When Breathing Becomes a Pre-existing Condition

Credit: KristyFaith/Flickr

Yesterday, House Republicans eked through a vote, 217 to 213, to repeal and replace major parts of the Affordable Care Act, setting the stage for a major overhaul of our healthcare system. The GOP's American Health Care Act (AHCA) will now make its way to the Senate where several  Republicans are expected to make major revisions.

One of the most contentious provisions in the AHCA would weaken protections for enrollees with pre-existing conditions. Although the new GOP bill requires insurance companies to cover pre-existing conditions, states could get waivers that would allow insurers to set higher premiums for enrollees based on their medical background, essentially pricing many Americans out of coverage. And the status of your health is not just based on your current health and health history, but also other risk factors, such as environmental threats.

Environmental justice communities continue to be part of a system that creates and reinforces health disparities based on their proximity to toxic waste and pollution, and limited access to healthy foods and recreational resources. This is in addition to social inequities based on socioeconomic status, race and ethnicity, literacy and education levels, access to health services and legislative policies. The physical and social environment of people of color, tribal populations and low-income communities continuously puts them at a disadvantage when it comes to their health.

In my home state of Virginia, Richmond continues to reign as one of the nation’s top asthma capitals, even taking the top spot in 2010, 2011 and 2014. Newport News, Hopewell and Petersburg – all cities with predominantly black and Latino populations – have some of the worst air quality at public schools in the nation.

Pollution, particulates and poverty are the biggest offenders, with outdated school infrastructure playing a major role in the number of children suffering from the condition.
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The American Lung Association reports the hospitalization rate for black children with asthma is twice as high as white children. Native American children have an asthma prevalence that’s almost six times higher than white children, where a large percentage are not using a daily controller medication.

There’s also cities like Flint, Michigan and the 2,000 water systems across this country that have excessive levels of lead, where many of the highest reported levels are at schools and daycares. According to the Center for Disease Control and Prevention, at least four million households have children that are exposed to high levels of lead. Half a million children ages 1 to 5 have blood levels which demand public health action.

Let's also not forget about Cancer Alley, the 85-mile stretch between Baton Rouge and New Orleans that is home to more than 150 plants and refineries in predominantly black towns, or Kettleman City, California, a Latino community which houses the biggest toxic waste dump west of Alabama and has a high rate of birth defects and infant mortality. And then there's Emelle, Alabama – dubbed the Cadillac of Landfills – which houses the nation’s largest hazardous landfill.

Not only are our nation’s leaders rolling back environmental regulations and putting the health of Americans at greater risk, they’re also compounding the issue by making it more difficult for people to receive health care for illnesses caused by polluting industries. Most uninsured people are in low-income families, and have worse access to care than people who are insured because they don’t receive preventative care and services for chronic diseases and major health conditions. It’s a never-ending cycle for our most vulnerable populations.
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The notion that a responsible person will eat right, exercise and go to the doctor regularly doesn’t work if you build a system where every American does not have access to nor can they afford good health care. Nor does it work if big corporations exploit the health of poor Americans to build waste facilities in their backyards. We’re setting them up to fail.

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