Becerra: Health Equity, Justice Remain “North Star” for HHS

After nearly a year of health equity work, Department of Health & Human Services (HHS) Secretary Xavier Becerra said the department will continue to make justice in the medical space a top priority.

“Dr. King famously called injustice in health the most inhumane and shocking form of inequality,” Becerra began in a keynote address during the Health Affairs Briefing: Racism & Health Virtual Event. “The past two years of this pandemic have really underscored the inequality in brutal detail, especially for communities of color.”

COVID-19 has killed Black, Latino, and Indigenous people at double the rate of White people, Becerra pointed out, while Native Hawaiians and Pacific Islanders remain three times as likely to contract the illness compared to White people.

But echoing many across the industry, health inequity did not begin when the novel coronavirus came ashore in the US. Rather, the pandemic illuminated stark racial health disparities present across a number of disease states, from maternal outcomes to cardiovascular mortality.

“We can, and we must, do more, and we must do better,” Becerra asserted. “That's why at HHS, we're putting equity at the core of everything we do.”

For example, the Department has prioritized equitable access to the COVID-19 vaccine, Becerra said, starting first with public health communication efforts. HHS focused on generating vaccine enthusiasm among communities of color—those who expressed hesitancy when the shots first got approval.

Particularly, HHS has convened a 17,000-volunteer group to conduct community health outreach and released about 1,500 ads in over 14 different languages focusing on public health education.

In terms of resources and vaccine appointment availability, Becerra said the agency has slotted billions of dollars for community health centers, which data has shown were instrumental in getting shots in arms, as well as provider relief funds targeted toward COVID-19 mitigation in rural parts of the country.

All this work has paid dividends as of today,” Becerra said.

In May 2021, when Becerra first assumed the role as HHS Secretary, the data showed that about two-thirds of American adults had received at least one dose of the COVID-19 vaccine, but for Black and Latino people, that number was below 55 percent.

“So, a significant gap between White America and Black and Brown America when it came to getting vaccinated,” Becerra emphasized.

But at the start of 2022, that picture has changed to reflect equity, he added. About 80 percent of White people had gotten at least one shot, with just about the same number of Black and Latino people reporting the same.

“It wasn't by chance, it wasn't by accident; it was because we work pretty hard,” Becerra said.

HHS has put that emphasis on health equity within other disease states, Becerra continued.

“We have done some really hard work to reach all communities and to deal with the disparities that we see often caused by racism and we're going to continue to do more,” he stated. “We know that this is something that pervades our healthcare system, and the Biden Harris administration has made it a priority to center equity in our COVID-19 response and in all we do on healthcare.”

Take, for example, the gains in Affordable Care Act coverage HHS reported for the 2022 coverage year. Between the traditional 2021 open enrollment period plus the special enrollment period that happened during 2021, the ACA will now cover 5.8 million new enrollees, per figures from the Centers for Medicare & Medicaid Services (CMS).

HHS has also zeroed in on maternal health outcomes, for which the US has the greatest racial health disparity of any developed nation. According to Becerra, the agency has allocated funding for states to expand their Medicaid programs to expand coverage for mothers, addressing a key coverage gap that many experts say contributes to poor outcomes.

At the time of the address, Becerra said Illinois, Missouri, Georgia, New Jersey, and Virginia had extended their 60-day coverage to a full 365 days for birthing individuals. That expansion will benefit more than 700,000 people, including 220,000 Latina women and 130,000 Black women.

Moving forward, efforts out of HHS will focus on other downstream factors contributing to health equity, like the environment and educational attainment, as well as other items in the Build Back Better agenda, Becerra said.

“We'll keep making equity and justice our North Star because we know healthcare is about more than just mending bones or dispensing pills; it's about giving people access to peace of mind to economic security and to a brighter future,” Becerra concluded.

“And that should belong to everyone, no matter where you come from, what your color, what language you speak. We think all Americans have that opportunity.”