Dr. Jocelyn Elders, former U.S. Surgeon General, speaks out about racial and ethnic health disparities

This post is written by Senior Fellow, Charmaine Ruddock MS. She directs Bronx Health REACH, a coalition of 50 community and faith-based organizations, funded by the Centers for Disease Control’s REACH 2010 Initiative to address racial and ethnic health disparities.  

Recently, former U.S. Surgeon General Dr. Jocelyn Elders was the keynote speaker at Connecticut Health Foundation’s Health Equity Media Event where she highlighted the ongoing crisis of racial and ethnic health disparities.

Her comments serve to remind us that,  even as we are one week in to open enrollment in the Health Insurance Exchanges set up by the Affordable Care Act, making it possible for millions of Americans who, have been without health insurance to finally get it, which, in turn, translates into much needed access to healthcare, health insurance alone will not solve the problem of racial and ethnic health disparities.

As the National REACH Coalition and its allies pointed out at a recent Congressional briefing hosted by Trust for America’s Health and the YMCA, without a targeted effort based in, and directed by the communities most affected partnering with departments of health, churches, schools, healthcare providers, grocery stores, parks, and even the research community,  we will still be faced with these disparities for many, many years to come.  In 2009, the Joint Center for Political and Economic Studies in a report, The Economic Burden of Health Inequalities in the United States, pointed out that between 2003 and 2006 the combined costs of health inequalities and premature death in the United States were $1.24 trillion. According to the report, the direct medical costs associated with health disparities for African Americans, Asians, and Hispanics were $229.4 billion in that same time period.

This is an enormous price tag for not solving the problem of health disparities. The biggest price, however, are the many Americans of color who will live sicker and die younger.  Dr. Elders, in her speech, reminds us that at every level this must be viewed as unacceptable and as a battle that must be fought and won.

 written by Charmaine Ruddock

This post is written by Senior Fellow,

Transgender Kids and AB1266: Fighting for Rights in the Bathroom

Joy Jacobson is the CHMP’s poet-in-residence. Follow her on Twitter: @joyjaco.

Coy Mathis, photo courtesy of GLAAD

For many good reasons that have to do with identity and personal integrity, the public restroom has taken center stage in our gender debates. For instance, in an article I wrote called “Helping Transgender Children and Teens,” on the role nurses play in the lives of gender-nonconforming kids for the October issue of the American Journal of Nursing, I discuss the case of Coy Mathis. A gender-nonconforming girl whose parents filed a complaint with the Colorado Civil Rights Division, Coy as a six-year-old had been barred from using the girl’s room in her school. The civil rights ruling in June stated that the school had denied Coy “equal treatment based upon harassment.”

And over the summer California became the first state to pass legislation that will let students in its public schools use facilities such as locker rooms and restrooms and participate in sports according to their gender identity rather than their sex. Assembly Bill 1266 will go into effect in January, but already there has been a significant backlash against it. Opponents are citing concerns over the “privacy rights” of students and are trying to get the signatures required to bring the issue to a referendum on the state ballot in November. But the privacy concern sounds bogus to me. Many of those organizing the opposition to AB1266 were also involved in the passage of Proposition 8, a well-funded campaign that for a short while banned same-sex marriage in California.

Why should we care what bathroom a child uses? The question is a matter of life, health, and well-being for many gender-nonconforming young people. Last week’s Newsweek cover story by E. J. Graff puts it in brilliantly plain terms. Graff writes about what’s at stake for children whose families, schools, and clinicians try to force them to conform to a gender they don’t identify with:

Gender identity (your internal sense of whether you’re a girl or a boy) and gender expression (how you walk, move, and talk) emerge and are relatively fixed by age 5, researchers now say; by age 11 or 12, if a child is still insisting on a trans identity, that’s almost certainly going to persist. Trying to undo that is as brutal as trying to undo later sexual orientation (which our nation has now rejected), and it results in increased risks of drug and alcohol abuse, depression, suicide attempts, and so on.

Graff takes stock of the gains realized by the LGBT-rights movement in a relatively short period—marriage equality will be realized in all states in a few years, she predicts—and goes on to say that while much remains to be done to end discrimination, there’s a big question we’ve yet to explore as a society: what constitutes gender, “the way our culture, our politics, and our legal system treats femininity, masculinity, and everything in between”?

Our schools are an appropriate place to begin this conversation. The National Association of School Nurses has issued a position statement on “sexual minority students” (those contending with issues of sexual orientation or gender identity and expression), and Beverly Bradley, the statement’s lead author, told me that school nurses can work to ensure these students’ health and safety, but not all of them will do so. “There’s no way to enforce it. But the standards are a terribly important place to start,” she said.

I’d like to hear from nurses: where do you stand on this issue? What role do you think school nurses should have in political matters affecting young people, like the fight over AB1266 in California?

Joy Jacobson is the CHMP’s poet-in-residence. Follow