The California Endowment notes on their website that a person’s zip code determines their life expectancy. In Baltimore, studies show a 20-year gap in life expectancy between upper-income, predominantly white neighborhoods and poorer, predominantly minority neighborhoods. In thinking about ways in which to confront these pernicious facts, the General Assembly of Maryland in April of this year, passed a piece of legislation that flew under the radar next to Doomsday budgets, tax increases, marriage equality and casinos. This piece of legislation, known as Health Enterprise Zones (HEZ), aim to improve healthcare in minority communities and reduce health disparities in the state of Maryland. Essentially, the pilot program would offer tax breaks and other incentives to local health departments in the state, as well as, to community groups for their program operation in underserved and neglected areas labeled as HEZs. The General Assembly has set aside $4 million for physicians and community health providers dedicated to improving access and affordability to health services in these HEZs.
The genesis of these zones is the result of a work group chaired by University of Maryland School of Medicine Dean Dr. E. Albert Reece. Lt. Governor Anthony Brown and other state officials were looking for ways to address the disparities in the state that cost Medicare an extra $26 million annually, according to a 2006 report. This report notes that black residents in Maryland are nearly twice as likely to be hospitalized for asthma, hypertension, and heart failure. The infant mortality rate amongst African American babies is practically three times more than for white babies in Maryland.
While Maryland boasts some of the best teaching hospitals and the nation’s highest median household income, it ranks 33rd in geographic health disparities and receives equally poor marks for infant mortality, infectious diseases and health outcomes, according to data from the Maryland Health Quality and Cost Council.
A long-lasting solution to those problems will have to not only bring more health services to the under-served communities, but set up a framework to entice the providers of those services to stick around. HEZs are designed for just this purpose in that the Department of Health and Mental Hygiene in Maryland will set the boundaries of enterprise zones — areas where residents lack access to health care either because of proximity, cost or both — and accept applications from private physicians, community health organizations and local health departments that promise to dedicate their resources to serving the area.