Iran as an axis of good in Mississippi

I’ve used this space to say some harsh things about my home state of Mississippi, but today I’m here to praise.

I hope you saw the cover story of The New York Times Magazine on July 29, but if you didn’t, click on the link.

Mississippi has always been poor. I used to say we were too poor to be as ugly as other places. Hard times in other parts of the country hit Mississippi harder, and have left poverty and its attendant ills: poor education, worse health, and no prospects.

Here are the State’s brutal statistics: 69% of adult Mississippians are obese or overweight. 25% of households don’t have access to decent, healthful food. In one of the country’s most fertile areas, people shop for groceries at gas stations and die from diabetes, hypertension, congestive heart failure, and asthma.

Dr. Aaron Shirley, 79, borrowed an idea from Iran to tackle the State’s health crisis—where even with Medicare, Medicaid, community clinics and home health services, thousands of people go to the emergency room for ills that could have been prevented by primary care.

The idea, begun in rural Iran in the ‘80s is this:

  1. Create “health houses” within an hour’s walk.
  2. Staff these with locals (because they’re trusted), trained in the basics of preventive health care: nutrition, family planning, blood pressure, prenatal care, immunization, etc.
  3. Use a single, multi-tiered system: from health house to rural health center to district hospital.

In Iran, where 17,000 health houses now serve 23 million rural Iranians, disparities between the care given urban and rural residents have narrowed. Rural infant mortality has been reduced 75%.

In Mississippi, using an Iranian advisor and with only $75,000 in outside money, Dr. Shirley began HealthConnect. His first health houses are set up in schools. Trained locals make house calls, providing constant attention for families where one stumble—like an unpaid electric bill—can escalate into medical disaster. In one year, HealthConnect cut the rate of readmission to the Central Mississippi Medical Center by 15 percent.

Why turn to an Iranian model? Dr. Shirley says, unlike everything else in Mississippi, it works.

5 responses »

  1. I think this illustrates the difference in the rationale for healthcare in Iran and the US.

    In Iran, care is focused on outcome.

    Here, care is focused on income.

    Not to ascribe altruism, but it serves the interests of the regime in Iran to provide effective healthcare.

    And it serves the interests of the healthcare industry in the US to provide expensive healthcare.

    Until that equation changes, and the only way it will change in any truly meaningful manner is with the implementation of a single payer system, such as other “developed” countries instituted decades ago, with the vastly improved outcomes to prove it, we’ll continue to sign the wholly unnecessary death warrants of countless numbers of fellow human beings.

    And the corps will keep on making a literal killing.


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