Disparities in Health Equity Among Black Children and Their Communities

By: Cecilia Scott-Croff | February 2, 2023

There is a new term that permeates throughout our community, Health is Wealth, this adage rings true for many of our black and brown communities which triple in challenges with diabetes, high blood pressure, and disparities in access to affordable and quality health care. While many healthcare stakeholders strive to provide universal care and resources for all, inequity continues to run deep within the healthcare system. This requires removing obstacles to health, such as poverty, discrimination, and their consequences—including powerlessness; lack of access to good jobs with fair pay; quality education and housing; safe environments; and health care. 

As mentioned in Early Childhood Is Critical to Health Equity an article published by the Robert Wood Johnson Foundation. Poverty or low income and discrimination can limit parents’ opportunities to provide their children with safe, nurturing, stimulating, and health-promoting environments, access to health care, and high-quality educational opportunities. In addition, more than half of the 74 million children in the United States are children of color and they are served by learning systems that are gravely inequitable.  

“Less access to quality medical care is the top reason Black Americans see contributing to generally worse health outcomes for Black people in the U.S. Large shares also see other factors as playing a role, including environmental quality problems in Black communities, and hospitals and medical centers giving lower priority to the well-being of Black people”. 

It is no secret that mostly black women don’t have health insurance or access to preventive care services. When giving birth or receiving prenatal care the service they receive are poor. An analysis of data collected from records of women undergoing cesarean section at N.C. Women’s Hospital between 2014 and 2016 shows that, even though black and Hispanic women reported higher pain scores than white and Asian women, they received fewer pain assessments and lower doses of all pain medication. This study also reported Black maternal health in the United States underscores serious gaps in care. Black women are three to four times more likely to die from complications surrounding pregnancy and childbirth than white women. 

As a young child, I grew up visiting what one would call "storefront health clinics." There was no relationship building with health providers or opportunities to ask questions. I also recall the following experiences from close family and friends growing up:   

1. Dental care is more reactionary rather than preventive. For patients with little to no dental care or teeth missing, associates recalled dentists behaving disrespectfully. Prior to treating them, they would ascertain some patients had little to no dental care. Patients stated, there was no discussion of preventive measures, just immediately pulling the patient’s teeth and moving on. With this type of treatment, the patient is less likely to return. They were embarrassed and angry but felt they had little to no recourse.  

2. Several colleagues reported while visiting their primary doctor, a whole team of interns and consulting physicians accompany the doctor on his rounds, yet everyone fails to introduce interns or consulting physicians who are viewing and commenting on their health information.  

3. HIPPA violations such as breaches in personal information.  

4. Lack of choices among healthcare providers. 

5. Providers who did not speak their language or explain certain terminology utilized.  

6. Challenges with prenatal care have led to higher rates of stillbirths and miscarriages among women of color.  

7. For children with special needs, a lack of diversity in service providers with experience to effectively refer or support parents.  

The COVID-19 pandemic underscored the ongoing health disparities many African Americans face in the U.S. The likelihood of Black women dying in childbirth and asthma rates are at the highest levels for Black and brown people in the Bronx. Social, economic, and environmental factors have been closely linked to health disparities. Research suggests that many disparities in overall health and well-being are rooted in early childhood. In early care and education, it is important to address health inequities by:  

• Effective patient education, resources, handbooks, and follow-up care.  

• Healthcare providers who can identify with their patients’ lived experiences, such as their language. 

• Giving patience agency through access, empowerment by way of resources, and appropriate information. 

• Providing increased opportunities for physical fitness initiatives. 

• Healthier food options for children and families served by your program.  

• Providing parents with information about access to early intervention services. 

• Exposure to free prenatal care and services. 

• Support for the unhoused. 

References 

Braveman P, Acker J, Arkin E, Bussel J, Wehr K, and Proctor D. Early Childhood Is Critical to Health Equity. Princeton, NJ: Robert Wood Johnson Foundation, 2018 

DeHaven, M. J., Gimpel, N. A., Gutierrez, D., Kitzman‐Carmichael, H., & Revens, K. (2020). Designing health care: A community health science solution for reducing health disparities by integrating social determinants and the effects of place. Journal of Evaluation in Clinical Practice, 26(5), 1564-1572. 

Hahn, R. A., & Barnett, W. S. (2023). Early Childhood Education: Health, Equity, and Economics. Annual Review of Public Health, 44. 

Study finds treatment inequities for pain following cesarean deliveries. (2019, November 7). UNC Department of Obstetrics & Gynecology. https://www.med.unc.edu/obgyn/study-finds-treatment-inequities-for-pain-following-cesarean-deliveries/