Healthcare Landscape Changes for the Better

Ten years after the earthquake the shook Seattle, the city has revolutionized its healthcare system. As a result of successful pre-event planning, healthcare access has expanded to neighborhoods and small communities throughout the county.

This story is a work of fiction, including all names and quotes, written by WWU DRR students for public education purposes. Site design by Dr. Scott Miles.

A key recovery goal for the health and well-being in the county has been improving community-scale public health capacities.  Health measures that have helped to increase well-being and quality of life in the region include improved walkability, additional parks, fewer food deserts, and alternative healthcare delivery options for low-income populations.

Part of increasing and well-being is rooted in access to healthy foods from local farms and gardens. In the case of King County’s earthquake recovery, this in fact played a significant role towards rebuilding a healthy community.

From the earthquake King County lost just under 25% of commercial buildings; about 9% of single family houses sustained severe to moderate damage⁴. The damage was devastating, however it presented the opportunity to create community gardens and urban farms on land zoned too dangerous to rebuild on.

For many residents living in food deserts—areas with poor access to fresh meat, fruits, and vegetables—the opportunity to construct community gardens was encouraging for numerous people.

Before the quake, Tukwila’s Sarah Bailey had to drive 13 miles in order to get to the closest supermarket. This is a significant barrier to fresh food for Sarah because she doesn’t own a car.

“I wish I could just climb into my car, drive to the supermarket and buy fresh veggies for my kids for dinner, but it’s too out of the way since I don’t have a car. We eat a lot of macaroni and cheese,” she laughed.

In the year after the earthquake, Sarah and her neighbors joined together to create a community garden on a 2 acre lot that once had houses. Three months after laying down the soil and planting the first seeds, they got their first harvest.

Sarah said, “All of the neighbors got together and we cooked a feast together. The tomatoes were the sweetest I’ve ever tasted.”

Sarah and her neighbors weren’t the only ones that embraced the opportunity for community gardens following the earthquake. It’s estimated that approximately 55 new community gardens popped up following the disaster in King County alone.

Residents of a Seattle neighborhood erect the first garden in their community.

Residents of a Seattle neighborhood erect the first garden in their community.

King County was especially inspired by New York City’s community garden program.

In New York over 600 gardens are available throughout the five boroughs for use by community members. This has created an increased sense of community, and allowed New Yorkers increased access to affordable and nutritious produce within their neighborhood.

Adding great value to the community, the gardens have given access those who may not otherwise have the privilege of being able to afford healthy produce. It also increases understanding of where fruits and vegetables come from and how they grow which encourages healthy lifestyles for children and other community members.

Many political and community leaders, including local mayors, rallied together to help improve the state of healthcare in King County. One mayor called for the development of new community health centers and was later joined with majors from the surrounding cities of North Bend, Shoreline, Enumclaw and more. The aim was one health center for every 10,000 residents in the city.

Today, 10 years after the earthquake, there are 200 community health facilities located in neighborhoods throughout City. The centers are currently providing quality healthcare services to residents of all ages and all incomes levels. They provide both primary and preventative healthcare, as well as behavioral and dental care. All of the health centers are local, community-owned, and non-profit. The centers provide options for the uninsured.

For Rosella Johansen, who lives in the suburbs of Seattle with her three children, access to adequate healthcare was a significant challenge. Today, the healthcare landscape has changed drastically and Rosella now has a healthcare center three blocks from her house.

“I remember back before the earthquake happened, Margie, my youngest was really sick, but we didn’t have insurance, and even if we did, the buses had stopped running by then so there was no way for us to get over there.”

A center opened in her neighborhood four years ago. The center provides healthcare to over 6,000 residents in the area; about 72% of those served are at or below the poverty line.

“We just couldn’t be happier now. I feel so much better knowing that they’re there if we need to them,” said Rosella.

For people who have specialized medical needs or are in very rural areas, new innovations in technology and healthcare services have made access for them even better. For example, telemedicine is one way that those in need have received increased access. For many people who need to see their doctors on a regular basis and aren’t able to travel to see them either because of distance or their physical ability to travel, telemedicine has opened their range of care options.

The expansion of telemedicine services was a godsend for residents like Maryann Macavoy who lives in Duvall. Maryann has a rare muscular disease and needs bimonthly checkups from the only doctor in the county that specializes in the disease. His office is in West Seattle.

“It was simply impossible for me to travel his office every two weeks,” Maryann explained.

With a grant from the state, she purchases a telemedicine system that takes and sends diagnostics to her doctor over the Internet, while allowing her to communicate through Skype.

“It’s a million times better,” she elaborated, “It’s like having him next door. If I need anything, I can contact him in a minute or two.”

Maryann isn’t the only one in King County that has benefitted from innovations in telemedicine. In fact, there are approximately 136,000 residents in King County that reside in rural areas, making access to some medical care difficult. The implementation of telemedicine has been a cost-effective and critical service for thousands.

Some members of the medical industry have lamented the fact that they have lost revenue as a result of the services that are now offered at many of the community centers. Regardless, many in the medical industry in the area have embraced the advances.

“We may be losing some patients”, explained the president of a local hospital, Tom Gains, “But there’s no denying the fact that residents of King County are much better off now.”

When the 7.2 magnitude earthquake hit Seattle, our healthcare system was completely overwhelmed. Many in the worst hit areas would even argue that it broke down entirely.  Having local community healthcare centers much more available now, spreads out healthcare services if something as devastating as the Seattle Fault earthquake were to happen again. Instead of having critical facilities, like hospitals concentrated in one place, the community healthcare centers spread out the available services to more people in more areas than ever before.

King County was especially inspired by Galveston Texas’ experience with telemedicine, which helped to create increased interest in the technology and give the push needed to result in implementation. When hurricane Ike hit Galveston Texas it had absolutely devastating effects on the local infrastructure and population. Over two million people were evacuated in preparation for the storm and many facilities were inundated with several feet of water. Because of this displacement and extensive damages to “brick and mortar” clinics, very few primary care facilities were available for nonemergency medical care.

Telemedicine in action

Telemedicine in action

However, due to the available technology, telemedicine services were able to be established by some care providers such as the University of Texas Medical Branch and they were able to reestablish normal clinical services to the majority of their clinical customers within two weeks of hurricane Ike. Because of the flexible nature of telemedicine, the system as a whole is able to easily adapt to changing and emergency situations.

Telemedicine services are unique in that they can be implemented in a way which allows the care providers as a whole to be much more resilient. Should a disaster occur which causes the system to fail, they are able to fail gracefully and save valuable data and records rather than in a dangerous and chaotic manner. While it may take years for the system to fully recover, telemedicine can allow services to return to normal quite rapidly which is invaluable in an emergency situation.

King County has plans to continue to expand both the community health centers as well as telemedicine services in the near future, making it their goal to make sure not even one person has to go without critical medical care simply before of their location or income. These steps have made King County a more enjoyable and healthy place for all residents to not just survive, but thrive.