The COVID-19 pandemic continues to create challenging situations across the country, changing the way patients get their care and exacerbating disparities in health care. Unequal access to health care and the wellbeing that comes with it is not new. Policies impacting access to care for marginalized populations result in health disparities–preventable differences in the burden of disease experienced by socially disadvantaged people. It’s something Community Health Centers have worked very hard to curb for over 55 years and is one of the many reasons they must survive this pandemic.
While the CDC says pregnant women have the same risks for COVID-19 as adults who aren’t pregnant, the pandemic may be creating more stress and issues accessing care. There are significant racial and ethnic disparities in pregnancy-related mortality. Non-Hispanic Black and American Indian/Alaska Native women are more likely to die from pregnancy-related causes. Black women are three times as likely to die of a pregnancy-related cause than white women.
As we shared in a previous blog post, “weathering,” a term coined by public health researcher Arline Geronimus, Sc.D, suggests chronic stressors for people of color increases their health vulnerability. Accelerated aging or “weathering” raises the pregnancy risks for black women.
COVID-19 worsens health disparities by adding new stressors. Patients may be forgoing pregnancy-related care and any other necessary care to avoid the virus. And, limited resources – access to the internet in rural communities and hospital beds in hot spots – makes connecting with trusted providers and counsel more difficult. As community-run organizations, Community Health Centers are intimately aware of barriers like these and have often found innovative ways to problem solve them—including setting up hotspots in parking lots. And during this pandemic, Community Health Centers are serving as shock absorbers in an effort to relieve the pressure on hospitals.
Necessary quarantining and social distancing increase isolation at a time when the community would usually gather around expectant families to add support for the arrival of their newest family member. With isolation and a rise in domestic violence, people may be staying home with their abusers, putting the life of the mother and baby in jeopardy. And, for people who cannot stay home due to work or who do not have adequate housing, the inability to isolate makes them vulnerable to catching COVID-19.
In communities experiencing more unemployment, a loss of income has made a tough situation more complicated. Buying food or keeping a roof over their head is now a struggle, and in many cases, a loss of a job can also mean the loss of health coverage. A report by the Institute for Women’s Policy Research indicates 60 percent of the COVID-19 related job loss will be among women due to their over-representation in the service industry. Community Health Centers can regularly be found assisting families in need through food and housing programs, and now is no different with many health centers holding food distribution events.
The challenges mothers-to-be are facing are great, especially women of color. However, we know three in five pregnancy-related deaths are preventable. The Community Health Center Model of Care fills some of the health care gaps.
Working on the ground and with their communities, Community Health Centers are trusted sources of care that understand the unique challenges their patients face. They seek to limit barriers to health and wellness by not only providing health care but also the enabling services. These non-clinical services increase access to care and help foster stronger, healthier communities. Enabling services vary from community to community, but can include expanded office hours, food pantries and community gardens, transportation, fitness programs, housing programs, and other social services.
The effectiveness of their efforts shows:
- Women at Community Health Centers are more likely to receive pap smears than their counterparts nationally.
- Health center patients have lower rates of low birth weight than their U.S. counterparts, despite serving more at-risk patients.
- Health centers achieve higher rates of hypertension and diabetes control than the national average, despite serving more at-risk patients.
Community Health Centers offer parents-to-be access to the compassionate, culturally competent care they need for a healthy pregnancy and beyond. They provide care regardless of socio-economic status, race, or ethnicity. Even as Community Health Centers are facing difficulties due to the pandemic, they continue to care for their patients, adapting as they always have, to community needs.
Sadly, as they wait for Congress to reauthorize funding, Community Health Centers are at risk. With plummeting revenues, staffing challenges, and temporary site closures across the country, they are struggling to keep their doors open. Currently, Community Health Centers are experiencing massive revenue losses – 70-80% for many centers as a result of the pandemic. Estimates indicate, over the next six months, they will lose $7.6 billion in revenue and 100,500 lost jobs. Keeping Community Health Centers open long after the pandemic passes is vital to the many who experience barriers to care, including moms and babies, pandemic, or no pandemic.
As we celebrate Mother’s Day, we must insist that Congress invest in a vital network of providers that helps to keep mothers, babies, and their families healthy – Community Health Centers.