People attach stigma to free health services


Bloomington’s Volunteers in Medicine clinic is on West Second Street west of South Rogers Street. A recent study found that there is a stigma attached to VIM and other low-income health care centers’ services. Rabi Abonour Buy Photos

People attach a stigma to receiving health care intended for low-income individuals, an IU study released last week found.

The study, which assessed Volunteers in Medicine patients throughout a two-year period, also found that a diverse population uses the VIM clinic.

Graduate students Kathleen Oberlin and Oren Pizmony-Levy collaborated with VIM to survey more than 700 patients.

“The VIM got a sense of who they were serving, literally where they lived,” Oberlin said. “Then they wanted to know more about the demographics.”

Patients who are eligible to receive VIM services must live at or below 200 percent of the poverty level. “We discovered one finding that we had, which is the diversity of patients,” Oberlin said.

More than half of the VIM patients said they perceived their health as poor. Respondents’ assessment of their health was more likely to be poor the less education they had.

Unemployed respondents were more likely to say their health limited daily activities, such as grocery shopping and housework. Slightly more than half of patients gave the same response.

“You might think that people who are unemployed are the ones using these services,” Pizmony-Levy said. “You’d be surprised.”

The reported number of employed people who use the services — 55.9 percent — means peoples have lost their health benefits, he said.

Half of VIM patients reported they knew someone who lacked insurance and were in need of VIM services but did not use them.

Only 7.7 percent of respondents said they would be embarrassed if others knew they used VIM services, but almost 30 percent said they thought others would be embarrassed if people knew they used VIM services.

Oberlin said these questions were used to indirectly measure community perceptions of services intended for low-income individuals.

Volunteer Robert Stone, director of Hoosiers for a Commonsense Health Care Plan, said he thinks people tend to have a “brutal, cruel” outlook of others without health insurance.

“That kind of attitude is expressed by a lot by people, whatever their political and spiritual philosophy is, that poor people don’t deserve health care,” he said.

Stone has been volunteering at the clinic since it opened and said he asks patients about how much health care they receive.

“I am aware of how embarrassed they are,” he said. “I’m a little cautious of how I ask those questions because I don’t want the patients to get the sense that I am grilling or judging them.”

Stone has cared for a variety of patients at the clinic including people with advanced degrees.

“There are lots and lots of people who are poor in the sense they can’t get health insurance for one reason or another,” he said.

Pizmony-Levy said the survey was a “win-win” for the Bloomington community, the clinic and the researchers, and that he hopes the survey will break the cycle of stigmatizing the use of low-cost health care.

“It’s better to go and use the VIM services and to take care of yourself health-wise than to be embarrassed and develop some worse health condition later on,” he said. “And that is an important message that we hope people will know.”

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