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by Kia Shaun Walton
The road to health equity is long and imperfect. That’s why on Friday, Dec. 8, in Oakland, Calif., it was the topic of rich discussion. Five leading health care professionals engaged in a 90-minute community forum about “health equity and the need for coverage and care in the African American community.” With 1.3 million Californians currently living without health insurance, a population disproportionately African American/Black, Latinx, and/or recently emigrated to California, healthcare remains, top of mind and top of heart, an issue of equity.
Hosted by the Health and Human Resources Educational Center (HHREC), moderated by Program Director Shanina Shumate, M.S., the panel addressed initiatives in support of the African American community, what health providers can do to earn back trust, and how the community can use their voice to take charge.
Factors that contribute to community divestment from the public healthcare system are wide ranging. From a “generalized mistrust” to “disenchantment” with the public healthcare system at large, the barriers to access are many. Chief among them, the cost of healthcare.
“We have people who go through the process to get coverage and in a year, they don’t see a single doctor. Certainly we know cost is a big reason that that happens, or fear of cost,” says Jessica Altman, executive director of Covered California, a free statewide service that has helped 1.7 million Californians access more affordable healthcare.
“We’re actually launching a new program this year; it goes live on Jan. 1. It is lowering cost at the point of care, your co-pay, your deductible etc. for over 650,000 people. We’re actually wiping out deductibles entirely for all of those people.” Altman concludes, “We are really trying to use our power to deliver on that promise [of equitable care] in all of the ways that we can.”
One of those ways is Covered California’s selection of healthcare plans that are “worthy” of enrollment. Dr. Monica Soni, a physician and Covered California’s first Black chief medical officer, stated, “What we have in our contract are real teeth for what we expect [from health care companies] from a quality and access perspective.” In one example, Dr. Soni explained recent data shows that 76% of all people who engaged with behavioral health services, often called “mental health,” did so online. Accordingly, Covered California will now only allow contracts with companies that provide a “telehealth option and sufficient digital access.”
Dr. Soni lights up when speaking about the robust database that represents 80 percent of all Covered California members, data that can help to not only keep a pulse on health disparities, but move the needle towards greater equity in healthcare.
Negative experiences with hospitals and institutions can, for some, be another factor of divestment. The quality of some county health facilities, as compared to those that are privately owned, can leave patients in want. While many Californians who access health coverage through the state or county are under the impression that they do not have another option, Dr. Kim Rhoads, a self-identified “troublemaker” and founder and director of Umoja Health, says otherwise: “Some people think that the type of insurance you have equals the hospital you can go to and that’s not true. Even if you have Medi-Cal, there are hospitals that are high quality you could be accessing.”
Umoja Health, a coalition founded in 2020 “to amplify voices of community and to hold public health and healthcare institutions accountable for advancing health equity,” can help with that. In San Francisco, San Mateo and Alameda counties, Umoja Health, “actively supports community-based vaccination, testing and information platforms,” in addition to “screening for cardiovascular risk, diabetes and colon cancer” in San Francisco and Alameda counties.
Still others have been dissuaded by experiences where they have felt disrespected, not valued or not listened to by their practitioners or public health officials. Distracted doctors and nurses can leave patients feeling like “you ain’t even listening to me.” Dr. Patton, director of the 3rd Street Youth Center and Clinic, notes, “The small things that we do don’t necessarily breed trust – that I am really listening to your needs. That I am going to be present with you.” Feeling like a number or a nuisance does not motivate community members to engage with the healthcare system as a patient or an advocate.
Zhonnet “Z” Harper, Patient Care Navigator for Breast Cancer at Alameda Health System and Public Health Commissioner for Alameda County and member of Umoja Health coalition, however, attests to the integrity of Umoja’s community centered approach. “Everyone sits at the same table. When we walk into Umoja, OK, we don’t walk in seeking empowerment, because we are recognized as being in power.” Z continued, “When you recognize the potential of a person, you are responding to intellect, you’re responding to dreams. That’s holistic health.”
Similarly, Dr. Patton encourages her clients at the 3rd Street Youth Center and Clinic to “sit at the table.” In San Francisco’s Bayview Hunters Point, the largest population of African Americans in San Francisco, she states, “as a director, the youth lead my decisions. The patients lead me into what we’re doing.” Residents as young as 12 years old are invited, if not needed, to drive equity-based decision making about their health and services that will be most relevant to them. Dr. Patton, a Bayview native, has a vested interest in listening to the voices of her community.
Dr. Rhoads speaks to the powerful collaboration between healthcare professionals and community members, explaining, “I can’t do this by myself because I need the stories. And I think the people that are telling the stories need the advocates who speak those different dialects of public health policy to translate.” Umoja Health hosts Zoom meetings every other week, and residents are encouraged to add to the “community-owned agenda.”
Panelists also underscored the importance of community raising their concerns with the Board of Supervisors and joining commissions. The commissions and boards are critical spaces within which the community can make change and advise on policy. Z, acknowledging the effort change requires, said, “I know we’re all tired. But if I’m tired, I want to be tired and healthy. Don’t be afraid and intimidated. Go in there and be who you are, because truth don’t tremble.”
Dr. Rhoads asserts, “Population level problems require system level solutions.” Californians may be happy to know the panelists, experts in their field and leaders in their community, collectively represent 40 percent of Californians, a staggering 18.2 million people, who are eligible to receive health care services. Insisting on community voice and using data to “fill in the gaps,” these health care professionals are not doing “business as usual,” but healthcare as it could be.
For more information, please visit or call:
- Covered California: coveredca.com, 800-762-9921
- Umoja Health: umojahealth.org, 888-763-0007
- 3rd Street Youth Center and Clinic: 3rdstreetyouth.org, 415-822-1707
Kia Shaun Walton is a freelance journalist and educator working in the Bay Area. Kia is committed to justice, integrity and community. Please direct any inquiries to kia.walton@gmail.com.
