We Must End Racism in Healthcare. Expanding Medicaid Is A Good Start.

Closing the Medicaid gap is one of the quickest ways to make the U.S. health system more equitable, particularly for Black and brown women.

Keandra Griffin, 11, of Belhaven N.C., attends a rally on July 28, 2014, in D.C. at the end of a 273-mile walk by advocates to call attention to the closing of rural hospitals and the need for Medicaid expansion. (Tom Williams / CQ Roll Call)

Every March, we celebrate Women’s History, amplifying women who have left their mark on history. But once March ends, many of the struggles that women, particularly women of color, face are ignored or forgotten.

Nowhere is this truer than in my home state of Mississippi, where many women still face challenges, particularly access to quality healthcare, which has only been exacerbated by the recent tornadoes that have claimed dozens of lives. Yes, the struggle is personal and very real. However, the people of the Mississippi Delta and other impacted areas have proven resilient and hopeful, notwithstanding the economic, educational and health challenges keeping them locked in cycles of poverty.  

Too often, the stories we tell in celebration of women leave out the complete history with all of its challenges and sacrifices—particularly for Black women. In retelling the rich history of some of our greatest champions for justice and equality, we overlook their personal struggles. Unfortunately, too many, particularly Black female icons, past and present, were burdened with health issues made worse by racism in healthcare. 

Famed civil rights activist Fannie Lou Hamer died of untreated breast cancer, just before her 60th birthday. Her untimely and preventable death was not her first run-in with America’s racist and oppressive healthcare system. In her mid-40s, Hamer was sterilized without her consent while undergoing surgery to remove a tumor—a common practice during that time often referred to as a “Mississippi appendectomy.”  

Aside from the gross instance of medical malpractice that Hamer suffered, the odds were stacked high against her recovery. Breast cancer is significantly more fatal for Black women than white women across the U.S., even though Black women have lower breast cancer incidence rates. This is not because Black women suffer from more aggressive cancers, experts say. They attribute this disparity to health systems’ poor treatment of Black women.

Gender equality advocate Pauli Murray died of pancreatic cancer at age 74, which has a higher incidence rate in Black people than in any other racial group in the United States. This is partly caused by higher percentages of Black people getting diagnosed with advanced and, therefore, inoperable cancer, research from the John Hopkins Department of Pathology suggests.

These disparities continue to this day, with the recent death of Fannie Lou Hamer’s daughter, Jacqueline Hamer Flakes, after a years-long battle with breast cancer. Black women and children are particularly affected, something I know well from personal experience.

As a breast cancer survivor, I have felt the stinging of a healthcare system that minimized my individuality when my doctor brushed aside my concerns after finding a lump and carelessly said that I didn’t fit the profile: too young, no maternal history of cancer—thus, it couldn’t be cancerous. Three years, chemo and radiation later—yes, it was indeed breast cancer. 

My story and those whom I’ve met as president and CEO of the Mississippi Center for Justice represent an ongoing healthcare crisis impacting Black women across Mississippi and our country. Today, Mississippi has the second-lowest overall healthcare rating for its Black population. And a recent report showed Black women in Mississippi have a pregnancy-related mortality rate four times higher than white women.

If things don’t change in the state of Black health in Mississippi, Black health in America will further decline. Critical funds are being cut, and according to experts, more than half of Mississippi’s rural hospitals could close soon, further exacerbating a system already in the throes of chaos.   

But it doesn’t have to be this way. Mississippi’s governor just signed into law an extension of postpartum Medicaid coverage—from 60 days to 12 months. Reports indicate the extension alone will enable up to 14,000 Mississippi women to gain additional health coverage after pregnancy for those necessary doctor visits before and after birth.   

Despite this recent victory for women and children in Mississippi, specifically Black women and Black babies, I warn that the mountain of health inequities that Black women in Mississippi still face can occur in any state. Simply put, Black women across America face many health crises buoyed by systemic failures ever-present since our country began. 

Linda Thigpen, second from left, talks with Gregory DeLaine, about signing a petition to put Medicaid expansion on the ballots during a Soul to the Polls event in Hallandale Beach, Fla., on Oct. 30, 2022. (Scott McIntyre / The Washington Post via Getty Images)

The fact that health disparities persist and widen is an indictment on our system and those whose health and well-being it prioritizes—but more is possible.  

Just this month, North Carolina, one of the few remaining holdouts, passed legislation expanding Medicaid in the state. Nevertheless, 10 states, including Mississippi, still have not expanded Medicaid coverage, despite the fact that 1.9 million uninsured people, primarily people of color, would gain health coverage this year if they chose to expand Medicaid, according to the Kaiser Family Foundation. Closing the Medicaid gap is arguably one of the quickest ways to make our nation’s health system more equitable. 

Health equity for all is achievable and begins now by doing right by Black women, and that starts with ending racism in healthcare.

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Vangela M. Wade is president and CEO of the Mississippi Center for Justice, a nonprofit, public interest law firm committed to advancing racial and economic justice.