Racial health equity for Black women

Blue Cross and Blue Shield of Minnesota has made it our mission to pave the way for everyone to live their healthiest life. To achieve this mission, advancing racial and health equity in Minnesota is critical.

Addressing health inequities requires a systemic approach that includes improving access to quality culturally concordant healthcare, achieving diversity in the healthcare workforce, and implementing anti-bias training for healthcare providers.¹

What Black women experience

Black women in the U.S. are disproportionately affected by a variety of health issues and inequities, many of which are deeply rooted in the country’s history of systemic racism that continues in our present time.¹

Socioeconomic stratification, segregated communities, and the dismissal by the medical community of Black women’s pain and other health conditions have been contributing factors to their health inequities.¹

The pain of healthcare inequities is felt not only physically, but also mentally. Black women are more likely to experience common mental health conditions such as depression and anxiety.² However, they are less likely to seek mental health treatment due to barriers such as stigma, lack of culturally responsive services and limited access to affordable care.³

Blue Cross recognizes that achieving racial and health equity leads to greater opportunities to improve health and reduce costs to the healthcare system. To address healthcare bias and adverse outcomes — and help people from all communities live their healthiest lives — Blue Cross is dedicated to implementing programs and initiatives to end the public health crisis of racism.⁴

Maternal health and family-building programs

Black women persistently encounter obstacles in obtaining adequate insurance coverage and accessing primary care, resulting in potentially dangerous and expensive gaps in care.⁵ Socioeconomic factors can exacerbate these issues, making Black women more susceptible to poor nutrition, unhealthy weight, and other lifestyle factors that compromise the likelihood of a healthy pregnancy and delivery. Often the most important factors for a healthy pregnancy exist before a woman is pregnant.⁶

In addition, healthcare systems don’t adequately represent or understand cultural norms and backgrounds, making navigating and seeking care even more difficult.

To address these issues, Blue Cross has launched several initiatives anchored in the needs of Black women. Programs include education and case management assistance to Black women during and after pregnancy. These efforts are designed to give the knowledge, support and access to care needed to achieve the best possible health outcomes for themselves and their babies.

Blue Cross is also implementing anti-bias training for healthcare providers to promote racial and health equity in the healthcare workforce, helping to spot and address weaknesses that reinforce structural racism, and establish protocols to ensure equitable treatment for all patients.

Examples of Blue Cross maternal health programs include:

• High-risk maternity case management (fully and self-insured clients): Education, support and coordination of care for pregnant people with a high-risk pregnancy diagnosis. 
• NICU transition of care (fully and self-insured clients): 24-hour phone support for parents who have babies in the NICU, to answer questions and provide compassionate guidance.
• Doula coverage (self-insured offering): Expanded doula coverage so members can find in-network doulas for birth support.
• Fertility support (client-specific): Customized benefit based on the client’s employee population.
• Blue Distinction^® Center access* (fully and self-insured clients): Healthcare facilities and providers recognized for expertise in fertility and maternity care.

Blue Cross maternity health programs are designed to meet members where they are in their health journey, helping Black women, in particular, access providers who are sensitive to their cultural values and unique healthcare needs.

Breast cancer prevention and awareness

As with maternal healthcare, Black women experience gaps in care related to preventive screenings that are critical to the early detection of breast cancer.⁷

In 2022, Blue Cross began participation in the Breast Cancer GAPS Project, a partnership with providers to identify gaps across the care continuum. Through interviews, community surveys and prototype testing, the program has identified barriers and opportunities to support Black women.

Blue Cross partners with the Breast Cancer GAPS Advisory Team, along with local providers and community members, to create customized communications to raise awareness of breast cancer screening for Black members. The partnership has spurred education resources, such as videos embedded in clinical settings and electronic health records.

Initiatives for 2024 include an education toolkit to help providers promote screening among Black patients and the development of breast cancer screening quality measures to establish baseline standards for value-based care.

Cardiovascular disease prevention and awareness

Inequities are also seen with cardiovascular health among Black adults, who have the highest prevalence of coronary heart disease, hypertension and stroke among all racial and ethnic groups in the U.S.⁸ But even more alarming is that Black women are more likely than any other population segment to suffer from these conditions. Due to gaps in care and a lack of education outreach, Black women often have less information and understanding about the risks and signs of cardiovascular disease than white women.⁸

To increase awareness and reduce cardiovascular disease among Black women, Blue Cross engages in community outreach, member education, and health screening events. Blue Cross also partners with organizations such as Health in Her HUE that connects Black women and other women of color with culturally competent healthcare providers and resources relevant to their lived experiences.

Studies show that culturally concordant care results in better patient-provider communication, earlier detection of symptoms, greater patient engagement and enhanced clinical outcomes.⁹

Committed to making a difference

Blue Cross is committed to providing high-quality healthcare to women of diverse backgrounds, considering their unique needs, experiences and values. We partner with providers on the cultural influences that shape patients’ health. And we embrace culturally competent care delivery that is respectful, inclusive and patient-centered.

But we are not done.

In a recent Blue Cross Report to the Community, President and Chief Executive Officer Dana Erickson said, “We are dedicated to taking meaningful action, and to reaching a time when racism no longer determines health outcomes or acts as a barrier to receiving quality care for Black, Indigenous, Latine, Asian American and Pacific Islanders, and other people of color.”

Erickson continued, “As Minnesota’s largest nonprofit health plan, Blue Cross has an unwavering belief that tackling health inequities and systemic racism is paramount for the health of all our members, their communities and the vitality of our state.”¹⁰