Two days of sleepless nights and contractions every 15 minutes are what Scott Darius and his wife experienced before they were finally inducted into UF Health Shands Hospital after she went into labor.
As the executive director for Florida Voices for Health, a health care advocacy organization connecting businesses, organizations and communities with health resources, this experience caused him to reflect on the matter of access to health care, he said.
After the closure of four hospitals in Suwannee, Union, Bradford and Columbia counties, Florida Voices for Health held listening sessions in affected rural counties to build relationships and understand issues outside of data.
“What do you do if you're two hours away and you make this drive and they tell you ‘We can't take you in right now?’” he said. “What does that person do, and what does life look like? What I learned after the roundtables was that it wasn't a hypothetical [and] that the worst case scenarios were actually happening in these communities.”
Addressing limited access to health in southeast Gainesville, community members and health care providers across Alachua County see solutions not only in improving access in policy, community engagement and education, but also in expanding food resources to the town.
East Gainesville, the part of town east of Main Street, is constantly referred to as a food desert. Having one supermarket, a Walmart Supercenter off Waldo Road, parts of the town are marked in the USDA Food Access Research Atlas as being low income and low access at one mile.
Conversely, health care in the county is an elaborate network of clinics and medical facilities including but not limited to: UF Health, Malcom Randall Department of Veteran Affairs Medical Center, HCA Florida North Florida Hospital, Florida Department of Health in Alachua and private practices.
Compared to other counties, health access in Alachua ranks high in Florida, being first in the rate of primary care physicians per person and second in physicians per county, according to a 2023 Florida Department of Health physician workforce annual report. However, in surrounding counties, the rate of physicians per person is at most half of what it is in Alachua.
Medicaid and coverage gaps
One issue Florida health care faces is that of coverage gaps. Florida has one of the most restrictive Medicaid programs in the country, Darius said. To qualify for the free and low-cost health coverage program in Florida, an individual must be either pregnant, disabled or share a household with a disabled person, responsible for a child under 18 years old or be over 65 years old.
Darius, who is also the board chair for the Alachua County Organization for Rural Needs dental clinic, said even when clinics are oriented to accept Medicaid, it is still hard to cover low-income adults.
“Medicaid reimbursement rates are super low, which means every person we see we lose money on,” he said. “Then you have a high number of people who are uninsured, and no one is getting reimbursed for that care whatsoever.”
While there has been legislation attempting to expand Medicaid coverage like House Bill 1529, Florida remains as one of 10 states that has not expanded Medicaid coverage through the Affordable Care Act.
This creates a dynamic, referred to as a “coverage gap,” where people exceed program eligibility limits but make under the federal poverty level for their coverage type.
Social determinants
Addressing a long awaited concern within East Gainesville, UF Health plans to open the Eastside Urgent Care Center on Southeast Hawthorne Road.
“This development will eliminate a health care desert,” said Brad Pollitt, UF Health Shands Vice President of facilities, in a June media release regarding the Eastside clinic’s groundbreaking ceremony. “It also has the potential to close a job desert, a housing desert and a food desert. There’s a lot of things this collective development will do as it grows out over the next decade.”
In that same media release, UF Health officials answered questions and updated viewers in a panel, addressing community input calling for primary care access.
Jennifer Woodard, the director of the UF Health Cancer Center Office for Community Outreach and Engagement, emphasizes the importance of understanding the social determinants of health, or the social factors that impact health.
Health care availability interacts with social factors — like one’s race, economic status, community and access to nutritious food — leading to outcomes like higher cancer death rates in underserved communities. Woodard said food deserts and medical shortage areas are alike in that lack of access to transportation, insurance and having time away from work are some of their root causes.
To engage communities in the 23 counties it serves, Woodard’s office partners with existing community health services to develop strategies that address needs understood by local social service providers and groups. For example, the Cancer Disparities Research Collaborative in Gainesville trains community scientists and holds events to share health information, such as events to address higher rates of prostate and breast cancer within Black people.
“The best ways that I have found to be trustworthy is to ask questions first. No one likes academicians coming into your county and telling you what you need,” she said. “You respect the history that made the distrust there, and you do the best you can to show up as a good human consistently.”
Kendrick Hill, a 37-year-old Gainesville local who grew up in the Sugarhill neighborhood, said he expects more from the city government when it comes to extending service into East Gainesville communities.
Citing the shutdown of Peaceful Sunday, a weekly event held at T.B. McPherson Park, due to safety concerns, along with his experience with limited RTS routes and sparse engagement outside of election years, Hill feels the city government does not engage with the community past Main Street.
“All I wanted to do was do something for the Eastside communities,” he said. “They have a whole bunch of promises when it’s the voter registration time or they want us to sign a petition. They’ll come out there for one day and give away some food or something… but they don’t see the big picture.”
Hill engages with his community by promoting events and partnering with businesses and groups like Swamp Religion, Little Caesars, Kava Bar and Hookah Lounge to sponsor food and bookbag drives for children. He hopes that people will recognize their strength in votes and collective organization.
Closures
Southeast Gainesville has seen many closures and vacancies in recent years, from the closure of the only supermarket in Southeast Gainesville to numerous closed businesses along East University Avenue and Waldo Road.
The effects of the 2009 closure of Alachua General Hospital, where UF’s Innovation Square now stands, are felt throughout North Central Florida. A decade later, ACORN medical clinic closed, being followed by Shands Live Oak Hospital in Suwannee County and Shands Stark.
The closure and moving of stores, health care services and supermarkets contrasts the comparatively rapid growth of the area closer to UF. Octavius Vance, co-owner of Lucille’s Southern Kitchen, said relocating closer to University Avenue will help their business.
Vance described moving out of their former location and into a food truck due to lease disagreements. Relocating to the lot in front of Wims Hair Studio, Vance and his sister, who is also a co-owner, anticipate that their business will grow during football season.
“[My sister has] only been here since the beginning of last year,” he said. “She’s going to do [football games] this year though. During football season, moving closer to UF to see what goes on and to see how business goes.”
Across the street from the UF Health’s Eastside Urgent Care construction site is the strip mall that Lucille’s Southern Kitchen used to be located in. A six-year-old sign outside the shopping center advertising a fully equipped grocery store for leasing remains, even after developers retracted plans to open a Bravo supermarket in 2022. As locals reflect on their current situations they are still grateful for what little they have.
“Luckily, we got Walmart,” Kendrick Hill said. “And that took 20 years.”
Contact Diego Perdomo at dperdomo@alligator.org. Follow him on X @diegoperdomoaq.
Diego Perdomo is a senior journalism major and the Summer 2024 Digital Managing Editor. He previously worked as the data reporter, design editor and a graphic designer. Outside of his studies, he likes to read comic books, bike and wonder how life would be outside of a car-dependent society.
