Health
Health Disparities & Medication Rejection for Patients of Color

Most patients encounter insurance delays or denials for prescription medication at some point in their lives. But do certain groups of patients encounter these barriers more often than others? And at what cost?
To explore this question, the Institute for Patient Access analyzed 2019, 2020, and 2021 national pharmacy claims for 3.74 million patients living with one of three diseases: asthma, chronic kidney disease, or cardiovascular disease. Claims data spanned both commercial health plans and Medicare.
The report said in an attempt to lower costs and protect profits, insurance companies can limit access to prescription medication using one of several mechanisms. Prior authorization, for example, can delay patients’ access while the provider waits for health plan approval for the prescribed medication. A lengthy rejection and appeal process sometimes ensues.
Through step therapy, insurers require patients to try and fail one or more medications that the health plan prefers before getting coverage for the prescribed medication. Claims data show that, among asthma, chronic kidney disease, and cardiovascular disease patients covered by commercial insurance, Black and Hispanic patients experience considerably higher rejections than white patients. Not being able to access prescription medications or abandoning prescriptions (because it’s too difficult to get) can contribute to unchecked disease progression and poor health among communities of color.
Some of the key findings
- Commercially insured patients – Black and Hispanic patients with chronic kidney disease had claims rejected 40% and 41% more often than white patients did, respectively.
- Medicare beneficiaries – Hispanic patients with cardiovascular disease, had claims rejected 40% more often than white patients. And Black patients with cardiovascular disease had claims rejected 25% more often than white patients.
Black and Hispanic patients not only experience higher rates of medication rejection, but also experience worse outcomes than white patients later on.
- Commercially insured patients – For the three disease states examined, Black and Hispanic patients whose medication has been rejected at least twice are more likely to visit the emergency room than are white patients who’ve had their medication rejected. Black patients with asthma visit emergency rooms 34% more often. Black patients are also more likely than white patients to be hospitalized.
- Medicare patients – Among patients whose medication has been rejected at least twice, Black and Hispanic patients with cardiovascular disease visit the ER 46% and 40% more often than white patients. They are hospitalized 21% and 15% more often.
The report also finds that Black and Hispanic patients are less able to tolerate high out-of-pocket costs, less likely to use a co-pay card, and more likely to abandon their prescriptions. High out-of-pocket costs can lead patients to leave the pharmacy empty-handed.
White patients have a higher tolerance for high out-of-pocket expenses. Out-of-pocket medication costs averaged $100 or more for Black and Hispanic patients on Medicare.
Regardless of insurance type, Black and Hispanic patients face worse downstream health outcomes than white patients, such as heart disease, stroke, cancer, diabetes, respiratory conditions, obesity, arthritis, and more.
The Institute for Patient Access is a physician-led nonprofit research organization highlighting the benefits of patient-centered care. To see the full report, go to (InstituteForPatientAccess.org).
Community
Emotional Emancipation Circles: Nurturing Black Mental Health

By Ayana Brown, MHPS
“We are going to emancipate ourselves from mental slavery because whilst others might free the body, none but ourselves can free the mind.” – Marcus Garvey
As Black Americans, we carry the weight of our ancestors’ struggles, resilience, and triumphs. Our collective history is filled with pain, but it is also infused with strength. In the face of ongoing challenges, it is essential for us to prioritize our emotional well-being and seek healing. There are more than 100 types of therapy, yet few are culturally based. Even fewer are made available to Black, Indigenous and People of Color, or the BIPOC community. One powerful tool that can aid in this process is the Emotional Emancipation Circle (EEC).
Emotional Emancipation Circles from the Community Healing Network (CHN) provide a safe and supportive space to confront and heal from the psychological and emotional wounds inflicted by racism, discrimination, and systemic oppression. Endorsed by the late Maya Angelou in 2009 and supported by the Association of Black Psychologists, EECs are rooted in the understanding that our mental and emotional well-being is as important as our physical health.
These support groups are structured and evidence-based settings where people from the diaspora participate in open and honest talks, allowing us to express the various feelings of being Black. We share our tales, worries, hopes, and dreams with the knowledge that we are not being judged. We offer support to one another via active listening, empathy, and affirmation, forming links of healing and resilience. We also discover our genuine history.
Empowered by what I was first exposed to in Panama, I became a certified facilitator in 2021. I recognize that the BIPOC community struggles with insufficient access to resources and feels their individual needs are overlooked. As a disabled veteran, caregiver, and parent, I am passionate about advocating, consulting, and collaborating with a nationwide network of providers dedicated to education and empowerment. This is a service that REACH Peer Support Services offers to “fill in the gaps” between our community needs and what is offered.
The Community Healing Network has formed these circles globally. If you want to learn more about CHN and other BIPOC-focused mental health resources and services for your church, organization, or family, go to (ReachPeerSupportServices.com). Those who join the newsletter will know about the next EEC location first.

