COMMUNITY HEALTH WORKERS
Integrating community health workers into health care teams without co-opting them
Cheryl Garfield and Shreya Kangovi, Health Affairs Blog, May 10
For generations, community health workers have worked in church basements, shelters, and food pantries to address a variety of health and social needs. As health care organizations gain interest in this workforce, community health workers are transitioning from their grassroots, community-based origins to become integrated members of health care teams. The marriage of community health and formal health care is powerful, but it’s also tricky. If community health workers lose their identity and become medicalized, their effectiveness in the community is lessened. Health care leaders must grapple with a fundamental question: How do we integrate a grassroots workforce into health care without totally co-opting it?
HEALTH DISPARITIES
Black women more likely to die of breast cancer — and what some are doing about it
Max Blau, Stateline, May 15
Treatment advances have improved breast cancer survival rates among all U.S. women, but the disparity between white and black women has grown: Black women are 40% more likely to die from the disease than white women, according to the Centers for Disease Control and Prevention. This occurs even though black and white women have similar mammogram screening rates and black women have a lower overall incidence of breast cancer. Federal and state officials have taken some actions to reduce this disparity, but for the most part, the task of closing the gap has fallen to individual actors and institutions.
Why racial gaps in maternal mortality persist
Patti Neighmond, NPR, May 10
Today it’s becoming more clear that disparities have more to do with racism than race, says Neel Shah, an OB-GYN and a professor at Harvard Medical School. For a long time there was “this baked-in assumption” that there was something different genetically among black women leading to their higher rates of maternal mortality, he says. But “genetically we are all the same,” he says, and the evidence is strong that it is the chronic effect of the stress of racism, or “weathering” as some researchers describe it, that takes its toll on pregnancy, childbirth and care for a newborn after birth.
HEALTH CARE COVERAGE
Maryland gov signs 1st-in-nation measure to help uninsured
The Associated Press, May 13
Maryland Gov. Larry Hogan signed a first-in-the-nation measure Monday to make it easier for people without health insurance to find out if they qualify for low-cost insurance after they file their taxes. The new law will create a box for people to check on state income tax returns. If a taxpayer checks the box, the state’s health care exchange will see if the person qualifies, based on information in the tax return. Those who qualify for Medicaid will be enrolled automatically. The exchange will reach out to people who qualify for private coverage.
PERSPECTIVE
‘Am I a bad person?’: Why one mom didn’t take her kid to the ER — even after poison control said to.
Sarah Kliff, Vox, May 10
Reporter Sarah Kliff reflects on the year she spent examining other people’s emergency room bills, including one that stuck with her from a mom who sat with her daughter in an ER parking lot rather than go inside because she couldn’t afford another bill. Kliff says it’s a sign of a larger problem: “Not only do the bills put patients in overwhelming debt, but they also affect the health care decisions patients make…There are those who can afford the care they and their families need, and those who can’t — because they worry about going broke from things like a single emergency room trip.”