Posted by on July 19, 2013 - 11:57am

For all intents and purposes, the Affordable Care Act (ACA), the President’s signature piece of legislation, will provide more health care coverage to poor and underserved populations. Persistently disadvantaged communities have much further to go than those with insurance, and new means of accessing and paying for care will benefit them disproportionately. Nevertheless, with more than 20 percent of the nation’s Black population uninsured, more than 30 percent of Hispanics uninsured and a country still grappling with understanding and properly addressing disparities, just how far does the ACA take uninsured women in the US?

By mandating individual health insurance coverage and expanding the list of covered preventative services, ACA legislation should, theoretically, improve the quality of health care for women at a disproportionate risk of being uninsured and having low incomes. However, research has shown that having health insurance itself does not necessarily have a substantial impact if women cannot find a doctor to see them, do not have proper information about accessing resources, or are not treated in a culturally and environmentally competent manner.

Moreover, when the number of uninsured could be decreased by more than half, but being uninsured is not equitable across racial and ethnic groups in the US, what happens to our countries most vulnerable women and children?

It has been well documented that low-income women and those without employee-sponsored insurance (ESI) are more likely to be women of color. Kaiser and US Census estimates indicate that there are significant differences in insurance rates by race and ethnicity, with national averages approximating there are almost three times as many uninsured Hispanics as Whites. In Louisiana, for example, it is believed that more than 50% of the state’s Hispanics are uninsured, while only 18% of Whites are. In the same state, it is estimated that 30% of Blacks are uninsured, reiterating just how unbalanced our country remains and how terribly far we have to go to eliminate inequalities.

Even in Massachusetts, where health reform has been a success, the number of Blacks and Hispanics that remain uninsured is two and three times that of Whites, respectively.

Although the ACA takes us a step forward in giving many of the countries uninsured woman an insurance card, the US must address what to do about probable provider shortages that will result from a lack of primary care physicians and different utilization in care between races, ethnicities and gender. We must be prepared to understand both to cultural differences in demand and pent-up demand of the previously uninsured, as well as start to really face how to deal with persistent racial and ethnic inequality in this nation that shows itself in our health care system every day.

Posted by on October 10, 2012 - 12:56pm

On Monday, The Scientist printed a valuable article linking to a TED video and a new book entitled Living Color by Nina Jablonski. The video and book delve into the importance of skin color and types for health and social well-being.

To me, there are three points of greatest value: 1) that as humans, our personal melanin and intake of ultraviolet radiation (UVR) are vitally important to our individual health, 2) that as migration and evolution has occurred our pigmentation gene is exceptionally labile, and 3) that skin pigmentation and our individual variations are not discussed nearly enough in our society.

Although I am an advocate for more open, honest dialogue about the significant role race has in this country, this argument for better quality health is different. We need to begin also addressing what pigmentation means for the individual and how women have varying skin needs.  This message is not about Black, White, Asian, Latino, or any other socially constructed label for race or ethnicity, this is about individual health concerns.

As the author correctly explains, the MC1R gene, which is the gene predominantly responsible for pigmentation, has little variation in African people. Those with darker (or more melanin-rich) skin have a “built-in defense” against harmful ultraviolet radiation, is often ideal for health and normal cell reproduction. However, as humans migrated and evolved there was a depigmentation of skin, leading to lightly pigmented (or melanin-poor) peoples. This mismatch of genetic predisposition and solar regimes can mean very different things for a woman’s health.

For example, Nina Jablonski asserts that, “People of Northern European ancestry, for instance, living in Florida or Australia confront intense UVR conditions with pale, melanin-poor skin and suffer from sunburns, high rates of skin cancer, and accelerated skin aging. People of central African or southern Indian ancestry living in Wisconsin or Wales face low and highly seasonal UVR conditions with exquisitely sun-protected skin and suffer from vitamin D deficiencies as a result.”

Ladies, knowing your body also means knowing the health risks and benefits associated with your skin.  Remember, your skin is the largest organ in your body, talk to your health care providers and keep yourself safe!