Health Reparations by Health Committee Chairperson Gayle Simmons

As I did the research for this blog, I personally felt so heart wrenching to read about the devastating conditions (bodily harm, lack of health care and treatment) our ancestors endured as enslaved people in the USA! Reparations are a form of economic, political, and social accountability for the harm done to Black Americans through violence, discrimination, and systemic oppression over centuries. Health Reparations will rectify the past injustices and remedy the current inequities. They will close the gap and empower our people on the road to good health, equity, and wellness for all.

Health reparations are long overdue!   There is so much information documenting the health history of African Americans, but not so much about health reparations.  The current health of the Black community was negatively affected long before COVID-19 as many of us know.  A historically racially biased health-care system continues to damage Black communities. The virus helped illuminate the health disparities among African Americans to the world.  Even the roll out of the vaccines did not initially include marginalized communities.

The COVID-19 virus pandemic highlighted that African Americans have disproportionate higher rates of hospitalizations and death as confirmed by the Center for Disease Control (CDC).  When people of color contract the virus, and if they have comorbidity (other underlying health conditions) such as type 2 diabetes, hypertension, asthma, heart disease, obesity, it is possible that their health can be compromised.

Your access to health care also affects your health risks. In general, you may live in a rural area farther away from hospitals or clinics.  You may reside or work in a town near factories with chemical pollutants. Health risks can be high among racial and ethnic minority groups especially if they live in multi-generational homes, crowded conditions, inadequate affordable housing, and densely populated areas.

Members of racial and ethnic minority groups are more likely to encounter barriers to getting health care if they have low paying jobs, not being paid when missing work to get care, or no health insurance coverage from their jobs. In 2017, according to the CDC only about 6% of non-Hispanic white people were uninsured, while the rate was nearly 18% for Hispanics and 10% for non-Hispanic Black people.

The type of work you do also may contribute to your risk of getting COVID-19.  Many people of color have service jobs (sanitation, transportation, office/hospital cleaning up) that are considered essential or cannot be done remotely and involve interactions with the public.  In the US according to the CDC nearly 25% of employed Hispanic and Blacks work in the service industry, compared with 16% of non-Hispanic white workers.  A University of Massachusetts study revealed in 2021 that in NC, 40.5% of service employees are Black.  Many people of color also depend on public transportation to get to work.  These factors can result in exposure to the virus.

Many African Americans have a history of mistrust in the healthcare system due to highly documented unethical, unscientific, and racially biased experiments on Blacks all the way up to the 1960s/70s.  Henrietta Lacks, a Black woman, was treated for her cancer and without her consent/knowledge cells were removed and used for important advancements in medical research.  The Tuskegee Experiment:  600 black men did not receive the antibiotics to cure them of syphilis and many died.  In 1970s the families affected filed a class action lawsuit to seek redress.  They won a $10 million compensatory reparations package that included benefits like lifetime medical insurance and burial services.

Our Mental health is another area that was drastically affected during the COVID-19 pandemic.  We were quarantined or socially isolated, anxious, stressed, depressed, angry, lost jobs so they were financially stressed, fearful, frustrated, bored, friends and family members were dying! Hospitals were filled.  Virtual learning was considered a disaster in many cases.  Many of us were sleep deprived.  Deaths due to opiod overdose rose substantially, and violence and suicide increased.  Snowden and Snowden (International Journal of Environmental Research and Public Health) reported that African Americans experience greater personal, social, and financial stress even when not personally touched by COVID illness, and they are again vulnerable as COVID diminishes their community’s capacity for mutual support.  The CDC and the National Institute of Mental Health research show that helping others is a coping strategy that can reduce the mental health impacts of the pandemic.  Many of us volunteered and provided support for others, when possible, by making phone calls and sending out emails to stay in touch.  We were told to exercise more; get outside in the fresh air.  Talk about Mental Health – How are you doing? Feeling? Really listen to what people are saying. Engage with people through visits, social settings; exercise – walking, biking, swimming, etc.

Reparations – What Can Be Done to Mitigate or Discard Health Inequities? Let’s Promote Health Equity…JUSTICE!  Here are some ideas:

Bring the Resources to the Community: Federal, State, Local money….

Expand Medicaid Coverage: benefits/treatment for maternal/infant healthcare; research/treatment for Sickle cell (blood transfusions, stem cell); make insurance costs more affordable: sliding scale.

Recruit more People of Color into Health Careers (research, treatment, listen to the patients).

Promote more literacy, knowledge, awareness, to the community, importance of wellness and preventive care; reduce rates at fitness centers.

Provide more grant money for public health; Go to the marginalized community and bring 1:1 support i.e. (visiting nurses).  Transport them to receive services; bring Dr/Nurse to them…

Increase Free Community Health Centers- use community members to tell what is necessary, engagement (equity, access, treatment, rehabilitation); listen to the community; provide trusted messengers.

Encourage Faith Based Community Conversations (with doctors, nurses, mental health therapists, social workers, etc.)

Eliminate Food Deserts in Marginalized Communities – encourage more community gardens; if the stores are not in the neighborhoods, then use shuttle buses to transport people to the grocery store, certain areas, certain days; more farmers markets in communities.

Add Environmental Green Spaces – outdoor/indoor parks – more trees; walking pathways; exercise stations.

“What Say You?  Can I hear from YOU about more ideas for Health Reparations??”

Social Determinants of Health

Goal of Economic Stability – Increase steady incomes that allow people to meet their health needs.  People with steady employment are less likely to live in poverty and more likely to be healthy.  Policies are needed to help people pay for food, housing, health care, and education which can reduce poverty and improve health and well-being.

Goal of Education Access and Quality – Increase educational opportunities and help children and adolescents do well in school. People with higher levels of education are more likely to be healthier and live longer.

Goal of Health Care Access and Quality – Increase access to comprehensive, high-quality health care services.  About 1 in 10 people in the United Sates don’t have health insurance. Without insurance, it is less likely people have a primary care provider, which then means they are not getting recommendations for specific services, like cancer screenings, etc.  Some people may not be able to afford health care services and medications they need.  Other times, people may live too far away from health care providers who offer services.

Goal of Neighborhood Environment – Create neighborhoods and environments that promote health and safety.  Many people live in neighborhoods with high rates of violence, unsafe air or water, and other health and safety risks.  Racial/ethnic minorities and people with low incomes are more likely to live in places with these risks.

Goal of Social and Community Context – Increase social and community support.  People’s relationships and interactions with family, friends, co-workers, and community members can have a major impact on their health and well-being.  Interventions to help people get the support they need are critical for improving health and well-being.

Resources/References:  Office of Disease Prevention and Health Promotion (ODPHP), Office of the Assistant Secretary for Health, Office of the Secretary, US Department of Health and Human Services.

Racism and Health/Health Equity/Center for Disease Control, Rochelle P Walensky, MD, MPH Director, CDC, and Administration, ATSDR, 2020 or 2021.

Health Disparities Among African Americans/, 2020.

World Health Organization, Social Determinants of Health, -health.