Nurse: More middle-class patients accessing system

CHCF Center for Health ReportingFebruary 20, 2011 


      At the Planned Parenthood clinic in Modesto, employees have handed out surveys asking patients “How has the economy affected your life?” Some of their responses: • “I am out of a job and have no income,” wrote a 23-year-old patient. “My boyfriend and I live off one salary raising three children.”

      • “Less money. Much harder to make a comfortable life for me and my kids,” wrote a 24-year-old patient.

      • “I have had to get my hours cut. It makes it difficult to find a second job to make up for the lost hours. I am going to be laid off at the end of the month,” wrote a 19-year-old patient.

      • “Lost a house. Had no place to stay for a moment. Bad depression,” wrote a 50-year-old patient.

      • “I lost my job had to move from house to house, lost my car,” wrote a 24-year-old patient.

      • “It affected me by affecting my father, which affected my family,” wrote a 22-year-old patient. “Jobs are just harder to come across.”

      • “The economy has made it harder for my family and I to live our daily lives because we are low on money and prices are going up and people are suffering,” wrote a 17-year-old patient, adding a “9” at the end.

Alice DeLaurier-O'Neil has worked as a nurse at Planned Parenthood for the past year and a half. Increasingly, she and others at the clinic on McHenry Avenue in Modesto see middle-class patients in their 40s and 50s coming into the clinic for the first time — with no insurance.

Some of these women say haven’t had a pap smear for years. Some say they’ve felt a breast lump for the past two years, but didn’t have the money to get it checked.

“It just tears your heart apart,” DeLaurier-O'Neil said.

Older patients often assume Planned Parenthood is all about condoms and birth control pills, and feel embarrassed to be seen there, she said.

But, as the economy continues to stagnate, and so many have lost jobs and insurance, they’re beginning to get past that stigma. The total number of visits to the clinic has increased from less than 12,000 in 2006 to almost 18,000 last year.

DeLaurier-O'Neil, 58, has worked in nursing on and off since 1975. Last year, she came to Planned Parenthood out of retirement because she, herself, needed health insurance.

The recent shift in need has been noticeable, she said. She’s long seen poor people and low-income workers struggle to access health care. But now the center staff is seeing professional women, bank tellers and teachers who’ve lost jobs or had their hours cut, or who are trying to cut corners after their husbands become unemployed.

One of DeLaurier-O'Neil’s colleagues, a nurse who used to work in private practice, said she’s seen about 20 of her former private practice patients coming into the clinic in the past 18 months.

A recent survey conducted by Planned Parenthood Mar Monte — which serves 42 counties across Central California and Northern Nevada — shows that more than 45 percent of patients had lost jobs or hours in the past year, and almost 53 percent had avoided seeing a doctor in the past year due to cost.

The Modesto center’s staff can provide limited types of care, but for many health conditions they must do their best to find other resources for their patients, calling upon doctor friends or other safety net providers for help.

Sometimes, the best thing DeLaurier-O'Neil can do is let patients tell her their stories.

“Sometimes just somebody listening to you is all you need to get through the day,” she said.

Capital Public Radio will discuss The Bee’s series on “Insight,” its interview program, Wednesday from 10 to 11 a.m. Listen at KUOP 91.3 FM or

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