By Caitlin Patterson, Intern, Care4Carolina
Hi all! To introduce myself here, my name is Caitlin Patterson and I am a rising senior at UNC Gillings School of Global Public Health studying Health Policy and Management. I plan to go into health policy after graduation, and have done research on health equity projects within my program covering topics of health equity, access, and quality of care. I am a strong believer that acknowledging and dismantling structural racism is essential for social justice efforts with the broader goal of achieving health equity for all populations. As an intern with Care4Carolina, I am proud to be interning for a coalition that is committed to seeing a North Carolina Medicaid Expansion program that reduces health disparities across the BIPOC communities.
June 19th is a significant day in the United States as it commemorates the emancipation of enslaved black populations. Juneteenth is observed as a national holiday symbolizing independence in the black community.
As we observe this holiday, we also acknowledge the structural racism and discrimination (through both interpersonal and organizational dynamics) within our healthcare system that has made it difficult for communities of color to access health care. In states that have expanded Medicaid, there are key findings that health disparities are reduced.
Data from the CDC has found that members of the black community face barriers in accessing a doctor due to high costs and limited access to care. They also experience a COVID-19 death rate 3.6 times higher than that of white Americans and are often diagnosed with serious medical conditions at a later stage. These health inequities are influenced by social determinants such as the social and physical environment, economic stability, education quality, and access to healthcare.
An analysis by the Kaiser Family Foundation (KFF) has found that Medicaid expansion significantly benefits black communities, given that they are more likely to lack health insurance and have lower incomes due to structural factors. Medicaid plays a vital role in providing health coverage for black individuals and helps ensure access to care while offering financial protection against high health care costs. Additionally, six out of ten people in the coverage gap in non-expansion states are people of color (POC). Therefore, North Carolina becoming the 40th state to expand Medicaid will bring considerable benefits to this population.
Research indicates that Medicaid expansion is linked to improved access to care, better health outcomes, and contributes to reducing racial disparities in health coverage. For instance, black men have higher incidence and mortality rates from prostate cancer when compared to white men. Medicaid coverage for this population could mean a greater likelihood of early detection and treatment of cancer. Moreover, Medicaid expansion in North Carolina is particularly crucial for pregnant women of marginalized communities, as it helps address maternal and infant health disparities by improved access to necessary preventative services.
Juneteenth provides an opportunity to discuss persistent healthcare disparities and advancements in racial health equity. Efforts like Medicaid expansion have proven effective in closing substantial care gaps, and broadening similar efforts to tackle structural racism and inequities in the U.S. healthcare system. This is key for advancing the health of North Carolinians.