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This Week on Health Care Equity

By October 28, 2022No Comments

Addressing systemic racial, ethnic, and other inequities in health care is among the most pressing issues in America. The causes of these inequities, and the corresponding actions needed to tackle them head on, are multi-faceted. As it stands, marginalized communities, including people of color, rural Americans, and people with disabilities, face worse access to quality, affordable health coverage, which contributes to dangerous health outcomes. This week, new research highlights the benefits of expanding and improving health coverage. Specifically, these studies examined how expanding Medicaid coverage, strengthening the ACA Navigator program, and making the delivery of community-led services more accessible can advance health equity. At the same time, findings about persistent disparities in maternal death, flu outcomes, advanced kidney disease, and heart failure treatment underscore the urgency of our unfinished business to ensure high-quality, affordable, and equitable health coverage is a right and not a privilege for everyone. Protect Our Care is committed to making health care a right for every American. Learn more about Protect Our Care’s work to advance health equity here


University of Wisconsin Madison: ACA Navigator Program Boosted Insurance in Marginalized Communities. “The ACA navigator program is a program funded by the federal government that provides free, one-on-one assistance to help people understand their health insurance options and sign up for health insurance, including Medicaid coverage or coverage through the marketplaces established under the ACA. To measure the impact of funding the navigator program, a research team led by Rebecca Myerson, assistant professor of population health sciences, UW School of Medicine and Public Health, compared changes in coverage outcomes in counties that were more versus less exposed to the cuts. When funding was reduced from 2017 to 2019, enrollment in health insurance coverage – and particularly, marketplace coverage – decreased among lower-income adults, according to one of the papers Myerson’s team produced. Cuts to the navigator program also significantly decreased insurance coverage among adults younger than age 45, Hispanic adults and adults who speak a language other than English at home. In the counties studied, the estimated declines implied that about 109,000 people who prefer to use a language other than English lost health insurance coverage because of the cuts to the navigator program, Myerson said.” [University of Wisconsin Madison School of Medicine and Public Health, 10/19/22]

WRAL News: Expanding Medicaid Will Improve Health Care Equity for North Carolinians. “A 2021 poll conducted by Altarum found that more than 3 in 5 state residents experienced healthcare affordability burdens in the past year and more than 3 in 4 (78%) are worried about affording healthcare in the future. According to analysis by the Kaiser Family Foundation, in 2021 as many as 9.4% of non-elderly North Carolinians were uninsured and faced the full financial burdens of their healthcare, despite living in a state with a wealth of medical care and research abilities; half of those uninsured were people of color. According to the North Carolina Justice Center, the uninsured rate among White North Carolinians is 9.6%, while 11% of Black state residents are uninsured. The greatest disparity though is among Latinx North Carolinians, for whom the uninsured rate is 30.3%. An analysis [also] published in the North Carolina Medical Journal found that as many as 20 of the 22 counties with the highest uninsured rates were rural. North Carolina is one of only a dozen states that has not yet expanded Medicaid under the Affordable Care Act. According to the Kaiser Family Foundation, a nonpartisan health policy research organization, this would possibly cover up to 600,000 people in the state and as many as 372,400 currently uninsured non-elderly adults, the majority of whom live below the federal poverty level.” [WRAL News, 10/20/22]

AHA Newsroom: New Initiative to Prevent and Treat Strokes Focuses on Furthering Health Equity. “As part of the new initiative, American Heart Association staff and volunteer experts with support from the HCA Healthcare Foundation and HCA Healthcare community colleagues will work in 15 select communities (listed below) to implement community education. The nationwide initiative will also focus on stroke risk factor awareness and professional education projected through the lens of equitable health for all. Working closely with health care professional thought leaders, including those from HCA Healthcare, the Association will also develop accredited education programming that will be available to all health care professionals, and a specific learning collaborative with 10 HCA Healthcare facilities focused on continuously improving quality of care.” [AHA Newsroom, 10/17/22]

