health officials are trying to get handle on the disease. But it hasn’t been easy, so officials there decided to take a new approach.”

Washington Post: U.S. life expectancy varies by more than 20 years from county to county — “People are less likely to live longer if they are poor, get little exercise and lack access to health care, the researchers found. Mokdad said the quality and availability of that health care — for example, access to screening for signs of cancer — has a significant effect on health outcomes. The United States, he said, needs to rethink how it delivers medical care, with a much greater investment in prevention, and a more holistic approach to creating healthy communities.”

Tuberculosis in the U.S.

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Tuberculosis And Rural Healthcare In America

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