HEALTH
EQUITY
TJC’s mission to ensure that our laws, policies and programs reflect and honor the value and potential of every human being, regardless of income, age, gender, sexuality, ability or race, is rooted in the goals of health equity. For over 24 years, TJC has worked to elevate the needs of marginalized groups – including, low-income families, seniors and people with disabilities – and make Tennessee’s policies more just and compassionate. This work must center health equity as its touchstone and confront racism as a systemic barrier to the equitable allocation of resources among different groups.
WHAT IS HEALTH EQUITY?
Health equity is achieved when every person, regardless of race, income, education, gender or other demographics, has access to what they need to be as healthy as possible. If there were equitable access to resources, including health care, housing, transportation and food, then a person’s zip code would not be a predictor of their life expectancy. The goal of health equity is to eliminate health disparities, such as higher rates of infant and maternal mortality, higher rates of chronic conditions and lower life expectancy, that are prevalent for people of color and are not due to genetic predispositions.
HISTORICAL CONTEXT
“For all of the widespread changes in the health care system…racial inequality has proven remarkably resilient.” – Gordon Bonnyman, TJC Co-Founder & Staff Attorney.
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Prior to the enactment of Title VI of the Civil Rights Act of 1964, racism was explicit in health care facilities across the South, and de facto segregation commonly occurred across the country. Explicit racism was eradicated by conditioning federal funding through the Medicare and Medicaid programs on desegregation in hospitals. From then until today, it has been evident that the problem of unequitable access to health care persists.
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Black and Latinx Americans are less likely to have health insurance, and even when they do gain access to health care, they are subject to racial discrimination that causes poorer health outcomes. Some health care providers still have long-held beliefs that black people have a higher tolerance for pain and other physical attributes that influence their medical judgment and clinical approach. Such provider bias, along with numerous, egregious medical assaults – such as the Tuskegee syphilis experiment and the story of Henrietta Lacks – has seeded a well-founded distrust of the health care system among Black Americans. Other discriminatory laws and policies, like redlining, cause segregation to persist even to this day and confine certain populations to under resourced communities that lead to lower life expectancy. Today’s challenge is to recognize the transgressions of the past while forging a path forward to end racial inequality through better policies and programs that uplift rather than oppress people of color.
SOCIAL DETERMINANTS OF HEALTH
According to the Centers for Disease Control and Prevention (CDC), social determinants of health are the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Improving these conditions is part of the work to achieve health equity. If you have ever experienced health disparities or health inequities, please fill out this brief survey. TJC wants to share your experiences to educate people about these issues and get them to take action to fix the problems in our healthcare system.
COVID-19 and Health Inequity
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The black community is disproportionately disadvantaged by the impact of COVID-19. A longstanding history of racial bias and inequity in healthcare access puts black people at higher risk of untreated chronic illnesses, as well as at higher risk of being underserved in times of crisis. There have been severe health disparities shown by the percentage of black people diagnosed with, hospitalized with, or dead from COVID-19 compared to the size of the black population in Tennessee. For example, earlier this year in Tennessee, approximately 30% of COVID-19 deaths are in the black community which accounts for only 17% of the state population.
LGBTQ HEALTH IN TENNESSEE
Lesbian, gay, bisexual, transgender, and queer people often experience significant obstacles in obtaining health care and health coverage, and our state’s healthcare system is no exception. In fact, in Tennessee, the LGBTQ community faces a range of barriers to access while also lacking critical protections against discrimination. For example,
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Tennessee does not ban conversion therapy;
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Tennessee does not have a law that bans health insurance providers from excluding coverage for transgender specific care;
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Tennessee does not have a law that upholds nondiscrimination regarding sexual orientation and gender identity for private health insurance companies.
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Tennessee is one of only 12 states that expressly bans access to coverage for gender-affirming care under our Medicaid program
The LGBTQ community also includes minority groups, meaning that many people in this community stand at the intersection of multiple groups who are underserved and underinsured. The need for additional protections for LGBTQ individuals in health care, housing, employment and other factors that impact health outcomes is obvious.
If you are having problems with your TennCare or other public benefits programs applications or have been denied due to discrimination, call us for free assistance: 615-255-0331.
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