At no other time has the health of all American’s been so threatened in our country due to COVID-19. However, it’s undeniable that the worst impact of the pandemic has been on communities of color, marginalized communities that urgently need focused attention on health equity.
It’s abundantly clear that health inequities have been exacerbated by the disparate access to essential services in communities of color. At Children’s Health Fund, mitigating the negative impact of these inequities is core to our work through the programs we foster and our advocacy. The COVID-19 pandemic has accelerated this work.
Since the pandemic began, we’ve elevated the voices of patients and students, and the providers and educators who support them on the ground and who are responding to the growing and changing needs in their communities, knowing full well that people in these underserved communities would face greater challenges than others.
As our nation moves to elect the next president of the United States, we intend to amplify our advocacy to move the needle on equity by concentrating on five key areas: increased access to telehealth; improved broadband access; mitigating service gaps for children of immigrants; support for Community Health Centers; and prioritizing children’s programs in federal spending.
Increase Access to Telehealth
Not only did telehealth meet many of the immediate needs of patients during the pandemic, but in some cases it proved to be a superior service model. In response to stay at home orders, Medicaid broadened coverage of telemedicine. Before this expansion, telehealth was limited to patients in rural areas who needed to travel to designated medical clinics to connect with specialty doctors. Telehealth addresses the medical and mental health needs of children and families in marginalized communities, whether rural or urban. The expansion should be maintained.
Improve Broadband Access
Access to the internet is such an important communication tool that the United Nations declared it a human right; however, 19 million Americans in rural and urban communities still lack fixed broadband service at threshold speeds. Even in areas where broadband is available, approximately 100 million Americans cannot afford to subscribe. Broadband is needed not only for telehealth and online education during the pandemic, but also for homework at any time and health visits when needed. The digital divide disproportionally affects communities of color: 35% of Native American students, 30% of Black students, and 26% of Hispanics students have inadequate internet access at home compared to only 18% of white students.
Extend Relief to Immigrants
An estimated 6 million immigrants work in frontline occupations such as healthcare, food production, and transportation, placing them at risk for COVID-19 infection. An equal number work in economically hard hit industries such as food and domestic household services. Noncitizens have greater difficulty accessing and paying for medical care. Immigrants often do not receive health insurance from their jobs and generally do not qualify for public coverage. Not only were unauthorized immigrants excluded from the $2 trillion CARES Act, but their U.S. citizen and legal permanent resident relatives were also excluded. An estimated 3.7 million children who were either U.S. citizens or green-card holders did not receive cash benefits.
Expand Funding to Community Health Centers
Community Health Centers (CHCs), by serving over 30 million patients a year, are a key component of the public health infrastructure. The fact that 9 million of those patients are children makes CHCs a crucial part of the Child Health Safety Net. Not only do CHCs save the healthcare system nearly $24 billion annually, they perform just as well as other healthcare providers on quality measures. CHCs see all patients without regard to insurance status or the ability to pay. And they are located in medically underserved communities in all fifty states and five U.S. territories.
Prevent Cuts to Federal Spending on Children
The effects of widespread layoffs and furloughs due to the COVID-19 pandemic are already apparent. The World Bank projects that this year the global economy will shrink by 5.2%, representing the biggest recession since World War II. The duration and progression of this recession is unclear, but child poverty is expected to increase dramatically.
Far more children than adults live below the Federal Poverty Line, yet children’s portion of the federal budget was only 9% in 2019. As a share in the economy, investment in children only accounted for 1.9% of the gross domestic product (GDP). Under the Trump Administration’s proposed budget, spending on children’s discretionary programs would be reduced by 22%. The proposal includes cuts to education, immunizations, nutrition programs, and housing assistance.
Read our full 2020 COVID-19 Policy Report here.