Health Care for Women of Color: Listening to What They Need

by Cheryl D. Edwards, JD                                            photo by Wally g cc

As President Barack Obama works to reform the health care system, he need look no further than a few blocks from the White House to see neighborhoods where many people, particularly women of color, suffer from unnecessary morbidity and mortality due to preventable acute and chronic diseases as a result of a lack of access to care. The District of Columbia (DC) provides a unique lens on the problems women of color face in accessing care nationwide. We must acknowledge the special roles that women play in the health care system, not only as consumers of health care, but also as primary catalysts for family and community health. 

In 2008, the George Washington University Jacobs Institute of Women’s Health completed a baseline assessment of the health and health care needs of women of color who are at risk for health and health care disparities in the District of Columbia. The study report entitled “In Their Own Voices” was funded by the United States Department of Health and Human Services, Office of Minority Health.  The goal of the study was designed to inform health policy makers as they develop and implement broad legislative policy reforms intended to improve the health care systems for medically underserved populations, particularly in eastern Washington, DC. 

These women in their own voices expanded upon the necessary requirements, if met that would assist them in improving their health status despite their social and environmental issues.  The requirements recommended by these women were interventions, such as transportation, dependent/child care, nutrition education, and community health workers.

As we learned from the limited literature available about women of color in D.C. and, more importantly, from the women themselves, the cost of health care can be a significant barrier to access—resulting in delaying care, skipping recommended screenings and tests, not filling prescriptions, and cutting back on dosages. As important as cost is (and many health reform efforts focus on the laudable goal of improving the cost-effectiveness of care), women face additional barriers that affect the convenience of accessing care, such as the lack of transportation and child care.

Our focus group participants underscored the need for policy interventions to continue to improve access to care for women of color of all ages. Increased efforts to build more sophisticated gender-specific health data systems will assist in identifying where problems are, especially where services are lacking or duplicative or too costly or ineffective at improving health outcomes. Universal healthcare reform must include a carve out to address the specific needs of women’s health. And this means comprehensive primary and specialist care, not just reproductive health.  Population health indicators in Washington, D.C. suggest the need for serious and sustained improvement efforts across the spectrum of women’s health needs.

While these options for health care reform are deliberated, it is important to remember the lessons that can be learned from listening to women themselves, in their own voices.

Cheryl D. Edwards, JD is an Assistant Research Professor
at The George Washington University's Deptartment of Health Policy