4/10/2025

One area that the United States has always been a leader is in collecting accurate health data. We have long been the leaders of science and research around health issues. An important aspect of moving forward is knowing where we stand on access to health care services. In North Carolina, the Office of Health Equity has been publishing a report over the last 20 years that focuses on health disparities. This report is looking to identify ways to make an impact with historically marginalized persons or ways to reduce the health disparities across health outcomes. The report is available at NCDHHS Health Disparities Analysis Report, with a focus on the social factors impacting access, access itself, chronic diseases, communicable diseases, mental and behavioral health and health across all ages. I encourage you to review the report published in 2024 so you can more fully understand the significant challenge that people in North Carolina face related to access to health care.

How does this report connect to your work? The six areas of focus highlighted in the report will impact each of us at the individual level, in our professional work and as part of the systems we rely on to help others. It does not contain all the answers but it will help you to consider the current and future health challenges through different perspectives. There is no single solution to allow all people in the United States equal access to quality healthcare but we can work together to address each of these six areas and help close the current gap in services.

The main social drivers analyzed in the report include the impact that education, economic status and poverty have on your health. It may seem logical but the data show less education is associated with less understanding of health, health prevention and health care thus potentially contributing to disparities. Similarly, economic status and poverty contribute to an inability to afford an investment in health care or prioritizing other basic needs before health care. We have previously mentioned risk and protective factors and in this context North Carolina is the only state to successfully implement a pilot program focused on a whole health perspective to include areas such as housing, neighborhoods and health literacy.

On average, over 10% of North Carolinians are uninsured with American Indians/Native Americans uninsured at 15.6% and Hispanic/Latina uninsured at a rate of 28.8% in the recent report. Data demonstrate the disparities in the area of race, ethnicity, socio-economic level, disability, rural environments, and gender or sexual identity. The data do not show anything surprising but they do demonstrate the gaps that many people fall into and that decrease their access to quality health care services. 

In the area of chronic health conditions, the data shows unsurprising trends related to cancer and cardiovascular disease. African American or Black North Carolinians have increased rates of stroke, diabetes, COPD and kidney disease. Important factors related to chronic health condition diagnosis are related to the level of health education, decreased tobacco and other substance use, and increased environmental factors.Similarly, communicable diseases such as HIV, STI’s and Hepatitis follow with African American/Black communities having 6-10% higher rates of disease. And the highest number of infections are found in young, gay, bisexual men of color.

Since COVID, there is a growing recognition of the importance of mental health. 18% of young people age 12-17 years of age report having experienced a major depressive episode. And the rate of suicide in our veteran population is 250% higher than the general population. Populations of focus beyond youth and veterans include justice-involved, housing insecure and historically marginalized persons who all report limited to no access to mental health services. And finally, the needs across the life span, including birth to death reflect the importance of being able to access health care at all stages of our lives.

Sadly, the accomplishments cited in this report are heavily focused on the successful expansion of Medicaid in North Carolina which took place in 2023 and opened quality health care to many people who did not previously have access. If the decisions at the federal level reduce or eliminate Medicaid, it seems clear the progress achieved will be erased. 

But we can all take actions right now to help ensure everyone has access to healthcare services, 1) respect different cultures and promote inclusive resource development and opportunities, 2) improve the use of inclusive language and respectful approaches to positive health, and 3) support a comprehensive approach to health care that is inclusive of prevention, treatment and a whole-person diagnostic approach. This report will give you a foundation in science and data which I hope will help you to advocate for people who need health care and to fine tune the systems the deliver health care.

The name of my group was called “The Name Game.” In recalling how to play the game, it reminded me of memories where me, my siblings, and other neighborhood kids would sit on the porch and play the game. As the youngest, I tried my best to observe and just keep up but I was never left out. In this thought, the conversation lead to community arts. The discussion revealed he is extremely interested in community arts. He also mentioned he thought in this meeting there would be painting which is a relaxer for him. This discussion sparked my mind and fostered a new vision for my groups moving forward.

I’ve spent the past couple of weeks, and the month of April as well as a group, researching activities in the community that will help reignite the expressive creativity in us. We’ll identify different facilities each month that host free art events like SECCA and Reynolda Gardens. It’s my intention we will be in areas of escape to recapture moments, while creating new ones. I’ll call these series of group gatherings, “Meet Us in the City.” The “Us” simply means clients and myself and the host. I want to build off the conversation in my meeting so no one is left behind and the ideas of other case managers to build something amazing.

Our next meeting for Region 3 will be on May 13th at 10:00 A.M.

In these meetings we take space for those to highlight work, accomplishments, and prove that those who are HIV+ thrive and are successful. As long as you're willing to help move the needle forward, by any action small or large, we genuinely want you to join us.

This year we're focused on mapping services that clients can access in our eight county region. We know that the work you currently, do, and might even begin to do is so critical to this effort. Even if you might not join us, we encourage to forward this invite to anyone who might be interested. After all, we're all in this together. 

Can we count on you to join us? If so, click the button below for more information on how to do so.

We can't wait to see you there.

Take a moment and imagine what we’d ask ourselves after receiving devastating health news. Will our health insurance cover this (if you have it)? Do we have a way to consistently get to our appointments? Do we have a safe place to live? Can we keep our homes if we miss work due to this? Will my friends and family be there for me?

For those we help, unfortunately those questions are met with extreme uncertainty. For this reason, PWA urges you to consider making a planned monthly donation to PWA. For as little as $30 a month, you can help heat a home in the winter and have A/C in the summer. For $50 a month you help children get a healthy breakfast each day. For $100 a month, you can help provide a housing deposit that allows a single parent to move into an apartment. 

In today’s challenging times, let’s come together to make sure that we can help as many as possible.