We do not have gender health equity in the United States, and this is not new information. Beyond the obvious lack of longitudinal research, the fact that women all over the country are more likely to be uninsured, unemployed and under resourced than men, there’s another issue that too often flies under the radar: regional gender health inequities – which boil down to the fact that women of color and economically under resourced women in certain states suffer most from the entrenched disparities.
States are abstractions. Literal lines drawn in the sand. Yet there are marked economic and racial divides in women’s deaths from breast and cervical cancers in certain states and women die there of preventable causes at higher rates. Why? It’s a simple truth: in states where Medicaid hasn’t been expanded, women are more likely to be uninsured, locking them out of crucial preventive health care. Culture wars aside, these concerns go far beyond access to abortion and reproductive healthcare. The Commonwealth Fund has put together a state scorecard on women’s health and it points out some shocking disparities. For example, women in the Southeast have less healthcare access and measurably worse health outcomes. This is not what health equity looks like; it’s far from the more perfect union that we all seek.
As one of my heroes, Dr. Paul Farmer wrote, “The idea that some lives matter less is the root of all that is wrong with the world.” The fact that we even speak of the notion of gender health equity and that drilling down leads to more demarcations of inequality should make us shudder.
But there’s reason to hope and do the work! Women’s health is finally in the news. The zeitgeist is with us. We’re having a moment. The complex social forces that make up our culture are poised for change and we cannot blink. My career has forced me to traffic in minutiae. While I’m not the most fascinating person at the party, I find that when I’m trying to help a woman through the maze of healthcare, it helps to understand what’s at stake. It’s important to crystallize what we’re fighting for, so the moment becomes a movement.
What’s On the Line
Our next election will affect women’s health. It’s a stark reality. Right here, right now. Forwards or backwards and here’s what that looks like:
1. Medicaid funding will either be bolstered or cut back. It will expand to cover more women and help them address more health challenges or it will be rolled back further. If it goes backwards, it will hurt poor women, women of color and women in states who are already bearing the disproportional brunt of a lack of gender health equity most.
2. Government support for women’s health research will either be built upon or de-emphasized. Everything from more data collection about health outcomes based on race and socioeconomics to understanding women’s diseases so we can prevent, diagnose and treat them more effectively is on the table.
3. Funding for Title X clinics will either be enhanced or slashed. Title X is the only federal program focused on providing low-income and uninsured individuals with comprehensive family planning and related preventive health services. Including cancer screenings. For a lot of under resourced women, especially in rural areas, these clinics are the only place to receive health services. Do we or don’t we believe that our government should provide this kind of safety net?
In real time.
Right here, right now.
Photo credit: Library of Congress, Harris & Ewing Collection
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