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, 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.
“For all of the widespread changes in the health care system…racial inequality has proven remarkably resilient.” – Gordon Bonnyman, TJC Co-Founder & Staff Attorney
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.
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.
#WeMustCount – COVID-19 and Health Inequity
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 are 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. For example, the infection rate of majority-black counties is three times higher than that of majority-white counties. Currently in Tennessee, approximately 30% of COVID-19 deaths are in the black community which accounts for only 16% of the state population.
Getting an accurate count for the 2020 Census will be particularly challenging given the conditions the ongoing pandemic have created nationwide. The Census determines how millions in federal dollars will be allocated to communities for the next decade, and some communities have been underfunded for decades due to inaccurate counts. White people are historically much more likely to be overcounted than any other racial group. This year in Tennessee, an estimated 2,000-35,900 white, non-Hispanic/Latinx people could be miscounted in this year’s census. This is a stark contrast to the likelihood of minority groups, who are expected to be significantly undercounted this year. In Tennessee, an estimated 29,500-43,800 black people; 200-900 American Indian/Alaska Natives; and 800-2,100 Asian American/Pacific Islander/Native Hawaiians could likely be undercounted. Help us ensure that #EveryoneCounts.
We are proud to be part of a community of leaders, movers and shakers who work to achieve health equity in our area and around the nation.
Do you want to learn more about pursuing health equity in your work? Click here to learn more.
HEALTH EQUITY DATA
TRENDS IN TENNESSEE’S CHILDREN’S HEALTH SAFETY NET
RURAL HEALTHCARE DESERTS
- For leading, up to date, information on Rural Health data in TN and nationwide visit Rural Health Info
- Check-out this map highlighting the disparities in health outcomes by region
- The Tennessee Department of Health has created an online resource providing guidance to access resources for rural communities here.
- Rural Health Info keeps continually updating here
- A report on the risk facing rural hospitals
- Uninsured Healthcare Provider Address List for TN here
- Blacks/African-Americans make up only 17% of the population, but comprise 32% of COVID-19 related deaths. READ THE REPORT HERE.
- Community Catalyst report: Congress Must Respond to Deep Health Inequities for Black People During COVID-19: Medicaid is the Lever
- The Equity Alliance Our Fair Share 2020 report: Covid-19 Nashville/Davidson County Community Needs Assessment.
- The American College of Physicians produced a report describing the causes of and the disparities for minorities. Please find the report here.
- Report: Low-Income and Communities of Color at Higher Risk of Serious Illness if Infected with Coronavirus
- The European Review of Social Psychology October 2013 report details that healthcare disparities among racial/ethnic minorities represent a serious problem in the U.S even when controlling for income.
- The CDC’s is the pre-eminent data collection agency on racial equity and their health equity page
- Within TN, the Tennessee Department of Health has an office dedicated to reducing health disparities in TN
- Uche Blackstock, is tweeting about the important work of health disparities.
- Kinika Young, Senior Director of Health for the TJC, writes an Op-Ed in the Tennessean describing Tennessee’s maternal mortality issues and focuses on disparities in minority communities
- Kinika Young reacts to the expansion in post-partum coverage with more facts and findings on Tennessee’s mortality issues
- American Progress has become a leader in helping lead the policy directives which can decrease Maternal health disparities. Find out how
- Read the report: National Health Law Program has a new report about “Building A Successful Program for Medi-Cal Coverage For Doula Care: Findings From A Survey of Doulas in California.”
- Standardizing Care is the most recommended policy to decrease maternal health disparities. American Progress published a report to decrease mortality disparities is to create standard processes for all patients to eliminate in treatment.
- Data from American Health Rankings details with clarity a summary of 2019 health disparities for minority women
- National Partnerships Black Women’s Maternal Health Report
- The CDC has created the Active Pregnancy Mortality Surveillance System to track and report on the current disparities in pregnancy mortality