By Bernard Freeman
Health Insurance Equity
Black Health and Wellness, the theme for 2020’s Black History Month, isn’t just about doctors, diets and doing more exercise.
The wellness journey for generations of African Americans has also been shaped by both historic obstacles even among more recent gains in health insurance.
The uninsured rate for Black Americans declined significantly after the Affordable Care Act was passed. More than 20 million people gained coverage under the ACA, and nearly three million of them were African American. Still, the uninsured rate among Black people is often double that of their white counterparts. Some 38% are on Medicaid.
The ACA made progress toward universal coverage, but costs still mean that access is a challenge for African Americans who don’t participate. The average American family spends about 11 percent of their total income on health care, including premiums, co-pays, prescriptions and other out-of-plan bills. But those same dollars represent a much larger percentage of income for the average Black family, which because of pay disparity may be spending more like 20% of their household income on wellness.
Millions more are underinsured, meaning doctor or hospital visits put a strain on their finances or even require going into debt. Nearly 20% of U.S. adults who are underinsured are African American.
Some may be helped with Medicaid expansions on the state level, but a number of governors and local legislatures are opting out. Following a trend, that leaves people of color as the ones most likely to find themselves in a coverage gap. They earn too much to qualify under the original Medicaid guidelines, but not enough to earn premium tax credit in the ACA marketplace.
These aren’t the only reasons why cost-friendly, fair coverage options is so important.
There are still marked differences in outcomes between Black people and whites in the areas of infant and maternal mortality, cancer, diabetes and heart disease. African American females are three times more apt to die in pregnancy than whites. The Black infant mortality rate is twice that of whites. Across a range of chronic maladies, simply being African American means you’re more likely to die compared to other groups.
Affordable health care might literally be the difference between life and death.
Unsung Female Leaders
Photo credit LIBRARY OF CONGRESS | Left to right: Rosa Parks, Septima Clark and Parks’ mother, Leona McCauley at Highlander Folk School in Monteagle, Tenn., in December 1956.
Towering figures like Martin Luther King Jr., W.E.B. Du Bois and Thurgood Marshall tend to dominate the story of the struggle for Civil Rights in America.
Only more recently have women like Harriet Tubman, Sojourner Truth and Rosa Parks begun to share the spotlight more equally. But that still leaves scores of unsung female heroes who played a significant role in the movement for racial equality. Here’s a look back at a few of them:
ELLA BAKER (1903-1986)
Though highly respected, Baker was a force away from the spotlight, mentoring and supporting Dubois, Marshall and King. She built her reputation as a movement builder, rather than as an outsized star, to the point that Baker was given the nickname Fundi — a Swahili word for someone who teaches the next generation.
DAISY BATES (1914-1999)
A newspaper publisher by trade, Bates played a key role in desegregating schools as president of the Arkansas chapter of the NAACP. She was a guiding hand in enrolling nine African American students in an all-white Little Rock high school, setting in motion a journey toward education equality.
SEPTIMA POINSETTE CLARK (1898-1987)
The “mother of the Civil Rights Movement,” Clark was a teacher activist who helped pave the way for Black educators to be hired by the city of Charleston South Carolina. She remained a dogged advocate of education, teaching literacy classes so that her Black neighbors could register to vote. President Jimmy Carter awarded Clark the Living Legacy Award in 1979.
DOROTHY HEIGHT (1912-2010)
DOROTHY HEIGHT | Photo Credit Schlesinger Library, RIAS, Harvard University, No restrictions, via Wikimedia Commons
Height was a principal organizer of 1963’s March on Washington, working behind the scenes with far more famous Civil Rights activists like Martin Luther King Jr. She later co-founded the National Women’s Political Caucus, and was awarded the Presidential Medal of Freedom by Bill Clinton in 1994.
DIANE NASH (1938- )
A member of the Freedom Riders, Nash served as a student leader during the height of the Civil Rights Movement, co-founding both the Student Non-Violent Coordinating Committee and the Selma Voting Rights Movement. Her efforts continue to speak to the power of our youth to spur change.
ANN ROBINSON (1912-1992)
The heroes of 1955’s bus boycott in Montgomery, Alabama, are seemingly well known — except Robinson. She distributed more than 50,000 flyers calling for the boycott after the arrest of Rosa Parks. Her fierce calls for justice and commitment to nonviolent protest helped define the era.
