The number of people without health insurance in Steuben County has been cut in half since 2014. That should mean more people have access to the health care system. But that’s not always the case, according to Erin Bankey, who manages funds from a state program aimed at reducing hospital visits in the Finger Lakes.
“The story starts there, with trying to get people insurance, but then we found even people who have insurance don’t necessarily have the relationship with a primary care provider, or transportation, or healthy food,” Bankey said.
Bankey’s employer is the Finger Lakes Performing Provider System. The system is charged with improving residents’ health and avoiding hospital visits in a 15-county swath of the state. One of those counties is Steuben, where uninsured rates dropped by half over the last five years.
But some new enrollees have been out of the health care loop for years, Bankey said. And they might lack the ability to access the care they just signed up for.
“They might be 50 miles from the provider that actually is the best fit for what their need is,” Bankey said. “Or they might not have a car to be able to take themselves to their doctor’s appointment.”
So Bankey’s organization distributes state funds to organizations like Catholic Charities of Steuben, which runs a program called Turning Point.
Turning Point staff helps people get to their doctor’s appointments, either driving or acting as bus buddies to help people navigate the public transit system.
Providing access to transportation has not traditionally been viewed as the role of the health care system, said Tess McKinley, who directs the Turning Point program.
Still, “without the ability to get to the doctor for preventive care, it doesn’t matter if you have health insurance,” McKinley said.
Turning Point offers other support to people who have been left out of the health care system in rural areas of the Finger Lakes, including helping people with rent and utilities payments and running a food pantry.
It’s part of a broader understanding of issues that McKinley and Bankey called “social determinants of health.” The idea, they said, is that people’s social position -- whether they’re on the brink of poverty, whether they have stable housing, whether they have a grocery store nearby, whether they live near friends -- can have a big influence on how healthy they are.
That means that especially in rural areas, sometimes the answers to improving people’s health come from outside the health care system. That approach is still developing.
“‘Turning Point,’ our title, implies change,” McKinley said. “We’ve gone through a lot of change, it’s crazy.”