While health insurance coverage rates have increased substantially due to the implementation of the 2010 Patient Protection and Affordable Care Act (ACA), 16.5% of non-elderly Black Women in the United States still lacked coverage as of 2014.

 

In California, more than 80% are insured. However, the cost of co-payments, deductibles and out of network costs is significant barriers to receiving care. In addition, although coverage is adequate, sufficient care is not. Provider availability was identified as a constant issue that many Black Women face when trying to get care. The lack of Black Women physician is a concern. In addition, the personal and institutional biases are issues in care delivery. Black Women have a higher Percentage of chronic diseases including diabetes and cardiovascular disease as well as the highest mortality rates from chronic disease.  

 

In addition, perinatal and maternal care continues to be an issue for Black Women regardless of income and social situation. We have the highest maternal mortality rate as well as the highest infant mortality rate in California. Black Women also have the shortest life expectancy.

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In addition to the overall health disparity gaps, the participants also identified the way in which Black Women experience the health care system as well as navigate the system as barriers. Respect is critical to the way in which Black Women want to be treated when navigating the health care system. Providers are challenged to create environments that embrace the cultural norms that make Black Women to feel welcomed and respected when receiving care.

The lack of health and wellness resources was identified as another barrier. Currently, there are resource and funding opportunities for enrollment and navigation services but they tend to focus on other barriers like language and immigration status that don’t necessary address the needs of Black Women. Policy focus also aligns with the funding priorities. There is an opportunity to expand these priorities to ensure that Black Women health disparities are included when developing policy and funding criteria.

Also, the intersection of mental health needs with physical health was also evident from the experience identified at the forum. Interventions should be an integrated approach especially when addressing chronic diseases that disproportionately impact Black Women. This should be comprehensive that incorporates solutions for social determinants of health.

 

There are models that were highlighted as best practices that can be replicated. The Martin Luther King, Jr. Community Hospital care delivery model pools together public-private resources to better serve the community utilizing resources from both. Another model identified was the Black Child Legacy initiative whose goal is to reduce African American Childhood Deaths. This approach is a collaboration with the Sacramento County, community based organizations and funders to intentionally address an issue that was identified as a community health problem.

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