It's difficult to read a newspaper or watch television these days without hearing about two major U.S. policy debates: health care reform and how to combat the "Great Recession". For many these seem like two separate issues, but for the 22 million American women and girls living in poverty they are closely related.
Among the many economic challenges women face, access to adequate health care is a particular struggle. The current employer provided health care system was established when men made up a large majority of the workforce, a time when many employers didn’t offer insurance in women-dominated industries. Back then if women had health insurance, it depended on whether her husband had family-based coverage. Today, women are on the verge of becoming the majority of the labor force for the first time in U.S. history, and yet the inequalities in health insurance coverage (as well as pay) remain. On the one hand, women are more likely than men to hold part-time or minimum wage jobs which rarely provide benefits, leaving many working women without health insurance. On the other, women who are married are more likely than men to rely on their spouse’s employer-based insurance coverage, leaving both partners without insurance if he suffers a job loss.
Owing to pregnancies and reproductive health concerns, women typically utilize health services and medical care more than men over the course of their lifetime, which means their overall costs for health care are higher. Insurance companies have not been shy in charging women higher premiums on account of this fact – adding another hurdle to women’s ability to afford insurance and access care.
Finally, the American family has changed dramatically since the establishment of the current employer based system: There are 11.5 million single-mothers in America, meaning that there are more women than ever who are not only shouldering responsibility for their health care, but also carry some or all of the burden for the health insurance of their children.
In a country where health and wealth are inextricably linked, women are at a vast disadvantage: To this day, women are 40 percent more likely to be poor than men. The Shriver Report, A Woman’s Nation illustrated how the situation takes the heaviest toll on women who are already struggling to simply make ends meet: “It is especially poor and low-income women, women of color, and immigrant women who are driven into the most hazardous and low-status jobs, who are given the least amount of flexibility in their schedules and who are least likely to receive employer-provided benefits such as health care, sick leave, or family leave."
When women must choose taking a sick day or sacrificing a day's wages and potentially losing shifts in the future, many simply push through, regardless of their own well-being. Between their jobs, their children and their basic necessities, poor women have neither the time nor the money to expend on their own health care.
This creates a vicious circle of low-wage employment creating poor health, which then further hinders their employment prospects. Either way, women end up sicker and poorer. According to a study done by the New York City Heath Department in 2005, women living in the city's poorest neighborhoods live an average of five years less than their high income counterparts.
Just as poverty disproportionately impacts women, so too do the flaws in an out-dated health insurance system; worse, these inequities fuel each other. The bottom line is that in order to combat both problems women need to have access to both -- adequate income and adequate health care. And just as wealth and health feed off one another negatively, successfully addressing one will necessarily help women and families address the other.
This weekend the House of Representatives courageously voted to move health reform legislation forward, meaning this vital issue is now in the hands of the U.S. Senate. The relationship between poverty and health is clear. The only thing that remains unclear is how long working women and families will have to wait for the solution -- health care reform -- they so desperately need.
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