Being a woman of color in Connecticut is bad for your health.
As a nurse working in an inner-city hospital, I have seen this first hand. I have seen women delay or forgo prenatal care because they do not have insurance. I have seen women who are here illegally ignore cancers growing inside them for years because of fear of medical providers, or fear of deportation. I have seen the stress and anxiety on a women’s face after being told she needs emergency surgery, and she has no way to pay for it.
These are just a few examples of the daily struggles minority women in Connecticut face on a daily basis.
Women’s health disparities in this state are staggering. Babies born to African-American women in Connecticut are almost three times as likely to die when compared to babies of white women. For Hispanic mothers, their babies are twice as likely to die when compared to white mothers. Connecticut is not the only state facing this problem. According to the American College of Obstetrics and Gynecology, Black and Hispanic women nationwide are more likely to have an unintended pregnancy, preterm birth, and cervical cancer when compared to white women. In fact, black women are the leaders in breast cancer deaths despite lower rates of breast cancer when compared to white women.
So what does all of this mean, and how do we fix it?
Women of color in our state are facing many unique challenges that make their health outcomes worse than white women. Not only are women of color responsible for caring for themselves, many times they are also caring for children, family members, friends, etc. Health outcomes are also affected by socioeconomic and education level. Women must be able to reach their health care provider, whether by private transportation or public. Women must also have information given to them at a level that they can understand in order for it to be effective.
If we want to reduce health disparities in women of color, women must be the center of our efforts to improve health outcomes. When a woman is diagnosed with a chronic illness, she must take responsibility for that illness and follow her provider’s recommendations on how to manage it. It is up to the provider to give high-quality treatment and education that the patient understands. However, the patient has to be held accountable to make changes in her life. She must stop smoking, change her diet, exercise, take their medications, monitor her blood sugar, and return for follow up appointments as directed. Women need to embrace personal responsibility and own their health.
Next we need to improve providers’ quality of care. This includes making health care patient-centered and evidence-based, while customizing care to the individual needs of each woman. When women have an established personal physician or source of care, they are more likely to get the care that they need and are reminded to schedule a preventative visits or screenings. Health care that is proactive rather than reactive can help to put women in control of their health and their lives.
While the Affordable Care Act (ACA) allowed millions of people to have access to health insurance, it does not cover everyone. Many of the millions of Americans whocontinue to go without health insurance are people of color. An expansion of the ACA would allow more Americans access to health insurance. Now, simply having health insurance doesn’t make a person healthy. Once health insurance is obtained, women still need to have access to high-quality, patient-centered care. This care needs to be accessible both physically as well as financially.
It is expected that by 2050 more than half of the United States population will be made up of Hispanic, African-American, Asian, and American Indian people. That is to say, this problem of health disparity is only getting bigger. We need to acknowledge the magnitude of this problem and work together as a society to make all women in Connecticut, no matter their race, healthy.
Molly Montano of South Windsor is a nurse and nurse practitioner student at the University of Connecticut.
The word “Medicaid” doesn’t appear in this article. So an important part of the context is missing.
Also part of the context is what happened when Obamacare funded pilot programs assuring that patients received monitoring and encouragement to take medications, change habits, and keep appointments. The sort of interventions the article recommends.
To the surprise of many, including me, such actions made approximately no difference. At least one program had some cost savings compared to a control group (a metric used to indicate outcome changes), but the difference was so small that a single heart attack would have changed the result to a loss. (The New Yorker had a good article on the subject.)
The article’s conclusions are written as if they’re established. They aren’t. More study is needed.
Thank you for sharing your voice to shine a light on an issue that is persistent and pervasive. It is understood among public health professionals like myself that this disparity exists across socioeconomic class. The disparity is not limited to women covered by medicaid. Without acknowledgment of the root of this disparity, the problem will continue to grow (as you mention with your point on the growth of black, hispanic, asian, and indian populations). I thoroughly enjoy the CT mirror and hope the conversation on this important topic continues!