Update: Tuesday 5:45PM

Michael McDowell said he hasn't had health insurance in years and has been difficult.

He goes to free clinics to qualify for basic health care.

He's already stacked too much debt from hospital visits.

Michael mcDowell said, "There have been many times when I needed health care and I didn't go or couldn't go. I already owe the hospitals as it is."

In a health study released Tuesday by the Ochs Center, Michael is among the thousands of people in our region without health insurance.

His unpaid trip to the ER has costs hospitals like Erlanger millions of dollars.

The uninsured costs for hospitals in our region have soared 168 percent since 2004.

David Eichentchal with the Ochs Center said, "What we found then was people were not accessing care, but were not paying for the care received."

Dr. David Seaberg is an emergency room physician for Erlanger. He said hospitals absorbing uninsured costs, is a growing trend around the country.

Dr David Seaberg said, "This is true all through the country where we don't have enough physicians. People are getting sicker, they are getting older."

The Ochs study said Hamilton County hospitals are responsible for almost 80 percent of the region's healthcare.

Seaberg said many ER's are so busy because, simply put, enough doctors aren't available.

Friday 11:30 PM

By Rich Sobolewski
Eyewitness News

CHATTANOOGA (WRCB) - How are you feeling? Many Chattanoogans say they are in good health, according to a new report, but how you respond has much to do with who you are and where you live.

The survey of people living in the Chattanooga Metropolitan area was conducted by the Ochs Center for Metropolitan Studies.

The study examined the Chattanooga Metro area in comparison to 10 other metropolitan areas: Ft. Wayne, Indiana; Allentown, Pennsylvania; Winston-Salem, North Carolina; Huntsville, Alabama; Columbia, South Carolina; Salem, Oregon; Boise, Idaho; as well as Knoxville, Nashville and Memphis in Tennessee.

[Read the full report]

In the report, 62% of Hamilton County residents said they were in excellent or very good health.  But the numbers differ drastically, outside of Hamilton County.

By comparison, more than one-in-four adults in Marion County say they are in fair or poor health.

Many adults in the outlying counties were also much more likely to be uninsured; such as in Dade, Walker and Catoosa counties in Georgia where nearly one-in-five people has no insurance.

It's a similar story in  Marion and Sequatchie counties in Tennessee where two out of every five people is on some form of government sponsored health insurance plan.

Racial, Economic, and Social Divide

The study also says African Americans, people with lower incomes and those that had a high school education or less are less likely to say they are in good health.

The survey showed that African Americans in Hamilton County were more than twice as likely to be uninsured than their white counterparts.  

The report also shows that African American adults were more than twice as likely to die from diabetes, 61% more likely to die from heart disease, 20% more likely to die from a stroke and 18% more likely to die from cancer than white adults in Hamilton County.

Infant Health

When you look at the children, the numbers are even more staggering.

According to the report, an African American baby is two and a half times more likely to die before their first birthday than a white infant.

The study points to low birth weights and lack of prenatal care for the mother as contributing factors to the infant death rate.

One in ten children born in Hamilton County had a low birth weight, a major contributing factor to health problems throughout the life of the child, or even premature death.  When looking specifically at the African American community, that number rises to one in every five children have a low birth weight.

The survey also looked at premature births as a factor for childhood mortality.  In Hamilton County, one in seven babies were born premature, but among African American babies, that number climbs to one in five.

Among the communities surveyed, Hamilton County had the fourth highest premature death rate at 8,534 per 100,000 residents.

The study pointed out four counties in particular - Sequatchie, Hamilton, Marion and Walker counties - with infant death rate higher than the statewide average.

Access to Healthcare

Hamilton County serves as a the health care center for the entire region, according to the study.  Seven of the nine community hospitals are located in Hamilton County and nearly half of the patients admitted were from outside of Hamilton County.

Most of the doctors are also found in Hamilton County. Nearly 80% of the primary care physician were located in Hamilton County.

In fact, some counties, such as Dade and Walker in Georgia, had only one doctor for every 3,000 citizens and no hospital available to treat their residents.

Uninsured  & Government Insurance

A full 17% of people living in the Chattanooga Metro don't have any form of health insurance and another third of the population relies on some form of government-sponsored health plan.

According to the study, between 2004 and 2008 uninsured admissions to area hospitals increased by 123%. During that same time, uninsured emergency room visits increased by 62%.

In 2008, the Ochs Center estimates that local hospitals spent $90.8 million in charity healthcare, $56.9 million more than they did in 2004.

When looking at the demographics, there were significant differences in health care coverage by income, race, age and education.

Hamilton County residents who made less than $50,000 per year were four times more likely to be uninsured than those making more than $50,000 per year.

African Americans were twice as likely to be uninsured than whites. And adults under the age of 35 were significantly more likely to be uninsured than older generations.

The study also found that as education levels increased, so did the likelihood of having insurance - only 8% of college graduates were uninsured, compared to 27% of residents with a high school diploma or less.