Six weeks after Gov. Jim Justice began his daily pandemic press briefings, Marion County resident Romelia Hodges was frustrated.
It was a month to-the-day after West Virginia had lost its first resident to the virus: 88-year-old Viola York Horton, a Black woman from Fairmont who loved to sing and dance. And despite decades of health and economic inequity, piled on top of emerging research that COVID-19 disproportionately impacted Black communities, Justice had yet to publicly address the role of race in the pandemic.
“African American communities across the state of WV are reporting delays in testing and obstacles when trying to receive adequate testing. These obstacles and impediments are time-consuming and eat away at the precious time needed to address the immediate health concerns of this vulnerable population,” Hodges wrote in an email to West Virginia coronavirus czar Dr. Clay Marsh on April 29, complete with a plan to establish a pandemic task force to address the needs and vulnerabilities of minority populations.
Ultimately, officials created the temporary task force. But despite the lessons learned during COVID-19, efforts in the West Virginia Legislature to establish a permanent Minority Health Advisory Team to address the state’s racial health disparities have stalled.
Supporters of such efforts say that addressing racial health disparities requires bringing together experts in the medical field, but also from other sectors in the community in order to address broader issues — like income, education and housing — that impact health. Just convening those groups with a set purpose and goal, supporters say, is a first step toward a more equitable West Virginia; a step that has been discussed before but never actually taken.
“This bill comes up year after year and goes nowhere,” said Delegate Danielle Walker, D-Monongalia, who is co-sponsoring House Bill 2611. “If it had been passed multiple years ago, then [the state] could have been prepared and prevented some of the unnecessary suffering. But it took Romelia Hodges for the state to do anything for Black West Virginians.”
For the last five years, legislators in the West Virginia House of Delegates have introduced bills similar to the one that Walker is co-sponsoring this year.
West Virginia has one of the highest poverty rates and the lowest life expectancy in the country. And for Black West Virginians, the poverty rate is nearly twice as high and the life expectancy is about three years lower than white residents. Black infants die at a rate nearly double that of white infants.
Despite these disparities, lawmakers have never supported efforts to establish a Minority Health Advisory Team. Nearly every year that the bill has been introduced and assigned to a committee, the chair hasn’t ever put it on a committee agenda. The bill dies without discussion or a vote, as though the legislation hadn’t ever been proposed in the first place.
“There are people in this state who don’t want us to exist,” said Walker, who is the only Black woman in the West Virginia Legislature. “But we do. And we want equity.”
But even in the wake of a pandemic that has further highlighted existing racial disparities, the bill to establish a Minority Health Advisory Team is still not moving. It’s been assigned to the House Health and Human Resources Committee for more than a month and still hasn’t been placed on an agenda. Delegate Jeffrey Pack, R-Raleigh, who chairs the committee and controls the agenda, did not respond to requests for comment about the bill. And with only three days left before bills are due out of committee for the session, it’s not looking good.
Information gaps
If passed, HB 2611 would bring together people working in sectors across West Virginia for the purpose of addressing the disproportionately low health outcomes for the state’s Black and brown populations. The bill seeks to not only address the prevalence of disease — Black West Virginians are nearly twice as likely to die than white West Virginians from diabetes and heart disease — but also how issues like housing, education, food access and incarceration rates affect health.
And of equal importance, the advisory team would provide a launchpad for further research on Black health outcomes in the state. While nonprofits like the West Virginia Center on Budget and Policy have issued reports on minority health and racial inequity, there hasn’t been an official state report on minority health outcomes since 2007.
“When you try to just get simple data on infant mortality disparities, the gap in the Black and white infant death rates, you can not get that from the state,” said Dr. Lauri Andress, an assistant professor of health policy at West Virginia University’s School of Public Health. “It’s an exhibition that the state doesn’t care.”
Andress, who contributed research to the WVCBP’s report on racial inequality last year, has researched racial health disparities and infant mortality rates across the country. In December, she presented her research on West Virginia’s infant mortality rates to the U.S. Surgeon General, where she showed how factors like trauma, socioeconomic status and systemic racism influence health outcomes for African-American mothers.
That health outcomes are worse for Black West Virginians is a problem. But Andress says the fact that data on racial health outcomes isn’t broadly available and frequently updated in West Virginia takes the issue to a whole other level.
“You can’t understand the breadth or depth of a problem [without data],” Andress said. “You can’t plan to address it.”
Andress said HB 2611 is a small, but important step, toward addressing systemic and institutional racism in the state. And some of the state’s biggest medical players agree.
A spokesperson for West Virginia University Medicine, the largest health care provider in the state, said in a written statement that legislation like HB 2611, which seeks to address racial health disparities, needs to be considered. Danny Scalise, executive director for the West Virginia State Medical Association, said the association fully supports the bill.
And in a year that’s further heightened inequality because of the pandemic, Walker said the need for this legislation is now indisputable.
“[The disparities] are no longer hidden,” Walker said. “We need inclusion and we need equity, and we can start with the Minority Health Advisory Team.”