September 16, 2009

Access to Health: It’s Not Just a Third-World Issue

[We're happy to welcome Amy Johnson, a new fellow working with Bread for the City on food access and security issues. —ed]

When it comes to poverty, the real problem isn’t a matter of lack of resources, but a lack of access to resources. The technology, supplies, food, knowledge, etc are all available for people to live healthy and secure lives - but vast swaths of our fellow men and women can’t access these resources.

This is especially true in the Third World, and disproportionately afflicted upon women and children. In the September 15 briefing by Women’s Policy, Christopher Elias of the Program for Appropriate Technology and Health (PATH) and Richard Green of US Agency for International Development (USAID) explored health technology options for improving maternal, newborn, and child health.

The results of limited access to obstetric health technologies are tragic. Every minute of every day, one woman dies in child birth. In Pakistan, one in five children dies in childbirth. 30 to 40 percent of children under the age of 5 die of malnutrition. Many of these deaths could be prevented with trained medical personnel, emergency birthing kits, clean water, and vaccines. Everything that we take for granted here in the U.S.

But do all Americans even have access to these resources?

Our nation ranks 41st in the world in maternal mortality rate rankings. That’s not great. What’s more, the rate is rising. In 2005, the rate was 15.1 deaths per 100,000 births, 84% higher than in 1990.

Now, Washington DC’s maternal mortality rate is way below the national average - 5.3 per 100,000 from 1998 to 2002 [PDF]. This is indicative of DC’s progressive health care plan system – 90%of our residents have health insurance, largely thanks to the DC Health Care Alliance. However, there are not enough health care providers to actually provide care to those who have this insurance plan. Additionally, Washington, D.C. has one of the highest rates of infant mortality. The national number of infant deaths in the United States is 6.8 [PDF], but in Washington, D.C., it’s 12.2. Additionally, there is a higher infant mortality rate among African American women than women who are White or of other races. Wards 2, 5, 7, and 8 have higher infant mortality rates [PDF] than the rest of the city, demonstrating that this lack of access to and utilization of medical resources spans both racial and geographic boundaries.

These statistics demonstrate the results of a citywide lack of access that leaves low-income women—especially African-American women, who constitute the majority of Bread for the City’s clientele—on long waits and at a greater risk of maternal or infant death during pregnancy. So despite our exemplary health care network, there was an overall 10 % increase in the proportion of deliveries involving medical risk factors between 1998 and 2002. We cannot accept these figures.

This September is Infant Mortality Awareness Month, and a reminder that there is more to be done—within our own city and in our global society—to ensure that everyone has access to life’s necessities. At Bread For the City, we hope to reverse these numbers and help the women and children affected by inequalities in our health care network. Our medical clinic primary care practice, our food pantry's Nutrition Initiative, and our Fit for Fun classes are examples of our efforts to provide women and their children with the support they need.

Thanks to Julie-Irene Nkodo, who also contributed reporting to this post. —ed

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