In Connecticut, a pregnant woman of color is more likely to lose her infant at birth than is a pregnant white woman. A woman of color is less likely to receive adequate prenatal care in Connecticut, and – if she carries to term — more likely to give birth to a low-weight baby, according to a March report from the state Department of Public Health.
The state’s racial divide reaches all the way into the womb.
A recent report from the Center for Reproductive Rights and other agencies paints a stark picture of racial disparities nationwide, particularly in reproductive care. Women of color are far less likely to have insurance. They’re more likely to die in childbirth, and as people of color now account for the bulk of the U.S. growth, the public health crisis grows. Late in August, the United Nations Committee on Elimination of Racial Discrimination (CERD) decried the U.S.’s lack of progress in correcting racial disparity in a variety of areas, including health access. The recommendations include eliminating “racial disparities in the field of sexual and reproductive health.”
Disturbing state and local health data shouldn’t come as a surprise, says Jill Zorn, Universal Health Care Foundation of Connecticut senior program officer. In June, The Commonwealth Fund ranked the United States dead last – and not for the first time – among health care systems in 11 developed nations. (The U.K. ranked first.)
In Connecticut, the first line of defense for many impoverished women is their local community health centers. Most are like Hartford’s Community Health Services, started in the ‘70s by a handful of advocates and serving as the safety net for impoverished neighborhoods like those served by the Southwest Community Health Center in Bridgeport, where the median household income is just under $40,000, compared to the state’s $69,519.
While advocates for this underserved population hope that the Affordable Care Act (Obamacare) will correct some disparities, according to Deb Polun, director of government affairs and media relations at the Community Health Center Association of Connecticut, improving health care to the poor goes beyond their possessing insurance. It includes knowing how insurance works.
“There’s a difference between health literacy and health insurance literacy,” said Polun. “People who haven’t had insurance before don’t know what it means that they should get a physical every single year. They don’t know what it means to have a deductible. There’s another piece where it is not in their background to go to the doctor when you’re not sick.”
Well-visits (checkups and the like) could go a long way toward preventing complications during pregnancy, she said.
A report last year by the U.S. Department of Health and Human Services examined the state’s community health services, and found that nearly 57 percent of the patients served were women. Roughly 55 percent were white; a quarter were African American. A quarter of the patients’ first language was something other than English. All were living in poverty. Forty-one percent came from homeless shelters; 7 percent came from the streets.
There’s been some forward motion. As the Washington Post recently reported in a story that featured Southwest Community Health Center, while the national income gap is growing, the health of infants born into poverty is improving.
In many ways, said Polun, community health centers are leading the way.
“What we see now in health care is systems moving toward prioritizing primary care,” she said. Community health care centers have long emphasized preventive care, which saves money in the long run — but we have some distance to go.