Tackling Health Inequities Through Collaboration and Community-Based Care

Like many communities, access to healthcare in Fulton County, Georgia, can depend heavily on where a person lives. The southern part of the county faces a life expectancy that is seven years shorter than the north, a reflection of deep structural inequities that were made worse by the COVID-19 pandemic and hospital closures.

County leaders are now working to rebuild that safety net—one partnership and one program at a time.

Pamela Roshell, Ph.D., chief operating officer for Fulton County Government, said two major events reshaped the local health landscape.

“It left certain parts of the community without reasonable drive-time access to an emergency room, and it also pulled out an extensive network of healthcare services,” she shared. “What most individuals really didn’t understand is when that hospital left, it took the whole ecosystem with it. It took primary care clinics, all sorts of specialty care, and so what we have seen since that time is the continuation and the exacerbation of health disparities.”

Roshell said the county responded by forming partnerships with Morehouse School of Medicine and Grady Health System to create new access points for care.

“Government usually, especially at the local level, while we fund healthcare, we're usually not in the business other than a public health system of providing direct care,” she said. “We needed the community partners who actually have all of the medical expertise and the same vision for health equity.”

For LaTrina Foster, director of Behavioral Health & Developmental Disabilities for the county, that same philosophy guides her department’s work.

“We have the ability to offer barrier-free access to care. And what that means is that regardless of your ability to pay, we will see you,” Foster said.

Fulton County’s 24/7 Behavioral Health Crisis Center represents a major step in that direction, where patients are greeted by “peers” or someone who is living in recovery, as well as medical professionals.

Giving folks the option to stay for up to a week, Foster said the crisis center team hopes patients “transition back into the community with all the support that they need, and they’re successful and begin their journey, or restart their journey, to recovery.”

Both Roshell and Foster are reframing what equitable healthcare looks like by combining local leadership, academic partnerships and community trust to close long-standing gaps in access and outcomes.