Q55: Do you have a plan to address critical health disparities impacting Black women—including high infant & maternal mortality, HIV/AIDS, diabetes, breast
Biden: Yes. Compared to other developed nations, the U.S. has the highest rate of deaths related to pregnancy and childbirth, and we are the only country experiencing an increase in this death rate. This problem is especially prevalent among black women, who experience a death rate from complications related to pregnancy that is more than three times higher than the rate for non-Hispanic white women. California came up with a strategy that halved the state’s maternal death rate. As president, I will take this strategy nationwide.
I will also build on the Obama-Biden administration’s work to address health disparities related to HIV/AIDS, and pledge to tackle our greatest public health challenges, like curing diabetes and cancer.
My climate plan also addresses how our climate policies must address racial disparities and environmental racism. Vulnerable communities are disproportionately impacted by the climate emergency and pollution. My administration will take action against fossil fuel companies and other polluters who put profit over people and knowingly harm our environment and poison our communities’ air, land, and water, or conceal information regarding potential environmental and health risks.
View details of my plan to address critical health disparities, including reducing our unacceptably high maternal mortality rate, which especially impacts people of color, HERE.
Bloomberg: Yes. Mike has a detailed Maternal Health plan centered on fighting disparities impacting women of color, by addressing racial bias among health care providers by requiring implicit bias training, increasing the number of people of color in the healthcare workforce by boosting funding for medical schools at historically black colleges and universities (HBCUs) in states that haven’t expanded Medicaid, provide a free of charge public-option insurance program for low-income Americans that will expand coverage during pregnancy and postpartum to hundreds of thousands of women.
Buttigeig: Yes. In the United States, Black women die from maternal complications at triple the rate of white women, are over 40 percent more likely to die from breast cancer than white women, and account for over 60 percent of new HIV cases, despite making up 13 percent of the population. These poor health outcomes are profoundly shaped by institutionalized racism and gender discrimination, not just at the doctor’s office or in the emergency room, but in all political, economic, and social structures in our country. As President, achieving health equity will be a national priority, as I share in my health equity plan (https://peteforamerica.com/policies/health-equity/). In addition, my Women’s Agenda for the 21st Century (https://peteforamerica.com/policies/building-power/) shares my approach to end the maternal mortality crisis and my plan for LGBTQ+ Americans (https://peteforamerica.com/policies/lgbtq/) commits to ending the HIV/AIDS epidemic by 2030, which disproportionately affects gay and bisexual Black and Latino men, and transgender women. The commitment to ending health disparities must come from the highest level, and I pledge to hold all federal health programs and policies explicitly accountable for their impact on these disparities. I also know it will have the greatest impact when led by those closest to the ground. Accordingly, I will mobilize and invest in communities to address the disparities most pressing to them. As equity solutions must be grounded in sound data, I will increase investment in public health data collection to systematically measure and highlight health disparities everywhere they exist, and encourage payment reforms that reduce race-based disparities in our hospitals and clinics. My administration will also fund and develop new initiatives to combat implicit bias among our public health workforce, and expand the training and professional development of Black and other minority clinicians and researchers.
De La Fuente: Yes. By modifying the Affordable Care Act we will provide extra funding to address such disparities.
Klobuchar: Yes. As President, Senator Klobuchar will address persistent racial disparities in health care and health outcomes. She will invest in research into health disparities and how these disparities can be reduced, including when it comes to chronic illness, heart disease, mental health, and maternal care. Senator Klobuchar will also immediately implement a new law that tackles the shortage of maternity care health professionals — including nurses, midwives, and obstetricians — in underserved areas, and she will develop best models of care and promote training to address racial disparities in maternal and infant mortality. Senator Klobuchar has also committed to preventing, treating and facilitating a cure for Alzheimer’s disease, with the goal of putting us on a path toward developing a cure and treatment by 2025. To support researchers, she will make sure that funding is reliable and consistent. Since African Americans and the Latino community will represent nearly 40 percent of the 8.4 million American families affected by Alzheimer’s disease by 2030, Senator Klobuchar will increase federal research into disparities in the incidents and outcomes of Alzheimer’s and other forms of dementia. Senator Klobuchar is also deeply committed to improving access and affordability of health care to help address racial health disparities. That means reducing costs of health care and prescription drugs, expanding access, outreach and enrollment, increasing and expanding premium subsidies, providing immediate relief for co-pays and deductibles, and providing significant additional incentives to push states to adopt the Medicaid expansion. Senator Klobuchar also believes that mental health is as important as physical health, and as one of her first major policy proposals as candidate for President she released a plan to prioritize mental health and address racial disparities in mental health care. That means launching new prevention and early intervention initiatives, expanding access to treatment and building a health care system that integrates mental and physical health care by enforcing federal laws like the Affordable Care Act and the Wellstone-Domenici Mental Health Parity Act that she helped pass to ensure health insurance companies cover all mental illnesses and substance use disorders in the same way they do physical illnesses. Research also suggests that there are significant racial and ethnic disparities in the quality of long-term care as well as disparities in coverage for long-term care. Senator Klobuchar is committed to tackling disparities in care through expanding access to long-term care with a focus on reducing inequities as well as addressing the costs of long-term care services for people in the greatest need of assistance.
Sanders: Yes. Bernie’s Medicare for All program will guarantee comprehensive health care to everyone in this country, including the nearly 4 million uninsured Black Americans. Medicare for All will eliminate all copays, premiums, deductibles, networks, and surprise bills and cap annual out of pocket charges for prescription drugs at $200 per year. Bernie’s administration will address racial disparities affecting African Americans within the U.S. health care system.
