Pharmacy Closures: The Impact on Communities of Color
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Chapter 1: The Rise of Pharmacy Deserts
Pharmacies across the United States are closing at an alarming rate, particularly in neighborhoods predominantly inhabited by people of color. This has resulted in dangerous "drug deserts" where access to essential medications is severely limited.
Recently, I learned that my local pharmacy might shut down. The franchise owner, Mohamed, had been contemplating relocating his practice after experiencing armed robberies four times within just nine months. The culprits targeted high-value drugs, unaware they were secured in a time-delay safe. It remains unclear whether they were drug users or criminals seeking a lucrative score.
If you had asked me to name a safe profession, pharmacy would have been high on my list—right alongside accounting and librarianship. Yet, the reality is that working in a pharmacy has become perilously close to operating a liquor store. Who would have guessed that selling medications could be so risky?
During a recent visit to pick up my prescription, I noticed the installation of bulletproof glass as a security measure. Fortunately, Mohamed chose to stay in my neighborhood, opting for enhanced security rather than abandoning his community. Sadly, many others have not been as fortunate, losing their local pharmacies for various reasons, particularly in areas with higher populations of people of color.
I’m grateful that Mohamed has remained, as his exceptional service and personal care for his clients are invaluable. He knows my family well and once caught a dangerous medication mix-up that could have endangered my father's health.
Pharmacists serve as a crucial last line of defense against medication errors, especially in an era where miscommunication among healthcare providers is common. Their work is vital to our healthcare system, yet many communities are losing access to these essential services.
The Growing Issue of Drug Deserts
A "pharmacy desert" refers to an area where residents struggle to access medications. In rural regions, this typically means there is no pharmacy within a 10-mile radius, while urban areas see this distance drop to just one mile, or even half a mile in low-income neighborhoods.
This may not seem far, but consider the demographics most reliant on medications: the sick, disabled, and elderly—groups that often face challenges in traveling. Alarmingly, one in four neighborhoods in the U.S. is classified as a pharmacy desert, with the majority located in communities of color.
Historically, independent pharmacies were the first to close, particularly during the 1990s and early 2000s, as larger chains like Rite Aid, Walgreens, and CVS took over. Research indicates that between 2009 and 2015, closures disproportionately affected independent pharmacies and low-income areas. Currently, major chains plan to shut down over 1,500 more locations.
Reports indicate that "CVS will finalize the closure of 1,124 stores by the year's end, Walgreens announced the closure of 450 locations by August, and Rite Aid's bankruptcy has led to nearly 200 store closures."
The pharmacy industry faces significant challenges, with closures primarily occurring in low-income neighborhoods, particularly those with high concentrations of minority residents. A study by Cornell and Yale Universities revealed that of the 670 pharmacy deserts in cities like New York, Los Angeles, Chicago, and Houston, nearly all were found in neighborhoods with predominantly minority populations.
The closures in these areas stem from the reliance on Medicare and Medicaid, which offer lower reimbursements than private insurance, making it difficult for pharmacies to sustain operations. The rising costs of utilities, rent, labor, and crime further exacerbate the situation. Many pharmacies struggle to find staff, leading to a perfect storm of financial instability.
The Consequences of Pharmacy Deserts
When pharmacy deserts emerge, not only do residents lose their local access to medications, but nearby pharmacies can become overwhelmed and understaffed. This can lead to medical errors, especially for those who find it challenging to travel further for their prescriptions. The sick, disabled, and elderly often have the least access to transportation, making even a slight increase in distance a significant barrier.
The emergence of pharmacy deserts exacerbates existing inequalities, particularly along racial lines. Pharmacies, like many entities within the U.S. healthcare system, operate as for-profit businesses. They are motivated to pursue profitability, which complicates the situation for underserved communities.
While mail-order and online pharmacies could serve as alternatives, they cannot replicate the essential in-person services that pharmacies provide, such as health clinics, counseling, prenatal care, and vaccinations.
To address this issue, state-level interventions are crucial to ensure secure access to pharmacies, which are integral to overall healthcare. Protecting at-risk pharmacies, especially independent ones, is essential. Moreover, reforming Medicare and Medicaid reimbursement rates is vital to ensure that pharmacies can afford to operate without incurring losses.
I came close to losing my pharmacy due to crime, while others face the threat of closure due to financial strains imposed by government reimbursement rates. The reality is clear: access to pharmacies and lifesaving medications should not be a privilege; it is a fundamental human right that requires protection.
The first video titled "How pharmacy deserts are impacting Americans" provides insights into the serious repercussions of pharmacy closures in underserved communities.
The second video, "Howard University is working to close the Black pharmacist gap," discusses initiatives aimed at addressing disparities in pharmacy access and representation.