Many people living in the ‘Diabetes Belt’ are plagued with medical debt
She turned to her co-workers. "And I asked, I said, 'Why y'all got it so dark in here? They said, 'Delores, it's not dark in here.' I said, 'Yes, it is. It's so dark in here.'"
She landed in the hospital. Her A1C level, which shows the average percentage of sugar in someone's blood over the past few months, was 14%.
A reading of 6.5% or higher indicates diabetes.
Lowery's home in
And of those counties,
That's much higher than the national rate, which is 13%, according to the
"The single most important predictor of a county's medical debt is the prevalence of chronic conditions. So it's basically the share of the population that has disease, such as diabetes, hypertension, and other types," he said.
That finding is from an analysis conducted by the
Lowery has been dealing with both the medical and financial challenges of Type 2 diabetes, and much more. The years since her diagnosis have been extremely difficult, with one life-changing event having overwhelming health and financial consequences.
In 2017, she came home one day to find her daughter, Ella Shantrica, on the floor, stabbed to death. The body of her granddaughter, 8-year-old Iyana, was found 12 days later in a nearby creek. In February, a man was found guilty of the killings and sentenced to life in prison.
In an interview in the front room of that tidy single-family home in
"Every day, 24 hours a day, that incident is in my head," she said. "It will never, ever go away."
She credits her church's pastor with helping her go back to the house, which she shares with grandson Tyreon, a teenager on the autism spectrum. With her daughter gone, Lowery said, she is Tyreon's sole caregiver.
Paying for diabetes care along with bills for food and housing has been a constant financial strain that eventually put her in debt.
"The cost of living was so extremely high in trying to raise my grandson that I just got behind," she said.
Many Americans are facing similar hardships. In addition to
"Because diabetes is a chronic illness, there are always six-month appointments," said
Dees built up thousands of dollars in medical debt and got help from RIP Medical Debt, a nonprofit group that says it has wiped out more than
Lowery will tell you that she gets high-quality and compassionate health care from a local provider. But the financial challenge of living with diabetes has put her health into decline.
A drug that once helped her, Ozempic, is now too costly for her. She said the medicine had been helping bring her diabetes under control. She was getting it delivered to her home, but she didn't meet her copays, and the bills piled up as unpaid debt. Soon, the deliveries stopped and Lowery tried to renew the prescription at the local pharmacy.
"I went to get it and the woman told me, 'I don't think you're going to be able to afford this.' I said, 'Why not?' She said, 'Because it's seven hundred and some dollars.'"
Worse, as the drug's profile skyrocketed in recent months as a treatment for weight loss among celebrities, demand increased and a shortage developed.
Lowery said this year that she hadn't been able to get Ozempic for several months and that her diabetes was getting worse. Her insurance company has been of no help.
"Nobody is willing to work with me with Ozempic. I don't know what to do," Lowery said. "They won't send me the medicine."
She and her provider even talked about getting physician samples, but given Ozempic's growing popularity, that didn't work.
A Changing Economy
In Lowery's hometown, others are struggling too.
More than 1 in 3 residents of the surrounding county have medical debt in collections, and 1 in 3 live in poverty.
It wasn't always this way, locals told
But one by one, employers moved out. Today, downtown
"
Weaver works for
As she walks the halls of the clinic, checking on colleagues and patients, she says that of the 3,300 appointments she takes every year, more than 90% of the people she treats have Type 2 diabetes.
She and others point to
"The fast foods don't help at all, and a lot of people just eat it every day, and that's a problem. It truly is," Weaver said. "But we have programs to help them. We even have a program where we take patients to the grocery store and we teach them what to buy."
For Lowery, having a medical provider like Weaver has been a lifeline. "She's seen me through so much," Lowery said. "She tried different medicines to get my diabetes intact."
Finding Weaver came at a time when her family's murders threw her into depression, her finances spiraled out of control, and her diabetes worsened. Weaver, she said, helped get her into counseling.
"When she found out what had happened, I honestly believe in my heart that she cried just like I cried," Lowery said. "She did so much for me."
While there is no easy solution for Lowery, who is over 65 and enrolled in Medicare, the
"Seventy-nine out of the 100 counties with the highest levels of medical debt are in states that have not expanded Medicaid under the ACA," the
Also known as Obamacare, the ACA offered states the option to expand their health insurance programs for the poor.
A
The centers in states that did expand Medicaid reported better diabetes control than those in states that didn't expand the program, and the effect was quick — within three years of the expansion.
Those improvements happened consistently among Black and Hispanic patients, who have higher rates of diabetes.
A study in
Lowery said that going forward she will continue to rely on her faith and her church community to help her through the tough times.
Still, she worries about the possible worsening of her diabetes and the financial stress of daily life.
"I wish things would get better," she said. "I think I would sleep a little better, because sometimes it's kind of hard for me to try to keep some food on the table."
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This article is from a partnership with
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About
"Diagnosis: Debt" is a reporting partnership between
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the
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