After serving honorably in the United States Navy, Ayana Brown, MHPS, launched REACH Peer Support Services, LLC in 2021 to use her various experiences towards her passion, empowering families to heal with advocacy and non-judgmental support.
Community
Campaign to Bring Awareness to Black Maternal Health

- According to the Centers for Disease Control and Prevention, approximately 700 women die each year in the United States as a result of pregnancy or delivery complications.
- Almost two-thirds of pregnancy-related deaths are preventable (Source: CDC)
- In 2020, Black women were most disproportionately affected with a mortality rate of 55.3 deaths per 100,000 live births, compared to 19.1 deaths per 100,000 live births, and 18.2 deaths per 100,000 live births for White and Hispanic women, respectively (Source: CDC).
- In 2020, the maternal mortality rate for Black women was 3 times the rate for White women in the United States. Multiple factors contribute to these disparities, such as lower quality healthcare, structural racism, and implicit bias from healthcare providers, and underlying chronic conditions. (Source: CDC)
- The U.S. has an infant mortality rate of 5.4 per 1000 live births in 2020, with a health disparity among Black babies at a rate of 10.6 deaths per 1,000 live births in 2019. (Source: CDC)
Recently the Black Mamas Matter Alliance, Inc. (BMMA) kicked off its 6th annual Black Maternal Health Week (BMHW23) campaign with the introduction of the organization’s new comprehensive issues and values-based policy agenda, Black Mamas Matter: In Policy and Practice.
Black Mamas Matter: In Policy and Practice is organized into six overarching policy issues that are central to the work that BMMA partners do across the country and represent the issues on which BMMA is frequently asked to engage and endorse legislation. They include:
1) Structural and Social Determinants of Black Maternal Health
2) Full Spectrum Maternal, Sexual, and Reproductive Healthcare
3) Black Maternal, Reproductive, and Perinatal Workforce Development 1
4) Criminalization of Black Women, Birthing People, and Families
5) Research and Data Transformation
6) Black Women and Birthing People’s Leadership
Launched by BMMA in 2018, Black Maternal Health Week is a week-long initiative held from April 11 through April 17 that amplifies Black and Black women-led efforts across the U.S. and globally to improve and advance maternal health, rights, and justice for Black mothers and birthing people. Black Maternal Health Week takes place each year during National Minority Health Month and coincides with the International Day for Maternal Health and Rights on April 11. The theme for this year’s campaign is, “Our Bodies Belong to Us: Restoring Black Autonomy and Joy,” which captures the ethos and spirit behind collective efforts to amplify the voices, perspectives and lived experiences of Black women and birthing people.
“As we reckon with the upending of Roe V. Wade and the relentless attacks against reproductive rights and bodily autonomy, this year’s Black Maternal Health Week campaign speaks to our strength, power and resilience, and our unassailable right to live freely, safely, and joyfully,” said Angela D. Aina, Co-Founder and Executive Director of the Black Mamas Matter Alliance. “Further, BMMA’s policy agenda is both the culmination and continuation of the work being led by our Alliance partners to end the maternal health crisis in the United States, and offers sound, evidence-based policy recommendations that would genuinely support and advance the Black maternal and perinatal workforce.”
Building upon its commitment to improving Black maternal health across the country, #BMHW23 Sponsor Baby Dove will unveil their latest initiative – the NEW Black Doula Directory, developed in collaboration with Sista Midwife Productions. This new accessible online resource will limit barriers to accessing Black doulas who can provide culturally competent care that acknowledges the unique experiences of Black families.
Black Life Texas
Increase Your Health Literacy IQ at Free Health Fair

It is estimated that only 14 percent of the U.S. population has proficient health literacy, and the Black and Latino populations typically score lower in health literacy compared to other races.
To improve health outcomes, The Department of Health and Human Services hopes that observing National Minority Health Month in April will highlight the importance of improving health and reducing health disparities among people of color. Health disparities are the imbalance in the quality of health and health care experienced by groups based on their environmental condition and social, racial, ethnic, and economic status.
One way to improve your health literacy is to attend a health fair honoring National Minority Health Month, sponsored by the San Antonio Chapter of The Links, Incorporated, on Saturday, April 8, from 9 am to noon at Second Baptist Church at 3310 E. Commerce Street.
The fair includes panel discussions on mental health, diabetes, kidney disease, hypertension, prostate cancer, and more. Bring the family to enjoy door prizes, an easter egg hunt, easter baskets, and other free giveaways.
The origin of National Minority Health Month was the 1915 establishment of National Negro Health Week by Booker T. Washington. In 2002, National Minority Health Month received support from the U.S. Congress with a concurrent resolution that “a National Minority Health and Health Disparities Month should be established to promote educational efforts on the health problems currently facing minorities and other health disparity populations.”
The resolution encouraged “all health organizations and Americans to conduct appropriate programs and activities to promote healthfulness in minority and other health disparity communities.”
To register for the free health fair, visit this link.
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