New Preventive Services: Giving Latinas More Control Over Their Health Care

by Mayra Alvarez

Director of Public Health Policy – U.S. Department of Health and Human Services

Like so many of us, the topic of health care for this Latina is personal.  Talking about health care brings to mind the well-being of our aging abuelita, or our mother’s constant use of Vicks Vaporub when we were kids, or the worry we feel when a loved one needs health care but can’t afford it. The Affordable Care Act, the health care law President Obama signed in 2010, gives Latina women and their families the security they deserve.

Compared to other American women, Latina women historically have had higher rates of heart disease, diabetes, cervical cancer, and HIV. Too many Latinas live sicker and die younger in America than they should. They are less likely to have access to quality health care and are less likely to get the preventive services they need to stay healthy. And too often, Hispanic women, like other American women who are the caregivers for their families, face difficult decisions between getting the preventive care they need or paying the bills at home.

But because of the health care law, Latina women can make their health a priority and have more opportunities to keep their families healthy.  Today, more than 6 million Hispanic Americans who have private insurance can get many preventive services without paying anything out-of-pocket.  For many Latinas with private health insurance, they have access to services like mammograms, pap smears, and well-woman visits without paying any additional cost.  Getting these preventive services with no out-of-pocket costs makes it easier for women to access them, which can help address critical health challenges, such as diabetes and cervical cancer, that disproportionally affect Latinas.

Consider annual well-woman visits that help women and their health care providers determine which preventive services they need to stay healthy. Or think of the $20 or $30 co-pay for a mammogram or pap smear. We no longer have to worry about how that money could be used for groceries or gas instead of an important preventive service. And when it comes to taking care of their family, Latinas can know that these free preventive services include cholesterol, type 2 diabetes and obesity screening for men and women; immunizations for adults and children; and obesity and autism screening for children.

In addition, the Affordable Care Act ensures that the nearly 4 million Latinos on Medicare are now eligible for free annual wellness visits and screenings for certain cancers, and may be eligible for discounts on covered prescription drugs.  For the many Latinas taking care of not only their children but also their parents, strengthening the Medicare program brings peace of mind.

Having a place to go for health care is also important to the health of Latinas.  The Affordable Care Act is building on investments this Administration made through the Recovery Act to put more doctors and nurses in underserved communities and expanding and strengthening community health centers. Community health centers are trusted resources in their communities. As a result, more than one in three patients served by health centers is Latino.

And this is just the beginning. Not only do Latinas have an easier time getting care they need, more and more of them will be able to get the health insurance they need. Starting in 2014, over nine million Latinos who were previously uninsured will be able to get health insurance coverage. Because of the health care law, Latina women – and their families — across the nation will have the opportunity to lead healthier lives.

Our Voice Matters: Registering and Educating Voters in Texas

Soy poderosa, and my voice matters. That’s the final push from now until Election Day. However, there is more to activism than just voting, and that’s evident in the work being done in Texas led by several poderosas from our Latina Advocacy Network (LAN).

From September 24 to 29 they held various events in Texas, starting with a health fair. It took place in an activist’s home, and over 35 people attended and 9 registered to vote. Can you imagine the energy in the room and the desire to make a difference? Participants learned how critical it is to ensure their voices are heard, whether it is through voting or through speaking with friends or family members about the importance of voting.

After discussing the importance of voting, everyone enjoyed one another’s company by playing lotería, or bingo, and eating a home-cooked meal. These are the moments that matter the most, being able to connect with activist on a personal level and share stories. It’s also fun (duh)! Voting is not a sole person’s decision, or one voice being heard. That person will be voting for thousands who are not being listened to. How can one vote without knowing the issues affecting the community they are representing?

One of the Texas LAN leaders, Lucy Felix (who was featured on our Poderosa profiles), participated in a White House briefing on Wednesday the 25th of September to talk about the work they are doing around the Rio Grande Valley. This was her experience:

The White House briefing was an unforgettable experience! As part of the panel I spoke about the importance of promotoras and all the work being done in the Valley. It was as if all the stories of the women I’ve worked with were united in one, and their challenges and success were expressed through me. For me, it is an honor to be able to speak about how PODEROSAS we are and how privileged I am to work with them! There are no words to express how much potential and desire for change there is every time we get together and successfully execute an event in which we educate others and grow more as leaders. Seeing all these women transform into even bigger fighters that want to create a better society and change many of the broken systems is the best gift God has ever given me! I also want to thank the Latina Institute for allowing us to participate in such amazing events that really highlight how extraordinary all these women are.
Lucy

Lucy Felix, wearing our Poderosa shirt, at the White House briefing.