The Wenatchee World: Community Action Groups Help Increase COVID Vaccine Access and Reduce Health Care Racial Disparities. “In January 2021, Confluence turned turned to a community action group known as Parque Padrinos — ‘Godfathers of the Park’ — who had previously shown how community-led, grassroots advocacy could work. A partnership was born and soon the Confluence Health Foundation, a philanthropic organization that seeks to enhance and support Confluence Health’s ability to provide safe and superior healthcare close to home, pledged $200,000 to the cause, partnering with a local company, Teresita’s Consulting, to spearhead the effort to provide multigenerational, community-focused outreach. Later, a Health Resources and Services Administration (HRSA) grant was also obtained. With a combined 4,721 hours worked and 7,491 miles of travel on the original grant from the Confluence Health Foundation, the Madrinas de Salud were busy. All told, their efforts yielded over a thousand directly-scheduled appointments, reached out to 300 employers, and held more than 100 community presentations. Between October 2021 and June 2022, the Madrinas facilitated 3,742 vaccinations. Through their dedication and partnership with Confluence Health, the effort bore fruit. From a rate of 43% of the COVID-19 ICU patients at Central Washington Hospital identifying as Latino at the end of August 2021 despite making up only 30% of the population, that number dropped to 20% or less within only one month. Across the state as of September 2022, 64.2% of Latinos have initiated their primary series of the vaccine; in Chelan County, that number is 65.6%; in Douglas County, 67.7%; and in Okanogan County, 76.4%, making North Central Washington a leader in vaccination rates.” [The Wenatchee World, 10/17/22]


Axios: One in Four Maternal Deaths Due to COVID According to Federal Watchdog Group. “COVID-19 contributed to a quarter of maternal deaths in the first two years of the pandemic, with Black pregnant women experiencing a mortality rate nearly three times higher than their white peers, according to an oversight report to Congress released on Wednesday. The findings from the Government Accountability Office, a nonpartisan federal watchdog, used CDC data on births and deaths in the U.S., including maternal deaths in 2020 and 2021 where COVID was a contributing cause. The CDC has found COVID increases the risk of delivering a stillborn baby and that people who are pregnant are more likely to have severe illness from the virus than those who aren’t. In a separate CDC analysis from January 2020 to December 2021, pregnant women were five times more likely to be admitted to an ICU than non-pregnant women.” [Axios, 10/19/22]

Axios: Marginalized Groups Are More Likely to Be Hospitalized Due to the Flu. “Black, Hispanic and Indigenous adults are more likely to get hospitalized for the flu and less likely to be vaccinated against it compared to white adults, according to a new study released by the Centers for Disease Control and Prevention (CDC) on Tuesday. The study, which analyzed data from the last 13 flu seasons, found that Black, Hispanic, American Indian and Alaska Native adults were 1.2 to 1.8 times more likely to get hospitalized compared to white adults — and had more severe outcomes. During the 2021–22 season, 53.9% of white adults were vaccinated compared to 37.9% of Hispanic adults, 40.9% of American Indian and Alaska Native adults and 42% of Black adults. This disparity — which was present among those who reported having medical insurance, a personal health care provider and a routine medical check-up in the past year — was largely attributed to ‘distrust of the medical system, misperceptions about vaccine safety, and higher levels of concern about side effects,’ researchers wrote.” [Axios, 10/18/22]

Axios: Patients Within Marginalized Groups More Likely to Advance to Kidney Disease. “The review of more than 650,000 patient records found that Native Hawaiian, Pacific Islander, Black, Native American and Hispanic patients with diabetes had disproportionately higher rates of chronic kidney disease than white patients. Researchers examined electronic health records from Providence and UCLA patients from 2015 to 2020 to see how many with diabetes clinically progressed to chronic kidney disease. Rates were 60% higher in Pacific Islanders and Native Hawaiians than whites; 40% higher in Blacks; 33% higher in American Indians and 25% higher in Hispanic people. Less than 10% of patients who had early-stage kidney disease were aware of it, lead author Katherine Tuttle told Axios. This means that annual testing is falling by the wayside, Tuttle said, which delays the beginning of treatment.” [Axios, 10/13/22]

CNN: Study Finds Black Heart Failure Patients Less Likely to Obtain the Devices and Transplants They Need. “A study published Wednesday in the journal Circulation: Heart Failure finds that among a group of adults with heart failure, White people were twice as likely as Black people to receive a heart transplant or a ventricular assist device, a mechanical heart pump often used for patients with end-stage heart failure. The data showed that a heart transplantation or a ventricular assist device was performed in 11% of the Black patients compared with 22% of the White patients, although death rates were similar in both: 18% in Black patients and 13% in White patients. The researchers noted that patients’ preferences for ventricular assist devices, heart transplantation or other therapies did not affect the results. Experts in the field say the findings offer confirmation of what doctors have been seeing for years.” [CNN, 10/20/22]