Christensen: Health Disparities Hurting Women
Reform Provisions Help Address Gender, Racial Inequities and Improve Care
The 2011 theme for Women’s History Month is “Our History Is Our Strength.”
As we reflect upon and celebrate the myriad ways that women’s shared histories unite families, communities and the country, as well as the positive strides that women across the country have made, it is important to remind ourselves that there is work that still remains to be done. This is especially true of women’s health.
It has been one year since the Patient Protection and Affordable Care Act was signed into law. This landmark legislation has already had and will continue to have a disproportionate and positive effect on the health and health care of women because it will take the nation several significant steps forward in efforts to eliminate gender health disparities. For example, not only does the new law ensure that being a woman will no longer be treated as a “pre-existing condition,” but it also ensures that women will not be dropped by insurance companies when they become sick or charged higher health care premiums than men for the same coverage. Further, the new law improves the coordination of care for older women under Medicare, expands access to free preventive services — such as colonoscopies and mammograms — and, beginning in 2014 when the health insurance exchanges are established, will move millions of women out of the ranks of the uninsured.
These great strides and the anticipated positive effects of forthcoming health care reform provisions that are yet to be implemented could not have come at a better time because numerous studies confirm that there are grave inequities in health care access, quality and health outcomes across different populations of women. For example, the racial and ethnic disparities in women’s health that leave millions of hardworking women in poorer health, without reliable access to high-quality, affordable health care and thus more likely to die prematurely and often from preventable causes are well-documented and have found the following:
• Women of color — especially African-American and Latina women — are disproportionately more likely than white women to be uninsured or underinsured, to lack dental coverage and to lack vision coverage;
• Vietnamese-American women have cervical cancer rates that are higher than any other racial and ethnic group of women, and African-American women — despite having a 10 percent lower incidence of breast cancer than white women — have a 50 percent higher mortality rate from the disease;
• Racial and ethnic minority women are more likely than white women to report that they are in fair or poor health, and African-American and Latina women have diabetes prevalence rates that are nearly two times higher than in white women; and
• Racial and ethnic minority women are significantly more likely than white women to report that in the past two years, they needed to see a doctor or a specialist or have a prescription filled, but were unable to do so.
Other studies confirm that racial and ethnic minority women are disproportionately more likely than white women to receive a lower quality of health care, even when they have the same insurance status and the same health conditions. These disparities in health care directly sustain and even exacerbate the disparities in health outcomes and health status that negatively affect the lives and life opportunities of millions of women of color every year.
There also are rural health disparities that we — as a nation — must address. For example, women in rural communities are at greater risk for living in poverty. While the disparity in income is even greater for women of color living in rural areas, poverty among all rural women dramatically affects health and health care not only for them, but for their families. Additionally, recent survey data show that rural women — regardless of race and ethnicity — are disproportionately more likely than women in urban areas to:
• Report being in fair or poor health;
• Report no health care visit in the past year; and
• Report less confidence in the health care services they receive.
Health equity experts confirm that eliminating all health disparities will require a far greater focus on the social determinants of health that detrimentally affect health and wellness. However, health equity experts also note the health care reform law — if fully implemented — can and will play a pivotal role in reducing disparities in women’s health. Therein lies the catalyst for our staunch defense of the health care reform law. We know that these disparities exist, and thus we developed and enacted a piece of sweeping legislation that will address so many of these inequities.
What better way to honor Women’s History Month this year and every year, and what better way to continue to show that “Our History Is Our Strength,” than by seizing the moment we have today to reduce gender and women’s health disparities by protecting the Patient Protection and Affordable Care Act and ensuring that it is well-implemented? In doing so, we will be improving the health, health care and thus wellness and life opportunities of every woman, family and community across the nation. To do otherwise is not only a nonoption, but also is wholly unacceptable.
Del. Donna Christensen (D-Virgin Islands) is a member of the House Energy and Commerce Committee and the Congressional Caucus for Women’s Issues.