Dr. Creshelle Nash is Arkansas Blue Cross and Blue Shield’s medical director for Health Equity and Public Programs.
With 2021 still fresh in our minds, we reflect on our experiences of the past 12 months and look ahead to what the rest of 2022 may bring. When we did this last year, most of us reflected on the trauma and disruption brought by the COVID-19 pandemic, financial uncertainty, and social unrest. We sat with the pain of loss, the loneliness of isolation and yet held hope for a stronger, healthier year ahead. It’s heartening to see that, for many, 2021 turned out to be a brighter year than 2020. However, the persistently poor experiences of minority communities reinforce the need to address health equity and disparities that disproportionately affect those with the fewest resources to overcome them.
This year, many Americans will be in a position of greater uncertainty and with a need for greater support. Beyond the ongoing risks of the COVID-19 virus, there has been a serious increase in health issues, creating secondary health crises. Most concerning of all is that the rise in many of these secondary health issues is impacting communities of color and low-income populations at far greater rates, a fact which is exacerbating disparities and inequities in our nation.
The need for behavioral health
Behavioral health issues have been on the rise in America for some time. Yet the past two years have brought to light a crisis of mental health and substance use which is putting the lives of millions of Americans at risk. One of the most striking issues is the dramatic increase of fatal drug overdoses. According to the Centers for Disease Control and Prevention (CDC), drug overdose deaths increased 30.8% nationwide between March 2020 and March 2021.
While this crisis is hitting communities across the nation, some populations experience even greater risk. States with lower income and lower access to resources experienced far greater overdose deaths, including a 57% increase in Kentucky and a 62% increase in West Virginia. Moreover, communities of color experience the risk at greater levels. Research released in November 2021 by the National Institute on Drug Abuse at the National Institutes of Health exploring pre-COVID-19 overdose deaths found that the rate among Black people alone increased by 38% from 2018 to 2019. While researchers continue to explore the disparity among Black Americans, many anticipate the variation to continue or even worsen unless there is coordinated and intentional action.
Another stark disparity can be found in rates of suicide, which recent CDC data show have dropped overall in the U.S., yet increased for American Indians and Alaska Natives, Black Americans and Hispanic Americans. Yet another is maternal health, where Black women are three times more likely to die from a pregnancy-related cause than White women, again based on CDC data.
What does the future hold?
As we meet each day with renewed hope for a brighter, healthier future, it is important that, no matter our background and personal circumstances, we acknowledge that our experience with health can differ greatly based on our race, ethnicity, geography, and other factors. We will continue to strive for personal health, and that of our community, yet we can not truly be healthy until we acknowledge the disparities and find ways to take collective action to overcome inequity. Awareness is the first step, and now, with the crisis we have faced since the pandemic began, there is opportunity for meaningful system-level change which can only be done by working with local partners and diverse organizations.
In my own state of Arkansas, I see collaboration leading to action. From trauma intervention in schools, to increased resources for addiction and suicide prevention, to academic partners increasing access to care professionals in rural and minority communities. Through collective action and engagement, I believe we can achieve a healthier future for all.