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.