CINCINNATI (Reuters) - Since January, Patricia Roberts has had access to something that many of the poorest people in the United States can only dream of: a pharmacy in her neighborhood.
The nation’s first not-for-profit pharmacy is located in Over-the-Rhine, Cincinnati’s most notorious neighborhood — one that is more blighted by boarded-up buildings than blessed with brand new businesses.
“I used to have to go all the way uptown to get my medicine,” said Roberts, who lives off government disability payments due to seizures and asthma. “Sometimes I wouldn’t have money to catch the bus. I just had to walk.”
Neighborhoods like Over-the-Rhine underscore the plight of millions of poor people in the United States.
A Christian health clinic opened in the mostly African American neighborhood in 1992, but that still left big gaps in patient care. With no pharmacy for miles, prescriptions often went unfilled, and patients skipped medications and got sicker.
More than 46 million people in the United States, including a disproportionate number of blacks and Hispanics, lack health insurance, according to government figures.
While the poorest 25 percent are eligible for the government’s Medicaid program, most go without care or medicine unless they can find free clinics or hospitals funded by charities.
Last year, the health clinic’s public relations director, JoAnn Riley, and Cincinnati-born pharmacist Chad Worz stepped in with an idea for a on-site pharmacy that, like the clinic, would find a way to serve people with or without health insurance.
Worz said his decision to bring a pharmacy to the poor and crime-ridden section of Cincinnati raised eyebrows.
“People said ‘You’re going to open a pharmacy in the center of the city’s illicit drug trade? Are you crazy?’” he recalled.
Opening a pharmacy and selling narcotics in an area notorious for drug and gun crimes required special planning.
The pharmacy, located on the ground floor of the Crossroad Health Center, was built with bullet-proof glass and drywall separating the pharmacists and drugs from the customers.
A police substation takes up a corner of the waiting area, and pharmacist Susan Lattier wears a panic button on a lanyard around her neck in case of attempted robbery.
“Actually, we haven’t had any problems,” said Lattier. “The people appreciate you. They are so grateful that you are here.”
The pharmacy is more inviting than it sounds. Plants and posters have been donated to decorate the waiting area, and Lattier tends to open the pharmacy door to interact with patients directly rather than from behind bulletproof glass.
The challenges of dealing with very poor clients are many. Lattier sees a lot of diabetes and asthma. Nearly all of the small children are anemic and need iron supplements. Patients struggle to pay even $1 and $2 dispensing fees.
“They come in and see what they’ll have to pay, and say ‘I don’t have the money yet. I’ll have to come back,’” Lattier said. “Then a few hours later they’ll be back. You don’t want to know how they came up with the money, but they do what they have to do.”
The clinic gets funds from local government, the University of Cincinnati, church groups and even a local billionaire philanthropist. Many of the medications are paid for by Medicaid, a government program that provides health care for the very poor.
Nursing homes donate unused medications, and drug companies give discounts.
Any profit the pharmacy makes will be poured back into the business or used for education programs.
Linda Elam, principal policy analyst at the Kaiser Family Foundation, a nonprofit group that funds research on health care, said it is a great model for communities — inner-city neighborhoods and rural areas alike — where a lack of a pharmacy has left a gap in health care.
“There is sort of a space between a physician writing and a patient filling a prescription, where you can lose a lot of people, whether they don’t have money to fill it or don’t have access to a pharmacy,” Elam said.
“The poorest communities often have the largest illness burden, and they are the ones with the least means to deal with it.”