AACF report: Policies should seek health equity for Black women

Black women in Arkansas face health challenges as a result of a history of discrimination and unconscious bias, so health policies should intentionally and aggressively seek to create health equity, a report by the Arkansas Advocates for Children and Families argues.

The report, “The Critical State of Black Women’s Health,” was written by CaSandra Glover, health policy fellow, and released Tuesday (April 12).

The study says that Black women have higher excess mortality and shorter life expectancies, and they disproportionately suffer from chronic health conditions. They also receive less effective medical treatment.

Black women fare worse than white women in many health measurements. Forty-nine percent age 20 and older have some kind of heart disease. The heart disease mortality rate for Black women was 209.1 from 2011-15, compared to 171.1 for white women. Black women are twice as likely to be at risk for stroke and more likely to die at an earlier age than other women, and they are two to three times more likely to have high blood pressure. Diabetes rates are twice as high for Black women as non-Hispanic white women. From 2011-15, the age-adjusted diabetes mortality rate was 45.2 for Black women in Arkansas and 17.9 for white women.

Black women in Arkansas were 2.2 times as likely to die from pregnancy-related causes than white, non-Hispanic women. Nationally, Black women were more likely to die from a pregnancy-related cause than white women of the same education levels. Black women with at least a college degree were five times more likely to die as white women with a similar education level. Also, Black women in Arkansas in 2017-19 were more likely to have a live birth pre-term (15.5%) than white women (10.8%).

In 2014-15 in Arkansas, there were 118.3 incidents of breast cancer per 100,000 Black women compared to 110.4 cases in white women, and the death rate was 29.8 per 100,000 Black women and 18.9 for white women.

The report says that in 2016, Black women who worked full-time year-round had a median annual income of $28,018, compared to $33,943 for white women. They are 50% more likely than white women to be their families’ primary source of economic support.

It says that redlining, where residents of predominantly Black neighborhoods were denied mortgages, loans and insurance until the practice was outlawed, continues to have effects on Black women’s health. It made it harder for Black families to create wealth and contributes to chronic diseases and lower life expectancies.

Also, communities of color have more exposure to air pollution and are nearer landfills and hazardous waste sites. They are more often exposed to contaminated water. Low-income communities of color have lost more supermarkets and fresh food retailers, creating more “food deserts.” Black communities have the fewest supermarkets at all poverty levels, the report says.

Among the specific proposals, the report recommends increasing Arkansas’ minimum wage, which is currently $11 an hour. As of 2020, a single adult would have to earn $18,240 annually, or $9.12 per hour, to survive in Arkansas, but that number increases to $46,812 for a family of four, which is equivalent to $23.41 for one income or $11.71 for two.

Moreover, a family of four that is economically viable, has employer-sponsored insurance, and has a 10% savings plan requires a family income of $80,676. That’s $40.34 per hour for one income and $20.17 for two.

The report also recommends that Arkansas continue to support the Medicaid expansion program that occurred as a result of the Affordable Care Act, otherwise known as Obamacare. Medicaid patients should receive medical care through patient-centered medical homes where providers coordinate care to address a patient’s needs, it says.

It recommends funding the University of Arkansas for Medical Sciences’ High-Risk Pregnancy Program, which helps women at risk of pregnancy complications receive perinatal care through telemedicine. Postpartum Medicaid coverage should be extended from the current 60 days to 12 months. The cost of such an extension would be $1,500 per person in 2022, according to the Congressional Budget Office. One-third of maternal deaths occur postpartum.

It says the state should further fund school-based health clinics, expand broadband access, and increasing the percentage of health care providers who are Black.

It says medical professionals should undergo training so they don’t make assumptions based on a patient’s culture and background.