Bernie will address the need for drastically increasing funding to the National Health Service Cops and Teaching Health Centers to train and hire more Black doctors, Black dentists, Black nurses, and Black psychologists that are greatly needed. Bernie knows that a key way to address epidemics disproportionately impacting Black Americans is by ensuring Black Americans have health care providers that look like them and relate to their cultural and life experiences firsthand.
One major issue affecting African Americans is the maternal mortality crisis. Black women are three and a half times more likely to die from pregnancy than white women and almost twice as likely to be uninsured. In 2017, 14 percent of African American women were uninsured. Making sure every pregnant Black woman has insurance is a foundational step to tackling this crisis. Under Bernie’s plan, we will work to guarantee every pregnant Black woman access to treatment by culturally competent health care professionals as the baseline standard. Additionally, Bernie will establish the Office of Primary Health Care to increase access to high-quality primary health care in Black communities. No later than one year after this office is created, it will set national goals to eradicate disparities that oppress Black Americans through targeted approaches. His Medicare for All plan includes explicit language that bans providers from discriminating against patients, including discrimination based on race, color, gender, and pregnancy, and allows courts to award damages to patients if this is violated.
Bernie believes we can and must end the epidemic of HIV and AIDS in the United States and abroad. The government, using taxpayer funding, developed and patented the research that led to the use of the drug Truvada for PrEP in preventing HIV transmission. That drug is now being sold by the pharmaceutical giant Gilead for as much as $2,000 a month and generated $3 billion in sales for Gilead last year. This is unacceptable. Tens of thousands of individuals with HIV and AIDS are still uninsured or cannot afford their treatment. Sanders wrote legislation that would give the federal government power to authorize generic versions of medicines if drug companies refuse to stop charging Americans higher prices than they do in other industrialized countries.
He will create a multi-billion dollar Prize Fund to reward medical researchers and developers of medicines who create lifesaving drugs for HIV and AIDS treatment and prevention based primarily upon the added therapeutic value a new treatment offers and the number of people it benefits — instead of a system where the market is manipulated to keep out all competition. Under Bernie’s plan, drugs could have generic competition immediately after FDA approval.
Bernie will also fight to expand the Housing Opportunities for Persons with HIV/AIDS (HOPWA) program that currently provides funding for housing assistance and related services for tens of thousands of low-income people living with HIV and their families and the Ryan White HIV/AIDS program which provides HIV-related services for those who do not have sufficient health care coverage or financial resources. He will expand efforts overseas for treatment and preventing transmission. Together we will work towards a generation free of HIV and AIDS.
Steyer: Yes. Black mothers die of complications from childbirth at a rate that is over three times that of their white counterparts. And 6.7 million Black live in counties with oil refineries, exposing them to environmental hazards and dangerous air pollution, resulting in increased rates of asthma and other environmental health conditions in black children. And many of these counties do not have access to nearby healthcare facilities, which only exacerbates the damage and the danger. In the richest country in the world, it is unconscionable that we neglect to care for such a large percentage of the population. My administration will address long-standing racial inequities in the health care system by increasing access, investing in more hospitals in disadvantaged communities, and holding healthcare corporations accountable for equal treatment for all Americans. My plan will ensure the vitality of community health care systems, including those in rural and low-income areas, by targeting additional resources to rural hospitals, encouraging community health centers, and investing in telemedicine. It will ensure that every child in America has access to dental and eye care, as well as fight the opioid and mental health crises with billions of additional dollars for new and innovative programs. Together, we can create a better health care system that delivers better outcomes for patients in terms of physical health, mental health, and social belonging as core metrics of an improved health care delivery system.
Warren: Yes. Inequality isn’t just an economic issue — it’s a health care issue. That’s why I will also fight to address the Black maternal mortality crisis facing our country. The data shows that Black women are three to four times more likely than white women to die from pregnancy or childbirth-related causes.These are structural problems that require structural solutions, and as they have so often in the past, Black women and activists are leading the way. I support these efforts and have also introduced another idea: holding health systems accountable for protecting Black moms. Paying for better care means both rewarding excellent health systems and identifying, investing in, and demanding more from struggling ones. By rewarding health systems that keep mothers healthier, pressing for broader adoption of best practices that we already know help Black and Brown moms, narrowing racial inequities, and holding both hospitals and care teams accountable for preventable failures, we can save women’s lives and demand change. The women of color who have championed the reproductive justice movement teach us that we must go beyond choice – to ensure comprehensive reproductive services, including STI prevention and care, birth control, comprehensive sex education, care for pregnant moms, safe home and work environments, adequate wages, and so much more. We must build a future that protects the right of everyone to have children, the right of everyone to not have children, and the right to bring children up in a safe and healthy environment. My reproductive justice plan calls for repealing the Hyde Amendment, ending the Trump administration’s gag rules, and fully supporting Title X family planning funding, which many Black Americans depend on for essential reproductive health services. Finally, we can’t improve people’s health without a strong curative health care system. But we also know health care problems require more than health care solutions. They often require solutions in other parts of patients’ lives — ones that cannot be prescribed. I have released a wide range of plans that aim to reduce the many different sources of inequality that can contribute to poor health, including plans to: – protect everyone’s right to choose when and how they start a family; – increase access to safe and affordable housing and correct environmental injustice, making sure that no person suffers adverse health outcomes because of where they live; – ensure that every kid in America gets breakfast and lunch at school, so they receive the nutrition they need to stay healthy; – reform our criminal justice system and decriminalize mental health crises and invest in diversion programs for substance use disorders — making sure people get the care they need instead of needless incarceration; – expand Social Security, making sure that our seniors have the social support they need and can afford basics like healthy food, transportation to appointments, and more. You can read more about my plan to address the maternal mortality epidemic here: https://elizabethwarren.com/plans/addressing-maternal-mortality-epidemic/