Ensuring Health
A note of appreciation…
“Just wanted to thank you again for [the child tax credit flyers!] We made copies and distributed them with all of our backpacks. Hope we caught some families that did not know what to do and got them connected. Love what you're doing with the Leading Ladies.”
Sue Gabriel
Beverly Bootstraps Executive Director
Dear Leading Ladies,
“As long as you have your health!” is a common refrain among friends, especially as we age and winnow our priorities down to the essentials. Yet, since the beginning of the Covid-19 pandemic, we have become woefully aware of the unequal access to the means to stay healthy in this country.
Health care gaps go beyond Covid-19
First, we saw the virus disproportionately hit poor communities, where population density spread the infection more rapidly, and frontline workers of color were more likely to reside. People in communities with poor air quality and water, and those suffering unequally from pre-existing conditions such as diabetes and high blood pressure became easy targets for the new virus. Then, once vaccines were available, there is considerable evidence that the rollout to communities of color was not equal to the rollout to white, more affluent areas. Moreover, we continue to see resistance in some communities of color, the result of being mistreated and abused by medical experiences such as the Tuskegee experiments.
Olivier Douliery/Agence France-Presse — Getty Images
Now, a series of studies published in the Journal of the American Medical Association (JAMA) and reported on in the New York Times last week, further describe the continuing racial inequities in access to health care in our country. Covid may have shone a light on the problem, but unequal access to health care is a pervasive and persistent disgrace in our land of plenty.
The many sides of the health care gap
The new studies, for example, show that:
Although insurance coverage for those previously left out has improved in the past few years, the “racial health gap did not significantly narrow from 1999 to 2018.”
An important contributor to this situation is that “...fewer health care providers and specialists are found in low-income and minority neighborhoods, which is a function of structural racism and a legacy of residential segregation,” according to Kenton J. Johnston, an associate professor of health management at Saint Louis University and the lead author of one of the studies.
Consequently, “White Americans, for example, are more likely than members of minority groups to visit primary care physicians and specialists in the community, rather than a hospital or emergency room,” even when they have the same insurance.
This is particularly problematic because primary care physicians (PCPs) manage chronic issues such as diabetes, heart conditions, and pulmonary issues like asthma and COPD. Left untreated, these conditions lead to “complications and problems downstream,” notes Johnson.
Black, Hispanic, Native American, and Pacific Islanders are also less likely to receive influenza and pneumonia vaccinations, at least in part because of lack of access to PCPs.
Another issue plaguing communities of color is the higher rate of gestational diabetes, infant mortality, and maternal mortality, even adjusting for age and income.
Given these disparities, it is not surprising that more is spent annually on outpatient care for whites than people of color, though the amount spent on emergency room care is higher for Blacks than whites.
Patients of color are more likely to seek care from a doctor of color, and yet in the United States, Black doctors make up only 5% of all doctors while the Black population is 13.4%. Hispanic doctors account for 5.8% of all doctors, while the Hispanic population is 18.5%.
And furthermore, the “proportion of faculty physicians at American medical schools who identified as Black or African American has only slightly increased over the past 30 years, from 2.6 percent of faculty in 1990 to 3.8 percent of faculty in 2020, still far less than their proportion of the general population,” according to the NYT article.
The big takeaway – and this may be surprising to some – is that providing people with insurance alone does not solve the problem of inequality in health care. Strides clearly have been made in insuring more people of lower socio-economic means, and that is all to the good, but there is much more work to be done to provide adequate health services for all.
What can we do?
Learn more at the National Partnership for Women and Families. Find out what the CDC is doing to advance health equity. Write to your senators and representatives, quote this letter, and ask what they are doing to change access to health care for BIPOC (Black, indigenous, people of color). Then, make it personal. Ask your PCP what he or she is doing to reach out to people of color in their community to encourage them to come for regular care and treatment. Does your doctor have professionals on staff who are POC? Does the practice have a satellite office in a community that needs services? Perhaps you could plant an idea that will change some lives.
Did you know that a synonym for “booster” is “champion.” May the booster shots be the champions we all hope they will be against Covid-19 and the Delta variant!
Stay safe,
Therese
Judy
Mary
Beth
Leading Ladies Executive Team
ladies@leadingladiesvote.org
leadingladiesvote.org