How Ohio should value Black lives in health care
Female health care worker explaining medical records to young patient in office. Maskot/Getty Images.
As a country, we are waking up daily to the unacceptable and completely avoidable loss of Black life. We know some of their names, like George Floyd and Breonna Taylor. But many more we sadly only know as numbers and statistics, reported as part of the daily coronavirus public health updates.
What they have in common is their cause of death: systemic racism.
The COVID-19 crisis has laid bare the inequities in health care that existed in Ohio and across the country well before the pandemic. We know this not only from the powerful experiences of Black and Brown people, we know it because we can see it in the data.
According to a recent study published in the Journal of the American Medical Association, while Black Ohioans make up just 13% of the state’s population, they constitute almost 32% of COVID-19 related hospitalizations. And in Montgomery County, Black people have died from the coronavirus at 11 times the rate of white people.
Lack of economic opportunity, lack of affordable housing and healthy food options, lack of access to health insurance, lack of quality affordable care, lack of representation in the medical field, implicit bias and stereotyping, all contribute to a system that does not adequately value Black lives.
A report issued by Gov. Mike DeWine’s Minority Health Strike Force in August acknowledged these disparities and their impacts on health outcomes and aimed to “establish a vision of Ohio as a model of justice, equity, opportunity and resilience to withstand future challenges.”
To make real progress on the vision laid out by the Strike Force and to reverse these deep-rooted inequities, we need fundamental reforms in our health care system. Yet there is one aspect of health care that is consistently overlooked as a key component of that work — oral health.
Poor oral health has a direct link to higher risks of chronic illnesses, including cardiovascular disease, diabetes, hypertension, asthma, and more. It leads to greater instances of depression and other mental health diseases.
Yet policy makers often overlook oral health as necessary to improving overall health. The fact is if we want to address disparities in health care, we must also focus on and prioritize oral health.
Research from the National Association of Dental Plans showed that over 74 million Americans lack access to dental coverage — four times the number of people who are medically uninsured. More than 45 million Americans live in areas without an adequate number of dentists. It shouldn’t surprise anyone that this gap in access disproportionately harms Black, and Brown Americans.
- Black adults are 68% more likely to have an unmet dental need than white adults.
- Latino adults are 52% more likely than white adults to report having difficulty doing their job due to poor oral health.
- Nearly 4 in 10 Black and Latino adults reside in the 14 states where Medicaid’s adult dental benefits cover no services or emergency-only care.
This has significant economic impacts as well. Due to a lack of access to preventive care and a reliance on emergency care, those living in poverty spend 10 times more as a proportion of their family income on dental services than high income families.. Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance.
Fortunately, there is something Ohio can do to address these disparities — protect existing adult dental benefits in the state Medicaid program. Maintaining an adult dental benefit for Medicaid patients should be a no-brainer. This will not only help our most vulnerable patients but also decrease the burdens on emergency rooms by reducing the number of people relying on them for dental care.
And cuts to Medicaid benefits have a disproportionate impact on communities of color. Black people are 13% of the state population but 24% of the Medicaid population in Ohio.
There are other things we can do as well. We need a revolution in patient care — integrating medical, dental, and behavioral health. And we must better leverage technology, like telemedicine, as not just a crisis tool but a long-term solution to increase access and reduce costs.
We also must empower patients, continuing to educate people about the direct link between good oral health and good physical health.
Dr. Martin Luther King Jr. once said, “Of all the forms of inequity, injustice in health care is the most inhumane.”
He was right. We must be outraged and motivated to end the racial disparities in our health care system. As we emerge from this pandemic, we have an opportunity — and a moral imperative — to do just that.
Black lives depend on it.
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