Two days of sleepless nights and contractions every 15 minutes are what Scott Darius and his wife experienced before they were finally admitted to UF Health Shands Hospital after she went into labor.
As executive director for Florida Voices for Health, a health care advocacy organization that connects businesses, organizations and communities with health resources, that experience made him reflect on the issue of access to health care, he said.
Following 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 the issues beyond the data.
“What are you going to do if you’re two hours away and you make this drive and they say ‘We can’t pick you up right now?'” he said. “What does that person do and what does life look like?” What I learned behind the tables was that it wasn’t hypothetical [and] that the worst-case scenarios were actually happening in these communities.”
Addressing limited access to health care in southeast Gainesville, community members and health care providers throughout Alachua County see solutions not only in improving access to policies, community engagement and education, but also in expanding food resources in the city .
East Gainesville, the part of the city east of Main Street, is repeatedly referred to as a food desert. Having one supermarket, a Walmart Supercenter off Waldo Road, parts of the city are listed on the USDA’s Food Access Research Atlas as low income and low access within a 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 Veterans Affairs Medical Center, HCA Florida North Florida Hospital, Florida Department of Health in Alachua and private practice.
Compared to other counties, health access in Alachua ranks high in Florida, ranking first in primary care physicians per person and second in physicians per county, according to an annual report of the Department of Health’s physician workforce in Florida in 2023. However, in surrounding counties, the rate of doctors per capita is at most half of what it is in Alachua.
Medicaid and coverage gaps
One issue facing health care in Florida is that of coverage gaps. Florida has one of the most restrictive Medicaid programs in the country, Darius said. To qualify for Florida’s free and low-cost health coverage program, 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 board chair for the Alachua County Organization for Rural Needs dental clinic, said that even when clinics are geared to accept Medicaid, it’s still difficult to cover low-income adults.
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“Medicaid reimbursement rates are super low, which means every person we see we lose money,” he said. “Then you have a large number of people who are uninsured and no one is being reimbursed for that care.”
While there has been legislation attempting to expand Medicaid coverage such as House Bill 1529, Florida remains one of 10 states that has not expanded Medicaid coverage through the Affordable Care Act.
This creates a dynamic, referred to as the “coverage gap,” where people exceed program eligibility limits but make below the federal poverty level for their type of coverage.
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 about the groundbreaking ceremony for the Eastside clinic. “It also has the potential to close a job desert, a housing desert and a food desert. There are many things this collective development will do as it grows over the next decade.”
In the same media release, UF Health officials answered questions and updated viewers on a panel, addressing community input seeking access to primary care.
Jennifer Woodard, director of the UF Cancer Health Center’s Office of Outreach and Community Engagement, emphasizes the importance of understanding the social determinants of health, or social factors that influence health.
Health care availability interacts with social factors—such as race, economic status, community, and access to nutritious foods—leading to outcomes such as 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 time away from work are some of their main causes.
To engage the communities in the 23 counties it serves, Woodard’s office partners with existing community health services to develop strategies that address needs perceived 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 the higher rates of prostate and breast cancer in people of color.
“The best ways I’ve found to be reliable is to ask questions first. Nobody likes academics coming into your county and telling you what you need,” she said. “You respect the history that caused the mistrust there and do your best to consistently come across as human. good.”
Kendrick Hill, a 37-year-old Gainesville native who grew up in the Sugarhill neighborhood, said he expects more from city government when it comes to extending service to East Gainesville communities.
Citing the closure of Peaceful Sunday, a weekly event held at TB McPherson Park, due to safety concerns, along with his experience with limited RTS routes and infrequent engagement outside of election years, Hill thinks city government does not engage with the community past on Main Street.
“All I wanted to do was do something for the Eastside communities,” he said. “They have a bunch of promises when it’s voter registration time or they want us to sign a petition. They’ll go out there for a day and give 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 such as Swamp Religion, Little Caesars, Kava Bar and Hookah Lounge to sponsor meals and book bags for children. He hopes people will recognize their strength in voting and collective organizing.
Southeast Gainesville has seen many closings and vacancies in recent years, from the closing of the only supermarket in Southeast Gainesville to the many shuttered businesses along East University Avenue and Waldo Road.
The effects of the 2009 closing of Alachua General Hospital, where UF’s Innovation Square is now located, are felt throughout North Central Florida. A decade later, ACORN Medical Clinic closed, followed by Shands Live Oak Hospital in Suwannee County and Shands Stark.
The closing and moving of shops, health care services and supermarkets contrasts with the relatively rapid growth of the area closer to UF. Octavius Vance, co-owner of Lucille’s Southern Kitchen, said moving closer to University Avenue will help their business.
Vance described moving out of their previous place and into a food truck because of lease disputes. Moving into the lot across from Wims Hair Studio, Vance and his sister, who is also a co-owner, anticipate their business picking up during football season.
“[My sister has] I’ve only been here since the beginning of last year,” he said. “She will do [football games] however this year. During football season, catching up with UF to see what’s going on and see how business is going.”
Across the street from UF Health’s Eastside Urgent Care construction site is the strip mall that housed Lucille’s Southern Kitchen. A six-year-old sign outside the mall advertising a fully stocked grocery store for lease remains, even after developers withdrew plans to open a Bravo supermarket in 2022. As locals reflect on their current situations, they’re still grateful for what little they have.
“Luckily, we have Walmart,” Kendrick Hill said. “And that took 20 years.”
Contact Diego Perdomo at [email protected]. Follow him on X @diegoperdomoaq.
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Diego Perdomo is a third year journalism major. Outside of studying, he hasn’t read a book cover to cover since high school. In his spare time, he is an avid media consumer of comic books, iceberg videos, and wikis.