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Racial disparities in Indiana health care: what’s being done?

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Diabetes. Hypertension. Infant and maternal mortality. COVID-19. 

All of these issues are more likely to affect — and kill — Black Hoosiers at a disproportionate rate. According to the Centers for Disease Control and Prevention (CDC), 14.2% of diabetes cases in Indiana are found in African Americans, compared to 12.7% for whites. The American Heart Association found African Americans nationwide are twice as likely to develop hypertension — which can cause heart attacks and strokes — than whites, and Black women and babies are significantly more likely to die during birth than white women and babies. 

During a press conference earlier this month, Gov. Eric Holcomb touted Indiana’s infant and maternal mortality rate — which is at its lowest since 2012 — as a sign that racial disparities in health care are improving, although he noted there’s still a long way to go. 

Despite the lowering numbers, the racial disparity still exists. Dr. Lindsay Weaver, chief medical officer for the Indiana State Department of Health, said Black infants are more than twice as likely than white babies to die within their first year of life. And while Black infant mortality is down from 15.3 infants out of every 100,000 in 2017, 13 African American babies per 100,000 live births will die or be stillborn, as opposed to 6 out of every 100,000 live births for white babies. 

“Clearly, we have a lot of work to do,” Weaver said.

Weaver said the health department, led by State Health Commissioner Dr. Kristina Box, has launched the OB Navigator program, which helps pregnant women find obstetricians and gynecologists near them. The department has also partnered with organizations to help make care and information readily available, particularly in Black and brown communities. 

State Rep. Vanessa Summers, D-Indianapolis, however, said it’s not enough, especially not for Black women. Summers plans to introduce legislation on infant and maternal mortality when the General Assembly returns to the Statehouse in 2021.

“In Indiana, 53 Black women die out of every 100,000 through childbirth,” Summers said. “ … When he [Holcomb] talks about OB Navigator, he isn’t digging down and helping the African American community. He isn’t addressing implicit bias, or doctors who don’t believe what their patients are telling them.”

While many say the ongoing COVID-19 pandemic is shining a light on racial disparities in health care throughout the country, Summers said it isn’t a new phenomenon. The evidence is simply reaching a new audience. 

“It’s nothing that we didn’t already know,” Summers said. “What has happened is … white folks see it now. That’s the difference. We’ve been knowing, and we’ve been fighting.”

Roughly 10.8% of the 88,421 COVID-19 cases statewide are found in African Americans, despite African Americans making up only 9.8% of Indiana’s population. In Marion County, Black residents make up 23% of the 35,380 positive cases and 32.3% of COVID-19-related deaths. 

Weaver said the state health department plans on tackling racial disparities in COVID-19 similarly to how it handled disparities in infant and maternal mortality: through information campaigns and increasing accessibility. 

“We want to make sure there is good access to testing,” Weaver said. “Before COVID, we recognized there were disparities, so we weren’t surprised to see disparities because of COVID. We’re making sure … we’re providing resources and working with local coalitions, whatever we can do to help us make sure we’re sending the right message and addressing concerns in the community.”

While the state doesn’t track socioeconomic status as it relates to COVID-19 positivity and morbidity, Weaver said she “wouldn’t be surprised” if — like other medical conditions — there was a correlation between testing positive for COVID-19 and having a lower income.

“If you’re worried about paying the bills so you can keep your lights on … getting those good, healthy foods becomes more difficult,” Weaver said. “Having regular doctor appointments, prenatal visits … those types of things truly affect people when it comes to socioeconomic issues.”

That’s where the newly created Chief of Equity and Inclusion Officer, announced by Holcomb in a press conference earlier in August, will hopefully come in. The position, which Holcomb wants filled as soon as possible, would entail working to ensure equity in state businesses and to increase accessibility to workforce development. 

Tracy Barnes, chief information officer for the state, said increasing diversity and equity across the board would likely impact other areas of life through policy changes. 

“When you talk about diversity in the workplace, it helps any conversation by bringing a different perspective to the conversation that may or may not be presented if folks from diverse backgrounds are not at that table,” Barnes said. “ … That helps the boardroom, small office meetings when conversations are happening with folks that can speak to the true impact of those decisions and those policies that are being set.”

Contact staff writer Breanna Cooper at 317-762-7848. Follow her on Twitter @BreannaNCooper.

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