The closing recently of Calhoun Memorial Hospital in tiny Arlington, Ga., comes not just as another body blow to health and healthcare in impoverished areas of rural Georgia -- but as a dagger to the heart of hopes for any kind of economic development or improvement. It also adds more weight to an anchor that already holds down the entire state's economy.
As it happens, news of the Calhoun Memorial closing came as the Partner Up! for Public Health campaign was finalizing research and analysis on health and economic disparities in Georgia -- research that had documented that Calhoun County was part of a cluster of counties in southwest Georgia that constitutes the least healthy region of the state.
Of 156 Georgia counties ranked by the University of Wisconsin in its annual County Health Rankings (three are too small to rank), Calhoun County ranked 154th for Health Outcomes. Its neighboring counties fared little better: Randolph ranked 147th, Quitman 149th, Early 150th, Stewart 153rd, and Terrell 155th. Only Clay County escaped the Bottom Ten, coming in at 100th.
The underlying data is just as startling. The premature death rate for the seven-county region is nearly 14 percent worse than that of Mississippi, the worst in the nation. It's also 130 percent worse than the premature death rate in the healthiest area of Georgia, the five-county region of North Metro Atlanta made up of Forsyth County (2nd in the Wisconsin report's ranking of Health Outcomes), Cherokee (4th), Gwinnett (5th), Cobb (6th) and Hall (9th).
And while Calhoun County and its neighbors suffer with a premature death rate worse than the worst in the country, the North Metro area boasts a rate better than the best, Minnesota.
If that doesn't tell you all you need to know about health disparities in Georgia, consider this: The low birthweight rate in the southwest Georgia cluster is 14.3 percent versus 7.6 in the North Metro area; the adult obesity rate is 34.2 percent versus 25.13 percent, and the teen birth rate is 76 births per 1,000 women aged 15-19 in southwest Georgia compared to 39 in the North Metro counties.
All these conditions come with massive healthcare, social service and opportunity costs. If all those costs were confined to southwest Georgia, the rest of the state might be able to dismiss the problems as theirs and theirs alone.
They are not. Those costs are -- to use a dirty word -- effectively "socialized" in a variety of ways: higher Medicaid expenditures for citizens of those counties, and higher state job tax credits that go to employers in poor counties, among others. Like it or not, the North Metro Atlanta counties are stuck with a share of southwest Georgia's tab.
This is not an appeal to spend less on Calhoun County and its sick and impoverished neighbors in southwest Georgia, let alone send a message that they're on their own. Short of sawing the state in half at the gnat line and quit-claiming South Georgia to Florida, there exists a shared interest in continuing efforts to build the economy in that area.
We at Partner Up! for Public Health have long argued that health status and access to health services in rural Georgia constitute a major strategic threat to the economic prosperity of the entire state. We have also argued that state government needs, on some meaningful level, to integrate its health planning and economic development efforts (and, for that matter, education). Currently it does not.
This is not a new or radical idea. As far back as the early 1970s, gubernatorial candidate Jimmy Carter talked about the importance of improving access to healthcare in rural areas as a prerequisite for economic growth. (As president a few years later, he sought and won passage of the Rural Health Clinic Services Act of 1977, which expanded access to care in rural areas nationally.)
As recently as 2004, then-Governor Sonny Perdue's Commission for a New Georgia produced a report that identified healthcare (along with education) as a fundamental building block for economic development. In an email exchange with me several months ago, the chairman of the task force that produced that report, David C. Garrett III, said he had told audiences at the time that "economic development in the absence of quality healthcare was an illusion."
That was true in Carter's day and in Perdue's, and it's true now. Just ask the folks in Calhoun County.
Charles Hayslett, CEO of Hayslett Group LLC, a public relations firm, and manager of Partner Up! for Public Health, funded by Healthcare Georgia Foundation; www.togetherwecandobetter.com.