Health Equity and the Supreme Court Decision on Contraception
The Supreme Court decision giving some corporations the right to deny coverage of certain types of contraception to their employees based on their religious freedom will have a great impact on women of color. Although, the ruling does not single out women of color, our political and economic realities tell us that women of color often bear the brunt of the negative impacts of restrictions on women’s health.
Differences in rates of disease and health status among women of color and other vulnerable populations can be defined by many factors including poverty, education, employment with living wages and good benefits, neighborhood economic conditions, presence or lack of social support networks, cultural values, affordable housing, the degree of toxins and pollution in the air and affordable, quality, accessible health services. When these differences are combined with conditions that are unfair, unjust and avoidable, health equity – the achievement of good health regardless of one’s social position or other social factors – is threatened. The Supreme Court’s decision impacts the health equity of women of color in thee ways:
1. The Cost of Birth Control: In 2011 approximately 57 million adult women were covered through employer-sponsored insurance. If the policies of other companies like Hobby Lobby become the norm rather than the exception, it could impact contraceptive access for millions of people in the U. S. and have a disproportionate impact on women of color who, with lower income and wealth on average, may not be able to afford to pay for their contraception out-of-pocket.
Women of color are more likely to be low-income, and also more likely to work a minimum wage job. Getting an IUD could cost as much as an entire month’s rent working at the minimum wage. Purchasing birth control pills without insurance or benefit of plans that include prescription drugs could range $20 and $130.00 a month depending on the brand. Women of color, who are already struggling to make ends meet, may face increased burdens. That could mean doing things like splitting one pack of pills between two women each month or not using birth control at all. There are now more than 1 million Asian-American women living in poverty, an increase from 700,000 in 1999. This decision is yet another barrier for Asian-American and Pacific Islander women who already face significant health disparities and barriers to insurance.
2. Risks of Unplanned Pregnancy: The risks of carrying an unintended pregnancy to term are much higher for women of color. Black women are four times more likely to die during childbirth than white women. Being unable to prevent a pregnancy due to the financial barriers put in place by this decision puts lives at risk. Women of color are also at higher risk for infant mortality, low-infant birth weight and premature delivery – all things that pose significant long-term risks to the mother and child.
3. History: Women of color have dealt with a long history of reproductive control at the hands of employers and the government. From treatment in public hospitals, to welfare reform, to family caps limiting the number of children welfare recipients can have. Women of color have long had to fight for the right to control their own reproduction. This case just adds another layer to controlling fertility, this time at the hands of employers.
For more than thirty five years the General Synod of the United Church of Christ has advocated for health care as a right and a priority for all people. We are rooted in the conviction that all forms of injustice can be overcome. Health inequities are the consequences of public policies, and as such can be changed. Tackling health inequities requires widening our understanding of health and health care to include the ways in which lifestyle factors influence individual and community health. The Affordable Care Act made great gains by requiring insurance companies cover birth control with no out of pocket cost to women. Many women of color rely on a safety net for basic health care and needs. Let us remain vigilant in our advocacy making sure this net continues to remain safe for everyone and especially for women.