Community Catalyst is proudly taking part in the Health Equity Can’t Wait! blog carnival celebrating National Minority Health Month. Participating bloggers are health, consumer, civil rights, and provider advocates committed to promoting health equity. You can find all the posts for the carnival here.
How does race and ethnicity intersect with other identities (including sex, gender identity, etc.) in ways that compound barriers to health care and lead to health disparities? How does your organization/community approach these concerns?
African-American women have been dying in childbirth at rates three to four times that of white women for more than six decades. That shocking statistic is where I begin the conversation with women of color about how the Affordable Care Act (ACA) can help address persistent health disparities. These disparities, I explain, must be approached from an intersectional frame of analysis that takes into account both race and gender.
I have given this presentation to such community-based organizations as the Caribbean Women’s Health Association, the Brooklyn Young Mothers Collective and members of Bronx Health Link network, as well as to members of the Black, Puerto Rican, Asian and Latino Caucus of the New York State Legislature. These audiences know about the problems of maternal mortality and morbidity from experiences in their families and neighborhoods. Still, they are outraged to learn that in 2008, African-American women in New York City had a maternal mortality that was seven times higher than white women.
Hispanic women also suffer from high rates of maternal mortality. They account for 24 percent of maternal deaths in New York City, more than twice the percentage for white women, even though the two groups of women account for the same percentage of live births in the city.
Both African-American and Hispanic women are suffering from a related problem: pre-term births, which can lead to infant mortality and morbidity. That point was underscored at an event Raising Women’s Voices-NY co-sponsored with the Brooklyn Perinatal Network on March 22. The event, which marked the second anniversary of the Affordable Care Act, was held at Brookdale Hospital in central Brooklyn, where the rates of pre-term births are extraordinarily high. Advocates, policy leaders, health providers and community representatives came together to focus on how some of the chronic health conditions neighborhood women experience – such as obesity, diabetes, hypertension, stress, and alcohol, drug and tobacco use – go untreated and lead to tragic pregnancy outcomes.
What can we do to address this problem? How can health reform, and the creation of the New York State health Exchange, help to address egregious disparities like maternal and infant mortality and morbidity?
The obvious starting point for change is recognizing that too many women can’t afford the health care they need. Women of color are disproportionately uninsured and underinsured. We stand to benefit enormously from the expansion of Medicaid and the offering of subsidized private insurance plans in state Exchanges like the one that Governor Andrew Cuomo has just created in New York State through an executive order. But there are also specific steps we can take in creating our state exchange that will begin to bring down the high rates of maternal and infant mortality and morbidity. Here’s the priority list we have at Raising Women’s Voices-NY:
- • Offering affordable health coverage that can help reduce the current high rates of uninsurance among women of color.
- • Requiring Qualified Health Plans to prioritize the reduction of maternal and infant mortality and morbidity as a health outcome that will be measured, tracked and used in determining whether a plan can continue to be offered in our state Exchange.
- • Requiring Qualified Health Plans to include in their provider networks a strong complement of reproductive health providers qualified and experienced in serving women who are at risk of pregnancy complications.
- • Including preventive services needed to help women plan and space healthy pregnancies in the Essential Health Benefits Package of services that must be covered by all Qualified Health Plans approved for offering in New York State’s health Exchange.
- • Ensuring that such services are delivered in a manner that is culturally and linguistically competent and accessible to women with low literacy.
– Jasmine Burnett, Community Organizer
Raising Women’s Voices-NY