Adding health to the reparations debate

Also: Obamacare's unauthorized enrollment challenge [Donate ❤️]( [View in Browser](  April 2, 2024 Hi CommonHealth reader, I've been wondering lately about reparations and [their possible role]( in making sure Black Americans have the same shot at health and life expectancy afforded to white Americans. I usually hear economists, historians, advocates or politicians make the case for reparations to address centuries of harm that started with slavery. One form of reparations they talk about is payments that could close the wealth gap, which includes income and assets like a home. That gap is [vast and growing](. One research [model]( showed reparations that help close the wealth gap could also narrow the difference in life expectancy between Black and white adults. There’s not much research about the impact of individual payments on health inequities like higher rates of [infant mortality]( [heart disease, and stroke]( suffered by Black Americans. Dr. Mary Bassett, a co-author on the life expectancy study, says reparations aren’t typically imagined as a tool to address these problems, but that needs to change. “Reparations can be seen as a health intervention, not only a moral repair,” Bassett [told an audience]( at Harvard’s T.H. Chan School of Public Health last week. “Money has to be part of it, let me be clear about that.” It's a big part, too. One recent estimate put the current value of wages lost during slavery, plus interest, at $14 trillion. Critics — and some supporters — of reparations call that figure unrealistic for any government program to pay out today. But the authors of the study say it’s the minimum needed because $14 trillion only accounts for past harms. It doesn't account for the financial impact of ongoing discrimination in housing, employment and the legal system. So some supporters of what are called "health reparations" are [making the case]( for a broader definition, one that goes beyond individual payments. Dr. Avik Chatterjee says it should include hospitals and health care professionals who offered worse care to Black patients, turned them away or experimented on them. He says health systems can make amends and prevent further damage by ending racist practices, opening clinics in underserved areas or taking other steps guided by community input. “Health reparations doesn’t necessarily mean cash to specific people,” said Chatterjee, an associate professor at Boston University School of Medicine. “It may mean changing the way we allow people to access health care. That will improve the health disparities we see now.” Boston City Councilor Julia Mejia sees a proposed [Neighborhood Birth Center]( run by women of color as one example of this. [Research shows]( patients who use similar centers have better experiences and undergo fewer medical interventions. She hopes the center will help reduce mortality rates for Black pregnant people. Statewide, data shows Black women are [nearly twice as likely to die]( during or shortly after giving birth as are white women. Mejia launched a [reparations task force]( in Boston that is expected to issue recommendations next year. She says health has to be the foundation of that conversation. “Health is wealth,” said Mejia. “People are not going to do well unless they are well.” Martha Bebinger Reporter, Health Support the news  This Week's Must Reads [ACA health insurance plans are being switched without enrollees' OK]( Rogue insurance agents access consumer information on the Affordable Care Act federal marketplace and make the changes. Policyholders can lose their doctors and end up owing back taxes. 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