Thoughts on Health Equity
Did you know that 8% of Westminster residents don’t have health insurance?
In my March newsletter, I spoke about the pervasive stickiness of poverty and its intersectionality with the student loan crisis. Well, debt-based poverty transcends student loans, spanning across all areas of our lives: credit card debt, payday loans, auto loans, mortgage debt, taxation by citation (fines, fees, etc.), and…medical debt. My lived experience suffering childhood poverty grants me the unique perspective of empathizing with our working class the feeling of knowing quality healthcare only by its absence.
In my opinion, medical debt (the largest cause of personal bankruptcy) is a social determinant of health, along with healthcare access/quality, education access/quality, social and community context (e.g. faith, language, culture), and neighborhood/built environment (e.g. lack of parks, safe streets, pollution).
The financial insecurity of our working families impacts their health because individuals of lower socioeconomic status, and other marginalized populations, are often disproportionately exposed to conditions and environments that negatively affect health risks and outcomes.
Besides economic class, higher rates of health disparities are similarly shared by other populations based on: race/ethnicity, gender, sexual identity/orientation, disability status, and geographic location.
For example, Americans living in rural communities (46% of population) are more likely to die from heart disease, cancer, stroke, opioid overdoses, car crashes, and more. Most of this is driven by inequitable distance between healthcare facilities and trauma centers, and lack of rapid access to specialized care.
About 44% of U.S. women report medical bill problems. Furthermore, a survey of 406 transgender and gender nonconforming adults in Colorado showed that 40% delayed medical care due to costs, inadequate insurance, and/or fear of discrimination.
In Colorado, there is no sales tax on medication, but there is tax on incontinence, diaper and period products, which burdens low-income women and families, as well as seniors on fixed incomes (see my list of solutions below on how to remedy this). Abortion care is also a health equity issue, as banning it would lead to a 21% increase in the number of pregnancy-related deaths. In Colorado, the RHEA Act passed, and aims to protect every person’s right to reproductive healthcare (sponsored by State Senator Julie Gonzalez, and State Reps. Meg Froelich and Daneya Esgar).
This mom, Virtue Oboro, started a new tech startup (called Tiny Hearts) that makes solar-powered cribs. These portable, deployable phototherapy units are powered by the African sun, and costs one-sixth the price of a normal phototherapy crib. It has been used on over 500,000 babies, all with no hospitals or electricity needed.
In Westminster, less than 2% of the population are Black, yet they are more likely to experience poor health outcomes such as diabetes, obesity, asthma, and more. 7 years ago, I had a medical checkup and asked my physician for a remedy to a seemingly minor, yet unyielding medical issue I was experiencing. He dismissed my concerns: “you’re young, you’ll be fine.” Many years later, I would learn from studies and local health equity experts, such as Kayla Frawley - a health equity policy leader and former midwife - about how Black Americans often have their medical concerns dismissed, disproportionately face longer wait times, are denied access to medical services, and face higher infant- and maternal mortality rates.
Ideally, we can nationalize the health insurance industry. But, absent of that...
...in order to advance equity in our healthcare system, I propose the following solutions:
Offer paid maternity leave to all, and invest in a racially diverse midwifery workforce to reduce maternal death and improve the quality of care
Ensure continuous postpartum Medicaid coverage for lower-income people
Reimagine and decentralize the shaping of policy and re-center the interests of marginalized populations in the policy process to address structural barriers of health: racism, sexism, classism, xenophobia, ableism, and heterosexism
Reduce prescription drug prices and fix the broken U.S. drug patent system
Integrate financial literacy into health services delivery to protect our working class and vulnerable families
Improve access/distance to healthcare facilities, including capacity and number of providers in underserved communities
Fill the coverage gap (5.8 million uninsured adults have incomes below the poverty level but above threshold to qualify for coverage subsidies)
Promote implicit bias training throughout the healthcare system to counteract the effects of systemic racism
Pass HB22-1055, which would create a sales tax exemption for incontinence products, diapers, and period products (sponsored by State Rep. Leslie Herod, and Westminster alum and State Rep. Faith Winter)
Do a better job of collecting, sharing, and acting on health data by race and ethnicity
