Wealth to Health: How it’s All Connected
By Rylee Sommers-Flanagan*
Earlier this week, my fellow intern, Courtney Fiske, reported on the findings released last month by the Institute on Assets and Social Policy at Brandeis University, which revealed a widening racial wealth gap between whites and blacks in the United States.
Unfortunately, while there are a few obvious economic implications associated with such a massive wealth gap, there are less-obvious and equally ominous implications in other arenas, particularly health. Recently, the New York Times presented the findings of a study conducted by the New York Academy of Medicine and the Health Department, indicating that rates of maternal mortality in New York, especially New York City, are unreasonably high. Unreasonably because, according to a study by the Institute for Health Metrics and Evaluation at the University of Washington, the rest of the world has managed to decrease rates of maternal mortality by about 35% since 1990, while the New York City Department of Health and Hygiene informs us that the United States has not seen a “significant drop in maternal deaths since 1990.” What’s more, from 2001 to 2005, New York City’s average maternal mortality rate was twice the average rate for the whole United States.
Some people, likeDr. Harold Wilensky of UC Berkeley, use death from pregnancy and childbirth complications as a measure of real health status. In other words, the rate of maternal mortality is an indicator of overall healthcare access and quality. So, what does this mean for New York City’s healthcare situation? Oddly enough, if you’re white, it may not be so bad after all.
Race matters. In the study, Latina and Asian women died twice as often as white women; black women died seven times as often. The majority of the women dying were from low-income areas of the Bronx and Brooklyn. Studies show that healthcare resources in New York City are guilty of de facto segregation, sending the uninsured or publicly insured to clinics with longer wait times, less expensive or advanced technology and student doctors and nurse practitioners rather than board-certified physicians. Those wealthy enough to have private insurance are sent to faculty practices, where they receive consistent care and have access to specialists and high-quality equipment. Groups like the New York Lawyers for the Public Interest (NYLPI) make it their work to advocate on behalf of community organizations, like Bronx Health REACH coalition, that are asserting their rights surrounding health care. Segregated health care is bad for all of us, but it is certainly worse for the poor. As Nisha Agarwal, an attorney and the Director of the Health Justice Program at NYLPI, noted in an OpEd for the Huffington Post, “Under federal law, hospitals are required to open their doors to Medicaid beneficiaries, and provide them care without discrimination, in exchange for accepting millions of dollars of government funding to modernize and upgrade their facilities.”
Though the New York City refused to make a causal link between poverty or race with maternal mortality, and the New York Times’ article cast its lot with obesity, it seems like avoidance of the issues. American obesity has been associated with a number of causes, including race and poverty, and while it may be an intermediate cause of maternal mortality, it by no means addresses the root of the issue.
We know the facts. The median family of color owns 16 cents to every white family’s dollar. Medicaid recipients and the uninsured are disproportionately people of color. People of color in New York City receive lower quality healthcare that results in disparate health outcomes. We live in a society of entrenched segregation.
Yet we learned long ago that separate simply is not equal. As women, we bear the burden of segregation, and serve as the indicator to the rest of the world that something is wrong with our system and distribution of healthcare and resources.
Until we address pervasive race-based economic disparities, the fight for integrated care will be impossibly arduous. Yet without integrated, public care, our mothers will keep on dying unreasonably.
* Rylee Sommers-Flanagan is a Communications Intern with the National Council for Research on Women. She is pursuing a degree in International Studies at Emory University.