And finally, to finish off the week, the Texas LAN held two more community gatherings in which dozens of people participated and registered to vote as well. It’s not enough for politicians to simply say nice things on TV — there are people like Lucy on the ground, making sure that our communities have the information they need to make an informed choice  in the voting booth. The Texas LAN will continue to hold more events until Election Day — contact us to get involved!

Regardless of our identities, our voices matter and we have the power to influence those around us. With our actions and stories we are able to change minds and hearts. Texas is pushing hard to not only educate the community, but to lift the voices of Latinas everywhere.

Are you interested in taking part of the Soy Poderosa and my voice matters campaign? There may be an event in your state! Contact us!

Best,
The Community Mobilization Team

Judge certifies visa for immigrant woman shackled during labor & awards $1.1 million

We’ve been following the case of Juana Villegas since the beginning. Just over a week after she gave birth, shackled, while in in jail due to her immigration status, we covered it here on Nuestra Vida, Nuestra Voz as an all-too-real example of the ways that immigration enforcement tactics hurt immigrant women and families. Shortly afterward, the New York Times covered Juana’s story, and it became a prominent if all-too-common reminder of the importance of considering gender in immigration advocacy.

I am incredibly happy to hear that last week, a judge in Nashville awarded Juana $1.1 milion to cover her attorney’s fees and other expenses during the three-year ordeal of lawsuits and appeals. Most importantly, the judge also certified a U-visa – a visa category that is available to undocumented victims of crime who may fear reporting them for fear of deportation. While this certainly does not represent justice – in a just world, this would never have happened in the first place – it is certainly positive that a court has recognized that Juana’s rights have been violated.

Of course, this is just one of many cases, most of which never make it to the media’s attention. With immigration enforcement programs such as Secure Communities taking hold across the U.S. and states taking immigration enforcement into their own hands, there is still much work to do.

Anti-choice researcher confirms that restrictions are designed to raise costs for women

A leading anti-choice researcher recently made some remarks at the Values Voters Summit (as if the rest of us don’t vote our values? but I digress!) that stray from the traditional anti-choice talking points, explicitly stating that increasing the cost of an abortion means that less women are able to get the procedure:

You can defund abortion by stopping Medicaid funding or by defunding Planned Parenthood. You can strengthen parental-involvement laws, by requiring both parents to be involved. You can strengthen informed-consent laws: Require the woman to see an ultrasound, or require two trips to the clinic. That raises the costs; that stops the abortion from happening.

Well, that is unfortunately true. Though generally the proponents of obstacles to abortion care – such as waiting periods, ultrasounds, etc. – frame these barriers in terms of giving women time to think, or “information,” or whatever they can muster that betrays their deep distrust of women to make informed decisions on their own, these revelatory remarks tell us that anti-choicers know exactly what they are doing: leaving access to abortion only for the wealthy.

Of course, reproductive justice advocates have known for a long time that the brunt of the weight of abortion restrictions falls on Latinas and other women of color, who are disproportionately poor. In fact, wealth has always facilitated access to abortion, even before Roe, when women who had the resources to do so flew to Sweden and Puerto Rico to get their procedures. The reality is today, and it always has been, that access to safe and legal abortion is an economic justice issue. Everything from waiting periods, to the added cost of an ultrasound, to the fact that federal Medicaid funds cannot go towards abortion hits low-income women and women of color the hardest. And the anti-choice movement knows exactly what they are doing.

