BATON ROUGE, La. — Patients begin lining up outside Capitol City Family Health Center before the doors open at 7:30 a.m.
The clinic, on a ragged stretch of the boulevard that separates the black and white sections of town, is a refuge for thousands of this old southern capital’s poorest and sickest residents. They come seeking relief from diabetes, heart disease and other debilitating illnesses.
Twelve hundred miles up the Mississippi River, in the shadow of a public housing tower in St. Paul, Minn., the waiting room at the Open Cities Health Center also fills daily with the city’s poorest.
But the patients in Minnesota receive a very different kind of care, which leads to very different outcomes. They are more likely to get recommended checkups and cancer screenings. If very ill, they can usually see specialists. Their doctors rely on sophisticated data to track results.
Diabetics at the St. Paul clinic are twice as likely as those in Baton Rouge to have their blood sugar under control. That can slow the onset of more serious problems such as kidney failure and blindness.
Young patients with asthma also benefit from Minnesota’s more comprehensive medical system. Asthmatic children in the state’s poorest neighborhoods are 37 percent less likely than those in Louisiana to end up in a hospital.
And poor seniors in Minnesota are half as likely to be prescribed a high-risk drug and 38 percent less likely to go to the emergency room for an ailment that could have been treated in a doctor’s office.
“Being low income doesn’t destine you to poor health care. Where you live matters,” said David Radley, a health policy expert who has led several studies on geographic disparities in medical care for the Commonwealth Fund, a nonpartisan research foundation that analyzes health care systems.