Creating Healthier, More Equitable Communities

Person-centered contraceptive access promotes reproductive autonomy, sexual wellbeing, menstrual regulation, and other preventive health measures. However, contraceptive access varies by social and geographic position, reflecting patterns in the US contraceptive access policy climate. State-level contraceptive access policies can enable access to family planning care, particularly for systemically marginalized and less socioeconomically advantaged groups, or conversely, may disproportionately disadvantage such communities.

As currently defined by the Department of Housing and Urban Development (HUD), Affirmatively Furthering Fair Housing (AFFH), part of the Fair Housing Act, has four goals: “a) addressing significant disparities in housing needs and in access to opportunity, b) replacing segregated living patterns with truly integrated and balanced living patterns, c) transforming racially and ethnica

Opportunity Zones (OZ) were implemented by the federal government and some state and local governments in 2017 to attract new investments to distressed communities in urban and rural areas in the United States. The program offers tax incentives to private businesses for investing in OZ designated neighborhoods.

For decades, Medicaid has provided virtually no-cost coverage to millions of Americans priced out of the private insurance market. Still, state legislators, policy analysts, and the popular press continue to question Medicaid’s value, particularly in relation to private coverage. Twelve states have not expanded Medicaid coverage under the Affordable Care Act (ACA) framework despite the offer of federal funding to cover 90 percent of the costs associated with the additional enrollees.

February is a time to reflect on and honor contributions made by African Americans. It’s also a time to discuss the critical work we, as a society, should be doing year-round to address structural racism and its effect on Black communities.

The US is experiencing a housing affordability crisis. Families that lack access to safe, affordable and stable housing face increased risk of eviction, especially in cities, where the rent burden is most severe. Research suggests that evictions worsen material hardship, can force families into lower-quality housing in more disadvantaged neighborhoods, and erode mental health.

Unfettered access to contraception is a critical component of reproductive autonomy. Allowing people to control choices related to their own childbearing and to independently plan their families results in improved economic, social, and health outcomes for people capable of pregnancy and their families, such as improved mental health and well-being, increased educational attainment and workforce participation, and financial stability.

Severe maternal morbidity (SMM)—defined by the Centers for Disease Control and Prevention as unintended outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health—is a major determinant of maternal mortality. Each year 15 of every 1,000 people hospitalized for a delivery experience SMM. In addition to adverse health outcomes, SMM can lead to disruptions in mother-infant bonding, which can compromise children’s social and emotional development, and confers substantial economic costs to families, communities, and insurers including Medicaid.

The health and well-being of people are intimately tied to the conditions of life in their communities—conditions that structure opportunities and pathways for lifelong and even inter-generational well-being. Philanthropic efforts to improve community health must attend to the many systems that shape life conditions by focusing not only on whom, what, or where to fund, but equally importantly, on how to fund. The Urban Institute’s recent comprehensive review of health-focused community development investments made by the Robert Wood Johnson Foundation between 2013 and 2019 yielded a wide range of insights about how philanthropic investments can drive enduring systems change needed to improve community health, well-being, and equity across the nation.

Darrick Hamilton, the Henry Cohen Professor of Economics and Urban Policy at The New School, has gained national recognition for shaping policy solutions to close the racial wealth gap, which refers to how hundreds of years of structural racism have deprived Black families of resources that accumulate and transfer from one generation to the next. The typical White family has 10 times the wealth of the typical Black family and seven times the wealth of the typical Latinx family. This stark and persistent racial wealth gap has harmed generations, driven disparities and appears to be growing, even after controlling for household characteristics and long-term education and income gains by Black people.

Childhood poverty is associated with worse health outcomes, including poor physical and cognitive development, and can adversely influence social and health outcomes in later life. While there is increasing interest in policies to address childhood poverty, limited research exists on whether current U.S. poverty alleviation policies, including the largest such program, the Earned Income Tax Credit (EITC), improve children's health.

Since the early 1990s, Medicaid has been critical in providing insurance coverage for pregnant women with low incomes in the United States - pregnancy-related Medicaid coverage is available to women with incomes up to 200 percent of the federal poverty level in most states. Because pregnancy-related Medicaid eligibility is almost always more generous than eligibility for other adults, many women with low incomes not otherwise eligible for Medicaid gain coverage during their pregnancies but then lose that coverage sixty days after delivery, when their pregnancy-related eligibility expires. The American Rescue Plan Act of 2021 included an option for states to extend Medicaid coverage for twelve months postpartum. While the ACA provided coverage improvements for pregnant women outside of pregnancy, especially in states expanding Medicaid, many low-income women remain uninsured before or after their pregnancies. Building on existing studies tracking changes in Medicaid coverage and uninsurance under the law, researchers Emily M. Johnston, Stacey McMorrow, Clara Alvarez Caraveo and Lisa Dubay examined data for new mothers with Medicaid-covered prenatal care in this study published in Health Affairs.