Central Valley Residents Discuss Health Priorities with Congressman Harder

On February 21, advocates held a community listening forum on health with newly elected Central Valley Congressman Josh Harder. Nearly 100 community members—including residents, health care providers, non-profit leaders, and city council officials—attended the forum to listen and share their health care stories.

Hosted by the Having Our Say Coalition, California Rural Legal Assistance Foundation, Mi Familia Vota, and the West Modesto Community Collaborative, the forum invited Congressman Harder to listen to personal stories and concerns around health from members of the community. Residents raised a variety of issues related to:

• Access to health care for all residents in the community;
• Health care that is affordable, high-quality, and culturally relevant;
• Health care that is comprehensive, including mental health, oral health, and preventive care; and
• Ensuring that communities have the social, economic, and environmental infrastructure necessary to live healthy lives.

Community residents shared stories highlighting challenges in accessing culturally competent health care, care for undocumented populations, mental health services, affordable prescription drugs, and more.

Disparities in the Valley

The district now represented by Congressman Harder covers the northern San Joaquin Valley encompassing Stanislaus county and portions of San Joaquin County, including the cities of Modesto, Manteca, Tracy, and Turlock. The region is a major agricultural economic center for the state and the nation, and yet rates of poverty and poor health status are disproportionately high, particularly among residents of color.  The data on this district reaffirm what residents already know about the persistent health disparities experienced in their communities. 

Congressional District 10 is racially and ethnically diverse – over half of constituents are from communities of color including Latinos (43.0%), Asian (6.7%) and Black (3.0%). Forty percent of the district relies on Medi-Cal for health insurance coverage and 13.4% of households in CD-10 receive food stamps to meet their basic nutritional needs. Both these numbers are higher than the state enrollment in Medi-Cal (33.7%) and food stamps (9.3%).

• Resource: Advancing Equity in House District 10 Factsheet

The Central Valley leads California in teenage birth rates, with rates higher among Latina women. In addition, rates of infant mortality and access to prenatal care are highest among communities of color in the Central Valley. The majority of emergency department visits by children in Stanislaus County are for diagnoses that are considered preventable such as respiratory conditions related to mold and air pollution. And for every 100,000 residents in the San Joaquin Valley there are only 45 primary care doctors.

The stories that residents shared underscore this data and highlight the need for equitable, affordable, and culturally competent care in the district. Residents discussed the lack of access to specialty care and mental health providers in the district. “If you need to see a specialty doctor, it can take months to be seen,” one resident shared. They also discussed the challenge of seeking medical care with a provider who speaks your language and holds your trust. Another major concern among residents was the cost of care and medication – particular among elder residents. Finally, residents highlighted the need to provide care to all residents of a community, regardless of immigration status.

Opportunities to Advance Health Equity in Congress

Access to health care was a key part of Congressman Harder’s campaign. At the forum he again shared the story of his brother, who was born 10 weeks premature and marked as having a pre-existing condition for life. Congressman Harder reiterated his commitment to health and listening to the needs of all members of the district. In his first year in Congress he is committed to championing Medicare for All, prescription drug reform, and improving access to mental health care.

Residents thanked the Congressman for listening to the West Modesto community and for championing access to health care a key priority.

As the Congressman heads back to D.C., we remind him to consider four key recommendations to advance health equity:

• Strengthen health care access and affordability: California should build on the promise of the Affordable Care Act (ACA) by advancing universal coverage proposals and continuing to strengthen access to oral and behavioral health care services to ensure all have access to care. We must continue to fight back against federal efforts to reduce funding for Medicaid and Covered California subsidies and attempts to weaken or eliminate the ACA and its protections for consumers with pre-existing conditions.
• Advance health care quality: Health plans should be held accountable for improving quality and achieving health equity. In addition, more funding is needed to support the collection and reporting of accurate U.S. Census information and granular data on racially, ethnically and linguistically diverse communities in national surveys, health and public health programs in order to inform quality improvement and planning efforts.
• Protect immigrants, communities of color, and LGBTQ+ individuals: Federal efforts to roll back ACA non-discrimination protections threaten the health and safety of communities of color, low-English proficiency, and LGBTQ+ individuals. Likewise, the proposed public charge regulation and other anti-immigrant policies place an unfair burden on immigrant families by forcing them to choose between urgent health care needs and family stability. These discriminatory policies should be opposed.
• Fund proven health prevention strategies: California has an opportunity to increase access to preventive and community-based care to prevent chronic and costly health conditions. Funding for the CDC’s REACH program should be expanded and proven strategies, such as community health workers and patient navigators should be embraced and fully funded.

Opportunities to Advance Health Equity in California

Having Our Say (HOS) is a statewide coalition comprised of 30 state and local organizations working to ensure that health policies address the needs of California’s communities of color. HOS works to advance health equity by advocating for state policies that expand health coverage for the uninsured, advance culturally and linguistically appropriate care, and improve health care quality and affordability.

HOS chose to kick off 2019 by meeting with newly elected State and Federal representatives across the state to introduce our coalition and highlight key priorities for advancing health equity in California including:

• Securing sustainable and innovative funding for outreach, enrollment, and care coordination work in order to ensure communities of color access and utilize available health care programs.
• Increasing culturally competent and quality care through increased funding for CBO services, expanded provider recruitment, and reliable access to in-language services and trained interpreters, etc.
• Passing Health4All, which expands access to Medi-Cal for all Californians regardless of immigration status.
• Supporting policies that promote public health and prevention including, housing affordability, transportation access, asthma prevention, and additional social determinants of health. 
• Supporting advocacy and community education to ensure that Census workers are adequately resourced and appropriately trained to ensure a robust 2020 Census.

HOS is convened by the California Pan-Ethnic Health Network and was happy to partner with local and regional leaders throughout our district visits. In particular, thank you to the California Rural Legal Assistance Foundation, Mi Familia Vota, and the West Modesto Community Collaborative for helping us organize and execute this community forum and your ongoing partnership.