Conversations about racial justice and equity are not easy, U.S. Rep. Chrissy Houlahan said during a virtual town hall event Tuesday.

“But it is a really important conversation to have, even if it is awkward and uncomfortable,” she said. “And it is definitely my responsibility and my job to help heal and help fix and also help communicate.”

The Facebook live event was a second in series focused on dismantling systemic racism through legislation and policy, launched by Houlahan in July.

The Chester County Democrat who represents Reading and parts of southern Berks County, said the purpose of Tuesday’s event was to shine a light on the racial disparities in health care in the U.S.

Guests were Rep. Lauren Underwood, D-Ill., a registered nurse and cofounder of the Black Maternal Health Caucus, and Vanessa Briggs, president and CEO of the Brandywine Health Foundation in Coatesville, Chester County.

Underwood is the sponsor of the Community Immunity During COVID-19 Act.

The legislation would provide federal support to initiate, build and evaluate community initiatives to promote recommended vaccinations during the COVID-19 pandemic.

“Around the topic of today’s conversation, it was Illinois on the forefront of releasing data out of the city of Chicago that illuminated the racial disparity around COVID-19,” Underwood said, noting Blacks and Latinos are more likely to contract the virus and Blacks are two times more likely to die of the virus than whites.

Access challenges

Even prior to the pandemic, Underwood said, there were significant disparities in health care in minority communities, including in the ability to access health care.

Access is an umbrella term, she said, that covers the inability to pay, or being uninsured or underinsured, not being able to afford copays or deductibles, and challenges in physically reaching doctors, clinics and hospitals, such as lacking personal vehicles, not having access to public transportation or being unable to afford a taxi or other ride service. Language also can be a barrier to health care in some ethnic communities, she said.

“These existing challenges were carried into the COVID-19 pandemic,” she said. “Solving this problem is not going to be easy, particularly when, as a country, we are not willing to address it head on and aggressively.”

Briggs said disparities in health care also are evident in Chester County and these impacted the effects of the pandemic.

“We are proud to say that we are the healthiest and wealthiest county out of the 67 counties in Pennsylvania,” she said. “However, we do have our issues around health disparity, discrimination and racism, particularly among people of color.”

There are pockets of poverty within Chester, particularly in the greater Coatesville area, she said.

In some of these areas, COVID-19 testing was not readily available, and when it did become available, there was distrust among the Black population due to historical distrust in health care, she said.

In other areas, such as Kennett Square, where immigrant communities are prevalent, language put up barriers to coronavirus testing and education.

To Briggs and others, who work in public health, she said, the way COVID-19 has disproportionately impacted minority communities comes as no surprise.

“It is because the safety net is just not there for those particular communities, around both social and economic health,” Briggs said, “and then you overlay that with discrimination, racism and bias.”

Maternity care

Underwood said one of the most striking examples of racial disparities in health care is evident in maternity care.

“We know that Black women are three to four times more likely to die in childbirth in this country,” she said. "And in my state, Illinois, Black women are six times more likely to die than white women.”

Even if controls are used for income, education and housing disparities, she said, Black women are more likely to die than white women.

The glaring disparity has forced the U.S. to lead the industrial world in maternal mortality, Underwood said.

“As the richest nation on the planet, we are still struggling to keep our moms alive,” she said.

Underwood said systemic-level changes are needed in the way the health care system responds and the way policies are set.

Houlahan agreed.

“It is really, really crucial that we keep talking, having these more difficult conversations to combat systemic racism in all its facets in our country, so we can be a more perfect union and that we can promise happiness and justice and liberty to all,” Houlahan said.