Community Health Workers and More: July Health Equity Update
A special note to our companions on the road to racial equity
Before we share our usual health equity update and resources, we need to talk about how we move forward in the context of recent events:
For those of us engaged in the daily work of bending the arc of history toward justice, the last few weeks have pierced us to our core.
As health equity advocates, the very heart of our vocation is a shared belief that every single human being has the right to live a healthy life—a right that must be supported with resources and concrete action.
In our own particular ways, we work to rectify the structural, social, and economic inequities that privilege some people and communities with every asset and opportunity to enjoy excellent health, while imposing severe health risks and toxic stress on the people and communities with the least resources to contend with them.
As we strive to correct long-standing inequalities in communities of color—whether in the arenas of health, education, economic opportunity, or the basic ability to go about our daily lives safe from violence—it is painful, even traumatizing, to be continuously barraged with the stark evidence of how far we have to go, even in 2016, for all lives to be truly valued equally.
Especially for those of us who work in social justice and are also people of color, a “tough day at the office” is something we can’t just put aside when we get home, any more than we could slip out of our own skins, or erase the sound of our parents’ accents from our minds, or forget that our children might someday be perceived as a threat by someone authorized to use lethal force.
So, as we see tough days stretch out to rough weeks, we must remember to take care of ourselves and each other, not just as individuals, but as communities too. The road ahead is not likely to get easier. We must guard against burnout and despair and find strength in each other. Too much is on the line, and we all must march on this path together.
Community Health Workers (CHW)—also known as promotores and community health representatives—have long been recognized as highly effective in helping communities of color and other vulnerable communities take control of their health, overcome barriers to good health, and actually improve health outcomes for certain conditions.
Much of their success in reducing disparities stems from the fact that they are trusted members of their communities, uniquely able to serve as bridges to the health care system, and provide the culturally competent community-based support that people need, but clinicians often cannot offer.
So it’s no surprise that their ranks have been growing, according to one recent estimate by as much as 27 percent in just three years. However, despite their proven effectiveness, securing sufficient consistent funding for their work and integrating them into patient care plans continue to be extremely challenging.
Our new issue brief describes the benefits of community health workers and gives advocates the policy solutions and advocacy strategies they need to secure Medicaid reimbursement for these valuable community assets.
Speaker Paul Ryan’s health care proposal would be devastating to communities of color
In June, House Speaker Paul Ryan released a policy paper outlining the Republican plan to repeal and replace the Affordable Care Act. Among other things, this plan would cut subsidies that make premiums affordable for working families, let insurance companies go back to denying coverage to people with pre-existing conditions, and slash Medicaid funding.
As we have noted, Ryan’s attack on Medicaid is especially problematic given that millions of people get health coverage through this program. Communities of color would be hit particularly hard. Although there are more non-Hispanic whites using Medicaid than any other demographic group (43 percent), the impact of Medicaid cuts would fall heaviest on Latinos and African Americans, where roughly 1 in 3 people rely on it to get the health care they need.
As the public debate on health care policy heats up over the next few months, it is important that advocates engage quickly and decisively and prevent these devastating proposals from gaining traction. See our Medicaid fact sheets for information about why these proposals are harmful.
Top health equity reads and resources
10 Health Advocacy Highlights from the 2016 Legislative Sessions, Patrick Willard, Families USA
HHS Must Improve Language Access to Make Meaningful Access a Reality, Kathy Ko Chin, Health Affairs Blog
Language Access in Pediatric Primary Care, National Center for Medical Home Implementation and National Center for Cultural Competence
Closing the Equity Gap in Health Care for Black Americans, Pamela Riley, M.D., Susan L. Hayes and Jamie Ryan, The Commonwealth Fund
Violence Related Trauma Resources, U.S. Department of Health and Human Services Office of Minority Health
At the Intersection of Urban Planning and Health in the New York Metro Region, Mandu Sen, Robert Wood Johnson Foundation
Health Literacy in Dentistry and Navajo Nation Community
Health Representatives, Steven P. Geiermann, American Dental Association; Mae-Gilene Begay, Navajo Nation, Department of Health; Lindsey Robinson, American Dental Association Trustee; and Sharon Clough, American Dental Association