This morning I attended an event sponsored by The Hill: Maternal and Child Health: Tackling Disparities, Improving Outcomes. Much of the information I was familiar with but no matter how many times I hear it, it angers but invigorates me.
This summer I’m interning at the Center for the Study of Social Policy with the Mixed Income Strategic Alliance. The Alliance is working on producing mixed-income communities to de-concentrate poverty and promote racial equity. I had to go beyond the surface to find out how this could relate to my focus in health policy. But my experience growing up in Appalachia, the talk I attended this morning, and the papers I’ve read about mixed-income communities have demonstrated place matters and place can determine your health outcomes for the rest of your life.
This morning, much of the conversation surrounded mothers, in particular African American women who are four times as likely to die from pregnancy complications than white women. Another startling statistic? African American babies are two times as likely to die than white babies. A few weeks ago, I listened to The Daily podcast about this issue and the maternal mortality rate is so high in the United States because of the African American maternal mortality rate. Even holding socioeconomic status steady shows that African American women who receive a college education and live in wealthy neighborhoods are still worse off than white women who received a high school diploma.
There are deeper historical causes and systemic racism that persist. Those problems are at the root of the trend of increasing mortality rates among pregnant women in the United States. Those systemic problems are exactly where social policy appears and seeks to address.
One surprising comment was Congressman Roger Marshall (R-KS) saying disparities between rural and urban health outcomes are a myth. However, he went on to contradict himself by talking about the lack of resources as the biggest issue for disparities. I grew up in a rural and impoverished area of the country and I was shocked by this statement because there are inherently a lack of resources in rural health systems and a lack of those systems in general. I know that the hospital receives disproportionate share hospital (DSH) payments and the nearest Planned Parenthood is an hour away.
My county is in the top 20 of worst health care outcomes in Ohio. In the U.S., Ohio is ranked 49 out of 50 states in infant mortality rates. In my state, a majority of people living in rural areas. There is a definite lack of resources and therefore a definite disparity between rural and urban health outcomes.
At the talk, other panelists believe place matters too. People are constantly under stress because they end up paying 75% of their income toward rent. In fact, half of millions of Americans’ salaries are going towards rent. They have to constantly move because of evictions. These evictions happen quick. Someone can lose their house after a two week notice if they’re late to a court hearing. Furthermore, there are no states that guarantee a right to counsel for a tenant in housing cases. There’s monumental stress associated with constantly having to go to court or being removed from your home. This amount of stress leads to acute and long-term effects on health, mentally and physically. Place matters.