Children of color in rural areas battle deep health care disparities

Orion Rummler
·4 min read

Living in the nation's poorest, most rural communities can be a death sentence for African American and Native American children.

Why it matters: Lack of health care and healthy food make Black and indigenous children in the nation’s most disadvantaged counties five times as likely to die as children in other areas of the country, the advocacy group Save the Children found after analyzing federal data.

Stay on top of the latest market trends and economic insights with Axios Markets. Subscribe for free

Mexican American children wait for health care services at Centro De Salud Familiar La Fe in El Paso, Texas. Photo: Russell Contreras/Axios

The details: The poorest families were coping with stress, debt and hunger before the coronavirus pandemic. The outbreak and resulting job losses have stretched millions of families close to the breaking point this past year.

  • Families struggling with poverty or underemployment often lack access to health insurance coverage.

  • Their rural areas and urban enclaves don't have access to quality health care technology and services, advocates say.

  • Black and Latino children entering emergency rooms are less likely than white children to receive X-rays, CT scans and other diagnostic imaging tests, according to a 2021 JAMA Network Open study meaning serious problems could go overlooked.

Since the pandemic's start...

  • About 1 in 5 families don't have enough to eat, and 1 in 3 families have had trouble affording medical care, the latest Save the Children's 2021 Child Protection Ranking found.

  • Black and Hispanic families are more likely to not have enough food or money to cover housing costs — or the right tools for kids to learn remotely.

  • 54% of rural households with children report they have experienced serious problems caring for their kids, including keeping their children's education going, helping them adjust to major life changes and finding space for physical activity.

Data: Kids Count; Chart: Axios Visuals

What they're saying: "Our people are too poor for the Affordable Care Act ... but too rich for Texas Medicaid. So you fall in the middle, which means you're uninsurable. Not uninsured, but uninsurable," Jorge Salazar of Centro de Salud Familiar La Fe in El Paso, Texas, told Axios.

  • Centro de Salud Familiar La Fe, a network of health clinics, serves a predominantly Hispanic area where the median family income is $14,019 a year. That's only 33% of the median income of El Paso County, which is already one of the lowest in the state.

  • The network tries to fight disparities through preventive care education via its federally funded community health clinics. It doesn't turn away patients seeking their services as long as there's room.

Amanda Larson, who has no running water, carries water for her son Gary Jr. to have a bath in the COVID-19 affected Navajo Nation town of Thoreau, N.M. Photo: Mark Ralston/AFP via Getty Images

Yes, but: A lack of transportation and long distances to affordable health clinics prevent some poor families from receiving routine checkups or basic care.

  • Residents on the Navajo Nation in Arizona and the Oglala Sioux Tribe in South Dakota have to travel for hours to receive treatment at a clinic.

  • An Axios reporter followed a 30-year-old Mexican immigrant mother as she tried to take her four children to dental appointments at Centro de Salud Familiar La Fe on a day off from cleaning houses and offices.

  • The car-less mother, with children ranging in age from 14 to 2, struggled to find a ride-sharing service that could take her whole family and then had to wait in traffic as trailer trucks from nearby businesses and border crossings clogged up the streets. She arrived late, but the clinic made room for the children.

  • "I have to work. I can't afford to take any days off," she told an Axios reporter in Spanish, as she tried to get her children to wait calmly. "But I know their health is important."

Join Axios' Mike Allen and Hope King on Tuesday at 12:30 p.m. ET for a Hard Truths event on systemic racism in health care, featuring White House senior adviser Andy Slavitt, White House senior policy adviser Cameron Webb and California Surgeon General Nadine Burke Harris.

More from Axios: Sign up to get the latest market trends with Axios Markets. Subscribe for free