“IMPROVING HEALTH CARE ACCESS OVER THE LIFE COURSE FOR AFRICAN-AMERICAN WOMEN”

1. Black Health Coalition of WI (BHCW) Milwaukee Healthy Beginnings Project “IMPROVING HEALTH CARE ACCESS OVER THE LIFE COURSE FOR AFRICAN-AMERICAN WOMEN” BHCW.LIFH Health Care Task Force. 12-14-10

2. Barriers to Healthcare for AA Women Excess More than insurance. *Under-Insured *Un-insured BHCW.LIFH Health Care Task Force. 12-14-10

3. Under-Insured • Medicaid/title 19 • Limited providers • Lack of Dental Care BHCW.LIFH Health Care Task Force. 12-14-10

4. Under-Insured cont… • Lack of culturally proficient providers • Inner city Vs. Providers further out • * Transportation • * Emergency situations – Can not schedule appointment with • primary care doctors vs. ER BHCW.LIFH Health Care Task Force. 12-14-10

5. Under-Insured cont… † Private insurance/ limited excess - Co-pays (medication, services, ER vs. urgent care, specialist, i.e. cardiologist, podiatrist, neurologist) - Physician Groups (HMO & PPO) BHCW.LIFH Health Care Task Force. 12-14-10

6. Un-Insured • Unemployed • Single • No Children BHCW.LIFH Health Care Task Force. 12-14-10

7. Excess • † 0-18 Covered by families insurance/title 19 • † 18+ limitations… • School/College • If becomes pregnant BHCW.LIFH Health Care Task Force. 12-14-10

8. Strategies: Promising Practices Milwaukee Healthy Beginnings Project (MHPB) • Funded by federal government in 1998 • Targeted population, pregnant women, infants, interconceptional women and their families. • Since 2000 provides case management, health education, mental health, AODA and domestic violence services in the Milwaukee County Jail. Currently 60% of participants are from the jail. BHCW.LIFH Health Care Task Force. 12-14-10

9. Milwaukee Healthy Beginnings Project (MHPB) • Started as a primarily outreach and referral program until 2004. • Since 2004 provide home based case management, health education, mental health, AODA, and DV services by professionals and paraprofessionals • Required to provide intensive services to family until youngest child is two. 90% of clients and family are African American. BHCW.LIFH Health Care Task Force. 12-14-10

10. Low Birth Weight (LBW) • City- five year average – 10.2 • Project Area – 8.4 • MHBP Participants – 10.4 • prevalence rose slightly among project area infants between 2004-2008. Among MHBP participants, the LBW increased in 2006 (13.6) and 2007 (10.9%) ,but declined back to the 2004 percentage of 9% in 2008. BHCW.LIFH Health Care Task Force. 12-14-10

11. Very Low Birth Weight (VLBW) • City – 2.8 • Project Area – 2.6 • MHBP Participants – 1.28 • 3.0% to 0.00 in 2008. • There was not significant change in LBW treads, but for VLBW statistically significant decreases were found in both MHBP clients and the project area as a whole. BHCW.LIFH Health Care Task Force. 12-14-10

12. Preterm 25-36 Weeks • City – 13.9 • Project Area – 11.34 • MHBP Participants – 12.64 • The data indicated a modest significant decline in the prevalence of premature infants in the project area and even a more drastic decrease (14.6-9.8) in 2008 among MHBP clients. BHCW.LIFH Health Care Task Force. 12-14-10

13. 1st Trimester Prenatal Care • City – 77% • Project Area – 74% • MHBP Participants – 66% • There was a significant decrease between 2004-2008 among both the project area and MHBP participant mothers. There was a 5% in the project area and 10% with MHBP, but no rates of change between groups over the time period. BHCW.LIFH Health Care Task Force. 12-14-10

14. Late or No Prenatal Care • City – 2% • Project Area- 5.34% • MHBP Participants – 8.2% • The rate increased significantly in the project area over the time period, but the increase for MHBP participants was not significant. BHCW.LIFH Health Care Task Force. 12-14-10

15. “Of all the forms of inequity, Injustice in Health is the most shocking and the most Inhumane.” Dr. Martin Luther King Jr. 1966 BHCW.LIFH Health Care Task Force. 12-14-10