Buy BP Monitor

BALTIMORE — The doctor told Sharlene Adams to get a blood pressure cuff, so Adams set out to buy one.

For Adams, who lives in West Baltimore, that meant four bus rides, a stop for a doctor’s signature, two visits to a downtown pharmacy for other medical supplies, a detour to borrow money for a copay, a delay when a bus broke down, and, at last, a purchase at a pharmacy on the east side of town.

The one-way, seven-mile trip took 5.5 hours. Then she had to get back home.

She seemed unfazed. For Adams, this is what it takes to follow a doctor’s recommendations.

‘Scum of the Earth’

Adams’ neighborhood is not far from where Freddie Gray grew up and died after being injured in police custody last April, an event that triggered a riot. Incomes average less than , 000 a year, according to the U. S. Census. Drugs and violence plague the area.

Adams’ story is not about huge barriers to medical care but about a series of hurdles that block access to help for her and many other low-income residents. Those hurdles add up to large health care inequities.

Follow Sharlene Adams on Her Hours-Long Quest for A Blood Pressure Cuff. Video by Nate Kresh, Rachel Bluth and Capital News Service

Adams, 55, has no car, no computer and no credit card. Her insurance will pay for a blood pressure cuff, but only with a prescription. She doesn’t have the ready cash that would allow her to pop into a drugstore and pick up a $40 blood pressure cuff off the shelf.

Adams acknowledges she used to use illegal drugs, but that, she says, ended years ago. Yet when doctors hear she used crack, she says, they sometimes dismiss her complaints.

“You have some of them that, they treat you like dirt, really, because they think you’re the scum of the earth anyway, ” Adams says.

She’s been treated for mental health problems including bipolar disorder, and she has been homeless — a time when she never saw a doctor. She tries to stay healthy, but she is working with limited resources and against a lifetime of ignoring her health. She expends a lot of effort and she intends to do right, but she fails as often as she succeeds.

For Adams, seeing a doctor or filling a prescription or scheduling a medical test is an exercise in frustration that middle-class patients don’t have to deal with.

She is diabetic but isn’t clear on exactly when to test her blood sugar levels. She doesn’t like needles and doesn’t want to take insulin. She wants to eat better but says the food her doctor recommends costs too much. She wants to lower her blood pressure, but she smokes.

For Adams, seeing a doctor or filling a prescription or scheduling a medical test is an exercise in frustration that middle-class patients don’t have to deal with. She knows that, and she resents it.

• Learn what is unearned revenue and how to calculate it.