These quotes remind me that women in our region often have many responsibilities. They are moms, daughters, friends, sisters, employees, students, church members, sorority members, girlfriends, wives and the proverbial list of “hats women wear” goes on and on. Subsequently, prioritizing others’ needs above their own is a current norm for most women. It also reminds me that the social determinants of health (e.g. where you live, work, play and pray) are REAL and they truly impact how women experience life and wellness. In order to create lasting change we as public health professionals need to strategize ways to make self-care for women the default choice, as well as ways to positively influence the social determinants of women’s health. Indeed, this is a tall order but it’s necessary to change the status quo.
|Savannah Cooksey, Connie Bish, Juanita Graham, Cheryl Doyle, Sarah Verbiest and Mary Craig (start top left to right)|
What about health care reform is exciting for you?
As October 1 draws arrives, I am excited that thousands of people across the nation who previously did not have health care will finally have the opportunity to get covered through the Affordable Care Act (ACA)! Specifically, I’m excited about mobilizing women, women of color, immigrants, and LGBT folks to enroll for affordable insurance options – especially in the southern states where we know the highest percentage of uninsured populations reside, many of whom don’t earn enough to be able to buy private insurance and aren’t eligible to be covered by Medicaid. Another exciting aspect about ACA is how it’s making insurance improvements. For example, no more gender rating (women will no longer have to pay more simply because they are women), no more lifetime or annual limits, no more pre-existing condition bans, and no more taking away insurance when you get sick!
To help women learn about the new options ahead of us, Raising Women’s Voices for the Health Care We Need and the Ms. Foundation have collaborated on a campaign that will complement, support, and amplify state level ACA outreach and enrollment efforts. The campaign, women 4 health care (@Women4HC), premiered on October 1 and includes an array of resources, tools, and materials for organizations engaging in this work, including Facebook and Twitter. Get the latest updates on Women 4 Health Care and learn more about how to get involved by filling out this simple form – click here.
What worries you / keeps you awake at night?
The new health care law will bring peace of mind and security to millions of Americans, but I worry about the people who will still fall into gaps that remain – some of which directly affect some of the people I’m closest too.
In many Southern states, conservative politicians have so far refused to accept federal funds that would allow them to provide insurance coverage through state Medicaid programs to more low-income people living and working in their states. This is a heart-breaking missed opportunity that will leave many people with no affordable way to get health insurance, like my partner. And according to economic experts in states that have done the analysis, it’s also a fiscal mistake because using federal money to expand Medicaid eligibility could actually save money for states, support well-paying health care sector jobs, and generate new tax revenues. It’s not too late, though, and I hope we’ll be able to make this worry go away by persuading more states to accept the federal funds and cover the new eligible populations.
Another gap that exists throughout the country is that undocumented immigrants, like my mother, are not allowed to buy insurance on the marketplace (even if they have the money and are able to pay full price). Immigrant youth who have filed for Deferred Action for Childhood Arrivals (DACA) are also not eligible, despite being recognized as “lawfully present” in the U.S. And even immigrants with documentation will face some barriers because of the five-year ban making them ineligible for the financial help they might need to make insurance affordable in the Marketplaces. People who can’t get insurance because of these gaps will have to rely on the same, limited sources for care that were available before the new law, including community health centers, which did at least get some new funding, thanks to the ACA.
For the millions who are eligible to buy insurance in the Marketplaces, I worry that women, women of color, and LGBT folks might not get the information they need to make informed decisions about plans that will meet their health care needs. These are constituencies that historically have been ignored and marginalized and, in the South and other rural states (like Montana), often face additional access challenges. To make sure they do get the necessary information, there will have to be outreach that’s specifically designed to overcome these challenges — taking the information directly to these communities — in their homes and by phone — and to places where people from various underserved communities are already coming together — like at community events, festivals, using social media channels where people congregate virtually.
Yet, there isn’t a challenge out there that doesn’t come with great opportunity. The need to do this targeted outreach creates space for organizations big and small to come together for a common goal. And there are some great organizations that are targeting these populations and engaging in outreach in the ways I just mentioned, like RWV, Out2Enroll, Enroll America, along with a slew of local and state-wide organizations. These are the challenges we face, that for one keeps me worried, but it’s also motivating to know there is a lot collaborative work being done.
What charge might you issue to women in the South about what we should be doing now?
I would give women in the South a charge of three things to do right now:
To expand on number one, you really have to think about what is important for you in an insurance plan. Does the plan include the doctor, clinic or hospital that you use? Does it cover your medical needs? Which plan best fits your budget? You can get more information and other thought provoking things to keep in mind in the Choosing a Plan section of the RWV website.
If you have enrollment questions you want to ask to a person, Healthcare.gov suggests you visit LocalHelp.HealthCare.gov to find help in your area, and you can also contact one of RWV’s Regional Coordinators if we have one in your state. We are always looking to expand our Southern partners, contact me if your organization is interested.
For number three, even if you don’t feel like an expert, remember that the best messenger for these very personal issues is often a person we know. You can use the RWV Fact Sheets to help your friends and family members learn about the changes that are coming, and share the 10 ways to get ready for the Health Insurance Marketplace with anyone you know who doesn’t have insurance!
What brought you to the organization and your current work?
One Key Question http://www.onekeyquestion.org/
This past June 2013 I had the opportunity to spend 8 days with a wonderful group of 15 and 16 year old young women on a service learning trip to rural Nicaragua. During our time in country we hiked in rainforests and learned about the challenges of preserving this precious ecosystem. We helped plant school gardens working side by side with parents in the community. The girls spent time with high school students practicing Spanish/English and sharing about each others’ lives. Supporting rural schools is a cornerstone program for the organization we traveled with and the girls spent time with young school children and their teachers, witnessing how people in other countries value as education as a gift and essential investment in the future. We played with children at the Los Pipitos clinic who had a range of serious physical, developmental and behavioral challenges whose mothers brought them 3 hours each way on foot to receive 2 hours of therapy a few times a year. The difference in the demand for services and availability of care was stark while the intense commitment of these parents to their children was humbling.
One of the more thought provoking visits on our journey was to the Casa Materna – a small home where women from remote areas could spend the last few weeks of their pregnancy and deliver their baby at the nearby health department. This is so important as one out of every 300 women die in childbirth in Nicaragua and their infant mortality rate is 3 times that of the US. During the visit the girls met a 16 year old who was due in a few weeks. In contrast to our perception of teen pregnancy, this young woman had planned her pregnancy and was looking forward to the way her new role as mother would impact her status in the community. A different looking glass to consider… We also learned that most women leave the health department pretty quickly after giving birth followed by a ride home on a crowded, bumpy bus or a long walk home. Women are strong and mighty indeed.
We also saw the positive impact of micro enterprise investments in women owned initiatives…and helped support those women by purchasing their lovely products while learning about their innovative business models. We witnessed the importance of entrepreneurship – be it business, social or just thinking outside of the box (as did the fabulous Peace Corp volunteer at Casa Materna). Finally, across the board as a group we loved the neighborliness of everyone we met. People in Nicaragua make time to stop and talk with each other. They gather in squares and on front porches. Homes may be tiny but hearts are big. Life might be hard but there is time to share.
The joys and challenges of being a Girl Scout leader is a topic for a different blog, but my decade investment in building leadership with my scouts (including my daughter) has been worth every second. I feel great hope for the future when I look at these young women and see how they embrace a world much bigger than the one they live in every day. They are smart, have cultural humility and recognize the interconnectedness of their life and those of women and girls around the world. And they aren’t afraid to get messy, try new things, support each other and believe that the world is full of endless possibilities!