Systemic racism has very real health impact
COVID-19 has laid bare the inequities
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 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.
Just last week, Massachusetts Gov. Charlie Baker released new COVID-19 data showing that blacks account for 7 percent of the state’s population, but 14 percent of COVID-19 cases. Hispanics account for 12 percent of the population, but 29 percent of the cases.
No wonder cities are now declaring racism a public health crisis, as Boston Mayor Marty Walsh did recently. They are absolutely right.
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.
These inequities have created a disparity so great that the life expectancy of a black man in Roxbury is 30 years less than that of a white man just a few miles away.
I saw this firsthand as a physician and CEO of the Dimock Center in Roxbury, where the relief on black patients’ faces when they saw a doctor walk in the room who looked like them – who would truly understand them – was palpable.
And I see it in my current role, leading the DentaQuest Partnership for Oral Health Advancement, a nonprofit organization working to reform the broken health care system.
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 oral health is often overlooked by policy makers as a way to improve overall health. The fact is if we want to address disparities in health care, we must also focus on oral health.
Recent research from DentaQuest 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 poor, black, and brown Americans.
- Americans in poverty are 2.5 times more likely to have an unmet dental need due to lack of insurance.
- Black adults are 68 percent more likely to have an unmet dental need than white adults.
- Latino adults are 52 percent 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, low income adults spend 10 times more of their annual family income on dental services than high income families.
Fortunately, there are tangible things we can do. Increasing access by keeping or adding 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. 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.
Dr. Myechia Minter-Jordan is president and CEO of the DentaQuest Partnership for Oral Health Advancement, a Boston-based nonprofit organization focused on reforming the broken health system and enabling better oral health for all. She is the former CEO of the Dimock Center.