By: Jennifer Ng'andu, Deputy Director, Health Policy Project
A decade ago there was little acknowledgment of the pervasive inequities in health care. At the annual Health Equity Summit in Oakland, California this past weekend, Congresswoman Lucille Roybal-Allard summed it up when she said, “Ten years ago health disparities weren’t even on the radar screen.” She went on in the spirit of celebration, emphasizing accomplishments that the diverse organizations in the room—and more often outside of it—have achieved by transforming the national dialogue. The Health Equity Summit brings together a rich group of advocacy organizations, community health providers, state and national elected officials, and individual leaders all for the common cause of moving an agenda that creates equity in health and health care. While in the past the summit has focused on the shortcomings of national policy in this area, this year the event was a reflection on the tough fights that we have undertaken to improve the state of health care for the Americans who are most underserved by our current health care system.
Despite landmark research illustrating deep disparities in the treatment of Blacks and Latinos in health care settings, skeptics have long doubted that people of color endure different health care experiences that threaten their well-being. Yet more than a decade ago, the Tri-Caucus, composed of the very determined Hispanic, Black, and Asian Pacific American caucuses of the U.S. Congress, raised the consciousness of national policymakers about the deep gaps in health care access and quality that can wreak havoc in the lives of people of color.
Last year, the work paid off. The Affordable Care Act was signed into law, not only with new coverage mechanisms for the uninsured, but with a bold new set of policy options that recognize that health is more than an insurance card. Community health initiatives, workforce expansion and diversification programs, data collection, and strong anti-discrimination provisions were just some of the important changes made.
The establishment of these programs and their subsequent implementation are an inarguable indication of progress, but let’s be clear: there is still work to do. Just as health is not only about having insurance, it is also not only about having access to medical care. Community infrastructure, poverty, and other social and economic structures often have more implications on health than do doctor visits. Given indications that racial segregation in the United States is not just high, but growing, it is imperative that the nation reverse these trends. Isolated communities of color are more frequently poor in resources and infrastructure, which fosters an environment that is ripe for unnecessary illness and disease. As I learned during the summit, a child of color born today in West Oakland, California is expected to have a lifespan that is 15 years shorter than a child born in the wealthier Oakland Hills.
The good news is that leaders of the Congressional Tri-Caucus—recognizing that we must build on what we’ve achieved—have come together once again to push for additional policy that improves medical care and addresses the social determinants of health. Days before the summit, they introduced H.R. 2954, the “Health Care and Accountability Act,” with a record 68 cosponsors. The bill drives health promotion resources into the community, moving away from a system of treatment and toward one of prevention. The even better news is that the sheer determination of the Tri-Caucus often results in real change. The vast majority of health disparities initiatives included in the Affordable Care Act were taken directly from previous Tri-Caucus legislation.
It took a long time to get where we are today, and it will take a longer time still to reach full health equity. But with the collective action of all our communities and the addition of the many powerful voices that I heard last weekend, there is no doubt in my mind that we will get there.