Protecting women’s decisions: Court rules woman cannot be prosecuted for self-inducing abortion

Last week, the U.S. Court of Appeals for the Ninth Circuit published an opinion regarding self-induced abortions.  Idaho mother Jennie McCormack was charged with committing an “unlawful abortion” when she terminated her pregnancy by ordering RU-486 over the web.  McCormack is a single mother of three, was raised as a devout Mormon, and was barely scrapping by.  An abortion would have cost at least $500 and involved multiple trips to a clinic hours away, so she turned to the Internet.  As a result of deciding what was best for her family, she was prosecuted in Idaho under a myriad of laws that included a pre Roe law that criminalized women getting abortions and another that criminalized individuals other than physicians for performing abortions, and during her case, the prosecutor stated that “he was aghast at the idea that McCormack, an unmarried mother of three, was irresponsibly and repeatedly getting pregnant and not ‘protecting the fetus.’”

The Court of Appeals upheld the U.S. District Court for Idaho’s decision that McCormack could not be prosecuted because she was likely to succeed on her constitutional argument that Idaho’s criminal abortion laws enabled the prosecution and incarceration of women who have abortions.  The Court relied heavily on the arguments that McCormack’s attorney and the National Advocates for Pregnant Women and their allies made in issuing their ruling.  The Court ruled that women cannot be charged under “physician only” criminal statutes regarding abortion even if the law does not specifically say so, stating, “[T]here is no Supreme Court precedent that recognizes or suggests that third party criminal liability may extend to pregnant women who obtain an abortion in a manner inconsistent with state abortion statutes.”  Additionally, the Court emphasized the herculean obstacles that low-income women confront when accessing an abortion such as lack of providers, financial barriers, and harassment at clinics, and the medical, moral, and ethical factors women must weigh when making decisions about pregnancies.

The Latina Institute is thrilled that National Advocates for Pregnant Women and their partners, particularly McCormack’s attorney, successfully defeated Idaho’s attempt to criminalize women who are making wise decisions for their families.  However, as advocates for women’s health, including the right and access to have a safe abortion, we know that there will be other cases like this one.  In the future, it may be a Latina who is prosecuted under these laws.  Due to issues such as cultural and linguistic competency, geographic location, transportation, income, and lack of information, Latina women and others may turn to self-induced abortions.  In fact, we know that Latinas have needed to self induce abortions for the reasons stated above.   The laws on the books need to realistically support and protect the decisions women make about their pregnancies.  We don’t need laws that further erode, humiliate, and deny women the ability to make the right choices for themselves and their families.

Poderosas: Not Just for a Week, but for Life.

After various conference calls, meetings and emails, our annual Week of Action took place from August 6-10 with the theme Soy Poderosa. Activists from all over the country took pictures of themselves with our poderosa signs filled with messages of strength, support and love. There were events held in various areas of the country to advocate for the reproductive health and justice of Latinas.

Activist says why she is a poderosa

Ms. New York says why she is a poderosa

We were able to reach thousands of poderosas through our blog, Facebook, twitter and email lists as well as through our Latina Advocacy Networks, who tabled and hosted several health fairs in different parts of their states. Latinas are fired up and willing to continue pressuring their governors until the Affordable Care Act is implemented in their states. Latinas will keep educating the community and providing support to Latinas all around the United States, like these activists in Texas who held over 5 health fairs in different areas.

Activists in Texas hold health fairs

Karen Guzman, our policy intern, at a briefing in DC

Actions like the ones that took place during this Week of Action are important in order to highlight the stories of those most affected by the lack of health resources. Many times, we drown in reproductive health statistics without realizing that these numbers are actual people, someone’s mother, daughter, sister or aunt. It is important to take back our stories and own our struggles. By telling sharing those struggles, we build a sense of community and unity with others who may not know you, but share your same values and ideas. It is important, not only to share our stories but to know our rights as well. Adahelia, one of our activists from New York, shares similar ideas, and has the following message for Latinas everywhere:

“Know your rights, all of them, from human, woman, immigrant, resident to citizen rights. Remember that being ignorant limits you and the decisions you make in regards to the different aspects of your entire life, not just your physical and emotional health. We must take responsibility over our own body and knowing our rights will have a huge impact on our lives. When we are educated and informed, it does not only affect us, but it also impacts the lives of our family, friends, partners and children.”

We want to thank all the poderosas who took part in our Week of Action by sending pictures, flyering on campus or simply writing a blog post, your courage and dedication is what keeps us motivated. Even though the Week of Action is over, the energy and need for relief is still present. We hope you can join us and be a part of the actions that are happening next. To stay up to date visit our website and sign up for updates.

