Equity Data Series: Health Insurance

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Keeping up with one’s health depends on the ability to afford basic health insurance and being covered in the event of major health complicationsHaving insurance to cover health expenses is tremendously helpful in avoiding serious financial trouble. 

We used data on insurance coverage to identify inequities in our service area. Here’s what we found:

White individuals make up 59% of the population but only 44% of total uninsured. 

Hispanic individuals make up 11% of the population but 25% of total uninsured. 
Black individuals make up 19% of the population but 22% of total uninsured.
 

People under age 65 living below 200% of poverty make up one fourth of the population, but account for nearly one half of all people uninsured. 

Research has proven that people without health insurance receive less medical care and have worse health outcomes than people with health insurance. An unexpected health problem is also more likely to become a major financial burden for people without insurance as well as people who are under-insured. Surveys of bankruptcy filers have found that health expenses are the most common contributing factor in financial problems, making this an issue that affects people along each of the Steps to Success

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When the economy began to suffer due to the COVID-19 pandemic, many people were left without stable employment and, as a result, without health insurance. While unemployment drastically increased for Black, Latinx and white workers in the pandemic labor market, the unemployment rate became significantly higher for Black and Latinx workers. In the first quarter of 2020, Black workers had the highest unemployment rate nationally, at 6.3%, followed by Hispanic workers (at 4.8%), white workers (at 3.1%), and Asian workers (at 2.9%).

Health insurance increases access to COVID-19 testing and helps ensure people can get care should they begin showing symptoms. 

In addition, Black and Latinx individuals were disproportionately affected by COVID-19. White individuals make up 58% of the population but only account for 38% of COVID-19 cases, 32% of hospitalizations and 51% of deaths while the following is true for Black and Latinx individuals:

 


 



How United Way Helps 

United Way of Greater Richmond & Petersburg currently funds 20 programs at 16 local nonprofits combatting barriers to equitable health care access. Our total 2020-22 investment in this area is $3,030,000.

Since its beginning in 1997, Virginia Dental Association Foundation’s Donated Dental Services (DDS) has provided dental services valued at over $15.2 million to over 4,200 patients. The program matches eligible low-income seniors and adults with disabilities with volunteer dentists, specialists and dental laboratories in their area that provide comprehensive treatment free of charge in their private offices and clinics.  

The program’s goal is to restore their patients to good oral health. To qualify for services, patients must be 62 or older or permanently disabled and have household income that is 150% or less of the federal poverty guidelines. Also in support of the program, DDS staff members provide case management, remaining involved throughout the process to ensure that screening, intake, treatment and follow up all go as planned. When the COVID-19 pandemic first hit in March 2020, dental offices were required to close along with other doctor’s offices considered non-essential to the fight against the disease. Dental offices were allowed to provide emergency care only and there was a marked decrease in the availability of dentists providing pro bono care. As dental offices waited for permission to fully re-open, Virginia Dental Association pivoted to provide where possible related to the pandemic. 

Staffers conducted pre-screening through tele-dentistry where possible. They reviewed applications and scheduling appointments in anticipation of dental offices reopening. Staff also conducted internal audits of their services database and completed licensure checks. More importantly, staff collected Personal Protective Equipment (PPE) to donate to the Virginia Department of Health, assisting with drop-offs statewide. Finally, the Foundation used funding from cancelled events to purchase PPE for clinics in need. 

Access Now is the only free clinic for specialty medical care for the uninsured in Central Virginia, coordinating with health system partners to provide interventional, surgical and diagnostic services to patients. It meets the complex needs of the patient with dignity and respect regardless of the patient’s inability to pay. Access Now provides 49 unique specialty services through 1,072 physician volunteers at a value of more than $5 million annually.  

Although medical facilities and offices were closed in the initial pandemic shutdown in March 2020, Access Now remained open and fully operational. After contacting all their specialty providers to learn of their status – open or closed, triaging patients, screening patients for visits – Access Now reached out to patients to begin the process of rescheduling appointments and sharing expectations from their specialty providers, particularly around COVID-19. In doing so, Access Now staff discovered that many patients did not have the most basic information and understanding of COVID-19. Despite local, statewide and national efforts to share information, many patients lacked knowledge regarding self-protection, quarantine and social distancing. Staff also realized that most patients had no experience with telehealth appointments.    

By the time the stay-at-home directive was lifted, Access Now had created new processes to reflect the changes in medical care in the age of COVID-19, including:  

  • Specialty Care – A focus on triaging all patients with appointments for acuity, screening patients for COVID-19 symptoms, preparing patients for online and telehealth appointments.  
  • Patient Education & Support – Making cold call check-ins with patients about COVID-19, publishing educational resources via Facebook and email, patient mailings and pre-appointment education on telehealth calls.  
  • Administration – Revisions to the screening process and creation of electronic patient screening and enrollment forms to reduce in-person contact between patients and staff.  
  • Clinic Partner Support – Staff sourced PPE and COVID-19 testing, assumed annual patient re-enrollment screening from clinics to allow them to concentrate on patient care and connected RAM Loving Trust Lunches RVA with Access Now community partner clinics to provide 1,315 boxed meals to seven community clinics through 54 weekly deliveries.  


How Can You Help?  

Donate to United Wayof Greater Richmond & Petersburg today. Your donation helps us make equitable health a reality for our region. 

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More on Health Equity: 

 

Other Equity Data Series Topics:

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