The Arkansas River looks stunning, even from the highway, and it’s a big relief from the arid stretches of land we’ve been riding through. Pueblo is often called “Colorado’s Second City,” but it’s not because of population. At a little over 100,000 people, it’s currently the ninth most populous city in Colorado. But for a long time, it’s been the economic center of southern Colorado and northeast New Mexico, and is still a hub for the steel and aviation industries.
With only two hours to go to Denver, now’s a good time to take a quick look at the Colorado healthcare system. Unlike New Mexico, where 40% of the physician workforce practiced in rural areas, Colorado is much more stratified -- with a whopping 89% in urban and suburban areas and only 11% in rural areas. This makes some sense in terms of population distribution, since 85% of Coloradans live in cities and 15% live in rural areas. But it means rural physicians have a lot of ground to cover! They also have a lot more to do -- the largest portion of Coloradans who are over 65 live in rural areas.
Despite the concentration in cities, the inner-city communities are still considered underserved -- a problem for cities like Pueblo, where 13.9% of families and 17.8% of the population lives below the poverty line.
Colorado is no closer to COGME’s ideal 50-50 ratio of primary care to other specialties, with only 39% of physicians in primary care. Slightly more concerning is Colorado’s shortage of OB/GYN physicians, where the Colorado Department of Labor and Employment estimates 20 new OB/GYN will be needed every year just to keep pace with demand.
Overall, Colorado has a lot to be proud of. Its population by most standards is healthier than the national norm, and features lower death rates from heart disease, cancer and stroke -- indeed, among the lowest in the nation.
But the Colorado Department of Public Health is up front about the healthcare disparities that exist in the state. These include:
By Region -- Southern Colorado, where we’ve been driving, is one of the most rural regions. Its shortage of primary care providers has led to increased incidents and death rates from respiratory disease and diabetes, chronic diseases that could be treated through better access to preventative care. Although Colorado’s diabetes health outcomes overall are better than the national norm, the huge difference in outcomes between rural and urban areas is striking.
By Ethnicity -- Latinos, Native Americans and African Americans have much poorer health outcomes than Caucasians. Caucasians and Asian Americans average 16 deaths per 100,000 members of the population each year from diabetes, but that’s less than half of the rate for African Americans (36) and Latinos (38). Similar disparities in health outcomes exist for cardiovascular disease and, for African Americans, cerbovascular disease.
More to follow from Colorado Springs. Check back here in about an hour.
Posted by:
Timothy Foley on 8/27/2008 at 1:16:00 PM