Lawmakers: Islanders need medical care
Posted on Tuesday, December 11, 2007
Lawmakers learned Monday that Northwest Arkansas’ Marshallese population is among the least healthy in the state, with high rates of communicable diseases and inadequate services to treat them.
Though they live and work in the United States legally under a compact with the federal government, natives of the Republic of the Marshall Islands are not eligible for governmentfunded health-care programs such as ARKids First, Medicaid and Medicare.
Legislators, worried about a possible infectious disease outbreak, want to persuade Congress that the state needs federal aid to help provide services such as a satellite health unit that would cater to the growing Marshallese population in Springdale.
“You can imagine the bomb we’re sitting on here,” said Sen. Bill Pritchard, a Republican whose Washington County district is home to what state health officials estimated as 6, 000 to 8, 000 Marshallese. “If we have an outbreak of a serious disease, it is going to be a state health problem.” At Pritchard’s urging, members of the Senate and House Public Health, Welfare and Labor Committees agreed Monday to find out what it will take to conduct a special census of the Marshallese. Lawmakers eventually hope to calculate the financial impact of the population on state and private health-care providers as well as the state education system.
Congress sets aside about $ 30 million annually in “compact impact” aid to Hawaii, Guam, American Samoa and the Northern Mariana Islands to help make up for the cost of services provided to Marshallese and other Micronesian people in those places.
Arkansas gets none of that money, though it’s believed to have the highest population of Marshallese in the continental United States. Springdale has become such an important population center for Marshallese people that they vote in their homeland’s elections at the Jones Center for Families and candidates personally travel to Northwest Arkansas to woo voters.
Pritchard and other lawmakers said they hope the state’s congressional delegation will try to persuade federal officials that Arkansas needs help with services for that population.
According to a special census in 2003, about 7, 000 Marshallese and other Micronesians lived in Hawaii, possibly fewer than in Arkansas if state officials’ estimates are right.
The United States and the Marshall Islands have an unusual diplomatic relationship called the Compact of Free Association that provides special privileges for the islanders to live and work in the United States without visas. When the Marshall Islands was under U. S. control after World War II, it was the site of nuclear weapons tests for more than a decade.
Rep. Billy Gaskill, D-Paragould, said he served in the Marshall Islands when he was in the military.
“What are we on a guilt trip here about the Marshall Islands ?” Gaskill asked Pritchard.
He pointed to statistics that show that the Marshallese have high rates of syphilis and leprosy.
“A nuclear bomb don’t cause syphilis, and it certainly don’t cause leprosy,” he said.
Pritchard said the state can’t do anything about the federal compact.
“We have a population that’s here legally.... The diseases could be a serious threat not only to themselves but the rest of the population,” Pritchard said. “So to me it’s a matter of a public health issue, and not a political issue at all.” Carmen Chong Gum, a Marshallese woman who serves as an outreach coordinator at the Jones Center, told lawmakers she doesn’t want to take them on “a guilt ride.” She said most of the Marshallese in Northwest Arkansas work in poultry processing plants. She began to cry when she described them as taxpaying Arkansas residents.
“Is this right for these people to work day and night, long hours of standing on production lines, money taken out of their hard-earned paychecks to fund programs they are not eligible for ?” she asked.
Pritchard said some of the Marshallese people are covered by their employers’ health insurance, but he said they tend to live among extended families with grandparents and others who aren’t eligible for coverage.
Dr. Joe Bates, the chief science officer at the Arkansas Department of Health, said the Marshallese don’t have to pass health tests to enter the United States, and they bring with them communicable diseases common to Pacific Island nations. They have “different ideas about wellness” and tend not to seek preventive care, he said.
Bates reported that: The tuberculosis rate for Marshallese in Arkansas is estimated at 50 cases per 100, 000 people, though health officials can’t be sure without a better estimate of how many Marshallese live here. The rate for all of Arkansas is 3. 6 per 100, 000.
The rate of perinatal hepatitis B among Marshallese mothers delivering babies in Washington County is 9. 65 percent, compared to 0. 1 percent for non-Marshallese mothers in Washington County.
From 2000 to 2005, six of nine cases of congenital syphilis reported in Northwest Arkansas were among Marshallese babies. During the same time period, 21 of 38 cases of infectious syphilis in Northwest Arkansas were among Marshallese people. There were eight cases of leprosy during that five-year period among Marshallese people in Washington County. Bates said the disease is not as communicable as most people think. It takes prolonged, intimate contact, usually among family members living together, to spread, he said.
If there are 6, 000 to 8, 000 Marshallese in Northwest Arkansas, they would make up less than 2 percent of the combined population in Washington and Benton counties.
Bates reported that there have been three outbreaks of tuberculosis since 2003, one in a poultry plant and two in Springdale schools, in which a Marshallese person was identified as initial patient among the population investigated.
Bates said the department has applied for but failed to get grants from public and private sources.
Pritchard said that ideally the Legislature will do what’s necessary to make the Marshallese population eligible for state health services and then use information such as the census to get help paying for it from the federal government.
Ryan James, a spokesman for U. S. Rep. John Boozman, said the Republican congressman from Northwest Arkansas has been trying to come up with a solution for more than a year. The trouble is, no one in Congress wants the compact changed to include funding for another state, James said.
“If we were to drop a bill today, it would go nowhere. It wouldn’t even get a hearing,” he said.
James said it’s possible that if Arkansas comes back with data and demonstrates the size of the population and burden on the state, “that might be the ticket to prove our point.”
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