In the struggle,

The NLIRH Community Mobilization Team

New HHS Iniative Uses Technology to Lower Cancer Rates for Women of Color

Today, the U.S. Department of Health and Human Services (HHS) announced a new challenge aimed at developing mobile application technology to connect women of color to information and resources for preventing and treating certain cancers. The challenge, or competition, called “Reducing Cancer Among Women of Color App Challenge”, encourages entrepreneurs, software developers, and others to develop this new technology, which will then be utilized to connect women of color to information and services to help them prevent and fight cancer.

According to the HHS Press Release,  “More than 300,000 new cases of breast, cervical, uterine, and ovarian cancer are diagnosed each year.”  Additionally, “while the incidence and prevalence of these cancers are widespread, disparities in prevention, early treatment, quality of care, and outcomes result in a higher prevalence and mortality rates among minority and underserved women.”

At the National Latina Institute for Reproductive Health (NLIRH), we know this to be true of  Latinas and cervical cancer. While mortality from cervical cancer is not as high compared to breast and other cancers (approximately 4-5,000 women die annually of cervical cancer compared to approximately 40,500 women from breast cancer), we know that Latinas make up a disproportionate share of women who are diagnosed with and die of cervical cancer. The reasons for this are many and complex (lack of health care insurance, lack of culturally and linguistically appropriate services, lack of immigration status) and point to larger injustices in who has access to preventive and other health care services.

The mobile applications will provide information  “directly to women at a high risk of breast, cervical, uterine and ovarian cancers or women who already have been diagnosed with these cancers.”  According to HHS, the winning app will:

• Provide users with general, accessible information about preventive and screening services for breast and gynecologic cancers – in different languages and in culturally appropriate contexts;
• Communicate with patient health records or provider-sponsored patient portals in a secure way that protects patient privacy and that will provide specific reminders and trigger electronic health record-based clinical decision support about preventive services;
• Support the secure storage, viewing, and the exchange of complex patient care plans in a way that protects patient privacy while strengthening communications between a patient’s care team that may be located across a large geographic area, such as a local clinician being able to work with a regional cancer center in a major metropolitan area; and
• Support patient engagement and caregiver support by helping patients and their caregivers keep track of complex care plans with a particular emphasis on connections to community health workers, such as promotores de salud.

The announcement was celebrated by the Congressional Tri-Caucus as it builds upon several months of advocacy by the Tri-Caucus to urge the Obama Administration to implement aspects of the Health Equity and Accountability Act (HEAA), a bill NLIRH supports which builds upon the foundation of the Affordable Care Act to eliminate disparities in health care access and health outcomes for communities of color and other intersecting communities. The Congressional Tri-Caucus- which consists of the Congressional Hispanic Caucus, Congressional Black Caucus, and the Congressional Asian Pacific American Caucus-  introduced HEAA in the House of Representatives last fall, and was introduced in the Senate by Senator Akaka (D-HI) in April 2012.

Today’s announcement is a step forward for Latinas, who suffer from cervical cancer at rates higher than all other ethnic and racial groups. The HHS announcement specifically mentions disparities in cervical cancer and the importance of providing information  on prevention in linguistically and culturally appropriate ways. The announcement signals an acknowledgement of  the role geographical challenges play in health disparities, the importance of securing privacy, and the importance of integrating community health workers and promotoras (who play a large role in connecting Latinas to health care information and services).  And according to a recent Nielsen report, mobile technology is an increasingly important way Latinos access the internet, receive information, and connect to others.

We look forward to the implementation of the winning project and to connecting more Latinas to the information and services that will allow them to prevent cervical cancer. At the same time, NLIRH will also work to fight efforts to limit Latinas’ access to reproductive and sexual health services, in places like Texas and Florida. We will urge state lawmakers to fully implement the Affordable Care Act, which will increase access to screenings through its support of Community Health Centers, expansion of the Medicaid program, and by eliminating co-pays for screening services in private plans.   And NLIRH will work to advance a standard of care that provides all Latinas, including LGBTQ Latinas, will all the possible options for preventing cervical cancer, including screenings, the HPV vaccine, and accurate sexual health information.

For more information about Latinas and cervical cancer, please visit the resources on our website which includes our 2012 Cervical Cancer Prevention Policy Priorities.