1. Characterizing Perceptions of Healthcare in the Athens Musician Community Nuςi’s Space GRU-UGA Medical Partnership April 8, 2013

2. Problem Statement Local uninsured, low income, working musicians and support staff do not utilize current resources available and do not have easy access to healthcare.

3. Goals for this Project Gather information and gauge the views and options of the musician community concerning: – How the community views healthcare – The different ways the community accesses healthcare – The challenges the community experiences while attempting to access healthcare

4. Methods Short Survey – 4 quick questions Allows us to collect a large amount of basic data quickly N=115 Long Survey – Paper survey with a combination of short answer and multiple choice questions Allows for more detailed information N=28 Focus Groups – Conducted at Nuςi’s Space – 2-8 individuals with two facilitators – Discuss the long survey and ask questions to elicit personal stories and comments – N=18 individuals total

5. A Large Fraction of the Athens Musician Community does not have Health Insurance Based on discussions, the expensive nature of health insurance was a large barrier. N=115 55% 45%

6. We designed this question to address stories of physician bias against the local musician community. However, our data demonstrates that musicians do not perceive this bias. During discussions, a large number of individuals indicated that physicians were unwelcoming if they lacked health insurance. N=115 61% 16% 23% 73% 10% 17% 31% 23% 46% The Majority of Musicians think Local Physicians are Friendly to their Community.

7. A Large Fraction of the Local Musician Community Does Not Think the Flu Shot is Effective These data and discussions may indicate that there is some distrust of the healthcare system and that additional health literacy is needed in this community. Of the individuals that indicated “Yes”, cost was a large barrier to actually getting the vaccine. N= 115 44% 45% 11% 47% 43% 10% 39% 48% 13%

8. Overall Conclusions and Trends A large fraction of musicians does not have health insurance coverage Local musicians feel that physicians are unbiased towards their community – Health insurance coverage was more indicative as to whether physicians are friendly or not A large fraction of the local musician community does not think the flu vaccine is effective – This may indicate additional health literacy education is needed in this community

9. Cost is a major barrier to healthcare – Many individuals would like to have a long-term local physician but do not have health insurance and cannot afford the cost When accessing the healthcare system, appointment availability and wait time is a major concern When sick a majority of musicians will use the internet and ask a friend for health advice before contacting a local physician or going to the emergency department – Could be problematic since the internet and their friends may have inaccurate information Overall Conclusions and Trends

10. Study Limitations We did not collect certain data points that would be useful – Age – Highest education obtained – Income In the surveys, additional follow up questions are needed: – Have you utilized a free clinic in the past? – Where do you currently obtain healthcare? – Would you like to have health insurance or obtain membership in a medical discount program?

11. How does this relate to Athens Health Network? Many Athens musicians are currently uninsured and have low incomes, thus many would meet the criteria for membership in AHN’s Health Assurance Program. Since most of them have jobs outside of the music industry as well, the shared responsibility model with respect to employers may be crucial. Lowering the cost and reducing the wait time to see the doctor will need to be essential components The importance of word-of-mouth communication may indicate that the Care Coordinator model will likely be effective Many musicians don’t identify as “poor” and thus a middle ground program not based on entitlement may work best Solutions to the disparities should be locally grown (if possible) and presented as such. Therefore, two conclusions follow: – The Athens musician community would be a great asset in the piloting phase of AHN’s future HAP. – The local musician community would benefit greatly from both proactive (before sickness ensues) and reactive (after sickness ensues) healthcare provided by membership within this shared coverage program.

12. Acknowledgements Nuςi’s Space Bob Sleppy Will Kiser GRU-UGA Medical Partnership Suzanne Lester, MD MPH Laurel Murrow, MD MPH Clive Slaughter, PhD James Eames Matt Lustig Matt Mullins Malinda Schaefer Tommaso Tosini Joseph Vinson Sarah Whyte Colton Wood The musicians that answered our questions