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Women Building Social and Health Equity
By Elaine Batchlor, MD, MP
Published May 3, 2018

Dr. Elaine Batchlor (Courtesy photo)

I recently joined a gathering of Black women leaders in Sacramento to discuss the well-being of Black women in California. It was a pretty amazing feeling to be in a roomful of women leaders from across the state—elected officials, business leaders, non-profit leaders and policymakers—who looked like me, all having this kind of discussion together. It doesn’t happen often enough.

The event coincided with the release of a report that highlights some striking disparities in the lives of Black women.

Black women have one of the highest workforce participation rates of any population group, with more than 60 percent employed, but their earnings lag far behind the general population—a persistent root cause of poverty among the full-time workforce.

Eighty percent of working Black women are family breadwinners.  Like many women, they also have primary caregiving responsibility for children, elderly family members, and family members with disabilities—underscoring the need for paid leave and sick days to help women balance work and family obligations.

Black women are underrepresented at all levels of elected office, where the policy changes that could create more fairness and equity in the lives of women and families are considered—despite the fact that Black women vote at a higher rate than all other population groups, including in the last two presidential elections.

When a woman is working full-time, still not earning enough to support a family, and struggling to balance family and child care responsibilities, she may end up placing her own health lower on the priority list than it should be. When she lacks resources and access to health care and healthy food, and experiences the discrimination and bias that are still at play in the lives of people of color, both physical and mental health are deeply affected.  Black women have a shorter life expectancy than White women.  Their mortality rate from heart disease is 33% higher and breast cancer 56% higher.  Heartbreakingly, Black women are 3-4 times more likely to die of complications from pregnancy.

We know that inequities in health care and health outcomes are largely driven by inequities in social conditions. These social inequities include unequal access to educational opportunities, pay gaps, lack of support for family care, lack of representation in government—and lack of access to quality health care.

Access to quality health coverage is an important social condition. Although Medicaid was originally conceived to address this issue, growing economic disparities in our country have expanded it from a program serving 4 million people in 1966, its year of inception, to a program serving 70 million people today.  A quarter of the U.S. population is now on Medicaid. In California, one third of the population and half of babies born are on Medicaid. The program has been stretched beyond what it was originally designed for, but so many people are now dependent on it. Low levels of provider reimbursement make it a less than adequate insurance program—California ranks 47th in the nation for Medicaid provider payments.  This is a key factor in lack of access to quality health care.

We need to create a better solution, one that balances access to quality care with providing doctors with the resources they need to do a good job. I think that’s one reason we’re starting to hear more conversation about a single-payer solution, including “Medicare for All,” where uniform standards of access, care, and payment would provide adequate access for all residents. These conversations are gaining traction at both ends of the political spectrum in a way that seemed impossible just a few years ago.

There are no easy short-term fixes, but progress starts by recognizing the problems and taking steps toward possible answers.

While the facts and the way forward can be daunting, I was impressed by the women I met at the meeting who are leading the way, the scope of issues that were addressed, the quality of the data that was shared, and the recommendations for actions to address the issues.

I was particularly impressed by the voices of the young women at the conference. They were outspoken and articulate. They talked about the need for community leaders and policy makers to be more strategic and to take more actions to address inequities affecting Black women.

With the #MeToo movement and the Parkland teens echoing in my mind, I was struck by what I saw in Sacramento:  Women ready to step up and lead. This excites me and gives me hope for the future. We have a lot of work to do together.

Dr. Elaine Batchlor is the chief executive officer of Martin Luther King, Jr. Community Hospital in Watts.

Share your comments and stories with DrB@mlkch.org.

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