Built on a bluff on the Mississippi River 80 miles from New Orleans, Baton Rouge began as a port town where sugar cane and cotton were shipped from nearby plantations. Grand antebellum homes shaded by towering live oaks still line the river to the north and south.
Today, an Exxon Mobil refinery, one of the nation’s largest, and the growing Louisiana State University and state government campuses give the area one of the region’s few diversified economies.
But large pockets of poverty remain. Empty lots and homes listing on their foundations scar neighborhoods around Capitol City Family Health Center.
Chronic diseases such as diabetes and cancer are commonplace. One in 5 patients at Capitol City Family has high blood pressure. One in 10 is infected with HIV, the virus that causes AIDS.
In addition to the crush of illness, nearly half the clinic’s patients lack insurance, as few businesses in the area offer health benefits and the government safety net covers fewer people than in many other states.
“Patients drift in and out. Sometimes they will go missing for months,” said Constance McNeely, the clinic’s nurse manager. “When they come back, it’s like we’re starting over.”
Other patients show up only after they discover a serious disease.
Ralph Washington, 59, left work at one of Baton Rouge’s chemical plants more than a decade ago to start his own laundry and dry cleaning business. In recent years, times have been tough, and health insurance was out of the question. Until last year, he hadn’t had a checkup or lab test in years.
When Washington’s legs started swelling in February last year, his wife pushed him to go the emergency room. He was diagnosed with Type 2 diabetes.
Doctors and nurses at Capitol City Family, which charges a reduced fee for his care, helped get Washington’s blood sugar under control. But the diabetes and high blood pressure had already taken a toll; he is now on several medications to slow the advance of heart disease, a common diabetes complication.