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Caregivers Brace for Economy’s Impact on Health

Washington Afro, News Report, Zenitha Prince Posted: Dec 29, 2008

December 23, 2008) - It’s the waiting that can kill you—the wondering, worrying about whether the next pink slip will have your name on it or whether an eviction notice will greet you at your door.

Levels of anxiety in communities across the United States have increased due to the faltering economy, medical experts say.

“This is a very stressful time,” said Baltimore Health Commissioner Dr. Joshua Sharfstein. “Everyone’s waiting for the next shoe to drop.”

It started with a rash of foreclosures, then the crippling of Wall Street, companies began to close their doors and in November alone, more than 500,000 people were laid off. Most economists predict that things will get worse, and medical, mental and social health professionals say the state of the economy likely will be reflected in people’s health.

“We are anticipating over the next few months not so much suicidality but depression will increase,” said Dr. Gabe Kelen, professor and chairman of the Department of Emergency Medicine at Johns Hopkins Hospital. “[And] when cupboards become truly bare, we’ll see a true level of despair.”

Kelen said so far, that increased anxiety has not translated into more emergency room visits but then, “People with mental health issues may come complaining of a backache—it may not be immediately obvious.”

Carlos Silva, a clinical psychologist and the Behavioral Health Integration coordinator at Baltimore Medical Systems, said traffic in their clinics has increased, and he believes there is a correlation between the economic depression and some of the psychosomatic displays he is seeing in patients.

“The fear of losing your job, of not being able to make ends meet—all those ideas get channeled into the body,” Silva said, “and they manifest those thoughts through symptoms like tension headaches, smoking, drinking, the increased use of [drug] substances, anxiety, depression, insomnia; people are eating more carbohydrates and junk food…people come in complaining of relationship issues….”

Counseling psychologist, Monica Banks Greene, who has a large African-American clientele, said she sees clients of different socioeconomic strata in her Largo, Md. office including some who once received six-figure salaries and have lost their jobs.

For those who were once independent, she said, the loss of a job is a crushing blow.

“A lot of African-American men I see here in my practice are having a difficult time with pride,” she said. “It’s their first time losing their job or feeling depressed and they don’t feel they can talk to their spouses or the stress is causing a lot of arguments…there is a lot more emotional abuse.”

Carol Arthur, executive director of the Domestic Abuse Project, a nonprofit in Minneapolis, Minn., said she has seen an uptick in familial abuse, a conclusion based on the requests for service and not on police calls.

“We know domestic violence increases whenever there are major stresses on families like the bad economy,” she said. “People are losing their jobs, foreclosures increasing, they’re stressed and they have no one to take it out on but their partner.”

But even as the incidence of domestic violence has risen, “many women are feeling like they have fewer options,” Arthur said.

Her state has 27 shelters and 30 motel/hotel/safehouses but all have been full in the last couple of months because they couldn’t move the women and their children out.

“It is more and more difficult to find the resources to move out of shelters and into independent living,” Arthur added. “As people are losing their jobs, companies are downsizing [and] companies have less money to pay benefits, there are fewer resources to help women transition.”

In Minnesota as elsewhere, part of the problem is that homeless women and their families are filling up those beds.

In Baltimore, too, the number of homeless people seeking shelter has increased.

And emergency rooms in the area could soon see more patients coming through their doors, Dr. Kelen predicted.

“As people lose their jobs and their health insurance along with it we may be seeing more emergency room visits because they have no other avenue,” said the Johns Hopkins physician.

Maryland, Virginia and Washington, D.C., are somewhat insulated because of the cushion federal government jobs provide, he added, but “word is coming from other parts in the country that have been very hard hit indicating that they’re seeing more of the uninsured and underinsured coming in.”

That anticipated deluge of clients is somewhat daunting, commissioner Sharfstein and others say, given the budget shortfalls many private and public entities are experiencing.

“The challenge is even as requests for services are going up, resources are shrinking,” he said.

Silva, the psychologist, said he expects their clinics’ doors, impelled by the “grim” financial forecast, will swing open more often but that they are already preparing to meet the need.

“We are trying to be more thoughtful as to how we use our resources as we are in competition for funds from the state, federal government and foundations,” he said. “[Organizations like ours] have to be more creative.”

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