As the pandemic continues to reveal discrepancies in our health care systems, the State of Black Arizona’s (SBAZ) fifth volume of the “Driving Local Investment in Black Arizonans” report, released earlier this month, highlights health care disparities faced by Black folks that have been exacerbated by the pandemic, but had existed long before.
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The SBAZ designated health as an “emerging area of interest”, and this is largely attributed to the lack of health-related high-quality data for Black folks in the state.
Teniqua Broughton, executive director of SBAZ, said challenges with data collection and reporting have made it difficult to make sound recommendations for policies and practices at the local and state level.
“We watched the public health department struggle to get clear data according to race and ethnicity, alongside with gender, income, age, by testing, hospitalizations, and deaths. Our current health infrastructure often just lacks the detail for race and ethnicity, and it failed to disaggregate [the data], making it twice as hard to tackle health inequities. What should be done is really a prioritization of disaggregated data, because a lot of decisions are made about communities of color, but there is no disaggregated data.”
The fact that Black folks only represent 5% of the state’s population has presented numerous challenges in the fight for quality data, she added.
“People will say, ‘Oh, that’s a significantly lower number’, or when you are in the process of trying to do any kind of [disaggregation], there’s going to be a huge margin of error. That doesn’t mean that you don’t do it, that just means we have to create some system changes to be able to figure out how we can get the proper data to do that.”
Broughton said she has been talking to the Arizona Department of Health about prioritizing disaggregated data so that these health care inequities can be adequately addressed.
“We need to be accountability partners for this. If you don’t prioritize disaggregated data, how can you make decisions for all Arizonans? For us to address our hardest inequities, we need to be able to speak for ourselves … We don’t have the chance to speak to the lived experience, because data can work for you or against you. You just need to be able to … understand how you need the data to share … with people who don’t understand the real issues and inequities.”
The report highlighted access to health coverage as a critical area. It states:
“…Being uninsured means being vulnerable to health issues that could be addressed with preventative care. Delays in treatment and primary care can negatively impact quality of life for individuals and increase costs to the overall health-care system down the road.”
The report clearly shows people of color are far more likely to be uninsured, with 11% of Black Arizonans reporting not having access to health insurance. This means one in 10 Black Arizonans are uninsured, which is more than the state’s white, Asian/Pacific Islander, and American Indian communities.
Broughton said adequate health care coverage is integral to addressing disparities in health outcomes.
“We have AHCCCS and Medicare expansion that play a role in Arizona at reducing the number of uninsured African Americans, but there’s still so much more that needs to be done … Non-elderly African Americans have death rates that are still more than 40% higher than their white counterparts, and are more likely to have diseases like high blood pressure, diabetes, and strokes at a younger age … Unfortunately, the uninsured are far more likely than the insured to forgo … medical visits, testing, treatment, and even medications …”
Broughton, as well as the report itself, also highlighted that one in four Black Arizonans report not having access to a primary care physician, and that the low statewide median income for Black folks is a major contributing factor. The current median household income of Black Arizonans is about $50,000, which is around $10,000 less than other demographics.
The report notes that “…primary care is often the first line of defense in detecting and preventing future negative health outcomes.” Broughton said:
“It’s important that you’re discussing access to physicians and urgent care … we have to improve health screenings, we need making health visits and access to medications affordable for key African American Arizonans — especially those that [get] about 15% less than the state’s average median household income.”
Broughton explained how COVID-19 only made matters worse, with the pandemic disproportionately impacting people of color not only in health outcomes, but economically as well.
“Many communities of color, especially African Americans, were the frontline workers … the frontline staff who were being exposed to COVID-19 most likely had higher rates. We saw at one point in Arizona that 47% of African Americans reported loss of income, and 51% reported that they did not have high confidence that their household would be able to make the next rent or mortgage payment. So, for many African Americans, COVID-19 was an economic, social and health crisis all at once. It really did expose … the pattern of economic insecurities and lack of access to health care due to the cost and the information.”
The report emphasizes the importance of good health outcomes to securing an education, a good job, and economic security. Broughton said that while pushing for policies would take some more time due to the lack of quality data available, SBAZ would continue to advocate for its key issues by having conversations with important decision-makers.
“It’s just important that Black health is not seen as a Black issue. It’s an Arizona issue. I need Arizona to realize that the only way we can have local growth is that [we] are making sure we are important and significant to the equation of being able to grow out.”